Care Home: Spring Cottage

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What the care home does well This home provides an excellent level of care in a homely and comfortable setting. Care is based on a thorough knowledge of each person, excellent assessments and plans of care which are regularly reviewed. Good risk assessments help people to be as independent as possible. People are assisted with their health care in a caring and friendly manner, and medicines are safely handled. Complaints are quickly dealt with and people are protected from harm by well trained staff. The home is clean and well maintained. There is a good ratio of staff to people, and staff are well recruited. The home consults people about practice and makes sure suggestions are acted upon. People made very positive comment about Spring Cottage, some examples are: `I am blessed to live here. They are wonderful.` `I think it`s wonderful here. I`m so pleased. Everyone is so kind.` `The home cooked food is delicious and full of nutritional variety. The individual bedrooms are cheery and homely.` `It`s a special place. I`m so grateful my (relative) has been admitted.` Another relative said: `I`m over the moon. I can`t speak highly enough of them`, and `It`s a little jewel.` `They care for my (relative) like I do, and I care a lot.` What has improved since the last inspection? Medication is now handled safely. The home has purchased a medication trolley and this is securely stored with a suitable facility for storing controlled medication when prescribed. What the care home could do better: This inspection has generated no requirements or recommendations. The manager of the home is good at recognising where improvements need to be made and the quality assurance system supports this process. Key inspection report Care homes for older people Name: Address: Spring Cottage Bazley`s Lane Langton Road Norton, Malton North Yorkshire YO17 9PY     The quality rating for this care home is:   three star excellent 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: Karen Ritson     Date: 1 3 1 0 2 0 0 9 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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: Spring Cottage Bazley`s Lane Langton Road Norton, Malton North Yorkshire YO17 9PY 01653695354 F/P01653695354 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Wendy Ann Marucci,Mr Paul Marucci care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Spring Cottage is registered to provide accommodation and personal care for a maximum of fifteen older people of either sex. The home does not provide nursing care. The ground rises to the rear of the building and consequently the first floor bedrooms can, if necessary, be accessed without the need of the stair lift. Spring Cottage consists of the main building and a detached bungalow. It is located on the fringes of the market town of Norton and is conveniently situated for the public transport network. It is set in large landscaped gardens with appropriate seating for people who live in the home. The home has its own vegetable and fruit garden and is adjacent to a racing stable that tends to be of considerable interest to people in the home. The home has its own car parking area. The accommodation in the main building is on two floors. The communal space consists of a dining lounge and two further lounges. Care Homes for Older People Page 4 of 25 Over 65 15 0 2 7 1 1 2 0 0 8 Brief description of the care home The home is working towards a no smoking policy. The home has a statement of purpose and service user guide, which provide information about the scope and nature of the care and facilities on offer. 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection for this service took twelve hours. This includes time spent gathering information and examining documentation before and after a site visit and in writing the report. The site visit took place on 13th October 2009 between 9.30 and 15.30. Information for this inspection was gathered from the following: A tour of the premises, observations of care throughout the day of the site visit, speaking with people, case tracking people on the day of the site visit, examining policies, procedures and records kept at the home, examining information regarding the home on the file kept by CQC, considering comments made by relatives, health care and social services staff. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations -but only when it is considered that people who use services are not being put at significant risk of harm. Care Homes for Older People Page 6 of 25 In future, if a requirement is repeated, it is likely that enforcement action will be taken. All key standards were looked at during this inspection. The manager was available throughout the day of the site visit. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their care needs well assessed. They are involved in assessing their own needs. Evidence: People have the opportunity to visit the service before deciding about admission. The manager arranges for a trial stay after which the home consults the person about whether they have settled well. Those already resident at the home are consulted about whether they feel comfortable inviting this new person into their home and a decision is made based upon all information gathered during the trial stay. This ensures that any new placement is suitable for the person concerned and that the opinions of people already living at the home are respected. The assessment takes local authority care plans into consideration, and the home uses its own process which takes place over a period of time so that care needs are well understood. Assessments cover all required areas. Documentation is now clearer and more focused than before and concentrated upon individual needs. Health care Care Homes for Older People Page 10 of 25 Evidence: professionals are also consulted wherever necessary, to ensure peoples medical and specialist needs are considered. Three assessments were examined. These clearly showed that people had been heavily involved in their own assessments and included life stories and aspects of each persons life which were considered of particular importance, this included examples such as past occupations, family details, likes, dislikes, friendships, hobbies and interests. This means that people are considered holistically and that staff have enough information to understand needs and preferences well. Care Homes for Older People Page 11 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health and care needs well met. They are protected by the safe handling of medication. Evidence: A care plan for each person is drawn up, based on the assessment. All specialist requirements are included in this plan, including medical and health needs. This ensures that peoples needs are considered holistically and that these needs may be met. All care plans are reviewed monthly with the person involved. The review is in depth and covers each area of the care plan. This ensures that the home is responsive to the changing care needs of those living there. Three care plans were examined and these contained detailed information on care needs and how these would be met. The key principle of