Care Home: Hope Cottage

What the care home does well This was not assessed on this occasion. What the care home could do better: Suitable numbers of qualified, competent and experienced care staff must be working at Hope Cottage at all times, to respond to the diverse care and support needs of the people living in the home. Care plans should be updated to include information on the skills and abilities each resident has. This will help staff to promote and maintain the independence and daily living skills of the people using the service. Risk assessments should clearly outline the control mechanisms to ensure staff have clear information on the action required to minimise / control risks. The health care needs of the people using the service should be closely monitored and issues of concern promptly referred to relevant health care professionals, to ensure the welfare of the people using the service is safeguarded. A system should be established to verify that the dependency needs of the people using the service and the resultant staffing levels in the home are appropriate for the needs of the people using the service. The staff allocation sheet should always detail the name of each staff responsible for undertaking specific non-care duties, to ensure staff do not multi-task and are available at all times to provide direct care and supervision for the people using the service. All staff should complete comprehensive training in dementia and an assessment of their skills and competency should be undertaken. This will help to ensure that the people using the service are supported by competent staff who fully understand the diverse needs of older people living with dementia. The edge of the treads on the outside steps should be highlighted, to make them visible for service users and a review of the health and safety procedures be undertaken. This will ensure the health and safety issues identified by the Environmental Protection Officer are addressed and improve safe working practices. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Hope Cottage 5-7 Pilkington Road Southport Merseyside PR8 6PD two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Daniel Hamilton Date: 2 6 0 1 2 0 0 9 Information about the care home Name of care home: Address: Hope Cottage 5-7 Pilkington Road Southport Merseyside PR8 6PD 01704536286 01704543222 hopecottage@cedarscaregroup.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Hope Cottage Limited care home 26 Number of places (if applicable): Under 65 Over 65 26 dementia Conditions of registration: 0 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: Dementia - Code DE. The maximum number of service users who can be accommodated is: 26. Date of last inspection Brief description of the care home Hope Cottage is a residential care home that provides care for older people with dementia. The home is Registered for 26 residents and is owned by Hope Cottage Ltd. The Responsible Person is Mr T Yilmaz. The home currently has an acting manager in day-to-day charge of the service. Hope Cottage is situated within a suburb of Southport and is within easy reach of the town centre [1 mile]. The home has been extended to include a conservatory and further bedrooms, bathrooms and toilets. The facilities are spread over 2 floors with a passenger lift serving the first floor. All communal space is on the ground floor and Care Homes for Older People Page 2 of 11 1 4 1 0 2 0 0 8 Brief description of the care home includes lounge, conservatory and dining room facilities. There is an enclosed garden to the rear of the building and parking space at the front. A ramp has been added to provide disabled access. 3 of the bedrooms can provide for residents to share. The fees at the time of the last inspection ranged between £415.00 - £510.00 per week. Care Homes for Older People Page 3 of 11 What we found: This random inspection was undertaken on 26th January 2009 and lasted approximately 3.5 hours. The purpose of the random inspection was to review progress and monitor compliance following a random inspection on 14th October 2008, during which some breaches in the Care Home Regulations 2001 were noted. The inspector from the Commission for Social Care Inspection was also accompanied by two officers from the Environmental Protection Department. Outcome area - Choice of Home. Two residents files were selected to view. Examination of records confirmed that a range of assessment information had been completed by the service for each resident, prior to being admitted to Hope Cottage as noted at the previous visit. A copy of an assessment had been obtained from a social worker for a resident referred via care care management arrangements. A range of risk assessments had also been completed for each resident covering a range of areas including: person-centred risks; pressure area / skin integrity; moving and handling and nutrition and falls. It was noted that some of the assessments used a tick box approach and there was limited information on the control mechanisms. This issue was brought to the attention of the acting manager and should be addressed, to ensure staff have clear information on the action that should be taken to minimise / control potential risks. Outcome area - Health and Personal Care. Two residents files were selected to view. Examination of records confirmed that a care plan had been developed for each resident as previously noted. Care plans outlined the assessed need; aim of care and key worker instructions and covered a range of areas including; safety, communication, breathing, nutrition, elimination, personal hygiene, body temperature, mobility, pain, mental health, social interests, sleeping, spiritual / cultural needs, final wishes, medication and any other significant information. Care plans viewed had been kept under monthly review and updated by the acting manager to ensure they contained more detailed information on how the needs of the people using the service were to be met. The acting manager was advised to include more background information on the diagnosis, level of comprehension and impact of dementia on the life of each resident. Furthermore, the acting manager was advised to clarify the skills and abilities each resident has in order to promote and maintain independence and daily living skills. Some gaps in supporting documentation were noted for one resident and this should be addressed to ensure all relevant information is available and carried forward from the assessment of need stage to the care planning process. Accident