Care Home: Castle View Residential Home

Similar services:

• St Vincents
• The Cotswold Home
• Winton House
• Rush Court
• Hillyfield Rest Home
• The Maypole Nursing Centre
• The Briars

What the care home does well This home provides a safe, comfortable, clean and homely environment for residents. Staff are kind, patient and attentive to residents. Some of the written comments from residents included:`My [relative] is quite happy and satisfied with her care at Castle View and myself and family thank the staff for their wonderful work`. `[care and support is given] invariably with kindness and good humour` `They [staff] care. Continually. They have a `fondness` for her [my relative] that is not always present in some care homes. There is a warmth between staff and guests`. People appreciate the activities and social gatherings that they can join in if they want to: `They do lots of activities...my [relative] enjoys her painting, singing etc. She loves to join in with the carers`. `I have learned to paint and feel quite pleased with our efforts. I have knitted quite a few things while I`ve been here and I always spend some time reading novels`. The home works hard to put into practice its stated aims and objectives of care for the people who live here. Residents are encouraged to give their opinions about how the home is run, including the meals and activities provided, and the manager and staff act on peoples` suggestions. The home has a good training and development plan for staff and staff are encouraged to learn and share their experiences with others, to improve the quality of care for the people who live here. The home owner organisation (the Order of St John Care Trust - OSJCT) and manager are enthusiastic and committed about improving the home`s environment and the facilities for residents and are looking forward to moving to the new purpose built home in Chipping Norton that should be ready by the end of 2008. The home has good links with local NHS and social services so that residents` health care needs are met. What has improved since the last inspection? What the care home could do better: CARE HOMES FOR OLDER PEOPLE Castle View Residential Home Spring Street Chipping Norton Oxfordshire OX7 5LU Lead Inspector Delia Styles Unannounced Inspection 10:30 21 February 2008 st X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Castle View Residential Home Address Spring Street Chipping Norton Oxfordshire OX7 5LU Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01608 642364 01608 645679 manager.castleview@osjctoxon.co.uk www.oxfordshire.gov.uk The Orders Of St John Care Trust Vivienne Smith Care Home 47 Category(ies) of Dementia - over 65 years of age (21), Old age, registration, with number not falling within any other category (47), of places Physical disability over 65 years of age (4) Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The total number of persons that may be accommodated at any one time must not exceed 47. The continued registration of this service past April 2007 is dependent upon the physical environment meeting standards. 18th January 2007 Date of last inspection Brief Description of the Service: Castle View is a care home for older people within close proximity to the centre of the market town of Chipping Norton. The home itself was built in the early 1970s and as a result the building appears dated and no longer meets many of the national minimum standards for care homes for older people, in terms of room sizes and en-suite facilities. A new home is to be built in another part of the town that will resolve these problems. It is anticipated that the move to the new premises will take place in 2008. The home is owned and managed by The Orders Of St John Care Trust, which is a large charitable organisation that also runs a number of homes in Wiltshire and Lincolnshire. The weekly charges for this service currently range from £491.00 to £596.00. Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection of the service was an unannounced ‘Key Inspection’ during which we assessed a number of the standards considered most important (‘key’) by the Commission out of the 38 standards set by the government for care homes for older people. The inspection visit took place over 7 hours and was a thorough look at how well the service is doing. We took into account detailed information provided by the service’s managers in the form of the Annual Quality Assurance Assessment (AQAA) - a self-assessment and summary of services questionnaire that all registered homes and agencies must submit to the Commission each year; and any information that the Commission had received about Castle View since the last inspection. A tour of the building, and inspection of a sample of the records and documents about the care of the residents and the recruitment and training of staff, were part of the inspection. Talking with a number of residents and staff gave us information about the home and peoples’ opinions about what it is like to live here. We also got more of the views about Castle View from residents and their relatives and representatives, through questionnaires (surveys) that the Commission had sent out before the inspection and some of their comments are included in the report. A total of 5 relatives, 1 resident and 1 independent advocate/visitor completed survey cards. The home’s registered manager, Vivienne Smith and an operations manager from the Orders of St John Care Trust were available for the afternoon of the inspection. Feedback was given to the manager and a care team leader at the end of the visit. We would like to thank all the residents, manager and staff for their welcome and