Care Home: Charnwood Park Residential Home

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What the care home does well We saw staff at Charnwood Park being helpful and cheerful to people who live there and treated them with friendliness and care. A number of residents said that there were no rules so they could choose to live their lives the way they wished. People are supported to maintain relationships with family and friends. A visitor said, `I am always welcomed by staff`. The menu is varied, and the food is liked by the majority of residents we spoke to, who said it was home cooked and tasty. The home is clean and tidy, and good standards of hygiene are maintained. `It is always very clean here`, one resident said. Staff know all the Agencies to refer to if they suspect abuse has taken place. Members of staff have received training in different areas of care practice to help them improve their skills. Management are very supportive of staff so that they can produce a high standard of care to residents. What has improved since the last inspection? There was evidence in the home`s records that medical services were contacted if a resident had a potentially serious injury. What the care home could do better: All aspects of residents lives should be included in the Care Plan, including, for example, preferred living routines, life history, and how frequently to assist residents with their continence. Assessments need to include the dates of previous health checks so they can be prompted in a timely manner. The frequency of activities needs to increase to its former level. Heating needs always needs to be sufficient for residents comfort, and the low water pressure resolved to ensure residents can have a comfortable bath. Staffing levels for care must always be in place to fully meet residents needs. Staff training on residents conditions needs to be extended to ensure staff skills in all relevant care issues. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Charnwood Park Residential Home 164 Charnwood Road Barwell Leicestershire LE9 8FU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Keith Charlton     Date: 1 7 0 8 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Charnwood Park Residential Home 164 Charnwood Road Barwell Leicestershire LE9 8FU 01455844770 01455844770 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Teresa Poynton Type of registration: Number of places registered: care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability sensory impairment Additional conditions: No-one under the age of 55 years who falls within category PD to be admitted to the home. Date of last inspection Brief description of the care home The last key inspection of this service took place on 11/9/2007. Charnwood Park Residential Home is registered to accommodate eleven residents. The home is an extended detached modern style house, within a residential area. The Care Homes for Older People Page 4 of 27 Over 65 11 0 11 0 11 0 Brief description of the care home home is surrounded by a large accessible garden. The ground floor consists of a large dining room, large lounge, with two bedrooms. The home has a shower facility, incorporating a toilet and additional separate toilets on the ground floor and a bathroom incorporating a toilet and a separate toilet on the first floor. In addition four bedrooms have en-suites consisting of a toilet and wash hand basin - one single and one double on the ground floor and two singles on the first floor. The home is within easy reach of shops and facilities, in both Barwell and Earl Shilton. The weekly fees range from #1875 to #1921 per month - the Manager provided this information on the day of the Inspection. There are additional costs for individual expenditure such as hairdressing etc. The home provides information to residents and prospective residents in the form of a Statement of Purpose and Service Users Guide that describes the services it offers, and a copy of the last Inspection Report. The Statement of Purpose is displayed in the reception area. The Service Users Guide and Inspection Report can be provided to enquirers upon request to give a view as to the quality of life for residents. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection included a visit to the service. We (the CQC) visited Charnwood Park on the 17th August 2009. The Manager, Owner and staff in the home helped us during the visit. The main method of inspection we used was case tracking. This means looking at the care given to people in different ways. We did this by, - talking to the people who live in the home and a visitor, - talking to staff and management, - watching how people are given support, Care Homes for Older People Page 6 of 27 - looking at records. We spoke to seven residents, and one visitor at Charnwood Park during our visit, who told us that staff were very caring and treated residents with respect. One resident said, Staff are kind and helpful. This is the best home I could live in. None of the residents spoken with had any complaints about the attitude of staff. We spoke with two members of staff during our visit to the home who told us about working in the home. They were enthusiastic about working with the residents and thought there was a good staff team and effective management to ensure residents had a good quality of life. One staff member said: We are well supported to make sure that residents are happy here. We checked all the standards that the Care Quality Commission has decided are key standards during this inspection. The information below is based only on what we checked in this inspection. We have kept details about individual people out of the report to make sure we respected their confidences. What the care home does well: What has improved since the last inspection? 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 set out on page 4. Care Homes for Older People Page 8 of 27 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. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this 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 living at Charnwood Park have had their needs assessed before moving into the home. Evidence: Residents said they had been provided with sufficient written information prior to admission to make up their minds about the home. I remember my daughter being given something when we first visited though I took no notice as I made my mind up with looking around, one resident said. We case tracked a person living in the home who had moved into Charnwood Park in the past. We checked that her family had received information to help with the choice of home, and she said she thought her relative had received enough information. We also checked that this person had her needs properly assessed prior to moving in, to ensure that the staff at the home could meet their needs and we found that the assessment system was detailed regarding most residents needs though past health Care Homes for Older People Page 11 of 27 Evidence: checks had not been included, which are useful to prompt these checks and improve the health and daily quality of life for people. We checked another person and the form had recorded that this person had confusion. This should prompt action to ask for a medical assessment to ensure that the service is not admitting people out of the registration category. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this 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 at Charnwood Park receive good health and social care practice. Evidence: Residents said that staff provided friendly and sensitive personal care: Staff are really good and are there for you all the time, one resident said. This was one of the many very positive comments that were made about how good the care staff are. Residents spoken with could recall having a care plan and said that they thought they could see it if they wanted but were not interested. We checked the care plans of two people living at the home who were case tracked. Plans showed detail regarding the support required by staff to ensure the physical health of people living at the home, though there was little information to inform staff of residents personal history, or information of preferred daily living routines of residents to ensure their social and emotional well being is fully supported. Continence information was recorded though no baseline assessments had not been completed. It was recommended that a referral to a specialist nurse is done to work out the individual needs of a resident, especially those with memory difficulties, who usually cannot ask staff for assistance when they Care Homes for Older People Page 13 of 27 Evidence: need to go. There were gaps on health check recording insofar as appointments for sight and teeth had not been recorded, which means that residents could have waited too long before having these appointments. Staff said they were asked by management to read Care Plans though one staff said not all Plans had been read. this is needed so that staff can fully understand and act on residents needs. The Manager said this would be followed up. Accident records were checked and medical services were contacted when a resident had a potentially serious injury, and residents said that staff contacted the GP if they were not well, thus protecting residents health. We checked the medication records, and found that there was good recording of the administration of the medicines in the home, with no gaps and good recording of incoming and returned medication. Staff said they had pharmacy training and we saw certificates to prove this. Medication was seen as signed before issuing to residents. Care staff said this was a mistake and would not occur again. Staff was seen to issue medication to a resident and encourage the resident to take it and witness this before moving off - this helps to protect residents health by ensuring medication is taken. Controlled medicines storage was in a secured cabinet. The Manager said they an up to date storage cabinet which conformed to the latest legal requirements had just been delivered and would soon be in use. We spent time watching staff interaction with people living at Charnwood Park. We saw staff being friendly and caring to people throughout the day with residents and a visitor confirming that staff respected the dignity of residents. Staff were seen to assist residents in various ways - giving choices for breakfast, encouraging residents in activities etc. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are opportunities for residents to have a relaxed lifestyle of their choosing. Evidence: The AQAA stated that there were activities every day. Residents said that they liked current activities but there were not as many as there used to be. A resident said There were regular activities but we dont get this any more. Staff said that this was the case owing to some residents needs becoming greater so there was not enough time to do activities every day. This was supported by information in the Residents Meeting of July 2009. The Manager recognised this was the case and said she would be rectifying this when she returned from holiday. Residents said there were games and quizzes, some trips out, aerobics, organist, singer, clergy visited, they watched TV, we witnessed age appropriate music being played in the lounges and residents said staff took residents out to the garden in good weather and for walks locally. The relations between staff and residents were observed to be relaxed. Residents and staff said there were no rules and they could get up when they chose, choosing what clothes to wear, food alternatives, self medication if possible etc. There was displayed Care Homes for Older People Page 15 of 27 Evidence: information on dining tables for reference to what food is being served that day etc. Visitors are welcomed at Charnwood Park and we were informed by a visitor that she could come at any reasonable time and she was always greeted in a friendly way by staff and offered a drink. Residents said they enjoyed the food: The food is really nice and home cooked, one resident said. Lunch was well presented and appetising and tasty and consisted of very tender stewing steak with two vegetables and potatoes,and was followed by a choice of dessert. Residents had home baked cakes for afternoon tea. Residents said they got what they wanted for breakfast. We observed bowls of fruit around the home for residents to help themselves to. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are listened to and protected from abuse. Evidence: Residents said if they had a complaint they were confident that Wendy, the Manager, would sort it out. Resident said they never had cause to complain but thought the staff or the management would quickly get the issue resolved. A resident said, I am sure everything would be done that was needed. We saw that the Complaints Procedure is brought to the attention of residents at Residents Meetings and that they can see the Manager in private if they choose, so that they are aware as to how to make a complaint. The Manager could not find the complaints Book and thought there would be no complaints in it. However one complaint was was found in staff records,which had been properly followed up. The Complaints Procedure was not totally clear that complainants can refer their complaint to the Lead Agency, the Social Services Department. The Manager said that this would be altered. We talked to staff to find out how much they knew about protecting people in the home from abuse. Records showed they had received training about safeguarding adults from abuse, and they knew the in house procedure, and Agencies to whistle blow to if the in house procedure failed. We looked at the staff recruitment records to see whether all the proper checks had Care Homes for Older People Page 17 of 27 Evidence: been made on staff and legal checks were in place to help management reach the judgement that people were safe to start employment. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this 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 living at Charnwood Park live in a homely and generally well maintained environment. Evidence: All residents spoken to said they liked their bedrooms: This home is always clean and tidy which makes me feel comfortable, one resident said. There was a comment in the homes QA survey that residents said they were cold sometimes - this needs to be borne in mind by maagement when the cold weather arrives. We saw people at Charnwood Park living in a clean and well maintained environment. The furnishings in communal areas are homely, and people said that they were encouraged to bring their personal possessions into their bedrooms. Records show that the home is well maintained, and good measures are in place to keep the home hygienic. There were no odours at all. There are radiator covers fitted to ensure that residents are protected from burn risks. Residents said they loved sitting or walking in the large gardens and appreciated the garden being was kept in good order. We saw that water pressure to a bath was very weak so the bath filled slowly which cooled water down considerably - the Manager said this had been looked into in the Care Homes for Older People Page 19 of 27 Evidence: past but had not been completely fixed. There had been a water leak from the first floor - the Provider said he had ordered workmen to repair this and they would be calling on the day of the inspection to do this. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are met by a competent staff group though staffing levels need to be reviewed and increased as needed and staff training extended to ensure staff have the skills to meet all residents needs. Evidence: There were some comments that staff were very busy and lately seemed too busy to do regular activities. Staff are wonderful but seem too busy sometimes, one resident said. The staff rota showed two care staff (one of whom is often the Manager), plus a cook (one of whom is also often the Manager), on duty throughout the day/evening with one awake staff member on at night, plus an on call system and a domestic worker for two days a weeek. We spoke with the Manager about the staffing and asked her to review staffing levels so there is time for her to do management tasks. A staff member said that although she had only been working at the home for a short time she had been encouraged by management to do further training and was looking forward to doing a NVQ 2 course in the future and had already completed a number of training courses and a thorough induction. From information obtained from the AQAA we saw that there are over 50 of staff with NVQ training, needed to ensure a good range of knowledge to meet residents needs. We found that staff have been on a Care Homes for Older People Page 21 of 27 Evidence: number of training events to help update their practice on areas such as Moving and Handling, Fire Safety, Infection Control etc though some staff had not received training as shown by the Training Matrix we saw - e.g. Sight and Hearing Impairment, Stroke, Mental Health conditions,Aggression, Epilepsy, Parkinsons Disease, Diabetes etc. The Manager said this would be followed up. Staff records showed that proper checks had been carried out to protect residents from unsuitable staff. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are management systems in place to protect the health and safety of residents. Evidence: Because of recent circumstances there has been a change in the ownership of the service. Steven Poynton is now the sole owner and recognised that he will need to apply for registration so to legalise the situation of the ownership of the home. Wendy Gilbert is the Manager of the home, who has completed the NVQ 4 Award in management skills. Residents and staff were very positive about Wendy and her management skills: Wendy make sure everything runs smoothly and that we are all well, one resident said. Wendy has an awareness of the Mental Capacity Act and the need to make referrals to the relevant Agency regarding deprivation of liberty issues, whch means that residents are protected from inappropriate deprivations of liberty. Satisfaction questionnaires were sent around the home last year, and the results were seen to be generally very positive: Care Homes for Older People Page 23 of 27 Evidence: Wendy is an excellent Manager and staff are extremely helpful and caring, were some of the very positive comments made. Analysis of the results to see if improvements in the service were needed was not in place. Written records regarding finances for residents are properly in place, and monies were checked for two residents and totals were found to be correct. There was evidence of Residents Meetings discussing relevant issues - activities, food, staff, complaints etc, which showed their involvement in the running of the home. Safe working practices were observed as we went around the home - e.g. e.g. instruction for staff to wash hands to prevent infection, use of alcohol gel, proper transfer of residents from wheelchair to sofa etc. Staff informed us that they were able to tell management of the problems they were facing and there were regular meetings and supervision to support them, which we saw as being well kept. There are proper Health and Safety systems in place in the home. We saw risk assessments for safe working practices and COSHH assessments to keep residents and staff safe. Proper fire records were in place with regular fire drills. Staff were asked about the fire drill procedure and they all knew what to do. A fire door to the outside was found to be sticking which was a safety risk. The Manager said this would be quickly followed up. There was a Health and Safety folder with Risk Assessments completed. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 3 A comprehensive assessment of need is needed before people are admitted to ensure the service can meet identified needs. Care Plans need to be detailed as to all residents needs and staff need to have read Plans to be aware of all these needs. The frequency of activities, of residents choice, needs to be extended. The water pressure should be rectified so that people can have a warm, comfortable bath. Staffing levels need to be reviewed to ensure that care staffing is sufficient to allow the Manager to also perform her managerial duties. Staff training is needed on some of the medical conditions that residents have, to increase awareness and skills of staff. 2 7 3 4 5 12 19 27 6 30 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@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) Commission for Social Care Inspection (CSCI). 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. 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