Care Home: College House

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What the care home does well The needs of people using the service are appropriately assessed to ensure it can meet them and information is available to help them to make an informed decision about iusing it. People using the service told us staff are `Friendly` and `Helpful` who support and encourage them to maintain contact with their friends. The concerns of people living in the home are taken seriously and staff training is provided to ensure they can do their jobs and safeguard them from potential harm. Appropriate management systems are in place to support the health, safety and welfare of people using the service. What has improved since the last inspection? Action had been taken to implement the requirements we previously made and good progress had been made to develop the service. Improved information had been developed to help people know what they can expect from the service. A part time member of staff had been employed to develop the activities available and improved records had been developed to help staff support people living in the home better. New menus had been developed to give people living in the home a better choice about these and management systems had been strengthened to support the running of the home. What the care home could do better: Medication given to people living in the home must be accurately recorded to ensure they are safeguarded from potential harm. The support plans for people living in the home should continue to be developed to reflect their personal interests in order to help staff maximise opportunities for them to be independent and exercise self control over the way they are supported. Further activities should be developed to enable people living in the home to have greater opportunities to have meaningful choices about their lives. People using the service should be further consulted about their meals to ensure their choices and wishes about these are met and that meal times are developed into more of a social event. Staff should check the temperature of bath hot water to ensure people using the service are kept safe from harm. The service should have a registered manager to run the home. Key inspection report Care homes for older people Name: Address: College House 87 College Street Cleethorpes North East Lincs DN35 8BN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Rob Padwick     Date: 1 4 0 7 2 0 0 9 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 24 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. 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 Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: College House 87 College Street Cleethorpes North East Lincs DN35 8BN 01472693957 01472351749 Maria.Gatt@ntlworld.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Maria Gatt care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: 1 day care place for under 65 with presenile dementia Date of last inspection Brief description of the care home College House is a well established home situated in a pleasant residential area in the seaside resort of Cleethorpes; it has good access to local amenities and public transport. The home is registered to accommodate 19 service users with residential care needs. Accommodation is provided on two floors; there is stair and chair lift access to the first floor. There are eleven single rooms and four shared rooms; three of the single rooms have en-suite facilities. The home has two lounges and one dining room; all rooms are decorated and furnished to a good standard. There are bathroom and WC facilities located on each floor. There is a pleasant courtyard area where service users can sit out. The home is well Care Homes for Older People Page 4 of 24 4 0 Over 65 19 19 Brief description of the care home maintained and provides a pleasant, homely inclusive atmosphere. The home is owned and managed by Mrs Maria Gatt. Information about the home and its services can be found in the statement of purpose and service user guide, both these documents are available from the manager of the home. A copy of the latest inspection report for the home can also be obtained from the manager. Information given to us by the Provider indicated the weekly charges for the home range from £ 361 to £ 410. More up to date information on fees and charges can be obtained from the manager of the home. Care Homes for Older People Page 5 of 24 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: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This inspection report is based on information received since the last key inspection of the home which took place on 15 July 2008 together with information gained during a site visit to the home. As part of the inspection process, we sent a self assessment document to the service that the manager completed and returned to us. This document should show how well Care Homes for Older People Page 6 of 24 the home is meeting regulations and national minimum standards and what has been done to improve it and what still needs to be done. Information from the self assessment was used as part of the inspection process and other information used included direct feedback from people living in the home, responses gained from relatives and professional staff who we spoke to, together with official notifications received by the Care Quality Commission. This information helps us reach judgments about the service provided. The site visit took place on 2009 and lasted for 5 hours. The provider was not told in advance when it would take place. The manager was available throughout the period of our site visit, and as well as speaking to him, we talked to the home owner, senior management, staff who were on duty and people living in the home. We looked round the building, including bedrooms and shared areas and we inspected the records of peoples care, staff files, health and safety documents and other records that were kept by the service. Care Homes for Older People Page 7 of 24 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 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. Care