Care Home: Four Seasons Care Centre

Similar services:

• Ashlea Mews Residential Home
• Eastwood
• West Lodge
• Arran House
• Avenue Community Nursing Home
• Cosin Lodge
• Farmborough Court
• Connolly House

What the care home does well The home carries out an assessment on each person admitted to the home to ensure that they are able to meet their needs. There are good systems in place to monitor people`s health and people said that they were well cared for by staff. Each person living at the home has a care plan which details the way in which their care needs should be met by staff working at the home. There is a comprehensive set of medication policies which provide clear guidance for staff handling medicines. There are good arrangements to assess people`s social needs and a variety of activities on offer. Visiting arrangements are good. There are clear systems for managing complaints and protection. The home has policies and procedures in place to support staff and all staff receive a range of different training to support them in their roles. What has improved since the last inspection? Staffing numbers remain under review and a number of new staff have been employed to ensure that the needs of people living at the home can be met. The home has a new manager who is in the process of applying to be registered with the care Quality Commission. What the care home could do better: The service users guide to the home should be updated to reflect the non smoking policy in place throughout the home. Assessments and care plans should be further developed to ensure that they include the fine detail in relation to how people`s needs are met. Although the dining experience is under review by management at the home, consideration should also be given for dignity issues for those people requiring support during mealtimes. The environment in the nursing unit would benefit from a programme of refurbishment/decoration and carpets should be replaced. An alternate door bell should be fitted to the residential unit. Further staff training should take place in safeguarding and first aid and all new staff should receive an induction. Quality assurance systems should be further developed to ensure that the views of service users, staff, relatives and other professionals are taken into account. All staff should receive a minimum of six supervision sessions each year. Key inspection report Care homes for older people Name: Address: Four Seasons Care Centre Ox Close Saltburn-by-Sea TS12 1NR     The quality rating for this care home is:   one star adequate 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: Tanya Newton     Date: 0 2 0 6 2 0 1 0 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 25 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Four Seasons Care Centre Ox Close Saltburn-by-Sea TS12 1NR 01287624516 01287624008 fs@keyhealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Key Healthcare (Operations) Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 53 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: Maximum Number of service users 53 The registered person may provide the following category of Service : Care home with nursing - Code N. To service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - Code DE maximum number of places 53, Mental Disorder - Code MD maximum number of places 53 Date of last inspection Brief description of the care home Four Seasons Care Centre has been operational as a Care Home since 1989. In April 2005, Key Healthcare Ltd became the Registered Provider. The home operates two separate units, 52 beds in total a 28 bedded nursing unit, primarily for older people with dementia, but also including up to 12 older people with a mental disorder, and a Care Homes for Older People Page 4 of 25 Over 65 0 0 53 12 Brief description of the care home 24 bedded residential unit for older people with dementia. All rooms are single rooms and the rooms within the residential unit also have en suite facilities. The home is situated on the outskirts of Saltburn, within close proximity of local shops, church and public transport. The sea is about one mile distant and can be seen from some parts of the home. The fee charged at Four Seasons Care Centre varies dependent on peoples individual circumstances. Care Homes for Older People Page 5 of 25 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: one star adequate 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: The quality rating for this service is a one star - adequate service. this means that people who use this service experience adequate quality outcomes. This unannounced inspection took place on the 2nd June 2010. Two inspectors from the Care Quality Commission (CQC) carried out the inspection. The site visit included included a tour of the building, a look at a sample of documents and records, which the home is required to keep and discussions with people living and working at the home. Comments from which have been included throughout the body of the report. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: The service users guide to the home should be updated to reflect the non smoking policy in place throughout the home. Assessments and care plans should be further developed to ensure that they include the fine detail in relation to how peoples needs are met. Although the dining experience is under review by management at the home, consideration should also be given for dignity issues for those people requiring support during mealtimes. The environment in the nursing unit would benefit from a programme of refurbishment/decoration and carpets should be replaced. An alternate door bell should be fitted to the residential unit. Further staff training should take place in safeguarding and first aid and all new staff should receive an induction. Quality assurance systems should be further developed to ensure that the views of service users, staff, relatives and other professionals are taken into account. All staff should receive a minimum of six supervision sessions each year. Care Homes for Older People Page 7 of 25 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 25 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 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given information about the service and in the main have their needs appropriately assessed prior to moving into the home. Evidence: We looked at the service users guide, this provides people with information about the home and tells people what is included in their fees. The service users guide needs updating to reflect that the home no longer has a smokers lounge. We looked at admission assessments. The home has a pre-admission pack which should be completed prior to someone being admitted to the home. Some of those viewed were not fully completed, others contained lots of detail. People who have been funded by the local authority had assessments which had been carried out by a care manager. These