Care Home: The Coach House

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What the care home does well People are fully assessed prior to admission to the home. All people accommodated in the home are treated as individuals and have choice in day to day living. Needs are set out in a plan of care. People have choice in the food they eat. The home is well maintained. The home is run in the best interests of the people who live there. What has improved since the last inspection? The requirements of the last inspection have been met. The is now lockable storage for all medicines including controlled drugs. There is a record of drugs received into the home. All required checks for people working in the home are in place. What the care home could do better: Daily records for people who use the service and a written record of staff supervision needs to be kept. The manager has agreed to implement these processes. Key inspection report Care homes for older people Name: Address: The Coach House 1 Hernbrook Drive Horsham West Sussex RH13 6EW     The quality rating for this care home is:   two star good 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: Sheila Gawley     Date: 0 7 1 2 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 22 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 22 Information about the care home Name of care home: Address: The Coach House 1 Hernbrook Drive Horsham West Sussex RH13 6EW 01403255197 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ms Sharon Anne Waters care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 2 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home The Coach House is a family run care home providing personal care for older people, and is registered to accommodate up to three residents. The registered provider is Ms Sharon Waters, who is also responsible for the day-to-day management of the home. The home is a detached property located in a residential area, just outside Horsham town centre, West Sussex. Accommodation for residents is provided in three single rooms all with en-suite facilities. The Coach House is arranged on two floors. Accommodation for residents is provided Care Homes for Older People Page 4 of 22 Over 65 3 0 0 6 0 1 2 0 0 9 Brief description of the care home on the ground floor, with the first floor reserved for the private dwelling of the proprietor and her family. There is a medium sized garden at the rear and front of the property, which is mainly laid to patio, well maintained and easily accessible. The home provides for the needs of elderly people with a degree of mobility and independence. The fees charged are £540 per week. Care Homes for Older People Page 5 of 22 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: two star good 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: This site visit as part of the inspection process was undertaken on 7th December 2009. It was undertaken by a Lead Inspector from the Care Quality Commission and was facilitated by the provider/manager. All three people accommodated in the service were involved in the inspection and documentation held in relation to them in the home was inspected. They all expressed great satisfaction with the care and lifestyle offered in the home. The home had sent us their AQAA when we asked for it and any documentation required on the day was made available. Care Homes for Older People Page 6 of 22 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 7 of 22 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 8 of 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed prior to admission. Evidence: People who use the service are fully assessed prior to admission to the home. All medical, nursing and personal care need is assessed and recorded. Social need and carer and family involvement is recorded. Service user plans for all three people accommodated were inspected and their pre admission assessment was present. The AQAA stated that they arrange for the person wishing to be accommodated and their relatives to visit the home at their leisure, the home provides transport if necessary. The prospective person can speak to the manager and staff, meet the other two people living there and take lunch with them if they so wish. There is a trial period for both parties and the contract allows for the termination of the persons stay without financial penalty should the home not be suitable. An up to date statement of purpose and service user guide is available. This stresses Care Homes for Older People Page 9 of 22 Evidence: the quiet nature of the home. The service user guide contains the complaints procedure. Care Homes for Older People Page 10 of 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed and set out in a plan of care and are met. Evidence: The care plans for all three people accommodated were inspected and these people were spoken to. All confirmed great satisfaction with the care on offer in the home and stated that every need is met. Comments included happy here, very fortunate very well looked after here. Care plans are in place and record personal care, diet and weight, sight hearing, communication, mobility and dexterity, continence and medication. The people in this home do not have complex health or personal care needs. People accommodated in the home have access to local national health services and the chiropodist was visiting on the day. The community nurse visits frequently to attend to catheter care. There was evidence of consultation with opthalmic, occupational health,and vascular specialist services. There was evidence of monthly review but the daily records were minimal with events such as hospital visits or visiting professionals being recorded in a diary. The registered manager agreed to Care Homes for Older People Page 11 of 22 Evidence: make these more comprehensive and person centred. Medication is received stored and recorded correctly in the home. The requirements on medication in the recording of receipt into the home and storage of the last inspection was met. The is now lockable storage for all medicines including controlled drugs. Care Homes for Older People Page 12 of 22 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 live the lifestyle they choose in the home and are happy with the daily routines Evidence: The routines of daily living are flexible and people can choose when to get up and go to