Care Home: Edgemont View

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What the care home does well Residents nursing and personal care needs are well met. Residents feel very well cared for at the home. Care plans show effectively how to care for residents and how to meet their needs. There are social and therapeutic activities put on for residents that they enjoy taking part in. Residents are well supported to make complaints if they need to. Residents are cared for by staff who do a good range of training to make sure they understand and meet their needs. The home is well run and there are good systems used to monitor the quality of care and service. The health and safety of people at the home is protected. What has improved since the last inspection? This is not applicable. What the care home could do better: Provide a more suitable carpet or flooring along the corridors. This will make the environment more homely and pleasing for the residents who live there. Key inspection report Care homes for older people Name: Address: Edgemont View 160 High Street Oldland Common Bristol Avon BS30 9TA     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: Juanita Glass     Date: 2 7 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 26 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 26 Information about the care home Name of care home: Address: Edgemont View 160 High Street Oldland Common Bristol Avon BS30 9TA Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Helen Elizabeth Hopson Type of registration: Number of places registered: care home 21 Edgemont View Ltd 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 who can be accommodated is 21. The registered person may provide the follwoing category of serivce only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Edgemont View is a privately owned home providing accommodation and nursing care for 21 service users. The proprietors also own another home, Edgemont House nearby and this provides residential care for older people. Edgemont View is located in Oldland Common and has shops, a public house and GPs surgery close by. The home is well served by local buses to Bristol and Bath. The premises were first registered Care Homes for Older People Page 4 of 26 Over 65 21 0 Brief description of the care home approximately 8 years ago when the building was extended to provide accommodation on 2 floors. There are 3 double rooms and 15 single rooms; one room has en-suite facilities. There is a large lounge and dining room with 2 adjacent conservatory areas. A small garden is maintained and provides a sitting area for residents. Current fees can be obtained on request. Care Homes for Older People Page 5 of 26 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: We met fourteen of the twenty one residents living at the home. Alistair Cannon one of our senior managers (whose job is the head of secretariat in the Commission ), was present for part of the inspection. We spoke to the registered manager, Mrs Hopson, three care assistants and a cook about the different roles they have, their responsibilities, training needs and what they do to help the residents. We saw staff help residents with their needs. We saw lunch being served. We saw a selection of records relating to the running and management of the home. The records we saw included a copy of the statement of purpose, the service user Care Homes for Older People Page 6 of 26 guide, medication records, information about social activities, menus, the complaints record, the homes safeguarding procedure, staff training information, three staff employment files, quality assurance information, three residents finance records and the fire log book. We read three residents care records and care plans. We saw most of the environment, the only parts we did not check were a small number of bedrooms. We found the home was operating within the required conditions of registration that we impose. The conditions of registration detail the type of care and the needs of residents and the numbers of residents who may stay at the home. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 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. Residents and significant others can get hold of a good level of information to make a choice about living at the home. Residents needs are properly assessed. The home does not provide intermediate care for residents. Evidence: To find out more about how people can find out what services there are at the home and what daily life is like, we looked at a copy of the service users guide and the statement of purpose. There is a copy of both of the documents kept in the entrance hall. This means anyone can read them. We saw in the statement of purpose and the service users guide useful information about the service residents can expect, the qualifications of the staff who will care for them and the accommodation provided. We read information about the philosophy of care in the home and how the service aim to Care Homes for Older People Page 10 of 26 Evidence: meet residents needs in both documents. A copy of the complaints procedure is in the service users guide so residents know how to complain about the service. We read two of the residents assessment records to see how well their nursing care needs are assessed. We found the assessment records were detailed and up to date. We read about the residents range of physical mental and social needs. We saw information about the actions taken to support the person in both assessment records. The assessment records we read had been reviewed and updated. Assessment records need to be regularly reviewed as this information forms the basis for planning the care and support residents receive. The home does not provide intermediate care. Care Homes for Older People Page 11 of 26 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. Residents needs are well met. Care plans and assessment records demonstrate effectively how residents are being supported. Residents health needs are met in the home. Residents are well treated by the staff who are respectful and polite to them. Evidence: We saw in residents care records a written health record, these records show when residents see a doctor, optician, dentist and chiropodist. They also record what treatment may be