Care Home: Curzon House

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What the care home does well Curzon House provides a valuable support service for older people, people with disabilities, and their carers. The individuality of service users is respected during their stays at the home and they are encouraged to be as independent as possible. An experienced nurse is available at the home five mornings a week to assess new service users and to provide advice, treatment and support for the home’s staff. Service users spoke very highly of the quality of their meals and of the good range of choice available. The environment is pleasant, clean and well maintained and equipment is provided to meet the needs of service users. There is a well-stocked sensory garden for service users to enjoy. Good recruitment processes are followed to ensure that new staff are safe and suitable to work with vulnerable people, and new staff receive a full induction programme to prepare them for their work. There is a ‘learning zone’ in the home with excellent facilities for staff to use. 70% of the care staff have a national vocational qualification in care.The home encourages feedback from service users and their families and many positive comments had been received. A letter written to the home by a relative described: a pleasant environment that is efficiently run and kept very clean, with highly professional and committed staff who provide excellent care, create a friendly and supportive atmosphere and are unfailingly helpful, courteous and understanding. What has improved since the last inspection? No requirements were made at the last inspection. A recommendation regarding recruitment has been addressed. There have been improvements to the environment including development of a sensory relaxation room and redecoration of bedrooms. What the care home could do better: Keep a written record of any complaints that are received and the action taken in response. These records will show whether there are any recurring issues and will provide evidence that complaints have been responded to appropriately. Develop a training matrix so that the manager can see which staff need to attend training updates. Ensure that staff have regular updates of moving and handling training so that service users can be sure that they can always be assisted safely. CARE HOMES FOR OLDER PEOPLE Curzon House Curzon Street Saltney Chester Cheshire CH4 8BP Lead Inspector Wendy Smith Unannounced Inspection 19th February 2008 11am 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 Curzon House Curzon House 517976.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. Curzon House Curzon House 517976.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Curzon House Address Curzon Street Saltney Chester Cheshire CH4 8BP 01244 680025 01244 681834 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) http/www.cheshire.gov.uk Cheshire County Council Paul Anthony Donovan Care Home 38 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (38), of places Physical disability (5) Curzon House Curzon House 517976.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 38 service users to include:* Up to 38 service users in the category of OP (Old age, not falling within any other category) * Up to 5 service users in the category of PD (Physical disability aged between 48 and 65 years) * Up to 18 service users in the category DE(E) (Dementia over 65 years of age) Date of last inspection 23rd February 2007 Brief Description of the Service: Curzon House is a community support centre, owned and managed by Cheshire County Council. The home is in the Saltney area of Chester about a mile from the city centre. There are shops and other community facilities nearby. Curzon House is registered to provide personal care for up to 38 people. There is also a Day Care facility in the same building. The fees payable are based on a financial assessment of the individual by the local authority and eight places are funded by the Alzheimer’s Society. Curzon House Curzon House 517976.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. An unannounced visit took place on 19th February 2008 and took four and three-quarter hours. A tour of the building, including all communal areas and some bedrooms, was completed. A sample of records was looked at and time was spent in conversation with residents, staff and the acting manager. Some of the information contained in this report is taken from the Annual Quality Assurance Assessment that was completed by the acting manager at the request of the Commission for Social Care Inspection. Prior to the visit, comment cards were provided for a number of residents, visitors and staff to give their views of the home. What the service does well: Curzon House provides a valuable support service for older people, people with disabilities, and their carers. The individuality of service users is respected during their stays at the home and they are encouraged to be as independent as possible. An experienced nurse is available at the home five mornings a week to assess new service users and to provide advice, treatment and support for the home’s staff. Service users spoke very highly of the quality of their meals and of the good range of choice available. The environment is pleasant, clean and well maintained and equipment is provided to meet the needs of service users. There is a well-stocked sensory garden for service users to enjoy. Good recruitment processes are followed to ensure that new staff are safe and suitable to work with vulnerable people, and new staff receive a full induction programme to prepare them for their work. There is a ‘learning zone’ in the home with excellent facilities for staff to use. 70 of the care staff have a national vocational qualification in care. Curzon House Curzon House 517976.doc Version 5.2 Page 6 The home encourages feedback from service users and their families and many positive comments had been received. A letter written to the home by a relative described: a pleasant environment that is efficiently run and kept very clean, with highly professional and committed staff who provide excellent care, create a friendly and supportive atmosphere and are unfailingly helpful, courteous and understanding. What has improved since the last inspection? 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. Curzon House Curzon House 517976.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 Curzon House Curzon House 517976.