bed and when and where to take their meals. Visitors are are welcome at any time and all three people receive visits from family members. People have personal autonomy and choice and two of the people who use the service stay up late and are assisted to bed around midnight. They may choose to sleep late in the mornings and one person who uses the service does this. There is not an activity programme in the home and all three of the people who use the service were spoken with about this and they all stated that were very happy with the quiet lifestyle in the home. One person stated To me this is just like living at home . Another stated We have been asked about entertainment and we declined . All can have newspapers and like to discuss the news and have other conversations with the registered manager and the carer. All people have their own televisions as well as the communal television in the sitting/dining room. Two of the people who use the service have their own personal computers. The registered manager stated that Care Homes for Older People Page 13 of 22 Evidence: previous people using the service attended a day centre in Horsham but these people currently using the service did not wish to do so. There is not a formal four week menu in place but people are asked daily what they wished to eat and are offered choice. Two people today had salmon encroute and another had a prawn Chinese meal. The person having the prawn meal stated that he was quite fussy with his meals and the registered manager made every effort to accommodate his requests. All stated that with the exception of a few personal dislikes that they enjoyed the meals. A hairdresser visits when required. Care Homes for Older People Page 14 of 22 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. Complaints are listened to and people are protected from abuse. Evidence: There is a complaints procedure in the home which is available to all people who use the service. The three people spoken with all stated that they knew how to complain and all were confident that any complaint would be dealt with.All stated that they had no need to complain. People have their own comments book in their rooms and they are encouraged to comment on care and life in the home. There are safeguarding policies and procedures in place and safeguarding training is booked for 29th January 2010. There have not been any safeguarding alerts in this home. Care Homes for Older People Page 15 of 22 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 safe and well maintained environment. Evidence: People are accommodated on the ground floor of a Victorian house. All people have their own room and all rooms are en suite. People can personalise their rooms as they wish. The communal space comprises of an attractive sitting/dining room. There are attractive well maintained accessible grounds. All people have their own televisions. There are laundry facilities, the washing although domestic in style does have washing programmes hot enough to to prevent the spread of infection. There are not significant continence issues in the home. Should the category of person using the service change then the purchase of an industrial machine may have to be considered. Baths have handrails and there is a call bell system in place. The home was neat, clean and free from offensive odours. The home is furnished and maintained to a high standard. Care Homes for Older People Page 16 of 22 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 are protected by the homes recruitment procedures. Evidence: The provider/manager provides personal care and there is one part time carer employed. The provider manager has the support of her partner and family. The recruitment file for the carer was inspected and it contained all the documentation required to protect the people using the service. It had evidence of identity, two references, work history and criminal records bureau clearance. She has completed the National Vocastional Qualification (NVQ) level 2 in care and is completing the Skills for Care Common Induction booklet. All family members providing support to the home have had criminal records bureau clearance. The provider/ manager is currently planning the training programme for the coming year and safeguarding adults is planned in January 2010. She is awaiting dates for other mandatory training. Copies of training certificates were held in the staff file. Care Homes for Older People Page 17 of 22 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 is run in the best interests of people using the service. Evidence: The provider manager manages the home on a day to day basis and offers most of the care herself with the support of one part time carer. She has been running the home for ten years and is completing the NVQ Level three in Care. When this is completed she intends to commence the NVQ level 4 and the registered managers Award. The provider/manager demonstrated a commitment to the service and the quality of life experienced in the home. People are treated as individuals and as equals and have choice in their day to day lives. There are not any formal quality assurance systems in place as the registered manager sees and speaks to all three people accommodated every day. She also communicates directly with visiting professionals such as the chiropodist and the community nurse. She responds directly to any request from the people using the Care Homes for Older People Page 18 of 22 Evidence: service such as meal choice or shopping needs. People spoken to on the day confirmed this. The AQAA was completed when we asked for it The home does not handle any finances for people using the service. Supervision is at present informal and records are not kept. The registered manager/provider agreed to do this from now on. The health and safety of people using the service and staff is protected by the provision of policies and procedures in health and safety and in the provision of staff training. Care Homes for Older People Page 19 of 22 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 20 of 22 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 Care Homes for Older People Page 21 of 22 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. 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. Care Homes for Older People Page 22 of 22 - 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!