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Care Home: Cornfields

  • Cranleigh Drive Whitfield Dover Kent CT16 3NW
  • Tel: 01304820019
  • Fax:

Cornfields is a purpose built property. The accommodation is on the ground floor and the first floor and is divided into four self-contained wings, or `units`. On the ground floor, these units are called Shamrock and Rose Lodge. On the first floor, these are called Daffodil and Thistle. Rose Lodge is reserved for people who have moved in for only a short period of time in order to recuperate before going home again. Often, they have been in hospital and need some extra time to recover their ability to manage for themselves. The people who move into Shamrock are also there for shorter periods of time. This can be on a one-off basis or as part of a planned programme. Usually, they Over 65 280 move in so that family carers can have time to themselves. The other units are reserved for people who have decided to make the Service their longer term home. Each of the units has a similar layout. There is a main lounge/dining area to which a small kitchenette is attached. There are bathrooms and toilets. All of the people have their own bedroom, each of which has a private wash hand basin. There is a call bell system and there is a call point in each bedroom. There is a passenger lift that gives step-free access around all parts of the accommodation. Cornfields is set in a residential area that is about three miles from the centre of Dover. There are some local shops nearby in Whitfield. This is a small village. There is a bus stop nearby and there is plenty of off-street car parking. People can get information about the home from the Service Users` Guide and Statement of Purpose. The weekly fees are set according to a set range up to a maximum of £379.02 per week.

  • Latitude: 51.159999847412
    Longitude: 1.2940000295639
  • Manager: Mrs Margaret Heathcote
  • Price p/w: £379
  • UK
  • Total Capacity: 28
  • Type: Care home only
  • Provider: Kent County Council
  • Ownership: Local Authority
  • Care Home ID: 4996
Residents Needs:
Old age, not falling within any other category

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Cornfields.

Key inspection report Care homes for older people Name: Address: Cornfields Cranleigh Drive Whitfield Dover Kent CT16 3NW     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: Christine Grafton     Date: 0 6 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 34 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 34 Information about the care home Name of care home: Address: Cornfields Cranleigh Drive Whitfield Dover Kent CT16 3NW 01304820019 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: margaret.heathcote@kent.gov.uk Kent County Council care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 28. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Cornfields is a purpose built property. The accommodation is on the ground floor and the first floor and is divided into four self-contained wings, or units. On the ground floor, these units are called Shamrock and Rose Lodge. On the first floor, these are called Daffodil and Thistle. Rose Lodge is reserved for people who have moved in for only a short period of time in order to recuperate before going home again. Often, they have been in hospital and need some extra time to recover their ability to manage for themselves. The people who move into Shamrock are also there for shorter periods of time. This can be on a one-off basis or as part of a planned programme. Usually, they Care Homes for Older People Page 4 of 34 Over 65 28 0 Brief description of the care home move in so that family carers can have time to themselves. The other units are reserved for people who have decided to make the Service their longer term home. Each of the units has a similar layout. There is a main lounge/dining area to which a small kitchenette is attached. There are bathrooms and toilets. All of the people have their own bedroom, each of which has a private wash hand basin. There is a call bell system and there is a call point in each bedroom. There is a passenger lift that gives step-free access around all parts of the accommodation. Cornfields is set in a residential area that is about three miles from the centre of Dover. There are some local shops nearby in Whitfield. This is a small village. There is a bus stop nearby and there is plenty of off-street car parking. People can get information about the home from the Service Users Guide and Statement of Purpose. The weekly fees are set according to a set range up to a maximum of £379.02 per week. Care Homes for Older People Page 5 of 34 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 report takes account of information received since the last inspection of 16th July 2008 and included a visit to the home. We visited the home on 6th July 2009 without telling anyone we were coming so that we could see what it is like for people living there on a usual day. We arrived at 09:25 hours and stayed for the day, leaving at 17:10 hours. We spoke to the senior team leader, plus five staff members. Seven residents and two visiting relatives were involved in the inspection and we also spent time in the company of other residents. We looked around the communal areas of the home and saw a sample of bedrooms. We observed what was going on, the home routines, staff practices, and what activities were taking place. We looked at some of the homes records and saw the lunchtime meal being served. We used the homes annual quality assurance assessment, known as an AQAA for Care Homes for Older People Page 6 of 34 short, to help us to plan our visit in the best way. This is a document that all homes have to send us once a year to tell us how they think they are meeting the national standards, how they have improved in the previous year, what they aim to do. It also lets us know when they have completed important environmental safety checks. This was received on time, but the information contained was brief and there were areas where more supporting evidence would have been useful for the planning of our visit. Information from the last inspection is referred to and we looked at the things identified