Homes for Older People Page 8 of 24 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 9 of 24 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. The needs of people using the service are appropriately assessed to ensure it can meet them and information is available to help those thinking about moving into the home to make an informed decision about it. Evidence: Since the last time we visited, information about the home had been updated and improved to help people thinking about using the service to make a more informed choice about using it. This information had been developed to a good standard and there was evidence in the case files that new contracts had been issued to people living in the home as was previously required, that gave details of the fee payable. We were told no one had had moved into the service since the last time we visited and the case files we inspected contained assessments of people who were living in the home carried out by the Local Authority and the manager to make sure it was appropriate to meet their needs. Care Homes for Older People Page 10 of 24 Evidence: The home does not accept placements for intermediate care. Care Homes for Older People Page 11 of 24 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. Whilst the health and personal care needs of people living in the home are generally well met, better recording of medication given is needed to protect them from potential harm. Evidence: People living in the home told us their health and personal care needs were being appropriately met and their case files contained support plans and health information that covered a range of their needs. There was evidence of good progress to develop and improve the support plans since the last time we visited and those inspected contained clear details of how people liked their support to be provided. Whilst the support plans were being regularly reviewed to ensure they were kept up to date it recommended they are further developed to reflect personal interests to help staff maximise opportunities for them to be independent and exercise self control over the way they are supported. We saw evidence of regular staff monitoring and liaison with professionals about the health needs of people using the service and Community workers we spoke said they had no concerns and that the service worked well with them. We observed people using the service choosing to spend time on their own or in Care Homes for Older People Page 12 of 24 Evidence: the company of others and they told us that staff were great and respected their personal privacy and dignity. Policies and procedures are available to help staff in giving medication safely to people living in the home and we made a requirement about this aspect of practice the last time we visited. We saw evidence of training for those responsible for this but despite regular management checks more action was still needed, as one chart had not been updated when medication had been given. Whilst the manager told us he would take further action to resolve this, a requirement is made as this places people living in the home at risk from potential harm. Care Homes for Older People Page 13 of 24 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported to take part in a variety of activities and encouraged to maintain contact with their friends. Evidence: People using the service confirmed they were able to take part in a variety of activities and a part time member of staff had been appointed to develop these since the last time we visited. On the day of our visit a reminiscence session had been cancelled due to staff sickness but we saw evidence of trips out, craft sessions and some games that took place. We observed staff interacting well with people living in the home and it was clear they took a positive interest in their wellbeing. Some people living in the home have complex behavioural difficulties and we saw staff working with them on a one to one basis. The service has use of a minibus to help people living in the home to get out in the community and they told us how staff assisted them to go out into town for shopping. Whilst people who were visiting confirmed they were made welcome in the home and were generally happy with the service, some relatives told us more entertainments and outings were still needed. The manager told us there are plans to further develop these in the near future, however a recommendation is made about this. The home has recently been awarded a three star food hygiene rating from the Local Authority and we observed procedures for these being generally followed Care Homes for Older People Page 14 of 24 Evidence: satisfactorily. We were told new menus had been recently introduced and inspection of them confirmed a variety of home cooked meals were provided. We observed pictures of the meals on display in the dinning room and people living in the home said they generally liked the food that was served. A member of staff said she felt lunch had not been as popular as normal on day that we visited and a recommendation is made about this. Care Homes for Older People Page 15 of 24 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. The concerns of people living in the home are taken seriously and staff training is provided to ensure they can safeguard them from potential harm. Evidence: People living in the home and their relatives told us they were generally happy with the service received and that staff listened to any concerns that they had. Since the last time we visited, the people running the home had developed the service users guide with more information about what people should do if they are unhappy with any aspect of the service and neither we nor the home had received any complaints about it during the past year. Policies and procedures were in place to ensure people using the service are safeguarded from harm and we saw evidence staff had received training about the protection of vulnerable adults and knew what to do should they have any concerns about this aspect of practice. We saw evidence new staff had been appropriately checked to ensure they are safe to work