Care Home: Castlemount

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What the care home does well People who live at the home said that they are very comfortable and very well looked after by the staff. The home is clean and comfortable and has a very homely and welcoming atmosphere where staff and the people who live there enjoy good relationships with each other. People are supported to make choices about their lifestyles and say that they very much enjoy their lives at the home. People enjoy home cooked meals of their choice. What has improved since the last inspection? Some refurbishment and redecoration has made sure that the home is comfortable throughout.CastlemountDS0000006172.V377326.R01.S.docVersion 5.2 What the care home could do better: The acting manager needs to make sure that people are not admitted to the home without having their needs assessed first. This will make sure that people coming to live at the home receive the care they need. To make sure that the risk of cross infection is minimised arrangements need to be made for sluicing and sanitising commode pans. Key inspection report CARE HOMES FOR OLDER PEOPLE Castlemount 54 Manygates Lane Sandal West Yorks WF2 7DG Lead Inspector Gillian Walsh Key Unannounced Inspection 6th August 2009 09:00 DS0000006172.V377326.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Castlemount Address 54 Manygates Lane Sandal West Yorks WF2 7DG 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) 01924 251127 CastleMountRes@aol.com Mr Abbass Bagheri Satari Mrs Julie Ann Satari Manager post vacant Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP, maximum number of places: 15 The maximum number of service users who can be accommodated is: 15 19th August 2008 2. Date of last inspection Brief Description of the Service: Castle Mount Care Home is a four-storey grade 2 listed building situated in Sandal on the outskirts of Wakefield. A short distance walk from the home is a bus service running to Wakefield and Barnsley. The home provides care and accommodation for up to 15 older people. The building is set back in its own grounds, some car parking space is available at the front of the home. Wheelchair access to the home is not available. The home has nine single and three double bedrooms (one of which is being used as a single), ensuite facilities are not provided however communal toilets and bathing facilities are available on all floors, which are accessible, by chair lift. A large entrance hall leads to the two communal lounges and dining area. The provider makes information about the service available to enquirers via a leaflet about the home and the home’s service users guide. Details of the Commission for Social Care Inspection are also in the Service User Guide. The acting manager said in August 2009 that current fees are from £398 to £420; hairdressing chiropody and personal newspapers are charged in addition to the fees. Castlemount DS0000006172.V377326.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 two stars good service. This means the people who use this service experience good quality outcomes. The following is a report of a key inspection, which included a visit to the home on 6 August 2009. The visit was undertaken by one inspector from the Care Quality Commission and took place over approximately five hours. During the visit time was spent speaking with people who live at the home, management and staff. Care records, staff files and other relevant documentation were looked at and the inspector spent some time looking around the home. At the time of the visit there were only eight people living at the home. The newly appointed acting manager was available to assist throughout the inspection visit. What the service does well: People who live at the home said that they are very comfortable and very well looked after by the staff. The home is clean and comfortable and has a very homely and welcoming atmosphere where staff and the people who live there enjoy good relationships with each other. People are supported to make choices about their lifestyles and say that they very much enjoy their lives at the home. People enjoy home cooked meals of their choice. What has improved since the last inspection? Some refurbishment and redecoration has made sure that the home is comfortable throughout. Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 6 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 7 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 Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 8 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable as intermediate care is not supplied. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People do not always have an assessment of their needs completed before they move into the home. EVIDENCE: The acting manager said that that one new person had been admitted to the home since the last inspection. The care file for this person was looked at but did not contain any information to show that an assessment of the persons needs had been made before the home offered them a place. Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 9 It is important that these assessments are completed to make sure that staff at the home have the skills needed to meet the persons needs and that the environment is appropriate for the person. The person concerned was spoken with and appeared satisfied with the placement and the care they were receiving. Other care files looked at did contain completed pre-admission assessments. Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are very happy with the care they receive. Medication systems are safe. EVIDENCE: Four care files for the people who live at the home were looked at during this inspection. All of the files contained a care plan although some gave much better detail and information about people’s needs than others did. The acting manager said that the care plans were being reviewed to make sure that they all gave staff all of the information they need to meet the individual’s needs. Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 11 Where staff feel that a person may be at risk, an assessment of this risk has been completed and is kept within the care file. Staff also make good and informative daily records about how the individual has spent their day and how they are feeling. People spoken with said that all the staff always treat them with respect and make sure that all their needs, including their dignity needs, are met. Records also showed that whenever necessary healthcare professionals such as GP’s, district nurses, dentists etc are consulted and their advice sought to make sure that people’s healthcare needs are fully met. Systems for the storage and management of medication were checked and appeared safe. The acting manager said that they are shortly to change to a new Monitored Dosage System which will also include monitored dosage of liquid medication. All staff who administer medications are also to start a city and guilds course in medication management. Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 12 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy the lifestyles they have at the home. EVIDENCE: People who live at the home said that they were very happy there and that they enjoyed the social side of living at the home. The acting manager said that care staff try to engage people in some activity every afternoon. People said that they particularly liked playing games, especially bingo and were all looking forward to a planned trip to the seaside. Entertainers come to the home on a monthly basis. Staff take care to make sure that people receive their newspapers and that they are informed about programmes of interest on the television such as football matches. Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 13 People’s friends and families are made welcome at the home and people are supported to maintain telephone contact with friends or family who are unable to visit on a regular basis. All of the people spoke with said that they very much enjoyed the food at the home and one person said how staff make sure that they get their favourite food from a certain supermarket. The lunchtime meal served on the day of the visit looked appetising and nutritious and was taken by the majority of people in a relaxed atmosphere in the dining room. One person chose to take their meal in their own room. Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel safe at the home. EVIDENCE: The acting manager said that they had not received any complaints about the home since the last inspection. No complaints have been received by the Commission. People spoken with said that if they had any problems at all they would speak to a member of the staff. People knew who the manager was and said they would be happy to speak to her about any concerns or worries they might have. All staff have had training in safeguarding people and know what would constitute abuse and the procedures to follow should they have any suspicion that abuse is taking place. Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a very pleasant and comfortable environment for people to enjoy living in. EVIDENCE: The home was clean and tidy throughout on the day of the visit. There is a very comfortable and homely feel which people who live there said they enjoyed. Since the last inspection a new boiler has been fitted which has improved the hot water supply to all areas of the home. There has also been some Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 16 redecoration and refurbishment in some areas including the downstairs bathroom. Although commodes are used there is not a facility to sluice and clean and clean the commode pans. To make sure that the risk of cross infection is minimised, arrangements should be made to ensure that commode pans can be cleaned hygienically and safely. Due to the lack of a shaft lift and lack of level access the home is not suitable for people with mobility problems. Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported and cared for by a well trained and friendly team of staff. EVIDENCE: People spoke very fondly of the staff and said that they are always available to them when they need them. A comfortable and mutually respectful relationship was observed between the staff and the people who live at the home. A training matrix showed that staff are up to date with relevant training. Over fifty per cent of the staff have achieved the level two national vocational qualification in care and four staff have achieved level three with another three staff currently studying for the level three award. This means that staff have the skills they need to provide the care needed by the people living at the home. The staff files looked at showed that recruitment policies and procedures are safe and that all new staff are subject to checks and clearances including references and criminal record bureau checks. Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 18 One of the staff files showed that the person had gaps in their employment history. Such gaps should be explored during the recruitment process as part of the checks on the individual to make sure they are safe to work with vulnerable people. Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management processes in the home make sure that people’s health and welfare is protected. EVIDENCE: There has not been a registered manager at the home for approximately eighteen months. The previous acting manager decided not to apply to the Commission to be registered and a new acting manager, who previously Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 20 worked at the home as a care assistant, took up her post just before this inspection took place. The current acting manager is in the process of applying to the Commission for registration. The previous acting manager is continuing to work at the home on a part time basis to support the new acting manager. Despite management changes there does not appear to have any detrimental effect on the management processes or the care provided. In a recent quality assurance survey conducted by the home people said: “All staff are brilliant at Castle Mount, I don’t know what I’d do without them” and “I am very happy, it couldn’t be any better” People said similar things during the inspection. Some of the people living at the home choose to keep small amounts of money in the homes safe. Accounts for these monies were checked during the visit and were correct and appropriate. Maintenance and safety checks are in place to make sure that people live safely in the home. Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 21 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 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 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 Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 22 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. 1 Standard OP3 Regulation 14 Requirement People must not be admitted to the home without their needs being assessed. This will make sure that that people are appropriately placed and receive the care they need. Timescale for action 31/01/10 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. 2. 3. Refer to Standard OP26 OP29 OP31 Good Practice Recommendations A facility for cleaning and sanitising commode pans should be provided to reduce the risk of cross infection. Any gaps in employment histories of prospective employees should be explored to ensure the safety of people living at the home. An application for the position of registered manager should be made to the Care Quality Commission. Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 23 Care Quality Commission Yorkshire and Humberside Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.yorkshirehumberside@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 24 Castlemount DS0000006172.V377326.R01.S.doc Version 5.2 Page 25 - 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!