required. There was information in the daily records that demonstrated staff monitor and observe residents and call a doctor when needed. Residents are registered with local GP surgeries. This helps to shows how residents health care needs are met. Care Homes for Older People Page 12 of 26 Evidence: To find out how residents are being supported to meet their nursing needs we read two care plans. The care plans were informative and set out how to meet the care needs of the person. The care plans explained what actions staff must follow to assist the resident and included information showing how to support residents who have varying levels of needs. The staff were familiar with the content of care plans and knew what actions they must take to meet residents needs. Care plans had been reviewed and updated regularly. This demonstrates residents needs are being monitored and kept under review. We saw staff knocking on bedroom doors before entering them and assisting residents in a polite and respectful manner. This shows the staff respect privacy. We saw screens being used when staff were assisting residents to also protect their privacy. We were told by all of the residents and the visitors we met that they were very satisfied by the overall standard of care they receive. We met a visiting GP. who told us the care at the home was the best in the area. The GP. said they if they had to place a family member in a home, they would consider choosing Edgmount View. We looked in detail at the practices and procedures for giving residents medication and for the storage and disposal of it. We saw the registered nurse give residents their medication at lunchtime and we saw that this was done safely. We looked at six residents medication administration records in detail. We saw a photo of the resident kept with the chart to make sure medication is given out safely. The charts we saw were clearly written. We found medication stock was well organised. We saw a satisfactory system for ordering and receiving medication and the records were up to date. Medication stock is stored in a secure cupboard and in two movable metal drugs trolleys. The manager does medication audits to check medication is being dealt with safely in the home. Care Homes for Older People Page 13 of 26 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 are able to do social and recreational events and activities both in and out of the home. Residents are able to keep in touch with family, friends and significant others. Residents are able to exercise choice and control in their daily lives. Residents can enjoy a well cooked and well balanced diet. Evidence: The residents we met told us they could do a variety of activities in the home. The sort of activities that are planned for the near future include, a drive to Bristol zoo, games, musical afternoons and gardening sessions. A member of staff puts on a range of social activities for three afternoons a week, one session is aimed at taking residents out into the local community. We saw notices on display telling people about planned events soon to take place in the home. We also saw information in residents care plans about the different social and therapeutic activities that they had done. We saw some of the residents have visits from their family and friends during the Care Homes for Older People Page 14 of 26 Evidence: inspection. We were told by visitors that the staff are welcoming and friendly. The residents can have a lunch at the home with their visitors if they want to. This is a really good way to encourage people to keep in touch with each other. There is a relaxed and flexible visiting policy. This will benefit residents as this means they can keep in contact with family and friends and people who matter to them. We were told by residents that they are able to choose what time they get up and what time they go to bed. Residents said they are asked about their preferred choices of meals and their likes and dislikes. There are residents meetings held in the home. These are good ways for residents to exercise choices and have some autonomy in their daily lives. We looked in detail at the residents menu to see if residents are consistently provided with a well balanced diet. The meal options seen were nutritionally well balanced and varied. There are choices available each day and staff ask residents what they wish to eat each day. Special diets can be catered for and there are a variety of special meals provided for residents if required. We took the opportunity to sample lunch. The meal was corned beef hash with cooked vegetables and mashed potatoes or chicken curry and rice followed by choices of deserts. We found the meal tasty and well presented. All of the residents that we spoke to commented really positively to us, about the standard of the food served at the home. Care Homes for Older People Page 15 of 26 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. Peoples complaints will be dealt with properly. Residents are protected from the risk of abuse. Evidence: We saw copies of the complaints procedure in the reception area and in residents bedrooms. We saw that the procedure includes our contact details for anyone who needs to contact us. There was also information explaining how to contact the owners of the home if people wish to contact them directly to make a complaint. The residents we met told us they would make a complaint to Mrs Hopson or any of the staff. The residents said that staff take their complaints really seriously. This tells us the home welcomes and responds positively to complaints. There are regular residents meetings held and we saw recent minutes from the last meeting. The minutes showed that residents are encouraged to make their views and any concerns or complaints known to the manager and staff. We looked at the complaints record to see how well complaints are dealt with. There had been four complaints received since the last inspection. All of the complaints had related to day-to-day matters within the home and had been dealt with thoroughly. The staff team do regular training to ensure they are up to date in their understanding Care Homes for Older People Page 16 of 26 Evidence: of the principle of safeguarding residents from abuse. We also saw an up to date procedure that would be followed