Care Home: North Corner

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What the care home does well There is a relaxed and homely atmosphere in the Service. The people who use the Service say that members of staff are kind and attentive. They say that they receive the support and assistance they need and that this is in line with their expectations. People are served with good quality meals. There are various social events in which people can choose to take part. Relatives appreciate the way that they are informed about how things are going. Sensible arrangements are in place to promote the health and safety both of the people who use the Service and of the care workers. What has improved since the last inspection? Various ongoing repairs to the premises have been completed. A number of training courses have been provided for care workers. What the care home could do better: There are some omissions in one of the arrangements used to respond to the special health care needs of two of the people in residence. There are some defects in the accommodation that detract rather from the overall homely standard achieved. Aspects of the arrangements used to deliver ongoing training for care workers need to be strengthened further. The quality assurance system needs to be strengthened. Some of the records that should be in the Service are not to hand. CARE HOMES FOR OLDER PEOPLE North Corner 1 Prince Edwards Road Lewes East Sussex BN7 1BJ Lead Inspector Mark Hemmings Unannounced Inspection 22nd February 2008 09:00 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 North Corner DS0000055776.V357935.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. North Corner DS0000055776.V357935.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service North Corner Address 1 Prince Edwards Road Lewes East Sussex BN7 1BJ 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) 01273 474642 Mr Schoonraad Mrs Schoonraad Mrs Schoonraad Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places North Corner DS0000055776.V357935.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. That service users are aged sixty five (65) years or over on admission. That the number of service users accommodated must not exceed sixteen (16). 7th November 2006 Date of last inspection Brief Description of the Service: North Corner (the Service) is registered to provide accommodation and personal care for 16 older people. When full, there are three bedrooms that can be shared. In practice, only one bedroom is shared and so the total number of people accommodated is reduced to fourteen. Each bedroom has a private wash hand basin and one of them also has a private toilet and bath. The accommodation is arranged on the ground and the first floor. There is a stairlift that gives step-free access around the building. There are various things to help people who have difficulty getting about such as a hoist in one of the bathrooms. There is also a call bell system that is designed to make it easier for people to contact a member of staff if they need assistance. On the ground floor, there is a communal lounge and dining room. The premises are a detached two-storey building to which a single storey extension has been added. The property is located in a quite residential area and it is short walk to Lewes town centre. There is ready access to local public transport. There is pay and display on-street parking outside the Service. Mr and Mrs Schoonrad are the Registered Providers. This means that they are responsible for the proper administration of the Service. Mrs Schoonrad is also the Registered Manager. This means that she is responsible for the day to day running of the Service. People who might want to move in can get information from several sources. There is a Service Users’ Guide. This is a brochure that outlines the principal features of the facilities and services available in the Service. There is also a document called a Statement of Purpose. This gives a more detailed account of the provision in place than does the Guide. The Registered Provider ensures that a copy of the most recent Inspection Report from the Commission, is available for reference. The range of fees charged currently for each of the service users’ residence in North Corner runs from £360.00 to £550.00. This fee includes the provision of accommodation, personal care and catering. It does not include items such as North Corner DS0000055776.V357935.R01.S.doc Version 5.2 Page 5 the purchase of toiletries and services such as consultations with the hairstylist. North Corner DS0000055776.V357935.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this Service is Two (2) Star. This means that the people who use this Service experience good quality outcomes. The Commission since 1 April 2006, has developed the way it undertakes its inspection of care services. This inspection of the Service was an unannounced “Key Inspection”. The Inspector arrived at the Service at 09.00 and was in the Service for about six hours. It was a thorough look at how well the Service is doing. It took into account detailed information provided by the Registered Providers. Further, it considered any information that the Commission has received about the Service since the last inspection. The Inspector also spoke with five of the people in residence, with the Head of Care, with the chef and with one of the care workers. What the service does well: There is a relaxed and homely atmosphere in the Service. The people who use the Service say that members of staff are kind and attentive. They say that they receive the support and assistance they need and that this is in line with their expectations. People are served with good quality meals. There are various social events in which people can choose to take part. Relatives appreciate the way that they are informed about how things are going. Sensible arrangements are in place to promote the health and safety both of the people who use the Service and of the care workers. North Corner DS0000055776.V357935.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? 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. North Corner DS0000055776.V357935.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 North Corner DS0000055776.V357935.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): Standards 1, 3 and 6. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People who might want to move in can find out what it is like to live in the Service. Their needs and preferences are identified so that they can be met. EVIDENCE: People who might want to move into the Service can find out what it is like to live there. They can read the Service User’s Guide and the Statement of Purpose. The Registered Manager and the Head of Care are happy to answer any further questions about points of detail. If someone is interested in moving in, they will receive a written statement of the terms and conditions of their North Corner DS0000055776.V357935.R01.S.doc Version 5.2 Page 10 residency. This document explains the rights and responsibilities of the person once in residence. The Registered Manager and the Head of Care complete an assessment of each prospective person’s needs for assistance. This is done before a decision is made about whether or not the Service is a suitable place for the person’s residence. The assessment is completed in consultation with the person concerned. As appropriate, members of their family are involved. When applicable, care managers (social workers) are also asked to make a contribution. The Service is available for people who do not plan to make it their longer term home. This might be because they need somewhere to live while a carer attends to other commitments. Or it might be because they have been in hospital and are not quite ready to go back to their own home. The Registered Manager says that suitable steps will be taken to help with the person’s return home. This will be done so that the stay is not longer than is planned and is necessary. North Corner DS0000055776.V357935.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): Standards 7, 8, 9 and 10. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People are provided with the personal care and with the health care they need. EVIDENCE: The people in residence say that the care workers offer them all the assistance they need. There is a written individual plan of care for each person. These are important documents. This is because they form one of the means by which people can be informed about and can agree to the assistance they will receive. Also, the plans are a source of information for staff. This then helps them to provide support in a consistent manner. North Corner DS0000055776.V357935.R01.S.doc Version 5.2 Page 12 Sensible arrangements are in place to anticipate and manage potential risks to people’s personal health and safety. People are assisted to maintain their health. Care workers are alert to the need to identify occasions when someone is becoming unwell. This is so that medical assistance can be sought promptly. Two of the people have a particular health care need. More information about the assistance to be provided now needs to be included in their written individual plans of care. The Registered Manager is going to do this by 1 March 2008. Suitable arrangements are in place to enable people’s medication to be retained and to be dispensed in accordance with the doctors’ instructions. The people in residence praise the members of staff. They say that they are courteous and attentive. One person summarised the general mood when he observed that everyone is, “very kind and helpful”. North Corner DS0000055776.V357935.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): Standards 12, 13, 14 and 15. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. There is a calendar of social activities. People are free to spend the day as they wish. Good quality meals are served. EVIDENCE: There is a calendar of social events held in the Service. This involves low-key things such as an art class and a book club. There is something happening on most days. People are free to join in if they want to and they say that the range of activities on offer is about right. The people in residence say that the pace of daily life in the Service is relaxed and unhurried. They say that they are free to decide what to do each day. As appropriate, they can retire to the privacy of their bedroom. North Corner DS0000055776.V357935.R01.S.doc Version 5.2 Page 14 People are assisted to keep in touch with members of their families, if this is necessary and if it is their wish. Family members and friends are welcome to call to the Service at any reasonable time. The Registered Manager and the Head of Care keep in touch with family members so that they know how things are going. People say that they receive good quality meals and that they have enough to eat. They consider meal times to be a relaxed and pleasant experience. There is a choice of dish available at each meal time. The menu provides people with a normal healthy diet. North Corner DS0000055776.V357935.R01.S.doc Version 5.2 Page 15 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): Standards 16 and 18. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. Suitable arrangements have been made to respond to complaints and to promote the wellbeing of the people in residence. EVIDENCE: There is a written complaints procedure. This explains in broad detail how the people in residence and other interested parties can go about raising a concern. Neither the Registered Providers nor the Commission, have received a complaint about the Service since the last Key Inspection. There is a written statement of the Registered Providers’ commitment to promote the wellbeing of the people in residence. The care workers are aware of how to go about safeguarding in practice the interests of the people who live in the Service. The people in residence say that they feel safe living in North Corner. North Corner DS0000055776.V357935.R01.S.doc Version 5.2 Page 16 North Corner DS0000055776.V357935.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): Standards 19, 22, 25 and 26. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. The people in residence live in a comfortable setting that promotes their independence. EVIDENCE: Most areas of the accommodation are presented to a normal domestic standard. This means that the communal rooms and the bedrooms are decorated and furnished to a homely standard. There are some exceptions. Some of the seams in the carpets have become a little frayed and others are covered over with silver tape. This is a rather unsightly arrangement. The North Corner DS0000055776.V357935.R01.S.doc Version 5.2 Page 18 Registered Providers say that these defects will be corrected by 1 May 2008. There is an area of damaged plaster on the first floor landing. The Registered Providers have agreed to attend to this matter by 1 June 2008. The premises are fitted with an automated fire detection system. This provides a high level of fire safety protection. The Registered Providers have prepared a fire risk assessment. This has been done to ensure that there are no particular hazards that might undermine the level of protection in place. They are now going to submit this assessment to the East Sussex Fire and Rescue Service. This is necessary so that this agency can take it into account when determining the continued adequacy of the provision already in place in the Service. The kitchen is clean and well organised. The chef is aware of the principles of good food management and of the importance of hygiene. The Registered Manager says that the local Department of Environmental Health has not required any improvements in the kitchen that remain outstanding. Suitable provision has been made to support those people who experience difficulties with getting about. There is a bath hoist and there is a mobile hoist. Also, there are banister rails. At strategic locations, there are assistance poles. These are fitted to the wall and they are there for people to hold onto for extra support. The people in residence say that the accommodation is always kept comfortably warm. There is a suitable supply of hot water. Sensible steps have been taken to help reduce the chance of someone being burnt or scalded accidentally. Suitable arrangements are in place to enable garments and linen to be laundered to a normal domestic standard. The laundry is quite small, but care workers say that they are able to work around this. The Registered Providers are going to check with the local water supply company to make sure that they comply with new regulations about preventing used water from leaking back into the main pipe-work. They are going to do this by 1 May 2008. North Corner DS0000055776.V357935.