Care Home: Edward House

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What the care home does well The home is well run and benefits from a low turn over of staff. Both the manager and deputy manager are very experienced, competent and approachable. Residents gave very positive feedback and said this was a good home. One lady said she was very lucky to live there. The home itself is well maintained and there are robust systems in place to ensure the residents are kept safe and their health and safety protected. What has improved since the last inspection? The home continues to maintain high and professional standards. Staff training remain a priority and the manager is involved on a dementia steering group. The home has invested lots of money on a new intercom system. They have also invested in a computer programme which enables staff to keep residents records electronically. What the care home could do better: Nothing was identified at the time of this inspection other than some of the paper records were out of date, but the information had been updated electronically. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Edward House Albion Row Cambridge CB3 0BH     The quality rating for this care home is:   three star excellent service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Shirley Christopher     Date: 2 2 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Edward House Albion Row Cambridge CB3 0BH 01223316776 01223368613 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Joy Wood Type of registration: Number of places registered: Edward Storey Foundation care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: No service users with Dementia to be admitted to the home. DE(E) to cover service users whose needs have changed. Date of last inspection Brief description of the care home Edward House is a care home proving personal care and accommodation for sixteen older people and up to four people already in the home with dementia. It is run by The Edward Storey Foundation, a registered almshouse charity, and only provides services to women. One of the registered beds is only used for short-term respite care. The home is purpose-built building, on two floors, accessible by stairs or a passenger lift. The home is physically linked to Storeys House, which provides sheltered accommodation. A number of people living at Storeys House visit the home for meals and support during the day; however the home is self-contained and has a separate entrance. The home is within walking distance of Cambridge city centre and local amenities. Despite being on a busy one-way road system the home is peaceful and has Care Homes for Older People Page 4 of 24 Over 65 4 16 0 0 Brief description of the care home access to a patio area and the gardens of Storeys House. All service user bedrooms are for single occupancy and all but one have en-suite facilities. The fees for the service are 485.00 a week. Residents are issued with a service user guide and the statement of purpose and last inspection report are available on request. Care Homes for Older People Page 5 of 24 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: three star excellent 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, the Commission for social care inspection carried out an unannounced inspection to the home on the 22 December and were there for approximately six hours. We looked round the home, spoke with the manager, some staff, residents, the activities coordinator a visitor and a trustee. We joined residents for lunch and observed care staff as they went about their duties. We case tracked three residents looking at their files, including finances, medication and care plans. We spoke either to the resident or their relative. We looked at three staff files and some other records including maintenance records, complaints log and quality assurance records. We requested the manager complete an annual quality assurance assessment, which she did in great detail. This was returned to our office prior to the inspection. We also Care Homes for Older People Page 6 of 24 looked at any information we hold about the home including information from the last review of the service, the last inspection report and surveys. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 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 24 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. The home have a good admissions policy and ensure prospective residents needs are assessed before they move into the home. Residents can be assured that the home are able to meet their needs. Evidence: The manager confirmed the statement of purpose and service user guide had been updated in terms of the structure of the organisation ,but no other changes had been made. We requested these documents were updated as per regulation. We case tracked three people and saw evidence that the home assess people prior to admission and the information obtained is satisfactory. Pre admission assessments are completed in consultation and with the involvement of residents, their families and other professionals. Residents and their families are encouraged to spend time in the home before admission and any new admission is subject to a trial period. Care Homes for Older People Page 10 of 24 Evidence: The Storey foundation own 41 flats which are for older people living independently and Edward house which joins on to the independent living accommodation provides residential care and can provide emergency respite care. Some residents may move from the independent flats into residential care when they require more support. They are therefore already familiar with the home. The kitchen in Edward house provides a meal for residents in the independent living accommodation if they request it. The home has an established and experienced staff team and have bank staff. The use of agency staff is kept to a minimum. Staff know residents well and have the necessary experience and expertise to meet residents needs. This was evidenced through staff records, information provided by the manager and through observations of care practises. Care Homes for Older People Page 11 of 24 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 health and