Care Home: Coombes Wood House

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What the care home does well Those living in the home describe the staff as very, kind and considerate. They said that the food is good, the home is spotlessly clean and they enjoy at least some of the activities. Their health care needs are well supported by the weekly surgery held at the home by a local GP. Visitors spoken to were also complimentary about the staff. They said that they are always made welcome and are kept informed about their relative`s condition. Their questions are answered readily and their suggestions listened to and acted upon. Staff said that they feel well supported and that they have good training opportunities. What has improved since the last inspection? All but three staff have now had fire training. A member of staff now has responsibility for organising activities which has resulted in an improved range of things for those living in the home to do. An admin assistant has been employed who has responsibility for obtaining police checks for any new staff. A laundry assistant has been employed which has improved the standard of the laundering of personal clothing. Two new wet rooms have been created which has increased the number of bathing facilities. What the care home could do better: Care plans need to be more detailed to ensure that the staff know what they are required to do for each person and also what that person is able to do for themselves. Staff training records need to include the date each member of staff attended training and when refresher sessions are due. This will ensure that all staff receive the training they require. CARE HOMES FOR OLDER PEOPLE Coombes Wood House Coombesend Road East Kingsteignton Newton Abbot Devon TQ12 3DZ Lead Inspector Susan Samways Unannounced Inspection 23rd April 2008 11:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Coombes Wood House DS0000003676.V362333.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Coombes Wood House DS0000003676.V362333.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Coombes Wood House Address Coombesend Road East Kingsteignton Newton Abbot Devon TQ12 3DZ 01626 365101 01626 365102 coombeswoodhouse@btconnect.com 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) Mr Louis Cook Mrs Marjorie Cook Mr Louis Cook Care Home 36 Category(ies) of Dementia - over 65 years of age (36), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (36), Old age, not falling within any other category (36), Physical disability over 65 years of age (36) Coombes Wood House DS0000003676.V362333.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th April 2006 Brief Description of the Service: Coombes Wood House is registered to provide personal care for up to 36 people aged 65 or over, who may also have a degree of physical or mental disability including dementia. The home owners are both registered nurses (general and psychiatric nursing) and have substantial experience of working with elderly people, including those suffering from dementia or functional illness such as depression. The home is situated in a rural position a little more than a mile from the centre of Kingsteignton, and there are attractive views from many of the windows. All but one of the bedrooms are single rooms, and nearly all have en suite facilities. There is a shaft passenger lift. A substantial purpose-built extension provides additional bedrooms and communal facilities. There are now two lounges (one very large) and two dining rooms, one with an adjoining sun lounge. There are extensive grounds, including a secure courtyard area, and ample car parking space. Current fees are £325 - £450 with the average being around £420. Coombes Wood House DS0000003676.V362333.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was an unannounced inspection which took place over two consecutive days and lasted for a total of 12.25 hours. The care manager and her deputy were available on the first day of inspection. They clearly knew all those living in Coombes Wood House very well and were able to answer questions about their care and about the assessment and care planning process. The registered manager was present on the second day of the inspection. During the inspection three people living in the home, two relatives and three members of staff were each interviewed in private, others were spoken to in passing. Care records, staff records and other documents were also examined. What the service does well: What has improved since the last inspection? Coombes Wood House DS0000003676.V362333.R01.S.doc Version 5.2 Page 6 All but three staff have now had fire training. A member of staff now has responsibility for organising activities which has resulted in an improved range of things for those living in the home to do. An admin assistant has been employed who has responsibility for obtaining police checks for any new staff. A laundry assistant has been employed which has improved the standard of the laundering of personal clothing. Two new wet rooms have been created which has increased the number of bathing facilities. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Coombes Wood House DS0000003676.V362333.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 Coombes Wood House DS0000003676.V362333.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those considering moving into Coombes Wood House are provided with sufficient information about the home and have a comprehensive assessment to ensure that Coombes Wood House is an appropriate home for them. . EVIDENCE: The files for five people living in the home were examined. All contained assessments by health or social services personnel and the comprehensive assessment completed by the home which clearly identifies what the person is able to do for themselves as well as their care needs. Coombes Wood House DS0000003676.V362333.R01.S.doc Version 5.2 Page 9 The statement of purpose and the service user’s guide are informative and clearly set out what is included in the fees and what is not. This information is also included in the contract between the home and the person living in the home or their representative. Both the care manager and the registered manager stated that those considering moving into the home are welcome to visit on several occasions and to have a trial period before making the final decision. This was confirmed by a relative who said that visits were made over a period of six weeks and how helpful this was in preparing for the move. Coombes Wood House DS0000003676.V362333.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those living in the home and their relatives are encouraged to be involved in planning and reviewing their care Staff treat those living in the home with respect and are caring and supportive. EVIDENCE: The files for five people living in the home were examined. All contained care plans, risk assessments and monthly and six monthly care plan reviews. The care plans need to be more detailed to ensure that all those providing care are clear about what they are required to do to assist the person concerned but also what that person is able to do for themselves. Coombes Wood House DS0000003676.V362333.R01.S.doc Version 5.2 Page 11 Care plan reviews are carried out each month with in depth reviews being done every six months, records of which were found in the files examined. Relatives are encouraged to participate in the reviews. A reminder of this was seen in the most recent newsletter and relatives spoken to confirmed that they are asked to contribute to the reviews. The home has a good relationship with the local GP surgery and the district nurses. One of the GPs holds a surgery in the home once a week which gives those living in the home the opportunity to consult the doctor without having to call him out. During the inspection it was observed that the staff treat those living in the home with respect. Those spoken to confirmed that the staff are kind and considerate and maintain their privacy and dignity. Discussions with the care manager, her deputy and other members of staff showed them to have a caring attitude towards those for whom they care and a high degree of understanding of those with poor memory. During this inspection a local pharmacist carried out a check on all aspects regarding medication which they found to be in order. Coombes Wood House DS0000003676.V362333.