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): Standards 27, 28, 29 and 30. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. The Service is adequately staffed by trustworthy people who know what they are doing. EVIDENCE: In the morning and until the early afternoon there are three care workers on duty to provide assistance for the people in residence. This number reduces to two for the afternoon and evening. At night, there is a waking staff presence in the Service. There is a chef who does most of the catering and there are domestic staff who do most of the housework. The Service is staffed adequately given the needs for assistance of the people currently in residence. There are seven care workers employed in the Service. Three of them are studying for a National Vocational Qualification (NVQ) in health and social care. This Award is useful because it provides care workers with a range of North Corner DS0000055776.V357935.R01.S.doc Version 5.2 Page 20 opportunities to confirm elements of good care practice and to extend their range of skills. The Registered Providers complete a number of security checks in relation to new care workers. This is done to ensure that they are trustworthy people to have unsupervised access to the people in residence. The Head of Care says that the completion of all of the necessary clearances has been double-checked since the last Key Inspection. New care workers receive introductory training before they work without direct supervision. This is done to make sure that they have the skills and knowledge they will need in order to support effectively the people in residence. After that, all of the care workers are provided with ongoing training. This is designed to develop further their ability to provide a high quality residential care experience. Some aspects of the way in which this training is planned, delivered and recorded are not as clear as they might be. The Registered Manager is going to address this by completing a review of the competencies of each of the care workers. This will be done using a model that the Commission recognises to be very useful. This development will be completed by 1 September 2008. Once it is completed, the Registered Manager will be in a much better position to decide what additional training for care workers will be of the most benefit. North Corner DS0000055776.V357935.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): Standards 31, 33, 35 and 38. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. The Service is well managed. There is a useful quality assurance system. Sensible provision has been made to promote the health and safety of the people in residence. EVIDENCE: The Registered Manager has various formal qualifications that are relevant to ensuring the proper operation of the Service. In addition to this, she has a North Corner DS0000055776.V357935.R01.S.doc Version 5.2 Page 22 good understanding of how the Service runs in practice. She oversees various systems that are designed to promote good team work. This is important because it helps individual care workers keep up to date with what they need to do in order to respond effectively to the changing needs and wishes of the people in residence. Several things are done to consult with the people in residence about how well the Service is running. These include informal discussions, house meetings and the completion of more organised questionnaires. The information collected by these means shows that the people in residence are generally happy with how things are going. The Registered Providers are now going to develop further the quality assurance system. This will be done by extending the process of consultation. This will mean that relatives and members of staff will be included in a more organised way than is the case at present. Also, it will mean that the results of the consultation exercise will be summarised in an annual quality report. This document will explain what action is to be taken in relation to any suggested improvements. The Registered Providers are going to complete the first of these quality reports in time for its results to be notified to the Commission in 2009. The Registered Manager and the Head of Care hold small amounts of money for each of the people in residence. This is done for the convenience of the people, so that they have enough funds to hand to purchase everyday goods and services. Suitable administrative systems are used to ensure that all of the transactions involved are proper and correct. Various regular checks are completed to ensure that the Service’s fire safety equipment remains in good working order. Two categories of these checks are not being recorded in the correct manner. The Registered Manager says that this oversight will be corrected henceforth. Items of equipment such as the stair-lift and the bath hoist are being inspected and serviced in the correct manner. The Registered Manager said that these checks also include the gas appliances in use in the Service and the electrical wiring system. The records to show this were not to hand. The Registered Providers have been reminded that in future these documents must be retained in or copies to the Service so that they are available for inspection. There have not been any significant accidents or other unwelcome events in the Service since the last Key Inspection. The Registered Manager is aware of the need to check on the premises and on the accommodation to ensure that there are no hazards that might cause someone to have an accident. As part of this exercise, she is now going to consider what further steps might need to be taken to suitably safeguard access to the stairs that lead down to the kitchen. This will be completed by 1 April 2008. North Corner DS0000055776.V357935.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 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 North Corner DS0000055776.V357935.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. Refer to Standard Good Practice Recommendations North Corner DS0000055776.V357935.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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