Care Home: The Cottage

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What the care home does well Peoples needs are assessed before they move into the home to make sure that the home is right for them. The home hold detailed records about the people who live there that includes information about their needs and how these are to be met by the staff. This information helps the staff to care for people in a way which is of their choosing . The home makes sure that people can see their family and friends, have plenty of activities to choose from and their choices are respected. The home make sure the staff are trained to recognise any forms of abuse and they know how to report this if they suspect anything. The home makes sure that all of the proper checks are done before some one starts working at the home, this makes sure that the people living there are protected from harm. What has improved since the last inspection? The home needs to keep some medication in a fridge this has now been provided and the medication which needs to be in there is stored properly. The home now makes sure that there is plenty of activities for people to choose from. When the home recruits staff they now make sure all the proper references are taken including one from their last employer and Criminal Record Bureau (CRB) Checks are done before they start work. What the care home could do better: The home needs to make sure that if any of the people who live at the home are prescribed or are taking any controlled drugs that these are stored in accordance with the relevant legislation. The owners of the home need to devise and start an improvement plan with regard to the decor of the home and make sure that this is carried very soon and sets time scales for completion and includes the replacing or repair of the windows. When checks are done on staff before they start working at the home it is sometimes possible that they have a criminal conviction; if this is the case the manager needs to start recording as evidence when she speaks to the person about this and any decisions that she makes about their employment. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Cottage 2050-2052 Hessle Road Hessle Hull East Yorkshire HU13 9NW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: George Skinn     Date: 2 6 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 23 Information about the care home Name of care home: Address: The Cottage 2050-2052 Hessle Road Hessle Hull East Yorkshire HU13 9NW 01482645098 01482633395 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Ian Crowther care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The Cottage is situated on the outskirts of Hull, adjacent to the town of Hessle. The home is registered to provide care and accommodation for up to 30 older people. Accommodation is provided on two floors, with a passenger lift allowing access to the first floor. Access to two rooms on the first floor still requires the negotiation of a short flight of stairs. Local shops, health services and large retail shops are within close proximity to the home, with local bus services available adjacent to the home. 30 0 Over 65 0 30 Care Homes for Older People Page 4 of 23 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: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. This inspection has used information from different sources to provide evidence these sources include: Reviewing information that has been received about the home since the last inspection. A visit to the home carried out by one inspector. A site visit was carried out which lasted five (5) hours. We spoke with the people who live at the home and staff. We looked at records relating to the people who live at the home, staff and the management activities. Care Homes for Older People Page 5 of 23 During the visit care practices were observed where appropriate and time was also spent watching the general activity within the home. 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. In future if a requirement is repeated it is likely that enforcement action will be taken. Date of last inspection 22nd January 2008. The manager was available to assist throughout the day. The current weekly fees range from 360 GBP to 410 GBP 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 set out 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 23 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 23 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. People receive the care they need because they have thorough assessments done by the placing authority and the home before they move in. Evidence: We looked at a sample of files which belonged to the people who live at the home and we saw that these contained copies of assessments undertaken by the placing authority and the home. This assessment information is then used to write a care or support plan describing what staff need to do to look after each person. The home does not provide intermediate care which is a specialist service aimed at maximising peoples independence and return home after a hospital admission. Care Homes for Older People Page 9 of 23 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. Every body who lives at the home has a care plan, these are reassessed or changed along with the changing needs of the person. People who live at the home are treated with dignity and respect. People are protected by the homes handling of medication Evidence: We looked at four (4) care plans which belonged to the people who live at the home. We saw that personal support is provided in accordance with the care plan; these contained risk assessments around the area of falls, tissue viability, nutrition and diet. Some of the people who live at the home have bed rails on their beds to prevent them falling from the bed and harming themselves. The use of bed rails must be accordance with guidance provided by the Department of Health, however we could not see any thing which would indicate that this guidance is being complied with and the proper risk assessments completed. We saw that the people who live at the home can access healthcare professionals like doctors and nurses when needed; some people also have input from specialist nurses like community psychiatric nurses (CPN). Some people have involvement with Care Homes for Older People Page 10 of 23 Evidence: psychiatrists, specialist social workers, physiotherapist and dieticians. When we spoke with the staff they were clear about how to maintain someones dignity and uphold their rights. We saw that the staff were sensitive to peoples needs when undertaking any personal tasks and were sensitive and patient when dealing with those people who have dementia. At no time did we hear any of the staff using any derogatory language or belittling any one in any way. We looked at the way the home handles and stores medication. We saw that the way this was done ensures the safety of the people who live at the home. The medication was stored in the proper cabinets and secured, however, the storage used for the controlled drugs does not currently comply with the relevant legislation and needs to be moved; this was discussed with the manager. None of the people who live at the home are taking any controlled drugs at the current time. The staff make sure that correct medication has been supplied by the pharmacist when it is delivered and any mistakes are quickly rectified. The staff make sure that the recording of the medication is up to date and gives a clear indication that the medication has been administered. The recording also indicates when the medication has not been given and why. All of the staff who give out medication have had the proper accredited training and we saw certificates which confirmed this. Care Homes for Older People Page 11 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are able to take part in age appropriate activities both in the home and in the local community. People who live at the home are free to come and go as they please and contact with relatives and friends is actively encouraged. People who live at the home are provided with food which is wholesome and nutritious. Evidence: When we spoke with the people who live at the home they said they could make choices about activities, food, how to spend their time and when to get up and go to bed. The home encourages contact with relatives and friends. We saw that visitors were