in that report that needed to be done better, to see if those things had been done. We found that they had. At the time of our visit there was a total of eighteen residents living at the home. This included eleven people staying for recuperative care, two people staying for a period of respite care and eleven people who live at the home permanently. The people who live in the home prefer to be called residents and this is the word used to describe them throughout the report. The registered manager was not present at the time of our visit, but we spoke to her in a telephone conversation afterwards to explain our findings. Care Homes for Older People Page 7 of 34 What the care home does well: What has improved since the last inspection? They have changed the way staff are allocated to work on the units within the home, so that the same staff work on the intermediate care unit. This helps to make sure that people staying for short stays on the unit receive consistent care. They have tried to offer more opportunities for residents to take part in activities and have introduced a weekly afternoon craft session, as well as the Friday evening craft club, which gives some residents extra enjoyment. Staff also organise some individual activities on the units when they have time. Care Homes for Older People Page 8 of 34 They have sorted out the problem with the hot water temperature in the bathroom on Shamrock unit. This makes sure that as well as reducing the risk of scalding, the water is also not too cool for comfort. They have increased the number of domestic staff on duty and changed their duties to include bed making. This has freed up the care staff time to assist residents in the mornings, so that it is not so rushed and to make sure that breakfast time stays flexible. They have continued with their staff training programme to help staff develop their knowledge and skills. This benefits residents, as they can have confidence in the staff that they know how to do things the right way. They have addressed the shortfalls in the staffing arrangements that we asked them to do at our last inspection. They did fill the vacancies so that care workers would not have to rush things to get tasks done. However, recently there have been more shifts to cover as some staff have left. They are currently recruiting new staff and residents and staff say that things are again starting to get better. They have made sure that they keep the proper records showing that staff have had all the right security checks completed before they start work at the home. This shows that they have made sure that new staff are suitable to be alone with residents. They have looked at how they find out residents views about the home. The manager and senior team leader have introduced monthly one to one meetings with residents. This gives residents the chance to say in private if there is something troubling them or to make suggestions about the running of the home. What they could do better: They have addressed the things we raised at our last inspection and we have not found anything serious at this visit that they need to do to safeguard the residents living in the home. They have identified where they need to improve and have already started making changes to address them and here are some of the things they plan to do. Care plans are not particularly detailed in some aspects, looking mainly at care tasks and they have already identified this as an area for development. They intend to look at how they can make care plans more individual to each resident to show how they recognise peoples differences and how they work in a way that makes sure their diverse needs are met. They still need to make sure that residents have enough choices of things to do to occupy their time without becoming bored. Care staff try to fit in activities between their care tasks, which often get left, if there are more pressing things to be attended to. They are aware that this is an area they still need to develop, but are currently recruiting more staff and will look at staff roles to make sure there is more time for activities. One bathroom does not have liquid soap and paper towel dispensers that are necessary for hand washing to prevent the spread of infection within the home. This is Care Homes for Older People Page 9 of 34 the only room where these facilities were not available and they have said it would be dealt with promptly. The information in the annual quality assurance assessment (AQAA) was too brief and did not show some of the things we have found that they do well, or show all the areas where they have improved, or what plans they have to develop the service for the future. The manager said they would spend more time on the next AQAA to make sure it contains all the necessary information. The management already have a number of ways to monitor the quality of care provided at the home. The manager now needs to strengthen some aspects of this to make sure the system is robust and shows how any issues raised have been addressed. This is to include keeping a summary of things raised as a result of residents questionnaires and meetings and showing what has been done about them. 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 10 of 34 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 11 of 34 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 who are about to move into the home benefit from having an assessment that tells staff about them and the support they need. This usually makes sure that their needs can be met upon moving in. On admission they are involved in drawing up their care plan and are asked how they want things to be done. People who stay at the home for respite and intermediate care have an assessment and care plan to support them in returning home. Evidence: The home has written information about it, which is kept in every bedroom so that residents can refer to it any time they need to. They have a guide that explains all about the home and the things they need to know, plus a more detailed document called the statement of purpose, which sets out what the home aims to achieve and has a bit more detail about things like the staffing complement, what training is provided and the names