personal care needs are met by the home, and there is a clear record of this. Evidence: We case tracked three residents which included a new admission, someone with low support needs and someone with high support needs. We were able to talk to a relative of one of the residents we case tracked and we spoke to a number of residents about the help and support they received. We observed care staff as they supported residents with their activities of daily living. The care plans are in a simple format but provide essential information. They were considered adequate for residents with low support needs but we felt a little more detail may be appropriate for residents requiring more support, to ensure all staff are meeting residents needs. For example one resident was said to like to get up early, but no time was specified. On a second care plan it stated the person needed assistance with bathing but did not state what. The home could simply add, the person is able to tell you what support they require. The residents spoken to felt that care staff understood and met their needs. Care plans Care Homes for Older People Page 12 of 24 Evidence: covered all areas of daily living and addressed social and physical needs. The home has invested in a computer system which is password protected. All care staff have received training and are required to complete all residents daily notes electronically. The system also includes a history of care plan reviews completed monthly and medical records. The system was comprehensive and it was easy to see how residents needs were being met or had changed. The manager was asked how the home could evidence that residents are involved in the monthly review of the care plan, because records seen were completed electronically by staff. Hard copies of records were not completely up to date and reviews had not been signed by residents. We spoke to a number of residents who were satisfied their needs were being met and said they were aware that there was a care plan in place. Evidence was seen of how residents religious, ethnic and cultural needs are being met. These are recorded and the home celebrate religious dates and gives regular opportunity for religious worship. We saw evidence from residents health care records that their needs are being met and recorded appropriately. The home use appropriate screening tools to identify residents who may be at nutritional risk and weights are recorded monthly. Specialist and general health care services are accessed as required.The home use screening forms to assess residents risk of developing pressure sores and take appropriate intervention when required. No resident has currently got a pressure sore. The home provides a number of activities which includes a physical activity class. Risks to residents health and safety were monitored and accident records were seen. This included a record of near misses.Resident falls are monitored and staff have had training but this was some time ago. Referrals are made to Brookfield clinic where appropriate. Medication was checked in relation to the residents who were case tracked. Records were accurate and medication was appropriately stored. One resident had been assessed as being able to take their own medication and this was appropriately recorded. Staff receive training in the safe handling and administration of medication run by the local authority. The manager carries out spot checks on medication and carries out regular audits. The manager said Boots do provide a medication audit service. Care Homes for Older People Page 13 of 24 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 can expect to have their social needs met and have the freedom and support to access community facilties. Evidence: Routines in the home are flexible and staff meet residents needs according to their wishes. These are recorded in their care plan. The home employs an activities coordinator 20 hours a week and she was spoken to. She provides a range of activities both suited to individuals and small groups of residents. She evaluates activities to ensure that they are appropriate. She also facilitates and has a budget for bringing in outside entertainers. She is involved in residents meetings which are held regularly and are well attended. Lunch time was observed and was managed well by staff who were polite and attentive. Food was well presented and served up to residents according to their wishes. The dining room was arranged so that residents sat at tables of no more than four. Staff also joined residents in having a meal once each resident had been served. Choices were offered and dietary requirements met. We were invited to have a meal and the food was hot and nutritious. A cold drink was served with the meal and tea or Care Homes for Older People Page 14 of 24 Evidence: coffee followed. Snacks are available through the day and their is a selection of fresh fruit and home made cakes served at tea time. Meals can be served in residents rooms, but residents are encouraged to eat in the communal dining room. Residents were spoken to about life at the home and most expressed their satisfaction and made positive comments particularly about the staff, but also about the flexible routines, good food, entertainment and the environment. The home has an accessible garden which is secure. Care Homes for Older People Page 15 of 24 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. The home has robust systems in place to protect residents. Evidence: The home had a well written, accessible complaints procedure. They have not received any complaints since the last inspection and we have not been made aware of any concerns about the service. The manager confirmed that she records all concerns no matter how small and issues are usually followed up immediately. Actions are recorded. The home has an accessible adult protection policy which all staff are made familar with. All staff have received training in adult protection as provided by the local authority. The manager stated a seniour member of staff had been nominated to complete the train the trainer in adult protection and become the protection of vunerable adults (POVA) lead. Staff files demonstrated that the home has good systems in