records had been completed to account for all incidents however the details of three falls for a resident had not been transferred to the service user falls risk Care Homes for Older People Page 4 of 11 assessment and care / action plan form. Concern was expressed regarding a resident who had fallen on ten occasions between the period 10/09/08 to 13/01/09 and the last recorded contact with a general practitioner was 1/09/2008. Outcome area - Environment. The area where an accident had occurred during September 2008 was inspected by officers from the Environmental Protection Department. Advice was given to re-paint the steps as the original paintwork was worn. Other issues were noted (please refer to the section entitled Management and Administration). Outcome area - Staffing. On the day the random inspection was undertaken there were 20 residents living in Hope Cottage and the acting manager, three care staff and 4 ancillary staff were on duty. Since the last visit a new laundry assistant had been employed to work 25 hours per week (Monday to Friday). The acting manager reported that the service continued to advertise for a weekend laundry assistant. Staff allocation sheets were reviewed to check the deployment of staff and to ensure there was adequate supervision and support for residents. Copies could not be located for 31/12/08, 3/01/09 or 4/01/09. Overall, the standard of recording had improved however some shortfalls were noted. For example, the records dated 24/01/09 and 25/01/09 did not adequately specify how staff were to be deployed as the forms detailed; All staff were responsible for laundry duties between the period 09.00 hrs to 13:00 hrs. There were only three care staff on duty on each day and additional cover had not been organised to cover laundry duties. This practice was not in accordance with written correspondence dated 17th October 2008, received from the responsible individual. Therefore, there was potential once again for all three staff to be engaged in non-care duties at the same time and to overlook the direct care and supervision needs of the people using the service. At the time of the visit the acting manager did not have a system in place to monitor the dependency needs of the people using the service and the staffing hours in the home. The acting manager agreed to refer to guidance produced by the Residential Forum and to keep the staffing levels in the home under regular review. The acting manager reported that funding had been agreed for a days training in dementia for all staff and that training dates would be agreed with a training provider in the near future. It was agreed that the acting manager would notify the Commission for Social Care Inspection of the dates of the training within the next four weeks. Management & Administration Health and safety practice and policies and procedures were reviewed by officers from the Environmental Protection Department. It was noted that documented systems in some areas did not reflect what was actually being carried out in the home. Advice was given regarding: window restriction policies and procedures; risk of scalding; accident reporting; legionella control and asbestos assessments and information, supervision Care Homes for Older People Page 5 of 11 and training for staff on health and safety matters. Progress in addressing these issues will be reviewed by the Environmental Protection Department in approximately six weeks. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 7 17 A record of all falls and treatment provided to service users must be maintained. This will help to provide information on the circumstances of the falls, injuries sustained and action taken. 17/12/2008 2 7 15 Care plans must describe in 17/12/2008 detail how the assessed needs of service users are to be met. This will help staff to understand how to deliver person-centred care and support in response to assessed needs. 3 27 18 Suitably qualified, competent 17/12/2008 and experienced persons must at all times be working at Hope Cottage in such numbers as are appropriate for the health and welfare of the people using the service. This will ensure that their are sufficient staff on duty to meet the diverse needs of the people living in the home. 4 27 12 Proper provision must be made for the care and supervision of service users 17/12/2008 Care Homes for Older People Page 7 of 11 at all times. This will safeguard the health and welfare of vulnerable people. Care Homes for Older People Page 8 of 11 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 27 18 Suitable numbers of qualified, competent and experienced care staff must be working at Hope Cottage at all times. This will enable staff to respond to the diverse care and support needs of the people living in the home. 03/03/2009 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 Care plans should be updated to include information on the skills and abilities each resident has. This will help staff to promote and maintain the independence and daily living skills of the people using the service. Risk assessments should clearly outline the control mechanisms. This will ensure staff have clear information on the action required to minimise / control risks. The health care needs of the people using the service should be closely monitored and issues of concern promptly referred to relevant health care professionals. This will ensure the welfare of the people using the service is safeguarded. The staff allocation sheet should be closely monitored to Page 9 of 11 2 7 3 8 4 27 Care Homes for Older People ensure it always details the name of each staff responsible for undertaking specific non-care duties. This will ensure staff do not multi-task and are available at all times to provide direct care and supervision to the people using the service. 5 27 A system should be established to verify that the dependency needs of the people using the service and the resultant staffing levels in the home are appropriate. This will help in workforce planning and ensure the needs of the people using the service are met. All staff should complete comprehensive training in dementia and an assessment of their skills and competency should be undertaken. This will help to ensure that the people using the service are supported by competent staff who fully understand the diverse needs of older people living with dementia. 6 30 Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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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