of the management team. It also describes the admission Care Homes for Older People Page 12 of 34 Evidence: process. The manager has recently updated these documents and we saw that they are accurate and easy to read. We spoke to one resident who had recently been admitted to the home to find out what it was like for them when they first moved in. They told us that they knew about the home already, because it has a good reputation in the area and they knew of other people who had stayed for respite care and gone home. We looked at this persons assessment and care plan and talked to them about their needs. Care managers had provided the pre admission assessment and following admission, the home had completed their own assessment and care plan, together with the individual. The records confirmed what the person told us about their care needs. They had been asked about what help they need and how they wanted things to be done. This includes practical things like any help with washing and dressing and how to move about safely. The records had been updated as things had changed and there is an ongoing process of monitoring and reviewing progress. People are usually admitted for either intermediate care or respite care, which means that they will be supported to recuperate and return to their own home, or stay for a short break when they need it. The resident that we spoke with about this told us that staff spent time with them when they first moved in, telling them all about the home and asking them about the support that they needed. They knew they had copies of the homes guide and other papers in their bedroom to look at, but they had not needed to, as staff had been so helpful, saying that if there is anything they need to know, they only have to ask. The manager told us in the annual quality assurance assessment (AQAA) that a high percentage of people staying for intermediate care return to their own home and this was confirmed in discussions with the staff that we spoke with. Since our last inspection, they have made a change to the way staff are allocated to work on the units within the home and now have specific staff that work on the intermediate care unit, to provide continuity of care. We spoke to a care worker about this and were told that it is much better, as they are more involved in the weekly care meetings that are held with other professionals, such as community nurses, physiotherapists and occupational therapists, about the care of people staying on the unit. This means that they have learnt more about the progress of people staying on the unit and have been able to follow their care through the whole rehabilitation process. The resident that we spoke with knew the care worker by name and was reassured that there were generally the same staff on duty in the unit that know and understand Care Homes for Older People Page 13 of 34 Evidence: their needs. Care Homes for Older People Page 14 of 34 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 can be confident that they will be provided with the personal and health care that they need, that their medicines will be managed safely and that they will be treated with respect. Evidence: We spoke to five residents and two care workers about the care received and given. Residents told us that when they need help with things such as getting up and going to bed, getting dressed, bathing, moving about and going to the toilet, that staff are always on hand and respond in a cheerful, friendly manner. Several described the sort of care they need that includes having to call for staff assistance during the day and night because they cannot do things for themselves any more. They expressed that although they are more dependent now, staff do things in a way that they prefer and at times that are suitable to them. One resident spoke about preferring to have two baths a week and of how when they wanted to watch the mens tennis final on television during Wimbledon week and the game went on during the time they would normally have their bath, their care worker Care Homes for Older People Page 15 of 34 Evidence: adapted it until it finished. A resident spoke of staff always being on hand at night, saying that if they ring their call bell during the night they can have a cup of tea. A resident described how they had been looked after when they were not well, saying, If youre not well they monitor you. They were very good when I had a feinting spell. I was taken to hospital and came back at 11pm. Staff were welcoming and greeted me nicely. They go out of their way to fall in with your wants. Another resident related how when they first came into the home, I was in a sorry state. They went on to say that with the care provided by the home, supported by visits from community nurses, they were now much better and able to lead the life that they want. They concluded by saying that everything about the home is good. We learnt how staff make sure that residents keep hydrated during the warm weather. A resident spoke about being given bottles of water and ice lollies in hot weather. This was reiterated by a visitor who said that staff have good attitudes towards the residents and that their relative could not have better care anywhere. They went on to say, They make sure that they all have plenty of fluids in the hot weather. They give them ice lollies and bottles of spring water to drink, as well as squashes and cups of tea and coffee. A care worker said, I know they get good care, relatives tell me this is one of the better homes and went on to say they feel they give the care that residents need. Each resident has a plan of care that gives staff the basic information about the assistance they need and how they want it to be done. We looked at three of these plans and saw that they cover things such as, personal care, healthcare, nutrition, mobility, skincare, communication, continence and risks. The care plans that we saw contained brief details in most of the different sections. There were some areas that had been left blank, where we found that there was a need, such as in one case, where there was a nutritional need that had not been recorded. However the care worker knew what to do to make sure that the resident stays