the home is that people using the service are in control of their lives and they direct the service. Staff were fully committed to supporting individuals to lead purposeful and fulfilling lives as independently as possible. One member of staff said: These people run their own lives, We are here to make sure they are supported to do whatever they want. We know each person really well and they each have individualised plans of care. Risk assessments are in place, and the home emphasises Care Homes for Older People Page 12 of 25 Evidence: independence. People are not discouraged from doing what they choose if there is an acceptable level of risk involved. Several people carry out domestic chores such as washing up and baking on a regular basis and can make their own snacks and drinks when it is safe for them to do so. Throughout the day of inspection people living at the home were observed making decisions about what they would do. For example, one person had chosen to spend the morning in her room resting, but wanted to join in with a church service in the afternoon. Staff made sure she was assisted to do this. Another person had chosen to eat lunch in a separate lounge but then join others for the church service. She was assisted to do this. Relatives and health care professionals reported that the people living at the home are continually consulted about their lives at Spring Cottage. One relative said: She can do what she wants when she wants. She lives her life the way she wants to. She sees it as her home and it is. Shes part of a family there. Another said: These people are really encouraged to interact, they are so treated as a person, if you understand. They are looked after as individuals and nurtured. Medication is now well handled. Since the last inspection the home has purchased a medication trolley which is attached to a wall in a room. Within the trolley is a safely attached controlled drugs cabinet. This ensures that medication is safely stored. Medication is well administered, with accurate records. The home carries out a monthly medication audit to make sure all medication continues to be well handled and recorded. All staff have received safe handling of medication training to make sure those living at the home are protected from unsafe medication practice. Throughout the day of inspection staff were observed taking an exceptional level of care and consideration in their duties with people. Privacy and dignity were well respected. Feedback from people living at the home and from visitors confirmed that the staff treat each individual with great respect. This means people experience being valued and respected as individuals. Care Homes for Older People Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are well supported to live the lives they choose. Visitors are made very welcome and people benefit from an excellent varied diet. Evidence: People are encouraged to live a full and interesting life at Spring Cottage according to individual preferences. Each person gets up and goes to bed when they choose. One person is supported to attend numerous local clubs. This person chatted to the inspector and said, Im a member of the Church and I go to the Salvation Army and craft classes. I go all over. The manager said this person had decided she would like to learn how to swim and had started going to swimming lessons at the local pool. One of the staff is able to drive the Red Cross Mini Bus, so that the home can hire this and take people out on trips. Examples have been Bridlington, the Lavender Farm, a daffodil run, visits to town and a local garden centre. The manager often accompanies people into town for personal shopping or just for a ride out. The home has an activities board in the entrance to the home, where photographs are pinned up of people enjoying outings and events. A local person visits the home to play music regularly, and there are three church services a month to meet peoples religious and spiritual needs. Throughout the day, staff and the manager were seen engaging people in conversation in a friendly and caring manner. People living at the home Care Homes for Older People Page 14 of 25 Evidence: clearly knew the staff and each other very well, and there was an atmosphere of inclusion and belonging. The manager said that they often would talk about life and death together, when residents wanted to and in a positive way, to allow people to explore their spiritual feelings and wishes. A resident confirmed that they often talked together about everything under the sun. One person said: I am blessed to live here. Im never left on my own if I dont want it and I do all sorts even though I cant see. Someone else said: Im always out and about, I love my life here. Another person described how she enjoyed spending most of her day outdoors sweeping up, and tending a part of the garden which she had planted with flowers and shrubs. She also reported how she had tamed two stray cats and had bought a shelter for them in the grounds of the home and went out each day to feed them. She was clearly living a fulfilled life at Spring Cottage. Another person said she felt much better now she had moved from a different home. People talk to me here. Its lovely. A relative said; Whenever I go they are chatting with each other. The staff talk on a level they know they can reach each person. Three relatives were spoken to who regularly visit the home. All said they were made to feel exceptionally welcome and part of the family. One comment was: Wendy and Tony, the proprietors, are wonderful people and all the staff have been chosen because they are kind, you can see that. Its a fantastic friendly place. Cant fault it. Another comment was: They keep you very well informed about things you need to know as a relative. They dont tell you in a clinical way either, they tell you the little things that are really important. The home has a varied and nutritionally balanced menu. It is almost self sufficient in vegetables and fruit, and other food supplies are purchased locally. Meal times are an obvious highlight of the day and people said they always enjoyed the food. On the day of inspection the meal was of a very high quality. The home caters for diabetic and pureed diets as required. This ensures people get the diet they need and enjoy. Most people choose to have meals together, but those who prefer can eat in another lounge or their rooms. Those people who go out on trips are offered something to eat whenever they return. One relative said: My relative got back in from a trip at about 10 oclock at night, but they put the kettle straight on and made us both a snack for supper before I went home. There was another resident sitting in the lounge and she was included in the conversation and asked if she wanted anything to eat or drink too. When I was offered a second drink, the manager asked the lady resident if she minded if I stayed a bit longer, which I thought was lovely, because it is that ladys home. This means that the home has a flexible approach to meals and mealtimes and that people are enabled to live their lives and have their meals as they would at home. Some of the people who live at Spring Cottage enjoy being involved in preparing fruit and