Inspection on 07/04/09 for Pennfields Court

This is the latest available inspection report for this service, carried out on 7th April 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Pennfields Court 08/08/06

Pennfields Court 13/03/06

Pennfields Court 03/05/05

Pennfields Court 02/09/04

Pennfields Court 24/05/04

Pennfields Court 12/05/03

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Pennfields Court Upper Zoar Street Pennfields Wolverhampton West Midlands WV3 0LA     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: Joy Hoelzel     Date: 0 7 0 4 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 25 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 25 Information about the care home Name of care home: Address: Pennfields Court Upper Zoar Street Pennfields Wolverhampton West Midlands WV3 0LA 01902444069 01902444070 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Heantun Care Housing Association Limited care home 21 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 21 The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 21 Mental disorder, excluding learning disability or dementia (MD) 21 Date of last inspection Brief description of the care home Pennfields Court provides a continuing care service to 21 people with mental health problems over the age of 55 years. It is owned by Heantun Care Housing Association Ltd and is one of a group of care homes. It is a purpose built unit and is approximately Care Homes for Older People Page 4 of 25 Over 65 0 0 21 21 Brief description of the care home 20 minutes from Wolverhampton City Centre. The accommodation comprises of single and double occupancy bedrooms. There are spacious lounge and dining areas, which are decorated to provide a homely atmosphere. There is a small-enclosed garden at the rear of the building with ample car parking at the front. Individuals are generally referred via a consultant, with fees paid via the Primary Care Trust. Commission for Social Care Inspection reports for this service are available from the provider or can be obtained from www.csci.org.uk 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: 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 last key inspection was conducted on 4th May 2007 with an annual service review in May 2008. On this occasion the home did not know that we would be visiting to conduct a full inspection of the service. A look around the home took place, which included a number of bedrooms as well as communal areas. The care documents of a number of people using the service were viewed including care plans, daily records and risk assessments. Other documents seen included medication records, service records, some policies and procedures and staffing records. Discussions were held with people at the home. Some people were unable to fully comment about their experience of life at the home. Observations were made of how they spent the day and of the interactions offered by staff in an attempt to obtain an overview of how they may be feeling. An Annual Quality Assurance Assessment (AQAA) document was posted to the home Care Homes for Older People Page 6 of 25 for completion prior to the annual service review being completed. The AQAA is a selfassessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for providers to share with us the areas that they believe they are doing well. It is a legal requirement that the AQAA is completed and returned to us within a given timescale. The registered manager completed this document and returned it the commission. Comments from the AQAA are included in this report. 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 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. Evidence: Information on the service is available in two documents, with both documents offering a brief description of the services that are provided. It was not possible to determine when the documents had been fully reviewed, as there were differing dates on many of the sections within the documents. The complaints procedure offers details of how the service will deal with any complaints/concerns that may be made but our contact details are incorrect and refer to the previous regulatory body (National Care Standards Commission). The level of the weekly fees of £600.00 per week is included in the terms and conditions part of the document; again it was not possible to establish if this information is current for 2009/10 as there is no date on the document. The current and correct information provided by the service ensures that people can decide whether the care home can meet their support and accommodation Care Homes for Older People Page 10 of 25 Evidence: needs. The case file of the person who recently moved into the home was looked at to see if information had been sought regarding this persons needs prior to moving in. Information had been gathered from the previous short, respite care stays at the service. The manager confirmed that the person had been visited in the previous place of residence prior to the decision being made to offer a permanent placement at the home. An assessment of the persons daily needs based on a dependency summary was completed soon after their arrival to the home. Other case files looked at included an assessment completed by staff at the home; it was not always possible to determine when the assessment had been carried out, as the date was not included on the document. The manager confirmed that a visit to the person in their current place of residence is always made prior to offering a placement at the home. A visitor told us that they arranged the placement, as their relative was unable to make decisions due to incapacity. They commented that initially there were a few problems but they were generally satisfied with the admission procedure and stated that the service offered and the staff were very good. The home does not provide an intermediate care service but has a dedicated respite, short stay room that is available when required. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal support is responsive to the varied and individual needs and preferences. The delivery of personal care is individual and staff are sensitive to changing and complex needs of people living at Pennfields Court. Evidence: Each person has a written plan of their care that is based on the assessments of their care needs. Three plans were selected to be looked at in depth with other plans looked at briefly to follow up any observations made during the day. There was no evidence in the plan that the person or their representative was included or involved in the planning process. The relative of one of the people living at the home told us that they were unsure of what a care plan is and has not actually seen any documentation relating to this. However he confirmed that he has regular discussions with staff and he is kept fully involved and informed of any changes in his partners care and condition. Staff also told us that the persons relative or representative is consulted when a change in need has been identified. The registered manager told us of the plans for a full review of the care planning Care Homes for Older People Page 12 of 25 Evidence: documentation, which will include an individually person centred approach. The plans currently in use offer overviews of the care provided and generally have sufficient details for the staff to ensure that care needs are met. Discussions with staff and observations of their working practices evidenced that they have a good knowledge and understanding of the complex and diverse care needs of each individual person. Medication is administered to people by the registered nurses. The procedures were looked at and staff explained the processes for the safe administration of medications. There are one or two areas that require attention to reduce the risk of harm to staff and residents. This was fully discussed with the manager at the time, who confirmed that immediate action would be taken. Observations during the day indicated that staff are respectful, considerate and discreet when attending and supporting people with interventions and personal care needs. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have the opportunity to participate in daytime activities according to their individual interests, diverse needs and capabilities Evidence: Daily activities are arranged and facilitated by the care staff but are very dependent on the needs of the person at the specific time. Many people require one to one support with participation in recreation. The manager and staff are very aware of the individuals preferences and are able to initiate the activity by their in depth knowledge of the person. Throughout the morning people were engaging in conversation, listening to music, walking around or just sitting quietly. The manager discussed the recent addition of pet therapy and described the positive impact the animals had on people. Photographs are now on display in areas around the home to offer a reminder of some of the activities arranged. Visitors to the home confirmed they are able to visit each day if they prefer and welcome the time that they are able to spend with their relative. The main front door is kept locked for security reasons staff answer the door and allow entry, a number keypad is used for exiting the building. Some store cupboards, the treatment room and private bedrooms are locked during the day. People have free access to the communal areas within the home. The garden has recently benefited Care Homes for Older People Page 14 of 25 Evidence: from renovation and now provides a safe enclosed area for people to use, weather permitting. Meals are prepared and served by the catering staff with people being encouraged to use the dining room. Some people are unable to use the dining room so are assisted with their meals and drinks in the lounge areas. Staff were observed to be assisting and encouraging people in a discreet and measured way. Care Homes for Older People Page 15 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. The home keeps a full record of complaints and this includes details of the investigation and any actions taken. Training of staff in safeguarding is regularly arranged by the Home. Other training around dealing with physical and verbal aggression is also made available to staff. Evidence: The complaints procedure is included in the service information documents. To ensure that people are able to contact us, should they wish to do so, our correct contact details should be included. The manager explained that a complaints log has been developed and is used as part of the ongoing quality audits for the home. The AQAA informs us - We have had two verbal complaints and one written complaint. Two have been satisfactorily resolved and the third is currently being dealt with. Care staff and visitors stated they would see the manager or a senior member of staff if they had concerns regarding the service. All staff have received recent training in protection of vulnerable adults and non invasive crisis intervention, this will ensure the continuing safety of the people living at the home. A review and revision is needed to the procedures for dealing with the safe keeping of peoples personal money and valuables. The manager confirmed that this will be actioned. Care Homes for Older People Page 16 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a physical environment that meets the specific needs of the people who live there. The home is comfortable and has a programme to improve the decoration, fixtures and fittings. Evidence: Pennfields Court is a purpose built care home providing accommodation for up to 21 people. There is a rolling programme to upgrade to environment with the communal areas and bedrooms being redecorated and some of the furniture being replaced. The AQAA identifies the improvements made during the last twelve months We have natural light now in the main corridors (via solar tubes), this has made a very big improvement and has been recognised by relatives. We have a rolling programme of re-decoration and replacement of fixtures and fittings. We have targeted poor lighting in corridors and as part of this we have changed the colour scheme to increase lighting levels. All bedroom doors have been repainted from a dark office colour to light airy pastel shades. Several residents carpets have been changed for new as needed. Changed most of the service users beds for more up to date profile beds We have a new dementia garden, and this is designed such, that half of the garden is suitable for residents to explore unsupervised, and improved access and safety surfaces have been incorporated to minimise injuries from potential falls. We Care Homes for Older People Page 17 of 25 Evidence: recognise the residents rights to be autonomous in where they wish to go and to take reasonable risks and be kept safe whilst doing so. During the tour of the premises all areas were clean and hygienic, visitors commented that they are satisfied with the accommodation and the service in general. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has plentiful staff available at all times to support the needs, activities and aspirations of residents in an individualised and person centred way. The service is innovative and shows a high level of awareness of staffing levels needed. The service is proactive in its staffing, recruitment and training, with planning for the potential needs of people who may use the service in the future. The result of this is a diverse staff team that demonstrate a thorough understanding of the particular needs of individuals, and can deliver highly effective person centred care. Evidence: A duty rota is maintained on a weekly basis to identify the members of staff in the home at any one time. During the morning of the inspection a Registered Mental Nurse was in charge of the home supported by four care staff. Ancillary staff and a student nurse were also on the premises. The registered manager arrived at the home during the inspection. The AQAA tells us that We have actively encouraged Nurses to risk assess the staffing levels required to keep residents safe. Staffing levels were based on risk assessment of need Every care shift over the last year has had staffing levels, which are at least, the recommended levels, and for many weeks and months we have well exceeded the recommended levels. Care Homes for Older People Page 19 of 25 Evidence: This has been because we are focused on residents needs. Staff were observed working positively with the people in their care and appeared motivated and committed to their work and demonstrated a good understanding of the individual needs of the people living at the home. The AQAA informs us that of the twenty-five permanent staff, twenty-three have gained an accreditation at National Vocational Qualification levels 2 and above. Two staff files were selected for inspection and included different grade staff. The files were well presented and contained the information required to safeguard the people living at Pennfield Court. Staff spoken with considered they are provided with good training opportunities to include mandatory and service specific topics such as infection control, moving and handling, dementia awareness and non-violent crisis intervention. Training certificates were included in the staff files sampled and leaflets advertising future courses, dates and nominees were seen displayed on the training information board in the office. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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. Evidence: Mr Tom Cullen continues in the role of registered manager, and has the Nursing Qualification RN3, Level 4 NVQ in Management and RMA and is currently undertaking Gold Standard Award/Framework. Through out this inspection Mr Cullen demonstrated a commitment to providing a quality service and good outcomes for the people in residence. People offered positive comments on the direction and leadership of the manager, all stated that they would have no hesitation to see him if they had any concerns or worries. It was obvious during the time of this inspection that good, professional relationships had been developed and maintained with the manager and people living, working and visiting the home. The AQAA completed by the manager contains excellent information that is fully supported by appropriate evidence. It includes a high level of understanding about the importance of equality and diversity and a wide range of evidence showing how they have listened to residents. The home Care Homes for Older People Page 21 of 25 Evidence: demonstrates a high level of self-awareness and recognises the areas that it still needs to improve, and has clearly detailed the innovative ways in which they are planning to do this. Quality assurance of the service continues with regular audits throughout the year, customer satisfaction surveys being distributed twice yearly. Staff meetings are arranged at regular intervals offering people the opportunity to discuss and comment of how they find working at the home. Family and friends are able to discuss either formally or informally any issues they may have regarding the provision of the service. The provider continues with the monthly formal visits as part of the monitoring of the service, reports are produced of the visits and available for inspection. A review and revision is needed to the procedures for dealing with the safe keeping of peoples personal money. Currently the money is being pooled with no separate recording documents for each transaction. The manager explained that petty cash system was previously used for all sundry expenses and it is only recently that the home has been requested to safe keep money for individuals. Records, documents and certificates are available for inspection to ensure that the weekly, monthly and annual health and safety checks are being carried out. The manager confirmed that the fire risk assessment for the premises has recently been reviewed but was unavailable for inspection. It is strongly recommended that a copy is kept on the premises and readily available at all times. 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 1 The service information documents should be reviewed at regular intervals to ensure that people have the very latest information to assist with deciding whether the home is suitable for their needs. To ensure peoples financial interests are safeguarded, the procedures for dealing with peoples money held at the home should be reviewed. 2 35 Care Homes for Older People Page 24 of 25 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. 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