properly nourished, including use of feeding aids and cutting up of food. We discussed another case with the senior team leader where the skin integrity risk section of the care plan had been left blank for a person who is no longer weight bearing. They agreed that this should have been recorded and said they would make sure that it is addressed. A care worker told us how they check the residents skin each day to see if there are any changes that might alert them to the start of a possible pressure area. Care Homes for Older People Page 16 of 34 Evidence: We saw a very detailed moving and handling assessment for a resident that cannot weight bear and needs a wheelchair to get about. This contains guidance for staff on how to do this safely, using a hoist or stand aid, in a manner that respects the residents dignity. We observed staff assisting this person to transfer from their chair to wheelchair in the way described. Care plans contain daily records of how each resident has been and show where any changes have occurred. There are also separate records of visits by doctors and other health care professionals that show how healthcare needs are being met. There was some evidence of regular care plan reviewing, but this was mainly in the form of dates and notes saying no change with the odd additional comment. There had been some changes in needs in one instance that we looked at, but the care plan and dependency assessment did not reflect this and had not been updated. The care worker and senior team leader knew about the changes and intimated that the information had been passed onto other staff verbally. Overall, care plans cover most of the things that staff need to know and discussions with the people involved in the inspection confirm that residents diverse needs are being met. However, care plans mainly relate to the care tasks that people need help with, rather than looking at some of the more individual things about them that would identify where there are differences, so that care is centred around the person. This is something that management has already recognised and they are looking into how they can make the care plans more unique to each person. At our last inspection, we saw that medicines were being managed safely. In their annual quality assurance assessment (AQAA) the manager stated that they carry out regular monitoring and auditing of medication and staff are trained in medication administration. The staff training matrix indicates that twenty one staff have received medication training. The senior team leader said that it is usually the team leaders that give out the medications. Either the manager or senior team leader carry out weekly medication audits and the manager does staff medication competency assessments every three months. Some residents manage their own medication and one resident spoke about how this works for them. They said how they keep their medicines under lock and key and we saw their lockable facility in their bedroom. The resident told us how the team leader monitors that they are taking their tablets and comes round to see them every morning when they do the medicine round to ask if everything is okay, saying that this is reassuring to them. The team leader then checks their tablets every week and Care Homes for Older People Page 17 of 34 Evidence: at the end of each month orders their next months medicines for them. We observed the team leader doing the medication round in one of the units and saw that this was done in a safe way. We also looked at a sample of the medication records and saw that things were in order. We saw staff interacting with residents in a calm, friendly manner. We observed staff assisting residents discreetly to the toilet or helping them to move about. Residents were seen conversing cheerfully with staff and one resident commented that there is a lot of friendly banter goes on between them. A staff member confirmed this and we saw that this includes lots of laughter, as well as quiet reassurance. Care Homes for Older People Page 18 of 34 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. Residents benefit from having some opportunities to take part in activities that suit their needs and from being able to keep in contact with families and friends. They are encouraged to lead their lives the way that they want. Residents benefit from receiving a nourishing and balanced diet and enjoy their food and the choices available to them. Evidence: Residents we spoke with described some of the things that they do to occupy their time. These are a mix of individual activities and some group activities. They were mostly satisfied with the opportunities available to them, although one person spoke of being bored sometimes. At the last inspection, the range of activities offered was not well organised and staff did not have enough time to offer a broad range of activities on a regular basis. They were asked to look at this as something they could do better. The AQAA states they have introduced a Tuesday afternoon craft session and residents spoke about a Friday evening craft club as well, that they enjoy. A resident spoke of their enjoyment in making craft items and showed us some of the things they Care Homes for Older People Page 19 of 34 Evidence: have made. Other residents spoke about joining in with quizzes, painting and enjoying hand massages and manicures. They also have a volunteer who takes the shop trolley round and does varying activities on a regular basis, including a fortnightly games afternoon. A beetle drive was being arranged for the week of our visit and some visiting entertainers had been booked for the following week. On the units, staff organise activities as time permits and keep records that show what individual residents have been doing. This confirms the things stated in the AQAA and what residents told us. However, on some days the only activities recorded were watching television, knitting and reading for some individuals. A care worker spoke of needing to spend more time on care tasks and fitting in activities when they can. This is something that the manager is aware of and they are currently recruiting more staff. Once they fill the current vacancies (see staffing