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): Standard 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are assessed by a social worker before their stay at Curzon House to ensure that this service will meet their needs. EVIDENCE: The maximum number of people accommodated is 34. Two people live at Curzon House and up to 100 others receive short term care each year. The home no longer admits people for long stay care although some people stay there for several months while arrangements are made for their future care. The short stay visits may be planned ahead or be at short notice during a crisis. Other people go to Curzon House following treatment in hospital. Curzon House Curzon House 517976.doc Version 5.2 Page 9 18 places on the ground floor are for people with dementia and 16 on the first floor for older people or people with a disability. Service users may be from any part of Cheshire. Places for dementia care are always booked directly by the person’s social worker but places on the first floor may be booked by the person’s carer under a flexi-care system whereby a number of days respite are allocated each year. All new service users have an assessment by their social worker, and the home receives a copy of this from which a care programme is written by the care coordinator. The care programme is updated as needed following each visit. Whenever possible new service users and/or their carer are encouraged to visit Curzon House before they have their stay. A service user guide in each bedroom gives information about the service. Curzon House Curzon House 517976.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): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People staying at Curzon House receive a good standard of care and are treated with respect. EVIDENCE: The care co-ordinator develops a care plan, known as a care programme, from the assessment carried out by the social worker. The programmes seen provided staff with the information necessary for them to look after the person’s needs. The carers sign the plan each time they give care or support to a service user. The care programme for one of the people who lives at the home permanently was looked at. This is currently being updated by the care coordinator and needs to provide more detail about her individual needs and preferences. Curzon House Curzon House 517976.doc Version 5.2 Page 11 A local GP surgery provides medical cover for people staying at Curzon House who are from outside the area. A nurse advisor works at the home five mornings a week. She can assess the health needs of service users and request a visit from the doctor when required. She is able to prescribe some medicines and provide nursing treatments. District nurses also provide support. There is a treatment room that is used by visiting medical professionals. Dementia care mapping is carried out twice a year to study the quality of the care being provided to service users with dementia. Three members of staff have completed training to carry out these studies. The home also has contacts with the Bowmere psychiatric unit in Chester and can access support and training from this NHS facility. Comments received from service users were that staff are very friendly and helpful and they have lots of patience. It was also evident throughout the visit that residents were treated with courtesy, respect and good humour by staff. Cheshire County Council provides written policies on the receipt, administration, storage, handling, recording and disposal of medicines. Service users’ medication is kept in a lockable cabinet in each bedroom. The arrangements for the administration of medication during the inspection were satisfactory. Residents who are able are supported to look after their own medication following an assessment. Medicines records are good. All senior staff have completed medicines training and are currently updating this. Curzon House Curzon House 517976.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): Standards 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to exercise choices in all aspects of their daily life. EVIDENCE: The care folder for each person includes a preference sheet. Service users said that routines in the home are flexible and they are able to make choices in daily living, for example times of getting up and going to bed, and where to spend their time. Staff members were observed to knock on the door and await permission before entering a bedroom. One service user had put a note on their bedroom door requesting not to be disturbed during the night. Care staff provide social stimulation, but the acting manager said that she is hoping to recruit people on work placement to provide more activities for service users. Service users can also join in activities taking place in the day centre. There are regular visits by a hairdresser and by local church groups. One room was recently fitted out as a sensory relaxation room that service users can use freely or with staff. A sensory garden has been developed in the grounds. Curzon House Curzon House 517976.doc Version 5.2 Page 13 Friends and relatives can visit at any time in the lounges or in the privacy of the service user’s room. There are kitchen facilities where service users and their visitors can make a drink. All of the service users spoken with were very happy with their meals. There is plenty of choice and meal-times are flexible. Service users can take their meals in the dining areas or in their own room. The people spoken with made many positive comments during the inspection including comments about the staff, the quality of food and the hygiene standards. Curzon House Curzon House 517976.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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The local authority provides robust policies and procedures to ensure that service users are protected. EVIDENCE: Service users have a copy of the Cheshire County Council complaint procedure leaflet in their information pack. Good records were available regarding a complaint that was currently being investigated, however records of other complaints had been archived in service users’ records. The manager should keep a summary record of all complaints received and the action taken. The home has policies and procedures provided by the local authority that comply with the Public Disclosure Act 1998 and the Department of Health Guidance ‘No Secrets’. Staff training records showed that all staff have received training about safeguarding vulnerable people. Curzon House Curzon House 517976.