vegetables from the large gardens for meals and for the freezer, and are often Care Homes for Older People Page 15 of 25 Evidence: baking or making snacks or drinks for themselves in the kitchen. Peoples likes and dislikes are well known and if there is something a person does not particularly like on the menu, the cook will always provide an alternative. This means that peoples individual preferences and requirements regarding food are taken into consideration. Care Homes for Older People Page 16 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. People are listened to and any complaints are addressed quickly. They are protected from risk of harm. Evidence: The home has a complaints policy and procedure. People living at the home said they were always encouraged to say if they were unhappy about any aspect of their care. One person said: Wendy says, if Im happy then shes happy. Visitors and health care professionals all reported that the home was very responsive to comments and always strove to provide the highest level of care. This ensures that the home works well with people to provide a good service and shows that the home has an open culture where individuals feel safe and supported to share any concerns in relation to their protection and safety. Staff have all received abuse awareness training, either directly or through NVQ training and those spoken to had a clear understanding of vulnerable adults policy and procedure. All accidents and incidents were recorded with outcomes, so that the home could track the vulnerability of people in its care and put safeguards in place. Risk assessments were focused on individual needs and gave detailed instructions for care. This means that people living at the home are protected from harm and risk of abuse. Care Homes for Older People Page 17 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. People live in a well maintained environment. Evidence: The home is comfortably furnished, maintained and kept clean and fresh smelling at all times. The people living at Spring Cottage said it was like being at home. There are open fires which are kept guarded at all times to make sure the risk from falling coals is minimised. Several people said how much they enjoyed being able to sit by a real fire. One person said: This home may not have expensive decor like some big homes have. Its not like a hotel, but its home. So what if the furniture doesnt always match? Mostly thats because a lot of it belongs to the people who live here. Its homely and Im so pleased my relative is living here. The home has its own fire risk assessment and meets the requirements of the local fire authority, also the environmental health department. The laundry is located away from the main home in a separate building. There are three domestic washing machines and two tumble driers which are used in preference to industrial machines, as the manager says each persons laundry can be more easily kept together. One person said: The clothes are kept beautifully. Care Homes for Older People Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a home which is run with sufficient staff, who are well trained and recruited. Evidence: On the day of inspection the home was caring for 15 people. The home is well staffed, with two members of staff and the manager on duty each day and one person on duty at night with the manager on call. The manager owns the home and lives in a building on site. This ensures that staff have good back up and can call for assistance whenever needed. Throughout the day of inspection staff were observed spending time with people and caring for them in a unhurried and friendly way. Staff are all recruited suitably, with required checks in place and references sought. This means that the home recruits staff in a way which protects the welfare of people living at the home. No new staff have been recruited since the last inspection. The home employs staff with the needs of people who use the service at its core, this shows in the relaxed and happy atmosphere throughout the home. One person said: The staff and owners are wonderful. I cant praise them enough. Another person wrote: My mother has been resident at Spring Cottage for two years and the care and indeed love she has received there is exemplary. Another person wrote: All the staff are so friendly and nothing is too much for them. They put themselves out for those in their care and to make visitors feel comfortable too. Care Homes for Older People Page 19 of 25 Evidence: A health care professional said: Ive been really impressed with how warm and caring the staff are. Staff have all had induction training which is well recorded. They have also received foundation training on a rolling programme. Whilst it was obvious that this training had taken place from speaking with staff and looking in staff files, it was not clearly recorded. Clear recording of foundation level training would help evidence that all staff were up to date with required topics of care. Some staff had also completed dementia awareness training to better understand the needs of some of the people living at the home. Care Homes for Older People Page 20 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from excellent management of the service. Evidence: The manager has NVQ level 4 in care and management. Throughout the inspection she demonstrated a clear vision of the home based on its values and priorities. She constantly confirmed that the people living at the home were central to the homes purpose and that the ultimate aim was to care for and nurture each person as an individual. The manager communicated this clear sense of direction to her staff and continually evidenced a sound understanding and application of best practice, particularly in relation to peoples quality of life and happiness. Equality and diversity, human rights and person centred thinking are given priority. The manager and staff demonstrated this throughout the day in numerous conversations with people living at the home and further evidence was available in care plans and daily records, from staff and from visitors to the home. This means people live in an excellently managed home. The manager operates a quality assurance system, where people are consulted about Care Homes for Older People Page 21 of 25 Evidence: the quality of their care on a regular informal basis and more formally when care plans are reviewed. All written feedback received is kept on file and comments are taken into consideration when planning improvements. Many people commented that the manager encouraged feedback and was excellent at listening to people and putting suggestions into practice. People are kept safe by the policies, procedures, safe working practices, risk assessments, staff training and regular maintenance of systems and equipment in the home. Care Homes for Older People Page 22 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 23 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 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 30 All training must be recorded to evidence that staff have the skills to care for people at the home. 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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