sections) they are hoping to have an extra care worker on shift during the day, so that staff will have more time for activities. Residents spoke about receiving visitors and some spoke about going out with relatives or friends. A visiting relative said that the home has a good reputation and staff are always extremely helpful and welcoming whenever they visit. They went on to say that they are offered drinks and kept informed if there are any changes concerning their relative that they need to know. We saw that residents are encouraged to make their bedrooms their own, for example bringing in things with them like small items of furniture, ornaments and photographs. We saw plenty of examples of all these in bedrooms we looked at. Residents told us that they can choose to spend time in their rooms whenever they want or socialise in the lounges. Independence is encouraged and we saw residents from the first floor units socialising with people in the recuperative care unit on the ground floor and going into the gardens. Spiritual and religious needs are discussed on admission and recorded in the care plans. None of the residents that we spoke with wished to celebrate their faith, but staff told us they make arrangements for clergymen or representatives from other faiths to visit individuals who express a wish in this respect. Residents say they enjoy their food and have plenty to eat and drink. We saw that menus are well thought out to provide nourishment, choice and variety. Mealtimes are relaxed unhurried occasions and where residents need assistance with eating, this is Care Homes for Older People Page 20 of 34 Evidence: done in a sensitive manner. One resident said, We have a choice of food. They bring the food list round every day, we usually have two choices and if were not happy we can tell them and they give you something different. We get big dinners. We can go to the other lounges to join and play games if we want. I love it here. Another said, We have a choice of two meals and we can have a cooked breakfast if we want. We have nice desserts. If Im only having a light lunch I have a cooked breakfast. If Im having a big lunch I have a yoghurt and toast for tea. Tonight Im having cheese on toast for tea, one of my favourites. Care Homes for Older People Page 21 of 34 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 can be confident that any complaints will be listened to and sorted out. They can be assured that staff practices in the home will safeguard them from harm. Evidence: There is a written complaints procedure on display that explains how someone can raise a concern. Each resident also has their own copy in their bedroom. Any complaints are recorded and investigated. We saw records of these showing that complaints are taken seriously, promptly dealt with and the records show how they have been resolved. We asked five residents how they feel about raising a concern and they all said that if they have anything worrying them they talk to any of the staff and that the manager is also very approachable. One resident spoke about talking to their key worker who helps sort things out for you or they talk to the team leader. Another resident spoke about having residents meetings where they can make suggestions and if we have any complaints we tell them. They sort it out. Everything is good. There is written guidance for staff about protecting people and keeping them safe. Staff read this when they start work at the home and they also have specific training on this. Since our last inspection, all staff have done training on the Mental Capacity Act and safeguarding people. The home has its own trainers for these subjects so that training can be done on site. We spoke with two care workers about this and they Care Homes for Older People Page 22 of 34 Evidence: described what they would do if they became concerned about something. They also know the signs to be alert for to indicate that something is not right and the action to take if this happens. The residents that we spoke with say they feel safe. Care Homes for Older People Page 23 of 34 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. Residents benefit from living in a comfortable homely environment that suits their individual and collective needs. They are protected by the safe practices in place to maintain hygiene and prevent the spread of infection within the home. Evidence: They say in their statement of purpose that Cornfields aims to provide all residents with a safe, relaxed and homely environment in which their care, wellbeing and comfort are of prime importance. We saw that this is right and what actually happens. The four units are self contained with their own lounge diners and kitchenette areas. They each have a distinct feel and are decorated in different colour schemes. One of the ground floor units also has an attractive conservatory with doors leading out onto a patio area and garden, with some raised beds. We saw residents moving about between the units and going into the garden. There are banister rails in corridors for people to hold onto. There are other adaptations to help people who have problems getting about, such as assistance poles fitted to the wall around toilets for them to hold onto for extra support. Residents told us that they find these aids useful to help them balance. There is a special rise and fall bath with side doors to make it easier for people to step in to and there is a walk in shower. Since our last inspection they have made the bathrooms look more welcoming. They Care Homes for Older People Page 24 of 34 Evidence: are painted in different colour schemes and pictures have been added. At our last inspection, there was a problem with the temperature of the hot water in Shamrock unit, in that it was too cool for comfort when residents had their baths. We made a requirement about this and were told that this had been sorted out within the timescale we specified. We asked a care worker to check the bath water temperature in our presence and found that it was within the safe recommended range. The care worker told us that staff record the bath water temperatures each time they bath a resident and that usually residents do not like it too hot. We spoke to one