assistance both on the day and in taking time to complete surveys. What the service does well: This home provides a safe, comfortable, clean and homely environment for residents. Staff are kind, patient and attentive to residents. Some of the written comments from residents included: Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 6 ‘My [relative] is quite happy and satisfied with her care at Castle View and myself and family thank the staff for their wonderful work’. ‘[care and support is given] invariably with kindness and good humour’ ‘They [staff] care. Continually. They have a ‘fondness’ for her [my relative] that is not always present in some care homes. There is a warmth between staff and guests’. People appreciate the activities and social gatherings that they can join in if they want to: ‘They do lots of activities…my [relative] enjoys her painting, singing etc. She loves to join in with the carers’. ‘I have learned to paint and feel quite pleased with our efforts. I have knitted quite a few things while I’ve been here and I always spend some time reading novels’. The home works hard to put into practice its stated aims and objectives of care for the people who live here. Residents are encouraged to give their opinions about how the home is run, including the meals and activities provided, and the manager and staff act on peoples’ suggestions. The home has a good training and development plan for staff and staff are encouraged to learn and share their experiences with others, to improve the quality of care for the people who live here. The home owner organisation (the Order of St John Care Trust - OSJCT) and manager are enthusiastic and committed about improving the home’s environment and the facilities for residents and are looking forward to moving to the new purpose built home in Chipping Norton that should be ready by the end of 2008. The home has good links with local NHS and social services so that residents’ health care needs are met. What has improved since the last inspection? The existing building no longer meets the government standards for care of older people because many of the rooms are too small and do not have ensuite toilet facilities. The planned new building will be purpose built and will meet the standards. Meanwhile, OSJCT has made sure that the home is kept well maintained and has continued with a programme of decoration and refurbishment, so that residents continue to have a pleasant and welldecorated home at Castle View. Residents and their families appreciate this, as shown in their comments, for example: Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 7 ‘Conditions much improved in the last six months since redecoration and recarpeting in the dining room’. ‘As Castle View is an old building they also keep it fresh and clean looking’. A room on the first floor has been altered to make it into a small sitting or dining room, for people to use if they prefer to have a quiet area to sit and/or eat. Following recommendations made at our last inspection, the home has introduced a way of assessing peoples’ nutritional condition so that they can try to improve peoples’ diet and health if they are found to be at risk – for example, if they are very underweight or overweight. The home has improved the records it keeps about any complaints received and about the actions taken to put things right. The home has improved the way it recruits new staff, by making sure that it has records of peoples’ police checks and references before they start work in the home. This protects people living here by making sure that information about new workers is thoroughly checked to make sure they are suitable to work in the home. The way in which peoples care plans (the information about each resident’s care and support needs) are written is being improved, to make sure that each person’s likes and dislikes and the way they want to be supported and helped, is clearly set out for care staff to know what they need to do. What they could do better: We found that the home meets the needs of the people who live here well. The manager and homes owner are committed to maintaining and improving the standards further and have identified and planned how they will do this. We have made two good practice recommendations. There was very little information about a person who was in the home for a short stay (respite) break. The home should make sure that there is enough up to date written information about people’s care needs and how to contact their families or friends in an emergency, to make sure that the staff can give the care and support needed during their stay. The new care plans should be improved by describing in more detail what actions staff need to take to best support and help residents; and to what extent residents feel the care they receive is effective – and if not, what changes will be made to improve this. The homes system for recording the receipt of residents’ valuables should be reviewed, so that the staff member(s) and the resident and/or their representative sign to indicate when the valuables have been handed over for safekeeping and when they have been handed back. This reduce the potential Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 8 risk of accusation that the home has not received or returned property belonging to residents or their authorised representative, appropriately. