Care Home: Eothen

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What the care home does well When asked what the care home does well, one relative said: "Most things." "The home is very well run - the staff are very helpful - the atmosphere is not regimented." - stated another of the 20 responses from people living at the home. "The staff are very helpful and caring." - this a general impression carried within most of the surveys received. "I am happy to be at this home." - an important outcome from people living at Eothen - a view which was strongly backed up by relative`s survey responses as well: "Eothen is providing excellent care and has developed a trusting and good relationship with my [relative]." "Eothen tailors the level of service to the individual, encouraging [my relative] to do as much as they can for themselves, even though [their] physical and mental ability is changed." The premises are kept in an excellent state of cleanliness, repair and decoration. The building is ever being upgraded - and innovative projects ensure that the home - though in some areas a possible liability due to it`s age - is made as modern and accessible as it allows. The comments above speak strongly and positively of the care provided, and the input of staff from the point of assessment to full residency is viewed as a good experience. Health care, spiritual care and social care aspects are all well handled by staff, as are protection issues relating to safeguarding people from abuse in whatever form could manifest itself. Staff report positive experiences of support - both personal and professional from the management team and supervision and appraisals are in place, alongside notable quantities of training - which is really valued by the staff. The management has now settled well after a period of previous instability, and the senior managers of the organisation - and the home`s manager and senior staff merit comment for the strong leadership that has ensured that Eothen has moved into a new phase of its existence. What has improved since the last inspection? Employment practices have been tightened further since the last inspection is 2006 - the whole recruitment system is now scrupulous in its detail and concern for the best and safest practice. Fire drill frequencies have increased, in line with the requirement set at the last inspection. The new manager has been registered with the commission and has settled into the role, with a new, and experienced, Assistant Manager also in place. A universally accessible telephone system has been installed throughout the home. Water services in all rooms now provided fresh cold water directly off the mains supply. CARE HOMES FOR OLDER PEOPLE Eothen 31 Worcester Road Sutton Surrey SM2 6PT Lead Inspector David Pennells Unannounced Inspection 17th September 2008 10:10 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 Eothen DS0000007193.V370550.R01.S.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. Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eothen Address 31 Worcester Road Sutton Surrey SM2 6PT 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) 020 8642 2830 020 8643 7961 sutton@eothenhomes.co.uk www.eothenhomes.org.uk Eothen Homes Limited Susan Margaret Henderson Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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 The maximum number of service users who can be allocated is: 36 2. Date of last inspection 12th October 2006 Brief Description of the Service: Eothen is a residential home registered to provide care for 36 older people. The service is underpinned by a low-key, but positively declared, Christian ethos ‘Eothen’ (from the Greek) means ‘The Dawn’ and is referenced into Paul’s Epistle to the Romans (13:12). Fees per range from £595 to £645 inclusive. The home is ideally situated just to the south west of Sutton town centre, no more than half a mile from bus and train services and the main shopping, leisure and entertainments centre of the town. The building forms a quadrangle, with many rooms looking out onto an extremely well kept and attractive central garden (maintained to a high standard even in the winter), and which service users can easily access throughout the year. The front (northern side) of the property comprises a three-storey (older) building with accommodation provided on all three floors (served by passenger lift, but still leaving [for some rooms] some steps to negotiate). Towards the rear of the property is the newer south wing, with accommodation on the ground and first floors. There is ample communal space that includes small quiet lounges, a central lounge, a large (underused) lounge in the south wing, and two dining rooms. The home is very well maintained and, despite its size, maintains a smart - but warm and homely ambience. There are thirty-eight bedrooms, three of which are large enough to be used as double occupancy for couples, if wished. Two rooms are currently being refurbished. All care and laundry services are provided in-house; meals are prepared on site in a well-provided kitchen, but by a separately managed catering company. Eothen DS0000007193.V370550.R01.S.