resident about their bath time and were told that it is an enjoyable experience and the water temperature is always about right, as the staff know how they like it. Another resident who likes a shower said they were happy with this. We looked at some of the bedrooms and saw that they are decorated in different colour schemes with coordinating carpet, curtain and bedcovers. They have a maintenance person who deals with any repairs and decorating. Residents told us that they like their bedrooms and that they are always kept clean. One resident said, We always have a nice clean bed. Since our last inspection, they have increased the number of domestic staff on duty and changed the cleaning rotas to meet residents needs. Domestics now make the beds to free up the care staff time to assist residents in the mornings. They have domestic staff on duty every day, including a laundry assistant. Residents told us that the home is always kept clean and we saw this for ourselves. Everywhere we went was clean and there were no unpleasant smells. The AQAA states that they have had an infection control audit carried out and we saw that they have good procedures to keep the home hygienic and safe for residents, staff and visitors. They have good hand washing facilities throughout the home, including liquid soap dispensers and paper towel dispensers, except Shamrock bathroom does not have these facilities. We discussed this with the senior team leader who said that this must have been an oversight. A care worker said they use terry towels and usually have a separate liquid soap container in there. However, the senior team leader said she would discuss this with the manager and felt sure that fixed dispensers would be fitted as soon as possible in this bathroom. There is a well equipped laundry and separate sluicing facilities. Residents say that their clothes are nicely laundered and returned promptly to them. Staff were seen adopting safe hygiene practices. Care Homes for Older People Page 25 of 34 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 can be confident that they will be supported by competent and qualified staff, and protected by the homes recruitment procedures. Evidence: We looked at the numbers of staff on duty and saw that there are currently four care workers on duty during the day, plus a team leader and other staff that deal with cooking, cleaning, laundry and administration. At our last inspection we were told that there should have been a fifth care worker on duty most days, but we found that this was not happening very often. Care workers were also having to cover some laundry duties and sometimes do the afternoon tea. Staff spoke of being rushed to get things done and residents had spoken about delays in things such as breakfasts being served. Consequently we made a requirement that all the planned care worker shifts were to be filled. At this visit, we spoke to residents and staff to get their views about how the care staffing numbers are now and learnt that although things are still not perfect they are getting better. Residents said that although staff are sometimes very busy, they always respond when they need help and they get the care that they need. Residents did say that staff seem to be busier now than they used to be and that staff do not have the time to sit and talk with them as much as in the past. On the whole they felt that there are enough staff on duty. Care Homes for Older People Page 26 of 34 Evidence: Staff told us that it has got better since the last inspection. Vacancies had been filled, but things had changed again, when due to staff leaving, some shifts have to be covered either by them doing extra hours, or sometimes, agency staff are used. Two care workers welcomed the recent change with the domestics making the beds, which allows them more time to care for residents in the mornings. However, they are still currently covering some laundry shifts and preparing some teatime meals. Discussion with the senior team leader indicated that they have recently recruited more staff, including three care workers and a new tea time domestic who are due to start soon. A new rota has been drawn up to provide five care workers on duty throughout the day on every day of the week. There are still three more care worker vacancies and two more interview dates have been planned to take place within the next two weeks. They are also looking at reducing long shift patterns to enable shifts to be covered more easily in the event of staff absences. The AQAA indicates improving staffing levels as something they could do better. A subsequent telephone conversation with the manager indicates that they have submitted a business case to higher management for additional staffing. This is to meet the needs of residents, who have varied and different dependency needs. Staff are encouraged and supported to achieve their National Vocational Qualification (NVQ) in care level 2 or above. Information in the AQAA states that twenty six out of thirty two permanent care workers have achieved their NVQ 2 or above and three more are currently working towards it. The training matrix also shows that staff have completed a wide range of training courses to enable them to keep people safe and provide the right care. Two care workers spoke about their training and said they have lots of opportunities to go on different courses. We looked at how they recruit new staff to see if it is thorough enough to protect people. They complete a number of security checks on new workers to make sure they can be trusted to be around the residents. We looked at two staff files and found that all the proper checks had been completed before the person started work at the home. These include checking the past employment history, taking up written references and carrying out criminal records checks. A resident told us that they took part in the recent staff interviews and asked their own questions. This shows that residents have the opportunity to have their say about whether they think the person will fit in. All new staff have to complete induction training, where they learn about the homes safety procedures, get to know the residents and learn about their role. Then they Care Homes for Older