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 3. Standard 6 does not apply, as the home does not provide intermediate care. Quality in this outcome area is good. Prospective resients and their representatives have the information they need to decide whether the home is likely to meet their needs. The personalised needs assessment mean that peoples diverse needs are identified and are planned for before they move into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager confirmed that she assesses all prospective residents before offering them admission. Prospective residents and their families are invited to visit the home for a full days assessment so that they can meet other residents and staff and discuss their views and experiences and view their room. In situations where prospective residents are unable to have an assessment at Castle View, the manager and an experienced senior carer visit the person in the hospital or their own home and undertake an initial assessment and encourage the person to visit the home and spend day prior to moving in. Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 11 Where a prospective resident is referred via Social Services and has undergone an assessment by a care manager, the manager of the home also undertakes her own assessment to ensure the home can meet the person’s needs. Overall, the sample of residents’ care records seen showed that the assessment process is satisfactory and that new residents are admitted for a trial period of four weeks so that both the resident and the home can decide whether Castle View can meet their assessed support and care needs. However, there appeared to be less information about the assessment of care needs for a person admitted for regular short-stay, ‘respite’ care. The home manager agreed that the assessment information for one such person, who has had several short stays in the home, was not up to date, and there was insufficient information about their usual care, support and family contacts. Although staff said they knew this person’s care needs from previous admissions (and the individual is able to communicate for themselves) there is a potential risk that changes in the person’s condition since their last stay may not be identified and so they may not have the level of care they now require. Also, the home should ensure that the person’s admission and discharge arrangements (for example, transport and prescribed medications) are in place, and who (of the person’s family or representatives) to contact in an emergency. The manager said she would re-assess and update this person’s records and a care leader confirmed and amended necessary contact details. One resident spoken with remembered having a brochure about the home when they came to live here. Copies of the homes Statement of Purpose, Service Users Guide and the most recent CSCI inspection report were available in the homes entrance hall for people to read. Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. The health needs of residents are well met with evidence of good multi disciplinary working taking place on a regular basis. The staff have a good understanding of residents care needs, and care is offered in a way that promotes and protects residents privacy, dignity and independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection further work has been done to develop and improve the way in which residents’ health and care needs are set out in written plans of care. Senior care staff (Care Leaders) have had further training on care planning and documentation in full days taught workshops. A sample of the new format care plans was looked at; these are in individual folders for each resident, and are well organised The plans are now much more focussed on each person’s individual needs and preferences. The manager and care leaders are continuing to look at ways of involving residents and families, when writing and updating the care plans, to make sure they are written in a way that residents understand and can comment on. Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 13 We discussed ways in which the staff need to record the actions they need to carry out to meet each resident’s listed assessed care and support needs; and to include the residents’ views about how well their care needs have been met (evaluation of care). As stated earlier in this report, the assessment and care plans for people who come in for short (’respite care’) stays should be improved to make sure that they are up to date and written in enough detail, so that care staff know what care and support is needed during each person’s stay in the home. The manager confirmed that since the last inspection, staff have had training in, and use a recommended method of assessing peoples’ nutritional status (the Malnutrition Universal Screening Tool – MUST). If people are found to be ‘at risk’ of being undernourished, the staff will take action to try and improve their diet and, if necessary will refer to the GP and dietician for advice and diet supplements. Two out of the 5 relatives who completed the survey cards we sent, feel that the home ‘always’ meets the care and support needs of the residents and 3 that this is ‘usually’ the case. The home has good working relationships with the local GP’s and community nurses and they visit residents regularly as needed. The staff follow the policies and procedures for the safe storage and management of medicines so that residents receive their prescribed medicines correctly. A check of the medicines storage area and a sample of residents’ Medicines Administration Records (MAR) charts showed that these are well managed and up to date. A local high street pharmacist, who dispenses and supplies residents’ prescribed medicines, undertakes regular visits to the home to check that the organization and systems are satisfactory. Care staff who have responsibility for administering medicines to residents have attended the recommended accredited