by the staff at the home if an allegation of abuse was made. Care Homes for Older People Page 17 of 26 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 live in a home that is clean and generally is satisfactorily maintained. Residents live in a home that is suitable for their needs and has the necessary adaptations and equipment in place. Evidence: Edgemount View is aproximately 12 years old in a residential area. It is a large house set in its own grounds in the village of Oldland Common in South Gloucestershire. The home is near to private houses, local shops, a bus stop and a pub. There are patio seats and an area where residents can sit and walk safely. There is a lounge and dining room. The residents that we saw sitting in this room looked comfortable and relaxed in their surroundings. The fixtures and fittings looked domestic and homely. However we noticed that the carpet on the corridors looks worn. We were told that the home are in the process of replacing it. This will benefit the residents as it will make this part of the home look more homely. The majority of bedrooms are single sized, there are three double rooms. The bedrooms are near to bathrooms and toilets. Bedrooms have been made to look more Care Homes for Older People Page 18 of 26 Evidence: personal and homely to reflect the tastes of residents. We saw photographs mementos and small items of furniture in residents bedrooms. We found the standard of furniture and fittings to be satisfactory. We found the home clean and tidy in all of the areas that we saw. We saw radiators are fitted with low surface temperature covers. Windows are restricted and this all helps to make the environment safer for the residents. Care Homes for Older People Page 19 of 26 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 are cared for by enough, well trained staff who are meeting their needs. Residents are protected by the homes employment practices and procedures. Evidence: We checked the number of staff to see if there is enough staff on duty to support residents. There is a minimum of one trained nurse and four care assistants in the morning, with one trained nurse and three care assistants on in the afternoon. At night there is one trained nurse and one care assistant on duty. There are additional staff members on duty on a regular basis to give extra support to residents both in and out of the home. Mrs Hopson works full time hours. There are full time catering, and domestic staff also employed. We did not fully review the numbers of these staff who are employed. The number of staff we saw on duty were meeting the needs of the residents in the home. We saw that staff on duty were warm and friendly when supporting the residents. Visitors we met told us that the staff have worked at the home for a number of years and they feel residents and staff have a really good rapport. The GP who we spoke to also commented that there is a very low turnover of staff and this is of real benefit for the residents. Care Homes for Older People Page 20 of 26 Evidence: We looked at the training records of three of the care staff so that we could see if they do a good range of training. We saw evidence that demonstrated the staff had done training sessions and updating over the last year. There are a high number of the care staff who have now done National Vocational Qualifications in care although this was not fully reviewed at the inspection. We checked the staff employment files of three care staff. We saw the necessary employment checks had been carried out for the permanent staff who work at the home. We saw confirmation of a POVA 1ST check, a Criminal Records Bureau check and written professional references for staff. Care Homes for Older People Page 21 of 26 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. Residents live in a home that is well run. There are good systems used to monitor the quality of the care and the service in the home. Residents money is properly looked after for them. The health and safety of people in the home is satisfactorily protected. Evidence: Mrs Helen Hopson is the registered manager. She has been the manager of the home since 2002. The residents and visitors we met said they see Mrs Hopson often and she is approachable. This demonstrates Mrs Hopson makes sure she is available for residents. Mrs Hopson was also observed spending time assisting and talking to residents. Care Homes for Older People Page 22 of 26 Evidence: The staff told us that staff meetings are held regularly. We looked at recent minutes, these demonstrated staff are consulted and their views listened to by the manager. We randomly checked three residents finances. The records and money we checked were up to date and in order. This helps demonstrates residents money is looked after safely. We saw the system used by Mrs Hopson for monitoring the quality of the care and the overall service. We looked at the residents survey forms that are used to audit the care and service in the home. We could see that the views of residents are obtained. We saw that Mrs Hopson acts on this information so that the home can improve further the standards in the home. The kitchen was clean and tidy and in good order. The kitchen staff do regular food hygiene training to ensure they have a good understanding of safe practises for preparing and cooking food. The home won a five out of five stars award in 2008 from the environmental health inspectors. This demonstrates that the home have very safe systems for handling food. The staff do regular health and safety training in a range of areas including food hygiene, fire safety and infection control. This helps ensure staff maintain a good understanding of health and safety principals and practises. We checked the fire logbook and we found that fire checks and drills are being carried out and done frequently. This helps to keep people safe as it shows that fire equipment is working and that people know what to do in the event of a fire. Care Homes for Older People Page 23 of 26 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 24 of 26 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 25 of 26 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 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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