made welcome to the home and had good relationships with the staff. We saw that a selection of activities are arranged for the people who live at the home to take part in if they wish; these included reminiscence, one to one discussions, bingo, quizzes, table games, dominoes, crosswords and nail care. Advertisements around the home told us that that entertainers visit regularly and during the summer months trips out are booked weather permitting. When we spoke with the people who live at the home about the food they told us it Care Homes for Older People Page 12 of 23 Evidence: was very good and choices are available for both lunch and tea. Lunch on the day of the inspection was nicely presented and looked wholesome and nutritious. Staff helped those people who required assistance when eating in a relaxed unhurried manner. Care Homes for Older People Page 13 of 23 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 who live at the home know who to complain to and they are confident that any concerns raised would be dealt with appropriately. People are protected by the home policies and procedures for dealing with any instances of abuse. Evidence: We saw that two (2) complaints have been received by the home since the last inspection. We saw that these had been fully recorded investigated and appropriate action taken. The CSCI have received no complaints about the home since the last inspection. The home has has not been the subject of any safeguarding referrals or investigations by the Local Authority Safeguarding team. In discussion with the people who live at the home they were aware that they had the right to make complaints and told us that they would talk to their key worker or the manager. The home has a policy and procedure for safeguarding adults and the staff interviewed were aware of this. All had received training about Protection Of Vulnerable Adults (POVA). Staff were able to describe what they would do if they suspected any abuse was occurring within the home. Care Homes for Older People Page 14 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in clean well maintained environment but some areas are now in need of redecoration and refurbishment. Evidence: We saw that the home is generally clean and tidy and there are no smells. Peoples rooms were maintained well but are now looking in need of redecoration. The lounge is in need of re-decoration as is the entrance hall and corridors. The outside of the building still needs a lot of work especially with regard to the windows as some are now rotten and in need of replacement. Some carpets have been replaced but there is still a lot of work to be done to the environment. The home has the required amount of toilets and assisted bathrooms. The staff have access to lifting aids to help them safely manoeuvre the people who live at the home who need this level of help. Care Homes for Older People Page 15 of 23 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 cared for by staff who are provided in enough numbers to meet their needs and who are qualified and competent to do so. Evidence: There is a satisfactory staff rota in place that records the role of each member of staff. The staffing levels are based on the needs of the people who live at the home. There is a cook on duty each day as well as a kitchen assistant and other ancillary staff. This enables care staff to concentrate on assisting people with personal and social care activities. Training records indicated that that more than 50 of the staff are trained to NVQ level 2 which includes training on equality and diversity and an awareness of abuse. The recruitment and selection procedures remain robust and all checks are undertaken prior to staff commencing work at the home. The staff files looked at contained two (2)references one from a previous employer, an application form which identified gaps in employment and a completed Criminal Record Bureau (CRB) check. Sometimes the manager has to make a decision as to whether or not to employ someone when they have a conviction. It is recommended that the manager records any discussions with the staff if their CRB check shows any convictions and the reasons for any decisions made about their employment. Care Homes for Older People Page 16 of 23 Evidence: There is a training and development plan in place that shows all staff have undertaken core training and that some staff undertake more specialised training such as palliative care. We saw that staff records include information about individual training achievements and a copy of training certificates is kept on their file. Staff have refresher training as needed to ensure that their skills and knowledge are kept up to date. All staff have received mandatory training in Health and Safety, Manual Handling, Basic Food Hygiene, First Aid and Fire. Staff receive regular supervision and developmental opportunities are given for the staff to attend further training if they wish to. When we spoke with staff they said they found the training excellent and where pleased that they were encouraged to attend lots of training. They felt this gave them the skills needed to care for the people who live at the home. Care Homes for Older People Page 17 of 23 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. People live in a home which is run and managed in their best interests. People are safe at the home because the staff have received the appropriate training and guidance from the management of the home. Evidence: The manager is registered with the CSCI and has the relevant qualifications and experience for this role. People who live at the home told us that the management are approachable and they have confidence in them. Staff told us that the management is supportive and provides them with good leadership. From speaking to the manager and staff it is clear that the homes ethos is to promote participation and inclusion for the people who live at the home. The home continues to have a well has developed quality assurance system that involves the people who live at the home, carers, family, staff and other professionals giving their views about the home. Surveys are completed throughout the year and an annual report is produced explaining the outcome of the surveys and any relevant action to be taken. People Care Homes for Older People Page 18 of 23 Evidence: who live at the home and or their families continue to manage their own financial affairs. The home has a fire policy and a fire risk assessment and the fire alarm is tested weekly. Tests on equipment are undertaken and fire drills are carried out on a monthly basis. The home has a nurse call system fitted to ensure that all the people who live at the home are able to request assistance when needed. All the equipment in the home is tested at the appropriate intervals and all maintenance certificates are up to date. The directors visit on a regular basis and monitor the home performance; reports from these visit should be kept at the home and made available for inspection. Care Homes for Older People Page 19 of 23 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 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 The use of bed rails must be 29/05/2009 in accordance with guidance issued by the Department of Health This will keep the person safe from harm and ensure the home are using the bed rails safely. 2 9 13 The storage of controlled 29/05/2009 drugs must be in accordance with the Misuse of Drugs (Safe Custody) Regulations 1973. This will ensure the homes storage is in accordance with legislation and is safe. 3 19 23 The registered person must provide a programme of redecoration and refurbishment which includes the replacement or repair of the windows with time scales to the CSCI 29/05/2009 Care Homes for Older People Page 21 of 23 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 This will ensure the people who live at the home live comfortable surroundings. 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 29 It is recommended that the manager records any discussions with the staff if their CRB check shows any convictions and the reasons for any decisions made about their employment. The home should make available for inspection any reports done by the directors by virtue of Regulation 26 of the Care Homes Regulations 2001. 2 33 Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - 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!