course in safe administration and handling of medicines. In discussion with residents and from information provided by surveys it was evident that residents do feel respected and their individuality is recognised and supported. In terms of staff respecting residents’ privacy and dignity, the homes own Resident Quality questionnaire (2007) responses showed that 30 felt this was ‘excellent’, 60 ‘good’ and 10 ‘adequate’. Staff were seen to knock on residents’ bedroom doors and bathroom doors and waiting for a reply before going in. No residents have to share a bedroom: the former ‘double’ rooms are single occupancy rooms now, none of which have en suite facilities. One survey comment was that ‘private toilet facilities etc. I think would be welcomed’. There are 7 bathrooms and ample WC facilities (22 in total) for the number of Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 14 residents and the new building will have the required standard of en-suite facilities in single rooms as well as assisted bathrooms and shared WCs. Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. There is a good range of activities within the home and wider community so that residents have opportunities to take part in stimulating and motivating activities that suit their abilities and interests. The meals are good and offer choice and variety and cater for residents special dietary needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a varied programme of activities – both group and ‘one to one’. Corridor walls had displays of photos of residents and staff enjoying social events, such as Halloween. Various paintings and craftwork done by residents in the home are on display. Unfortunately, the designated activities worker has recently left the home, but the home is advertising for a new person to take over this role. In the meantime, the manager and care staff make sure that residents continue to have the same opportunities to be involved in activities and social occasions as much as they can, or want to. The daily programme of activities is displayed on notice boards within the home, informing people about organised activities available through the week, and care staff inform residents on a daily basis of the activities for that day. Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 16 Activities include art and crafts, bingo, quizzes, a number of games, shopping trips and outside entertainers who visit to provide entertainment. The home has an activities room set up for art and crafts work, and a kitchenette area for simple cookery. Several of the residents enjoy knitting and are very accomplished. Survey responses showed that people appreciate the opportunity to take up former hobbies and learn new ones. Residents are able to receive visitors at any reasonable time, and are able to entertain them in their own bedrooms or in the communal lounges. From what we saw on the day and residents and staff comments it is clear that staff always make visitors feel welcome. Again this was shown in the homes own survey results (2007) with the welcome from staff, refreshments and facilities offered to visitors and communication with staff largely rated as ‘good’ or ‘excellent’. It is evident from the homes AQAA and discussion with the manager and care leaders that a great deal of thought and consideration is given to how the home can meet residents’ needs in a ‘person-centred’ way and is committed to promoting equality and diversity for all the people who live and work here. The manager has attended training about the Mental Capacity Act and she and the homes staff are thinking about the implications for how they care for and support the right of all residents to continue to take decisions over their own lives whenever possible. From the evidence seen and comments received, we consider that this home would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Most residents have their meals in the large ground floor dining room but can choose to eat in their own room if they wish. A first floor room has recently been redecorated and refurbished to create a sitting/dining room for those residents who prefer a quieter environment. People spoken with said that they enjoy the food and the variety and choice on offer. The homes own Resident Quality questionnaire for 2007 showed that the majority (over 50 ) of residents’ considered the catering was ‘good’, 24 considered it ‘excellent’ and 12 , ‘adequate’. Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. The home has a satisfactory complaints system and the practices and procedures in place ensure that residents feel their views are listened to and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The OSJCT complaints policy is clearly written and provides clear stages and timescales for investigationof complaints by the home and responses to complainants. A summary of any complaints or compliments received is available and updated each month. Residents and their representatives are made aware of the complaints procedure. Four out of the 5 relatives’ survey answers indicated that know how to make a complaint as did the resident and independent advocate. Feedback on all aspects of the service are encouraged and actively sought through regular review meetings with individual residents, family member or representative, and the manager. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. The homes own records showed that they have had 3 complaints in the last 12 months and these had been satisfactorily resolved. Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 18 All the homes staff have had training about how to identify and report suspected abuse (Safeguarding of Vulnerable Adults). As part of their induction new care staff have training about safeguarding of adults that meets the Skills for Care standards. All new staff receive copies of the General Social Care Council (GSCC) Codes of Conduct that set out the standards expected of employers and employees involved in social care. All staff are also given a copy of the organisations ‘whistle-blowing’ policy that explains their responsibility to report any poor or abusive practices that they witness and the organisations comittment to support them to do this, in order to protect vulnerable people in their care. Regular updates in safeguarding issues are part of the ongoing training and development of staff. The home is able to put people in touch with independent advocacy services for those residents who would like confidential advice and support - details are displayed on notice boards in the home. An independent advocate from Age concern regularly visits the home. His/her responses to our survey questions showed that they are confident in the manager’s willingness to listen to any problems or concerns reported to them by residents as part of their advocacy service. The manager and/or OSJCT have ‘always’ responded appropriately to any concerns raised with them. Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. The standard of the environment within this home is good, within the constraints of an outdated building, and provides residents with a clean, attractive and homely place in which to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is kept clean and fresh smelling; the housekeeping team are commended for the high standard achieved. In the homes own Residents Quality Questionnaire analysis (2007), 67 of the (31) people questioned felt the standard of cleanliness was ‘good’; 22 ‘excellent’ and the remaining 12 answered ‘adequate’. The home has just received confirmation that planning permission has been approved so that work on the new purpose-built premises can start. OSJCT expect that residents will be able to move into their new home later this year. Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 20 In the meantime, OSJCT continues to improve the existing building through a programme of redecoration and refurbishment so that residents have a comfortable and homely accommodation. Residents are consulted about the colour schemes for their rooms. Relatives’ survey comments showed that recent redecoration and other improvements are appreciated, for example, ‘Conditions much improved in the last six months since redecoration and re-carpeting in the dining room’. Residents who were visited in their rooms had their own small pieces of furniture, ornaments and pictures that made their rooms cosy and personalised. Some people said they looked forward to having more space for storage and for the layout of their bed and furniture in the larger rooms that they will have in the new home. Fresh flower arrangements, plants, pictures, photos and artwork displayed around the home give it a bright and cheerful appearance. Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. There is a good match of well-qualified staff offering consistency of care to residents. The recruitment and training practices of the home are good, so that residents are safeguarded from potential risk from unsuitable or poorly trained staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Most of the people who completed our surveys think that the number, skills and experience of the staff meet the needs of the people living here. Some of the additional comments made were: ‘They [staff] look after the residents really well – they work really hard to provide what they do. I am very pleased for what they all do for my [relative]’. ‘My [relative] is quite happy and satisfied with her care at Castle View and myself and family thank the staff for their wonderful work’ ‘They care. Continually. They have a ‘fondness’ for her that is not always present in some care homes. There is a warmth between staff and guests’. However, one person wrote: ‘Ideally there would be a greater ratio of staff so that they could spend more time talking to and interacting with residents’. The manager confirmed that usual staffing numbers are: 4 carers and one senior care leader in the mornings Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 22 3 or 4 carers and one senior care leader in the afternoons 4 carers and one senior care leader in the evenings 2 carers and a senior care leader overnight. A sample of 3 staff members’ files was looked at and showed that there are thorough systems in place for the recruitment and screening of new staff before employing them to work at the home. Induction training for new care staff consists of a day of ‘e-learning’ – working through a computer programme with assistance – and a day of corporate training. New care staff also ‘shadow’ an experienced member of the care team for as long as necessary so that they are confident, safe and competent in their work with residents. Eight of the current 23 care staff have achieved NVQ Level 2 in care and one of the care leaders is starting NVQ Level 3. This means that the home is not currently meeting the recommended percentage (50 ) of care staff with NVQ Level 2 or equivalent training. However, OSJCT has an established programme of staff training and its own dedicated training staff, including an NVQ centre, so that all staff have access to training and development. All care staff have attended a two-day training course about caring for people living with dementia; this has been very successful in helping staff to improve their understanding and care of residents with failing memory. Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. The manager is supported well by the provider and senior staff and provides clear leadership to the staff team. Residents views about how the home is run are actively sought and are acted upon so that the home operates in the best interests of the people who live here. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has achieved the Registered Manager’s Award (RMA) and NVQ Level 4 in Care and has considerable experience in care of older people both in practical and managerial roles. From observation and the comments received, it is clear that OSJCT and the homes manager run the home in way that encourages residents and their families to have a say in the way the home is organised. Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 24 The home has a new administrative assistant. We discussed the management of residents’ personal allowances and the systems in place that ensure that residents’ are not at risk of financial abuse. Those residents who are no longer able or do not wish to, manage their own money have relatives or an appointed person to do this on their behalf. Each resident (who chooses to) has a personal named account with a local high street bank. Small amounts of cash held in the home on residents’ behalf, can be made available to the resident on request from the care leader or administrator. Overall, the records seen were in good order and provide a clear audit trail. We recommend that the receipt and return (of residents’ valuables) records should include both the signatures of the staff member(s) and the resident or relative or representative involved in depositing or removing valuables from the home. The AQAA information shows that a firm of chartered accountants undertook an internal audit of the homes accounts in December 2007 and the home received a ‘very good’ rating. The residents’ amenity find was audited in April 2007 by a separate independent firm of accountants and showed that the funds are satisfactorily administered. The OSJCT sends out a ‘Resident Quality Questionnaire’ each year. The questionnaires are analysed by the OSJCT Quality Assurance Manager who arrives at an overall quality rating for each of the care homes. The results of the questionnaires are set out in a report that is made available to the residents in the home. An action plan is drawn up by the home to follow up any specific problems or suggestions made in the questionnaires. Residents and their relatives are invited to discuss the questionnaire with the home manager or another person from OSJCT. The overall quality rating for the home following the August 2007 Questionnaire showed that 12 out of 31 residents rated it ‘excellent’ and 19 out of 31 rated it ‘good’. There are regular residents and relatives meetings that are advertised and residents can to add to the agendas. The manager has an ‘open door’ policy and residents are encouraged to discuss their views. The manager also goes around the home on a daily basis to chat with residents and listen to any concerns they may have. The home also has unannounced visits from a senior OSJCT manager (as required by us under Regulation 26 of the Care Standards Act 2000); and also from a manager/colleague from another OSJCT home. The OSJCT County surveyor and Catering Advisor also visit and provide monthly reports. This means that OSJCT carries out ‘spot’ checks to make sure that the standard of care and facilities for residents is being maintained. The homes Health and Safety policy and procedures are available to all staff and there is regular mandatory training and updates in fire safety, First Aid, Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 25 care of substances hazardous to health (COSHH), moving and handling, food hygiene, and infection control. We noted from the homes AQAA information that many of the policies, procedures and Codes of Practice have not been reviewed since 2004. We were informed that OSJCT are in the process of reviewing and updating these documents and will making sure that they are available on the homes’ computer website and that those most relevant to the day to day practice of staff are also available in staff handbooks and paper reference files. Spot checks of the fires safety and accident records showed that these were up to date. Staff have attended fire safety instruction and drills and high proportion have attended certificated ‘fire marshal’ training with the specialist company used by OSJCT for training. There was evidence from conversation with staff, and from the homes staff training and supervision records, that the manager and staff put theory into practice so that residents can be confident in the safety arrangements in place in the home. Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations * Ensure that the assessment and care needs of people admitted for short-stay (respite) care are sufficiently detailed and accurate, so that care staff can plan and provide care that safely meets the person’s current care needs. * Ensure that the care plans are sufficiently detailed about the actions staff need to take to meet the assessed care needs and goals of residents. Care plans should be evaluated and changed if necessary so that they remain relevant and up to date. Review the procedure for signing the record of residents’ valuables and property held for safekeeping by the home, so that it is clear who has received property belonging to residents and/or has had property returned to residents or their representative. 2. OP35 Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Castle View Residential Home DS0000039225.V358001.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!