with people living in the home and the records of finances belonging to people using the service were found to be accurate and well maintained. Care Homes for Older People Page 16 of 24 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 in the home are provided with a clean and comfortable environment that is appropriately maintained. Evidence: The home was comfortable, clean and homely and people using the service told us they liked living there. New infection control hand washes had been installed since our last visit and we saw evidence it was being cleaned and maintained on a regular basis. Furnishings and fittings are of a domestic nature and bedrooms we inspected were individualised to reflect personal choices and tastes. Access to the bedrooms is by use of a staircase and stair lift, although people with limited mobility would be reliant on support to move freely in some areas of the home. The service has a designated smoking area for use of people who are living in the home and this is equipped with an air extractor to improve ventilation and make the environment more pleasant. The laundry area was clean and tidy and as previously noted, the service had been recently awarded a three star rating on hygiene from the Local authority. We saw evidence of regular checks to ensure the building is kept safe and although maintenance tests of the hot water are regularly made, a recommendation is made about this. Care Homes for Older People Page 17 of 24 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. Appropriate training is in place to ensure staff have the skills needed to meet the needs of people living in the home Evidence: People using the service told us staff listened to them well and that they were Friendly and Very Helpful. We observed staff interacting possitively with people living in the home and saw evidence of a range of training to ensure they can do their jobs. Staff told us training is always provided and that they liked working in the home and that Management are very supportive. The service has a generally very stable staff team and the file of the one person employed since the last time we visited contained evidence of appropriate recruitment checks to ensure they were safe to work with people living in the home. A training matrix was in place to help the manager make sure staff receive updates of their skills and we saw evidence of staff attendance at further training on the day of our visit. The staff files we inspected contained records of regular supervision and appraisals of their work together with discussions and advice to ensure their continued professional development. The manager confirmed over 50 of the staff team has an NVQ qualification at level 2 or above. Care Homes for Older People Page 18 of 24 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. Whilst appropriate management systems are in place to support the health, safety and welfare of people using the service, further development of these would enable them to play a greater contribution to the running of their home. Evidence: Feedback from people living in the home and others indicated it was being generally well run and we saw evidence of good progress made to improve the service. Action had been taken to implement the requirements and recommendations we made previously and we saw evidence staff were being encouraged to take a more person centred approach to supporting people with their individual needs. Whilst the service still needs a manager who is registered to manage the home, we saw evidence of improved management systems to support him and were told he was in the process of applying for this and was waiting for the outcome of some checks. We saw evidence of regular management and staff meetings to ensure a sense of leadership is provided and staff told us that management was supportive of them and that they liked working in the home. Quality assurance systems were in place to ensure the service can check Care Homes for Older People Page 19 of 24 Evidence: it is running effectively, and whilst the self assessment told us these still needed further development, we saw evidence of regular checks and consultation with people to ensure their views are considered and they are kept safe from harm. There was evidence of regular maintenance checks to ensure the health, safety and welfare of people using the service are promoted and protected and whilst the self assessment for the service told us how the home had developed over the past year, some greater detail about this would have been useful. Care Homes for Older People Page 20 of 24 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 21 of 24 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 1 9 17 The registered person should ensure accurate records are kept of medication given to people living in the home. This is to ensure they are safeguarded from potential harm. 17/07/2009 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 7 The registered person should continue to develop and personalise the support plans for people living in the home. This is to ensure they can contribute their views and help maximise their opportunities to exercise control over the way they are supported. The registered person should continue to ensure appropriate activities are developed. This is to ensure people using the service can make meaningful choices about their lives. The registered person should further develop and consult with people living in the home about the meals provided. This is to ensure people using the service are consulted Page 22 of 24 2 12 3 15 Care Homes for Older People 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 about decisions concerning their food and that meal times are developed into more of a social event. 4 19 The registered person should ensure staff test the temperature of bath water, to ensure people using the service are kept safe from harm. The registered person should ensure the manager is registered to run the home. 5 31 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 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. 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