are then shared with the home. Care Homes for Older People Page 10 of 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are adequately recorded within individual care plans. Systems to monitor peoples health and to administer their medication are good. Evidence: Care plans were looked at. Care plans set out the way in which peoples individual health and personal care needs will be met by staff working at the home. Care plans were reviewed regularly to reflect any changes in need. Care plans include risk assessments to minimize risks to people living in the home. Some areas of the care plan would benefit from further development as they did not contain enough detail or had not been completed fully. Some of the areas in the assessment had not been transferred onto the care plan. One of care files looked at contained information in daily records about the persons behaviour, yet there was no care plan in place to demonstrate how that should be managed. Some care plans were very general and need to reflect more accurately the needs and the abilities of the individual. Others were well written and contained very detailed information. The home should encourage where possible people to be involved with the development of their care Care Homes for Older People Page 11 of 25 Evidence: plan and this should be evidenced. Some of the people living at the home commented on the care they received, their comments include, I get well looked after, have a bit of a laughand I seem to have been here forever, the staff do seem to care about you and if you need help you get it. One of the relatives said, I have no real concerns regarding the care of my relative. There was clear evidence within care plans that peoples health needs were being closely monitored with input being sought from other professionals where this was required. This included district nurses for residential clients, GPs and dietitians. Medication systems were looked at. There was a good comprehensive set of medication policies which if followed help staff work consistently and reduce the risk of medication errors. The home uses the monitored dosage system (MDS). In the main medication was appropriately ordered, administered and recorded. The temperature of the drugs fridge should be recorded daily and any items which are no longer required should be returned to the pharmacy. The cupboard used to store needles should be kept locked. We were told that although this cupboard had a lock it was not known where the key was. People living at the home in the main seem to be treated with dignity and respect. There was a good rapport between staff and those living at the home and people were spoken to in a caring and respectful manner. To ensure peoples dignity during mealtimes (particuarly those who require support), meals should only be served when a staff member is available to support the individual. This ensures that food is hot and not left in front of someone (as was observed during the inspection). Care Homes for Older People Page 12 of 25 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. People who use the service are able to choose their lifestyle, social activity and keep in contact with family and friends. The dining experience is being reviewed to make it more Evidence: The home has a part time activities co-ordinator and has also just employed an additional co-ordinator. There are a range of activities on offer. One person showed me their memory box in their room, it contained lots of photos and personal items to remind them of their family and life prior to living at the home. They also had a my life booklet which contained detailed information about their social history, likes and dislikes. These are positive and reinforce individuality. Comments from people include, Theres not much going on, little or nothing, I do get visitors and Bit boring, not much going on, I like to knit, I havent been on any trips out. Activities include music, exercise, seed planting, baking, greenhouse activities, zoo lab and celebration of special days ie St patricks day. The additional activities co-ordinator means that more activities will be available. Visitors were seen coming in and out of the home during the inspection, there are no restrictions on visiting times, one of the visitors said, We visit the home daily, we can Care Homes for Older People Page 13 of 25 Evidence: come at any time. Lots of people spoken to during the day said that their family and friends visited. In the main people are supported to make decisions and choices about all aspects of their lives. Comments include, I can have a bath when I want to, Some restrictions on when you get up and go to bed. Comments about the food include, Nice food, plenty to drink, Get well fed, Food is OK, usually a choice. We observed the dining experience, one gentleman was at in a chair with his dinner on the floor. Another lady was sat with her dinner in front of her waiting for a staff member to come and provide assistance. The home should look at the delegation of staff during mealtimes or consider a staggered lunch time to enable those that need support with mealtimes to do so in a dignified way. We looked at menus examples were beef pie or lamb hotpot for lunch or spam fritters or sausage for tea. We asked how the home incorporates fresh fruit and vegetables into the menu planning. The area manager informed us that the dining experience was under review and that new menus were in the process of being devised. New menus will contain more fresh fruit and vegetables and more choice each mealtime. Care Homes for Older People Page 14 of 25 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. Any concerns or complaints are managed well by the home with policies, procedures and training in place to support staff. Evidence: The home has a complaints procedure. It requires minor updating to reflect the role of the local authority in investigating any complaints and the move move from registration and inspection to the Care Quality Commission (CQC). People spoken to during the inspection said that they had no concerns or complaints but feel confident in raising any issues if they arose. Comments from people include, I could tell someone if I had any concerns and I have no concerns or issues, I could talk to someone at the home if I did. The home had received five complaints, clear records of all complaints are maintained and any action taken by the home in response is recorded. The home has policies and procedures in place to help protect people from abuse. Staff had received training in safeguarding vulnerable adults. The safeguarding adults procedure needs updating as it was the November 2005 addition and makes reference to contacting the registration and inspection authority and not CQC. It does not reflect the role of the local authority in investigating any allegations of abuse. The home did have a copy of the Teeswide policy on safeguarding adults. All of the