People Page 27 of 34 Evidence: work through the Skills for Care Caring for Older People Induction workbook that usually takes about twelve weeks to complete. They initially work on shift with someone senior, who supervises them until they are ready to work on their own. They also have formal supervision meetings with a team leader. This makes sure that they can apply what they have learnt in practice. Care workers are then provided with ongoing training that includes a number of set courses that staff are expected to attend on a planned basis. These are called mandatory courses and include, fire safety, how to move people safely, basic food hygiene and safeguarding people. We saw that most of these are up to date, except the fire safety training, which is being arranged (see next section). Care Homes for Older People Page 28 of 34 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. The home is managed in a way that safeguards residents best interests, promoting and protecting their health, safety and welfare. Evidence: The manager is registered with us and has the experience and qualifications to run the home. There is a senior team leader and four team leaders that make up the management team. The manager was not at the home during our visit, but the senior team leader and one team leader were on duty, plus an administrator for part of the day. They assisted us in a competent way and provided us with all the information that we asked for. After our visit, we spoke to the manager in a telephone conversation to clarify a couple of points and give some feedback on our findings. The management team do a number of things to involve people in the running of the home. They hold regular staff meetings and residents meetings. We looked at the minutes of the last meetings. One thing that they have done as a result of this is that the manager and senior team leader have started to set aside a day each month to Care Homes for Older People Page 29 of 34 Evidence: talk to residents in private, on a one to one basis. We were told that residents have used this to talk about things that might be troubling them, or to make suggestions. We discussed that it would be good if any issues raised are recorded as part of the homes quality monitoring processes, together with details of actions taken as a result. A detailed record of the last staff meeting shows that as well as a number of safety issues discussed, the outcomes from residents quality monitoring questionnaires were fully discussed and it shows the actions to be taken. They also have handover meetings at the beginning and end of each shift. This is important so that staff can discuss relevant things that have happened to keep them fully informed, so they know what needs to be done to support the residents. Permanent residents are invited to complete questionnaires once a year, or in the case of people staying for shorter stays, before they leave. We looked at some of those completed during this year. They use two different sets of questions covering things like dignity, privacy, cleanliness, food, staff attitudes and the sort of care received from staff. People have said good things about the home. Here are two examples of the general mood, I feel Im well looked after Always satisfied, nothing done badly. A less positive comment was dealt with well, by following it up in a staff meeting and by the person completing a further questionnaire that indicates the matter had been satisfactorily resolved. This consultation process now needs to be formalised, with the results drawn together and summarised showing the outcomes of the exercise. This could then be added to the service users guide. The homes annual quality assurance assessment (AQAA) was completed on time, but was rather brief and could have provided more useful information to demonstrate the things they do well, where they have improved and any future plans. This was discussed with the manager after our visit and also with the providers representative, who carried out their unannounced monthly quality monitoring visit, known as the regulation 26 visit, during our inspection visit. The senior team leader handled this situation of having two official visits at the same time very well. The two requirements we made at our last inspection have been met. The hot water problem in Shamrock unit has been resolved. They have acted to address staffing levels, but they now need to make sure that any future vacancies are filled without delay and that the planned rotas they have specified, of having five care workers per shift, are continued for as long as residents needs dictate. We discussed with the senior team leader that ways of monitoring this, could include keeping a monthly Care Homes for Older People Page 30 of 34 Evidence: summary of residents dependency levels and recording a monthly falls analysis. We have not made any requirements or recommendations as a result of our visit. They now need to develop their own quality monitoring system, so that as they identify things that need to be improved, they can show what they have done to improve things and how they have acted upon residents and staff suggestions. The last inspection indicated that the home follows a good system for safeguarding residents financial interests. We discussed this with the senior team leader and administrator who said that things are still being done the same and they confirmed that everything is in order. The AQAA indicates that the homes equipment is regularly serviced and the staff training matrix shows that staff complete the mandatory safety courses. However, there were gaps in staff fire training updates. We were told that ten staff would be undertaking this on 9th July and another date is being set up for the remaining staff to do this. Care Homes for Older People Page 31 of 34 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 32 of 34 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 Care Homes for Older People Page 33 of 34 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. 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. Care Homes for Older People Page 34 of 34 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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