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 3 stars. This means the people who use this service experience excellent quality outcomes. The above rating is based on a full overview of all the standard sections, where the rating was no less than good and as a compound outcome, We visited the house unannounced and stayed for the day, including sharing lunch and observing the suppertime activities. The manager of the home, Mrs Sue Henderson, was present for most of the day, providing information and background to the service, but we also toured the home independently and met with and chatted with many people using the service and also meeting a number of relatives / friends who were visiting the home. Eothen in Sutton continues to provide a very good personal service to individuals resident at the home. Sue Henderson - the previous deputy, has now taken on the registered manager’s mantel entirely and is valued and appreciated by staff and service users alike. The home continues to run smoothly, and provides a quality service. The service had provided us with an Annual Quality Assurance Assessment the AQAA - that provides us with much up to date information about the home and also statistical information. The AQAA was well completed and gave us all the information we requested. We handed out 20 questionnaire surveys to people using the service (and 20 were returned - most completed by the individual personally), to relatives (11 were returned of 15) and to some staff (8 were returned of 10). The results of these questions, many with quality responses, are reported throughout this report. We are grateful to all the respondents to our surveys, for taking the time to complete the paperwork - giving us an ‘active’ idea of life at Eothen. Once again, the inspector reflects that these high levels of responses are exceptional - when compared to most homes - in their quantity, positive approbation and good opinion of the home’s service. We are also grateful to the people using the service at Eothen, to Sue Henderson, and to the staff at the home - for their interest, cooperation, welcome and hospitality during the inspection. Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Employment practices have been tightened further since the last inspection is 2006 - the whole recruitment system is now scrupulous in its detail and concern for the best and safest practice. Fire drill frequencies have increased, in line with the requirement set at the last inspection. The new manager has been registered with the commission and has settled into the role, with a new, and experienced, Assistant Manager also in place. Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 7 A universally accessible telephone system has been installed throughout the home. Water services in all rooms now provided fresh cold water directly off the mains supply. 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. Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 8 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 Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3, 5 & 6. 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. Service users can be confident that they will be furnished with adequate information – and opportunities to visit - to make an informed choice about moving into the home, this being accompanied by the home conducting an assessment which ensures that the home is suitable for them and able to meet the needs of the applicant. The process of admission to the home is also undertaken with care, thus minimising the trauma of moving into a ‘home’. The home does not provide intermediate (rehabilitative) care - and therefore Standard 6 does not apply. EVIDENCE: “The home provides an excellent professional service with skills and expertise it has made it a successful transition from family home to an environment where [my relative] can live safely and enjoy all the home comforts.” This report from a relative indicates the excellent work undertaken by the home - in Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 10 many varying elements - to ensure a smooth transition into the care home. Another relative acknowledged the “care and support provided in this difficult situation.” A brochure is available for the home, alongside the Statement of Purpose and Service User Guide, which is provided at the home; these documents are comprehensive and cover all areas required by Regulations 4 & 5 and the associated Schedule. The general introduction states clearly the bedroom sizes and states the policy on sharing double bedrooms (the home has 36 rooms, three of which may be shared by partners / relatives). Privately funded people living at the home account for 22 out of the 33 residents at the time of the inspection; the London Boroughs of Sutton, Croydon, Lewisham and Southwark have placed others at the home. Service users admitted to the home by local authority care management arrangements will have a care manager’s comprehensive assessment of need completed - a copy of which is obtained, kept on file and used to construct the subsequent care plan. Senior staff members assess other potential (‘selffunding’) residents and a three-page comprehensive proforma, relevant to the older person user group, is used. The home’s visit to the prospective service user also ensures that questions can be answered, and the potential newcomer is also considered in the light of compatibility with the existing service users. The assessor decides whether the home is able to provide appropriate care to prospective users; the home does not aim to offer care to people with dementia, and to this end, undertakes a modest assessment of users’ cognitive abilities. This visit also assesses whether a potential service users’ level of dependency might indicate a need more for nursing care – in which case a placement at Eothen would be