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those living in the home are benefiting from an increased range of activities including physical activities. Meals provided are nutritious and well presented. EVIDENCE: Since the last inspection a member of staff has been given responsibility for organising activities. This has resulted in a much wider range of activities ensuring that there is something for everyone if they choose to participate. The member of staff was spoken to during the inspection and was found to be enthusiastic about her new role, to have lots of ideas and to be keen to listen to the ideas of others including relatives. One relative said that a suggestion they had made about an activity had been listened to and acted upon. Coombes Wood House DS0000003676.V362333.R01.S.doc Version 5.2 Page 13 Activities include music with singing, dancing and exercises, board games, manicures, pet visits and walks out when the weather permits. There are also trips out in the minibus and people like sitting out in the garden. One person who is blind said that they appreciated the staff taking the time to read letters to her and to help her reply. When time permits they also read to her. A communion service is held at the home every week and one person goes to church regularly. The registered manager said that anyone wishing to participate in religious activities are, wherever possible, assisted to do so. Everyone spoken to said that the meals are good and those seen during the inspection were well balanced and nicely presented. The registered manager stated that the preferences of those living in the home are sought and their favourite dishes included in the menus. Coombes Wood House DS0000003676.V362333.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The rights of those living in the home are protected by the home’s complaints procedure and they are safeguarded from abuse by staff being made aware of adult protection procedures. EVIDENCE: The home has a clear complaints procedure with timescales for action. A copy was seen on the door at the entrance to the home. Most people spoken to said that they had never had cause to complain. One relative said that they had raised an issue and that it had been dealt with promptly and satisfactorily. The registered manager stated that all staff receive training in order to recognise abuse and to take appropriate action. However the training records seen did not reflect this. Staff spoken to showed an awareness of what constitutes abuse. The home had recently had to take action regarding possible abuse which they had done appropriately. Coombes Wood House DS0000003676.V362333.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is attractive, homely and appropriately equipped providing a clean, hygienic and safe environment. EVIDENCE: The home is in an attractive rural location and there are good views from many of the windows. There is a large garden, with level access from the building, and a courtyard area which has been made secure. All the bedrooms are single rooms. The communal facilities include two lounges and two dining areas. There is also a conservatory area. Two new wet rooms have been Coombes Wood House DS0000003676.V362333.R01.S.doc Version 5.2 Page 16 created. A wireless call system has been installed and residents can use their pendant outside in the grounds. The parts of the home which were seen were clean and those spoken to confirmed this is normally the case. No unpleasant odour was detected. A new commercial washing machine has recently been purchased which has a sluicing facility. One staff member is employed exclusively to do the laundry. Coombes Wood House DS0000003676.V362333.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff recruitment procedures and staff training safeguard those living in the home. EVIDENCE: The files for three members of staff were examined and were found mostly to be in order. However the manager must ensure that all the required procedure is followed. To this end an administrative assistant has been employed part of whose responsibilities are to ensure that police checks are made in good time. A good proportion of the staff have NVQ Level 2 or are working towards it. In addition five have NVQ Level 3 with another two working towards it. The care manager and her deputy are undertaking Level 4. Staff are also trained in fire procedures and most in first aid, food hygiene, health and safety and manual handling. Some staff have also attended specialist courses such as dementia care. All those responsible for administering medication have had relevant training. The training records need to be improved in order to clearly identify Coombes Wood House DS0000003676.V362333.R01.S.doc Version 5.2 Page 18 who has undergone what training, when they did it and when refresher sessions are due. Staff spoken to were appreciative of the training opportunities available to them. They also said that they felt well supported and that they enjoyed their jobs. Coombes Wood House DS0000003676.V362333.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management style is open and receptive to the views of those living in the home and others involved with the home. EVIDENCE: One of the registered providers also takes on the role of registered manager and is in day to day control of the home. There is also a care manager who, with her deputy, is responsible for the delivery of care to those living in the Coombes Wood House DS0000003676.V362333.R01.S.doc Version 5.2 Page 20 home. Both those living in the home and visiting relatives commented on the owners’ helpful and caring attitude. They are very involved in the home and know those living there well. Quality assurance surveys are carried out regularly to ascertain the views of those living in the home and their relatives and representatives. The results of the most recent were seen during the inspection. The results were very positive and the comments and suggestions made had been collated and distributed to interested parties. With regard to health and safety, the core training for all care staff includes manual handling, fire safety, first aid and food hygiene. All except for three staff had had recent fire training. All of the radiators accessible to residents are covered or of low surface temperature, to prevent residents from sustaining a burn injury. The registered provider confirmed that the upstairs windows have restricted openings to prevent residents from falling from them. Coombes Wood House DS0000003676.V362333.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 3 3 3 x 3 N/A 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 3 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 Coombes Wood House DS0000003676.V362333.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. OP7 2 OP30 Refer to Standard Good Practice Recommendations Care plans should be more detailed in order to ensure that staff providing care are clear about what they are expected to do for each individual. Staff training records need to include the training undertaken by each member of staff, when they did it and when refresher sessions are due to ensure that all staff receive the training they require. Coombes Wood House DS0000003676.V362333.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Coombes Wood House DS0000003676.V362333.R01.S.doc Version 5.2 Page 24 - 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. 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