place for vetting and selecting staff, and ensuring residents are protected from unsuitable staff. Care Homes for Older People Page 16 of 24 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. The home is fit for purpose and residents live in a safe, well maintained environment. Evidence: The home has a designated person responsible for the maintenance of the building. He is also responsible for its refurbishment and the upkeep of servicing records. A sample of records were inspected including portable appliance testing, hot water records, fire records and maintenance schedules. They were satisfactory. We walked round the home and found no obvious hazards to health and safety. The environment was well maintained and cleaned to a high standard. It was homely and accessible for the residents. A number of bedrooms were seen and it was noted that residents had appropriate equipment for personal use such as raised beds and specialist chairs. One resident who had recently moved to the home had brought with her a number of personal belongings. She did state she had no where to lock away any valuables and the manager said she would deal with this immediately. The call system has recently been updated and everyone observed had a call bell in easy reach and a means to summons staff help. Care Homes for Older People Page 17 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provide excellent support and training to its care staff. Residents can be confident that the staff have the neccessary skills and expertise to meet their needs. Evidence: The manager, deputy manager and a member of the senior staff were spoken to. The duty roster was inspected. We observed care staff as they went about their duties and spoke with them informally. We spoke to the activities coordinator about her role. We also look at a number of staff files. We were satisfied that the home was adequately staffed. On the day of inspection there were two care staff, the activites person and anxillary staff on duty. The manager and her deputy were also on duty. There is one night staff, but a person sleeps in and offers assistance where needed and there is an on call system. The manager confirmed that when she employs agency staff she asks for evidence that they are properly vetted and they receive a basic induction. There are a number of volunteers and they all have Criminal record checks. We looked at three staff files and found some information missing on the file but this was soon produced. The files should be audited to ensure a clear paper trail. We looked at three staff files and these provided evidence that care staff are properly vetted and recruited. Once employed staff are shadowed by more seniour staff and complete a twelve week foundation course in care. There are training and supervision matrixes which show staff are regularly and formally supported. Manatory training was up to Care Homes for Older People Page 18 of 24 Evidence: date and staff have regular team meetings. The manager likes to develop her staff and encourages them to take additional responsibilties. Three staff have completed a national vocational course both level 2 and 3 and a further 2 staff are doing level 3. Staff cover all the manatory training and also complete training in risk assessment and computer skills. Any specialst training is identified through supervision and provided where appropriate. Care Homes for Older People Page 19 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run and managed in the interest of residents. There is a robust internal quality assurance system in place to ensure high standards are maintained in the home. Evidence: The home is well managed and benefits from a stable management team. The registered manager has been in post for 19 years and the deputy manager for eight years. They both hold relevant qualifications in both care and management and have kept them selves professionally up to date. The manager has joined a steering group for dementia care. The home has a low staff turn over and staff are encouraged to reach their potential and take on additional responsibilities. Feedback from a relative and residents was excellent. All expressed how kind, caring and compassionate staff were and spoke of a good standard of care being provided. The home has its own internal quality system in place, which looks at what the home Care Homes for Older People Page 20 of 24 Evidence: does well and where improvements have been identified. The home actively seeks the views of care staff, residents, relatives and other stakeholders and where suggestions are made these are implemented if they are a benefit to the home. The manager does regular spot checks to ensure standards are being maintained. There are a board of trustees who complete a monthly internal audit of the home. Regular staff and residents meetings are held. We saw evidence that staff are properly vetted,and supported through robust employment procedures and good training, induction and supervision. The home was well maintained, warm and homely. There were up to date servicing and maintenance records. The records keeping was generally of a high standard and we audited a number of records relating to medication and personal finance. Some gaps in record keeping relating to staff and residents was because the home currently has two systems in place, a paper system and an electronic system. The latter was an excellent system which very quickly lets you see how a residents needs have changed. Care Homes for Older People Page 21 of 24 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 22 of 24 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 1 7 The home have two systems of recording information about residents needs, including a paper and an electronic method. The home should ensure there is a clear audit trail of information and records updated both manually and electronically whilst they still have two systems running. They should provide evidence that residents are consulted and involved in the review of the care plan. Care Homes for Older People Page 23 of 24 Helpline: 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 We want people to be able to access this information. 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