inappropriate. Seventeen of the twenty people in the survey confirmed that they had received enough information about the home before they moved in - so they could decide if it was the right place for them. Almost all the people responding to the survey acknowledged receipt of their contract. Most prospective residents are invited to the home to have a meal, to meet their potential fellow residents and the staff, and to view the facilities including the room on offer for their occupation. If the offer of a place is accepted, they are admitted on a trial period (six weeks), whereafter a Placement Review will be held, involving Care Managers and relatives and / or ‘significant others’. Respite care periods are offered to people if a room becomes vacant and is not immediately required for long-term occupation. Fourteen periods have been offered as respite care in the past year - varying from 20 days in duration to 1. Standard 6 does not apply, as Intermediate Care is not provided. Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 11 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): 7 - 10. 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. Service users can be assured that their needs will be clearly set out in a care plan – this including identifying social, emotional and general health needs, the use of medication where appropriate, and all other health & care requirements. Service users can expect to be treated with the cordiality and respect expected of a home espousing the Christian religious ethos, to also receive elements of ‘pastoral care’ – and can be assured that their rights to privacy and dignity are respected and upheld. EVIDENCE: Care plans are well established for each service user, setting out the clear individual needs and goals of each service user. One relative stated; “Eothen is very professional and they are supportive to the needs of [my relative].” Another relative was unequivocal: “The care staff are all very professional and have the interests of the residents at the forefront of their everyday support to residents.” The greater majority of relatives confirmed that the home met the Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 12 different needs of their loved one, and also assisted them to keep in touch with their relatives. One resident stated: “I have the greatness admiration for the carers.” Another said: “the staff are very helpful and caring.” Universally, residents stated that they staff act on and listen to what they say and are always or usually available when the resident needs them. Staff confirmed that they ‘usually’ or ‘always’ had enough information about the care plan for the people they worked with. Three handovers are held every day to ensure the smooth transfer of information to the next shift of care workers, and to provide an opportunity for staff to engage formally with the management /senior on duty. Staff identified in the survey the importance of communication between staff, including the manager, to ensure the quality of service to the residents. Staff confirmed that there was good communication between professionals (such as GP, etc) coming into the home. Residents confirmed that they receive the medical support they need. The principal House GP holds a weekly ‘surgery’ at the home itself. The Chiropodist visits three-monthly and Opticians and Dentists are regular visitors every half-year, as well as service users being encouraged to engage with the local community resources nearby in the town, or to keep their own practitioners if this is possible. “When [my relative] was unwell, I consider the home went to extreme measures to help [my relative] I take my hat off to them.” All staff members involved in administering medication have received accredited training from the supplying / visiting pharmacist, Boots the Chemist (inspection visits - minimally annually - were also satisfactory). Medication records were checked during the inspection, and all were found to be in a satisfactory order. Storage is concise and accurate. Observation of staff members administering medication at mealtimes showed that both recording and administration was undertaken as a ‘single action’ - best practice. The general culture of the home was noted to be respectful and dignified though at the same time being relaxed and friendly. A relative reported: “My relative is always clean and smart - which adds to his sense of wellbeing.” Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 13 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): 12 - 15. 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. Service users can expect life to the home to be pleasant and enjoyable meeting their social, emotional and spiritual needs; the home can provide opportunities for them to engage with activities both inside and outside the home – to ensure that activity and social links are maintained. Families and friends of service users can expect to be welcomed at the home at any time. Service users can expect to be allowed to exercise control and choice over their lives within the context of concerned care at the home. Service users are certain of a nourishing and nutritious diet being provided at the home, served in pleasant surroundings, with a courteous service, though a greater choice and variety could be developed. EVIDENCE: “As my [relative] is a Christian, his spiritual needs are well provided for - with services midweek and on Sundays.” A retired staff member from Eothen has alongside a pastoral team - the responsibility for the ‘pastoral (spiritual) care’ of the service users at the home. She continues this very important element of ‘extra’ / ‘value added’ care for the service users. Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 14 Surveys showed that Eothen ‘always’ or ‘usually’ supported the people to live the life they chose. Residents are able to exercise choice and control over their lives this being apparent through the following facts: some service users continue to manage their own finances, holding cheque books and statements, etc., some self-medicate if assessed as safe to do so. Solicitors / care managers / friends or relatives are involved with each individual resident at the home. Information about advocacy services is also available in the home. Contact with relatives is a positive experience, generally; people spoken to and responding to the questionnaire all indicated a positive welcome and friendly attitude of staff. Regular Relatives / Residents meetings are held and minuted. With one exception, (where the family are frequent visitors) it was reported that staff do make contact with relatives when an issue of concern arises: “Staff always contact our family if they have any concerns regarding the care of our [relative, and deal very promptly if [the relative] is worried about anything.” Staff confirmed that they felt there was a very good rapport between the home, the staff and relatives / friends. One relative reported: “I am always made very welcome regardless of the time of the day.” Predominantly, the area mentioned in a significant number of questionnaires to the question ‘What could be improved?’ was activities. In balance, however, one relative stated: “I am extremely happy with the care my [relative] receives; they are mentally so much better since they have been there.” The need for more entertainment and stimulation was highlighted in a number of responses from relatives and residents. “More activities for those that want them.” - was one phrase used, showing that the focus needs to be quite personalised. One resident stated: “I don’t take part; I stay in my room - thus asserting their own choice.” Staff also reinforced the fact that residents are able to make their own choices. One relative thought there was “very little stimulation”. Another, whilst acknowledging the current “concerts and Church services”, suggested more quizzes, sing-alongs and reminiscence sessions should be provided. Residents mentioned quizzes as a popular activity that does take place. Community links have been increased with the Age Concern befriending service visiting the home on a weekly basis, with the growing links with local schools promoting intergenerational contact and through contact with the cinnamon Trust which promotes the engagement of people with pets. Mealtimes, interestingly, was a major area for comment from staff in their survey: the issue of providing a greater choice was raised - and a more frequent menu change. One suggested that “more traditional meals - such as spotted dick and rice pudding” should be offered, though a resident Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 15 commented: “One only has to ask for something to their taste, and nearly always gets it.” Residents reported: “Our chef can cook, but our diet is monotonous.” A significant number stated: “They do provide good quality food.” - “The meals are very good - I enjoy them.” - “The meals are well cooked and plentiful.” but there was a plea for wider choice in sweets: “The puddings are very poor fresh fruit is almost non-existent.” The inspector was able to talk to residents in the dining rooms over lunch; good humour, as ever, pervaded. In line with the Christian ethos of the home, ‘Grace’ was said by a staff member, and joined in collectively by all present. Staff commented that the number of people helping at mealtimes was only barely adequate; to respond to the needs of all 30 residents - including some who eat in their rooms is quite a challenge. A suggestion from one individual relative was that supper should be moved further back to 5.30pm / 6.00pm as they felt that the meals were too close together. This entire issue is left with the home to further review. Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 16 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): 16 & 18. 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. Service users can be confident that their comments and complaints will be taken seriously and fully investigated and resolved, through using the home’s own procedure and guidelines. The home ensures that service users are protected from physical, mental and financial abuse, through the adoption of clear procedures and by adherence to best practice in this area – the Adult Protection guidance provided at the home ensuring that staff follow the most up-to-date procedures if / when required. EVIDENCE: All twenty people living at the service stated that they knew how to make a complaint, and also knew how to express a concern if they were unhappy. Relatives confirmed that they were informed about the procedure - confirming this information was given at the beginning of a relative’s placement. Records of the nine complaints received in the past twelve months were very well recorded and documented, and all resolved satisfactorily. One relative reported: “On the very rare occasion we have had a concern, this has always been dealt with very sympathetically.” All staff stated they were confident in dealing with a situation of a service user / friend / advocate or a friend had concerns about practices in the home. Staff members have been trained in understanding and handling incidents of abuse. Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 17 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): 19 & 26. 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. Service users can expect to reside in a home that is kept clean and odour-free, that is well maintained, and provides well-furnished and well-decorated communal and private rooms, and excellent external areas. Service users can expect that the home will be generally equipped to meet their specific needs, and that their own bedroom will be furnished / decorated according to their taste, and to accommodate their own personal property. EVIDENCE: The above judgements again reflect previous inspection outcomes that found all the environment standards were ‘met’. We independently toured the building - and found all to be clean, tidy and in good repair. A relative commented: “The common areas and private rooms are clean, bright and provide a wonderful environment.” Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 18 Maintenance records confirmed that all ongoing attention is taken to ensure the safety and comfort of service users. All records were up to date and monitored / checked off. Staffing rotas indicated cleaning services provided throughout both the week and weekend - ensuring the highest possible standards of ongoing cleanliness. Staff commented that the home has excellent cleaners. “The environment is very well kept” - was another comment and: “The home is always spotlessly clean.” The laundry stands alone from the home in the back garden is also staffed seven days a week - ensuring that the designated laundry person can ‘keep on top’ of the throughput, and maintain the laundry environment at its very high standard of order and hygiene. The home is now fully supplied from mains supply cold water throughout all rooms and tap outlets in the house - this substantially reducing any Legionella risk (though this is still monitored). A new telephone system, with large number keypads, is now in place, being provided in all rooms - and enabling contact throughout the house - including staff being able to put calls through to individuals in the privacy of their own bedroom space. A previous recommendation that an induction loop be installed in at least one lounge to advantage those who use hearing aids is repeated herein again – as the number of hearing impaired service users remains reasonably significant – and such a facility would encourage the use of such aids in a positive way. It is understood that this facility may well be installed in the coming year. Two staff mentioned that the issues of ‘wheelchairs’ in the house - and the need to provide them in good order; this results in a recommendation to the home that wheelchairs are routinely maintained and serviced to ensure they are safe and fit for purpose. Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 19 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): 27 - 30. 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. People using the service, their families and friends can be confident that the home will provide a safe, caring environment at Eothen, through ensuring adequate numbers of competent and trained staff being available to provide the service, and by maintaining strict employment practices. Service users can be confident that their safety and security is maintained through the home conducting a rigorous recruitment process, with appropriate checks, references and records kept. EVIDENCE: A staff member reported; “I am very happy working at Eothen. We have a good team that gives each other support and help.” Relatives felt that staff members have the right skills and experience to look after the people at the home. Terms such as “professional” and “caring” were predominant in both relative’s and resident’s responses. Another commented: “The staff are very caring - and seem to have time for the residents.” The home maintains suitable staffing levels of 5 or 4 care staff - and a senior on duty during the day, and 3 on duty at nights. There is capacity to increase these levels if needed. An independent catering company provides catering services. Cleaning and laundry staffing levels ensure sufficient input across the working week - including weekends. Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 20 Staff confirmed that their employment checks - such as references and CRB checks were thorough and carried out before they started work for the home. A number of new staff had been appointed since the last inspection visit. Personnel files seen showed all necessary checks were in place in good time prior to the worker starting their induction period. About half of the staff team have been working at Eothen for at least the past five years, lending ‘permanence’ to the feel of the staff team. A relative stated: “The staff are, without exception, very kind, caring, pleasant people.” Staff confirmed that the induction process (which conforms to the Common Induction Standards of Skills for Care) was good - and covered most things they needed to know before they started work; one member of staff said: “Yes, everyone was very helpful as I had never done this type of work before. Very good training is given.” All staff confirmed that training is given which is relevant to their role, helps understanding of a person-centred care approach, and keeps them up-to-date with new ways of working. “We get lots of training to help us be better carers.” At present, eleven of the permanent care staff members (66 ) have an NVQ qualification to at least Level 2, thus meeting the commissions standard target minimum of 50 . NVQ in Care training continues. A significant number have a First Aid qualification and basic food safety certificates. All management, senior staff and most night staff have been trained in the home’s medication policy and procedures. Staff members confirmed that regular monthly meetings for supervision and appraisals take place, and one stated that they could speak with the manager / senior on a daily basis if necessary. Regular staff meetings are also held. Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 21 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): 31, 32, 33 35, 36 & 38. 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. Service users and their advocates can be assured that the home will be managed and supervised in the best possible way. Service users can be assured that the home will be run, and assessed, against the criteria of their best interests and taking into account their opinions. Best practice with regard to finances can be expected, through the home operating concise and accurate financial procedures. The health and safety of both service users and staff can broadly be relied on, though attention to staging more fire drills must be increased. EVIDENCE: “Mrs Henderson is very supportive and helpful” - “The manager is always there and willing to listen.” - comments from staff, which is most encouraging. Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 22 Mrs Sue Henderson brings with her significant experience of working in a care home environment, having worked her way up the promotion ladder. Service users have expressed their pleasure at having a manager who knows the home from ‘bottom up’, and knows them as individuals and people in their own right. She has the NVQ at Level 4, and is finishing her Registered Manager’s Award. Sue Henderson is now formally the Registered Manager for the home. An experienced Assistant Home Manager - Teresa Schwartz - has also been recruited, bringing clear care expertise and knowledge to the service. The management’s capacity to undertake the guiding role for the home especially with the positive support from ‘Head Office’ - and the General Manager’s input in particular, is undoubted. Relatives commented: “Our experience so far (nearly a year): the management and staff do care.” Staff also backed up the generally good feeling at Eothen: “I enjoy working at Eothen and feel rewarded by residents who are happy and well cared for; I feel I am part of an excellent team.” The home employs a variety of audits to measure the quality of the service provided and user satisfaction. Among the spectrum is included management audits / surveys / meetings / associated staff supervision, training and appraisals. Survey audits are rigorous and seek to tease out details to improve and enhance the service. Relatives stated: “We haven’t seen much in the way of room for improvement.” Regulation 26 audit visits conducted by the proprietors are thoroughly carried out; the format is excellently concise. There are at least three styles of audit assessments: Resident-focused / medication-focused and premises-focused. There is an annual development plan available in the home including the ongoing schedule of proposed refurbishment / redecoration. Senior managers visit the home for two days a month from Head Office in Newcastle - and undertake audits of the quality of care, the premises, record keeping and meals and service user satisfaction. Residents’ finances held in safekeeping are well recorded / maintained with a clear audit trail available for all monies handled by the home. There is a safe within the home to which only designated senior staff members in the home have access. A limited amount of money is kept on site in safe keeping for individual users if they so wish, and transactions have to be signed by two people. Generally, the house is exemplary in ensuring the safest possible environment for both service users and staff. All maintenance and safety checks are confirmed by the home to be up-to-date - and we counterchecked these documents on our visit. Any remedial work is immediately undertaken when indicated by those professionals. Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 23 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 3 3 4 X 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 4 X 3 3 X 3 Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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. 3. 4. 5. Refer to Standard OP12 OP15 OP15 OP22 OP22 Good Practice Recommendations That a wider variety of activity / outings be provided to stimulate service users and to provide a broader spectrum of fulfilling opportunities. Staffing levels at mealtimes should be reviewed to ensure adequate cover to provide a quality time’ for residents. The issue of choice and menu variety should be reviewed. That an induction loop system be introduced to one or both of the main lounge areas thus enabling them to participate more fully in the social life of the home. Wheelchairs should be routinely checked and serviced to ensure they are fit for purpose and safe. Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Eothen DS0000007193.V370550.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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