Care Home: Eastwood

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What the care home does well The service carries out good assessments of the needs of the people who use it, and quickly draw up care plans to meet those needs. The service takes great care over service users` medications, records them well, and regularly checks the stocks. Feedback from service users and others is encouraged and responded to properly and promptly. Staff know how to respond to complaints or concerns. Surveys show a good level of satisfaction with the service. Fire and accident log books are kept up to date. What the care home could do better: Some care plans need to be more individualised and more detailed, especially regarding health needs. They also need to be better laid out. People admitted for Intermediate Care are not always getting a prompt or consistent service from the multi-disciplinary health team. Complaints and safeguarding documentation needs to kept available for inspection. All staff need to have safeguarding training, and other training required by law. Staff need to practice evacuation drills. Random inspection report Care homes for older people Name: Address: Eastwood The Drive Felling Gateshead Tyne and Wear NE10 0PY three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Alan Baxter Date: 2 5 0 5 2 0 1 0 Information about the care home Name of care home: Address: Eastwood The Drive Felling Gateshead Tyne and Wear NE10 0PY 01914336464 01914336465 eastwood@gateshead.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Gateshead Council Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 26 Number of places (if applicable): Under 65 Over 65 0 0 26 0 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Conditions of registration: 15 2 0 6 The maximum number of service users who can be accommodated is: 26 The registered person may provide the following category of service only: Care Home only Code 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, Code OP - maximum number of places 26 Dementia Code DE, maximum number of places 15 Physical Disability, Code PD, maximum Care Homes for Older People Page 2 of 11 number of places 6 Mental Disorder, excluding learning disability or dementia, Code MD maximum number of places 2 Date of last inspection Brief description of the care home Eastwood is a Local Authority run home that can provide short stay respite and rehabilitation for 25 older people. The home cannot provide nursing care. The home is a large purpose built establishment situated between Sunderland Road and The Drive in the Heworth area of Gateshead, close to main roads, the Metro interchange and bus routes. The grounds are extensive with many grassed areas and two car parks, one at the front of the home and the other to the rear. The front of the home has a paved sitting area and it has level access and is easy for service users to reach. All bedrooms are single and include en-suite facilities. Each bedroom has satellite television and a telephone for personal use. There are three assessment kitchens and a large number of lounges and small sitting areas throughout the home. The home is easy to get around and there is a lift to take service users to and from the first floor. All the necessary facilities are provided including an emergency call system and bathrooms that are suitable for frail or disabled people. The weekly fees are GBP76.85 to GBP878.85 per week depending upon care needs. Additional charges are made for personal items, toiletries, newspapers and magazines Care Homes for Older People Page 3 of 11 What we found: This was a Random unannounced inspection of this service. The service was last inspected on 11/05/2007, when it was rated an Excellent service. Since then, we have carried out two Annual Service Reviews, on 26/06/2008 and 29/07/2009. These reviews produced no evidence that the service had slipped below its Excellent rating, nor were any areas of concern uncovered. The focus of this inspection was on those key areas felt most important to the people living there, particularly health and personal care, complaints and protection, and the management of the service. During this inspection, we talked to the manager and staff, a line manager, and a small number of service users. We looked at care records and at other essential documentation to make a judgement about the quality of the care being offered. We observed some care practices. We told the manager what we found. Our findings were as follows: Eastwood ensures that it receives a full assessment of needs regarding any person referred to it for a service, as well as a care plan from the persons social worker. In addition, the home carries out out its own assessments of the persons needs, to make sure it can meet those needs. Elements of the assessment include nutritional needs, social history, skills and goals assessment, and a well-being profile. In order to meet those assessed needs, a range of care plans is drawn up. These include a 48/72 hour orientation care plan, to introduce a new service user to the home, and a night care plan. The quality of care plans was variable. Some good, detailed and informative care plans noted, well-personalised to the individual; others were less individualised and gave only rather general instructions to staff (for example, assist X to have shower as and when she wishes...). The layout of the care plans does not lend itself to appropriately detailed plans. Insufficient space is allocated to the Area of Promoting Independence, which is used as a heading, only (for example, Physical well-being), without specifying what the persons strengths, abilities and/or needs are. The latter then tend to get listed under the section Action to be taken by staff, leaving little space for the actual instructions to support workers. The Physical well-being care plans concentrate on the accessing of input from other health professionals, and do not address the particular health needs of the individual service user (for example, high blood pressure, epilepsy and diabetes), or their possible impact on the support workers work. Medications are well-recorded and safely stored. A weekly internal medication audit takes place, and an external audit is carried out by the homes supplying Pharmacist every six Care Homes for Older People Page 4 of 11 months. Each service user has a self-medication risk assessment undertaken to check if they can safely take responsibility for their own medicines. Problems were noted with service users who