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): Standards 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users environment. EVIDENCE: The home is maintained to a good standard both externally and internally. The bedrooms seen during the inspection were comfortable and well furnished and all have an en-suite toilet and hand-basin. Bedrooms on the first floor have been redecorated recently. There is plenty of day space on the ground floor, with a choice of sitting areas and room for people to walk around. Communal space is more restricted on the first floor and there is only one quite small lounge. enjoy a comfortable, safe, clean, and well-maintained Curzon House Curzon House 517976.doc Version 5.2 Page 16 There is a secure entry and exit system to the units that requires a swipe card to gain access. The gardens have been landscaped and provide very pleasant outdoor areas for service users to walk in or sit in, or just to look out on. The home has the services of a maintenance person two days a week. Curzon House Curzon House 517976.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): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Enough qualified and experienced staff are provided to ensure that the needs of service users can be met. EVIDENCE: The staff team includes a manager, a care coordinator, nine senior community support workers and 35 community support workers. There is a senior support worker on duty at all times with four support workers between 7:45am and 10:15pm, and two at night. One of the senior support workers takes responsibility for training, medicines management, booking staff holidays and other support tasks. All seniors have NVQ level 3. There are two domestic staff on duty each day and two people working in the kitchen. At present there is a vacancy for a laundry assistant. There are also four administration staff. Of the 43 care staff, 31 have a national vocational qualification in care and two others are working towards a qualification. The acting manager said that all staff have the opportunity to do NVQ after they have been employed for a year and have a permanent contract. Curzon House Curzon House 517976.doc Version 5.2 Page 18 Two new staff had been recruited and were currently working in a relief capacity. Good recruitment records were available which showed that procedures had been followed to ensure that these people were safe and suitable to work with vulnerable service users. New staff complete an induction process with the local authority. They have an induction work book that is completed during the first twelve weeks. New staff cannot work in the home until they have completed safe moving and handling training. There is a ‘learning zone’ facility within the home and e-learning with ‘social care information and learning services’ (scils) is being promoted. A trainer is based at the home and there are lots of learning resources available for the staff. Two comments cards received from staff were very positive about their employment at Curzon House. The staff considered that they receive a lot of training and take pride in providing a good service. At present the home does not keep a training matrix to show what training all staff have received and this makes it difficult to track which staff are due for updates. There were no moving and handling updates during 2007. All staff had received fire safety training recently. Curzon House Curzon House 517976.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): Standards 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed to ensure that people receive a consistently good service when they stay at Curzon House. EVIDENCE: The registered manager is currently on a secondment and is due to return to Curzon House in April 2008. The care coordinator has been acting manager for the home in the absence of the registered manager and one of the senior support workers has been working as care coordinator. They have both been employed at Curzon House for several years and the acting manager is working to achieve NVQ level 4. Curzon House Curzon House 517976.doc Version 5.2 Page 20 Service users and their families are encouraged to give their views about the service provided and the service user guide in each bedroom contains comments slips for people to fill in after their visit. This system appeared to be popular with service users and many very positive comments had been made together with a small number of negative comments. The locality manager, who is the registered person for the home, visits monthly and completes a detailed report that is sent to the Commission for Social Care Inspection. There are also regular visits from County Councillors. There is a monthly staff meeting and these meetings are minuted. The minutes of recent meetings showed that staff are able to put forward their views. Information provided by the manager in the annual quality assurance assessment, and records held on site, showed that required maintenance and health and safety checks of the building and equipment were completed. A maintenance file is kept in the reception area and this records all visits by contractors. A weekly fire alarm test is carried out and good fire records are kept. Satisfactory arrangements are in place for service users to be able to bring small amounts of personal spending money into the home with them. Curzon House Curzon House 517976.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X X X 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 X 3 Curzon House Curzon House 517976.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP16 Regulation 22(8) Requirement Keep a summary of complaints received and action taken in response. Timescale for action any 01/03/08 the RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP30 OP30 Good Practice Recommendations Ensure that all staff have regular refresher training about how to move and handle service users safely. Keep a summary record of all staff training so that the manager can identify which members of staff require training updates. Curzon House Curzon House 517976.doc Version 5.2 Page 23 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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 Curzon House Curzon House 517976.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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