staff who were asked about whistle blowing (telling someone) and reporting Care Homes for Older People Page 15 of 25 Evidence: abuse said that they would do so if they saw or heard anything inappropriate. Care Homes for Older People Page 16 of 25 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 in need of some refurbishment as some areas looked worn and in need of some attention. Evidence: We carried out a tour of each of the units. The residential unit was bright and welcoming with lots of pictures and tactile objects displayed. It has a pleasant enclosed garden area with seating so that people can wander in and out. An alternative doorbell may need to be considered as it was unanswered during our visit. The unit has a communal lounge and a dining area which is upstairs although people can eat in their own rooms if they want to. The residential unit has en-suite facilities in all rooms. There are also a number of communal bathrooms, some of which have aids to support people with bathing. We looked around the nursing unit. A number of carpets were badly stained and would benefit from replacement. The skirting boards in front of the kitchen servery were filthy and the floor stained. The manager informed us that the kitchen was due for refurbishment at the end of the month. The nursing unit also has a large enclosed garden area which is pleasant for people to enjoy in the warmer weather. Care Homes for Older People Page 17 of 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment systems need to include two references for all staff employed and the home needs to ensure that induction and training of staff is up to date so that staff can appropriately meet the needs of the people living at the home. Evidence: Staff recruitment files were looked at, of the five files examined, All contained an application form, and a CRB (police check). Two of the five files examined only had one reference in place. The manager confirmed after the inspection that two references had been obtained for all staff. Not all of the files viewed had a record of induction and there were some gaps in the training records viewed. We looked at staffing numbers at the home and comments from staff include, staffing levels are better now, I have done my mandatory training, staffing levels are better now then they have been although we would still benefit from some more. A relative said, Generally its better now than it was, staff are now more visible, they always have been kind. There has been a high turnover in staff and the home has recently recruited a number of new staff. This includes a manager, a deputy manager, night nurse, carers and an administrator. We were told that staffing levels ran at one nurses and four carers for the twenty eight nursing beds and one senior and three carers for the twenty four Care Homes for Older People Page 18 of 25 Evidence: residential beds. The manager is on duty in addition to this. Although the home has relied heavily on agency staff over recent months it is hoped that now new staff have been employed this can be reduced. Training files were looked at, a number of those seen were not up to date with all of the required mandatory training. the area manager acknowledged that there had been issues with staff training and that this would be addressed. Care Homes for Older People Page 19 of 25 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. The home has a manger who although is not registered with CQC has demonstrated that in the main the home is being run in the best interests of the people living there. Evidence: The home has a new manager who has just commenced employment at the home, she is applying to be registered with the Care Quality Commission. Comments from staff include, new manager seems nice, has been a lot of changes over the last year. It seems to be getting more stable. We looked at quality assurance systems, meetings take place to seek the views of staff, relatives and people living at the home. Regulation 26 visits are also carried out by the provider. Systems to seek the views of those living at the home, relatives and other professionals should be further developed. Although there are a number of systems to carry out quality audits at the home, at present these are not being used. We looked at systems for managing peoples money. Each person has an individual Care Homes for Older People Page 20 of 25 Evidence: personal allowance sheet which details any expenditure. a monthly breakdown is sent out to relatives. There is a pooled ledger balance but individual records are held for each person. We looked at a range of health and safety records. The electrical wiring and gas safety certificates viewed were up to date. Although there are a number of audit tools in place, some of these were not up to date and had not been completed since 2008. We looked at supervision records, the majority of those viewed were not up to date. The manager and area manager acknowledged that these needed to be completed for all staff. Care Homes for Older People Page 21 of 25 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 25 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 1 30 18 The owner must ensure that 30/07/2010 at all times suitably qualified and experienced staff are on duty. Training must include induction and safeguarding. Staff need to be kept up to date with training to ensure that they can meet peoples needs. 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 2 1 3 The service users guide should be updated to reflect the non smoking policy within the home. Each person admitted to the home should have a full assessment carried out prior to being admitted, to ensure that the home is able to meet their needs. Care plans should be be further developed and where possible people should be involved in developing their plan of care. 3 7 Care Homes for Older People Page 23 of 25 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 4 9 The temperature of the drug fridge should be recorded daily. Items that are no longer required should be returned to the pharmacy. The dining experience should be reviewed to ensure that all people are supported in a dignified manner during mealtimes. The dining experience should take into accont the support required for individuals. The complaints procedure should be updated to reflect the move from CSCI to CQC. it should also reflect the local authority role in investigating complaints. The safeguarding adults procedure should be updated to reflect the role of the local authority and the change to CQC. Carpets in the nursing unit which are badly stained should be replaced. The planned programme of refurbishment should take place. Systems to monitor quality at the home should be further developed. All staff should receive a minimum of six supervision sessions each year. 5 10 6 7 15 16 8 18 9 19 10 11 33 36 Care Homes for Older People Page 24 of 25 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!