have been admitted for intermediate care but who were not being given the expected input from the CROP multi-disciplinary care team of occupational therapists, physiotherapists etc. This was stated to be due to shortages of the required health professionals. The home has a Complaints and Representations policy that positively encourages all feedback from service users and other relevant persons. A complaints log listed five complaints for the past year. One concerned staff allegedly smoking; three complained about care issues; and one was about poor television reception. However, no details were recorded on the file about the investigation of these allegations, their outcomes, or the degree of satisfaction (or otherwise) of the complainant. The details had, apparently, been archived and were not readily available for inspection. Compliments are also recorded. Five were noted over the past year, with comments such as, Staff are so friendly and so willing to do anything to help. The home keeps no central records of safeguarding issues. One safeguarding referral is known to have been made, as a response to a complaint received about care issues from a relative of a service user, but the records of this are held at Civic Centre, only, and were not available for inspection. The manager and senior staff team have recently been given general safeguarding training, and will be going on to do further training, specific to Gateshead Councils safeguarding policy and procedures. Support workers have not had safeguarding training to date, although this training will be given to support workers from June this year onwards. In a survey, all seven staff who responded said that they knew what to do if someone has concerns about the home. The home has two large procedures manuals regarding quality assurance systems. No completed documentation was produced and no improvements to the service appeared to have resulted from these formal quality systems. However, the service conducts internal basic service user satisfaction surveys on a monthly basis. These are regularly collated by the manager, and there was clear evidence that remedial actions are taken, where necessary improvements are identified or suggested. Examples seen included improvements regarding social activities, t.v. reception, extra volunteers and better beds. Staff supervision records showed that support workers are not being given supervision at the required rate of a minimum of six sessions per year. This was stated to be due to senior staff shortages. Mandatory staff training is not being given at the required frequencies. Even allowing for some possible under-recording of training given, there were significant gaps in the staff training in areas including moving and handling; emergency aid; health and safety; and food safety. The fire log is being kept up to date, with the required checks and tests of fire safety equipment and systems being recorded at the appropriate frequencies. A building fire risk assessment is in place, dated December 2008. This should be updated annually. It was advised that partial evacuations should be regularly carried out, based on the individual Care Homes for Older People Page 5 of 11 evacuation assessment forms for service users. Accident records are kept, with different systems in place to record those accidents resulting in some injury, and those (near misses) that dont. A requirement was made at the last inspection, in 2007, regarding the need for the automatic main doors to be adjusted so that everyone in the home can leave the building freely. No action has been taken regarding this requirement. Visitors and service users are still prevented from freely going into and out of the home. No evidence was offered of any individual assessments regarding deprivation of liberty, meaning that, effectively, every user of the service is having his or her liberty restricted. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 11 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, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Ensure that all service users have a detailed and individualised plan of care that includes their wishes and preferences as to how that care is to be delivered. This is to ensure that people are actively consulted as to their care. 30/06/2010 2 16 22 Keep full details of all 30/06/2010 complaints received, including records of investigations undertaken, outcomes, any actions taken, and the degree of satisfaction of the complainant. This is to ensure that there is a clear audit of the homes responses to any complaints. Keep full details of all 30/06/2010 allegations or suspicions of any issues of abuse or neglect , including actions taken and outcomes. This is to ensure that there is a clear audit of the homes Page 8 of 11 3 18 17 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 responses to any safeguarding issues. 4 30 18 All staff must receive training 30/09/2010 in all areas that are required by law, with refresher training arranged as necessary. This is to ensure that staff have the knowledge and skills to meet the needs of the service users. Care staff must receive 30/06/2010 formal supervision at least six times a year. This is to ensure that there is a regular forum for the staff member and the supervisor to discuss any care or other relevant issues. 5 36 18 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 The layout of the care plan document should be revised to allow sufficient space for a detailed description of the service users needs, strengths, abilities etc. Physical care plans should address the assessed health needs/conditions of the service user and the potential impact of those health needs/conditions on the service user and on the carers providing the care. The entrance door to the building should not restrict the independence of service users to freely come and go into Page 9 of 11 2 8 3 19 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations and out of the building. 4 5 33 38 Quality assurance systems should clearly demonstrate ongoing improvements to the service provided. The homes fire risk assessment should be reviewed at least every year, and revised as appropriate, to ensure the assessment remains accurate and relevant, and continues to protect service users, staff and visitors in the event of a fire. Staff should regularly practice/simulate the homes fire safety evacuation plan. 6 38 Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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