Inspection on 23/10/09 for Portland House

This is the latest available inspection report for this service, carried out on 23rd October 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Portland House 01/11/07

Portland House 04/12/06

Portland House 15/08/06

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for older people Name: Address: Portland House 25 Belvidere Road Shrewsbury Shropshire SY2 5LS     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: Michael Moloney     Date: 2 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 26 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 26 Information about the care home Name of care home: Address: Portland House 25 Belvidere Road Shrewsbury Shropshire SY2 5LS 01743235215 01743353856 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: None Kelly Residential Limited care home 43 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 who can be accommodated is: 43 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: Old age, not falling within any other category (OP) 43 Date of last inspection Brief description of the care home Portland House is situated in a residential area of Shrewsbury. Kelly residential Ltd were registered as the provider in May 2006 with Mrs M Rai as the responsible individual. The home comprises of an older building with a modern extension situated within large grounds. Kelly Residential Ltd make their services known to prospective service users in: The Statement of Purpose and service user guide which has been updated for April 2009. Portland Houses rates are reviewed annually on 1st April each year and service users are notified one month in advance. The additional charges to service users are detailed in the service user guide. Fees for Portland House are Care Homes for Older People Page 4 of 26 Over 65 43 0 2 3 1 0 2 0 0 8 Brief description of the care home £650-£800 per week. Care Homes for Older People Page 5 of 26 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: We, the Commission, used a range of evidence to make judgements about this service. This included: surveys returned to us by people who live in the home, their relatives and staff as well as information from the provider which included a self assessment document that they are required by law to complete and notifications that have been received by the Care Quality Commission from the home about incidents, bereavements and other incidents that affect the welfare of the people who live in the home. The visit was unannounced with the purpose of carrying out a Key Inspection which is where the homes performance is measured against a set of standards identified by the Department of Health. No other visits had been made by Care Quality Commission staff since the last Key Inspection. This inspection was undertaken by one inspector, Mike Moloney and lasted five and a Care Homes for Older People Page 6 of 26 half hours. On this occasion we did not involve an Expert by Experience which is someone who has experienced the care provided by this type of service and is asked by the Care Quality Commission to assist and give their views during an inspection. During that time we Case Tracked a number of the people who live in this home. This means that we talked to them and/or their relatives, where this was practical, to find out their views of the care that was being provided to them. This also enabled us to see if the records that identified peoples needs such as the care plans that are provided for the staff to follow were accurate and covered each individuals personal issues. We also talked to members of the staff team and the manager to check that they were aware of the identified needs of the people who live in this home and whether or not they had the approach and training required to meet them. The standards set out by the Department of Health are in seven different groups. Each group can be judged as being either poor, adequate, good or excellent. The inspectors reach their judgement by following the guidelines laid down in the document known as the Key Lines Of Regulatory Assessment (KLORA) which is available on the Care Quality Commission web-site: www.cqc.org.uk Care Homes for Older People Page 7 of 26 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 26 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 26 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 looking to live are fully assessed so that the home can be sure that they can meet their needs Evidence: We looked at the records of two of the people who had been admitted into the home in the last few months. We saw that the home had been provided with an assessment of their needs by the local authority and the manager had carried out her own assessment about whether or not the home could meet those peoples needs. The assessment that she carried out looked at how well each person could care for their own personal hygiene, use the toilet, dress themselves, move around and talk as well as how aware they were of where they were. We saw further records that showed that shortly after their admission this information was developed to give guidance to the staff about how people should be helped if they Care Homes for Older People Page 10 of 26 Evidence: needed to move around, what care should be taken if they had fragile skin or were unable to move position for themselves, what foods they liked, needed or should be encouraged to eat and whether or not they should use bed rails. Care Homes for Older People Page 11 of 26 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. The health and personal care that a person living in this home receives is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: We looked at the records of three of the people who live in this home and, where possible, talked to them about the care that they receive. We also spoke to a number of other people and their relatives who were able to give their views about the home. We saw that the records that were maintained described the mobility needs of each person. One example of this was of a lady whose records said that she walks with a frame under the supervision of one member of staff. We saw this lady going from her room to one of the lounges and she was using her frame and chatting with the member of staff who was walking with her. The records we saw explained that she had lost confidence in her ability to use the frame and that the assistance was there to reassure her. Comments on those records had been signed and dated indicating that the need for this level of assistance had been reviewed monthly. Care Homes for Older People Page 12 of 26 Evidence: All of the beds that we saw had side rails built into them. The records that we saw said whether or not these should be raised and why and that the person had agreed to their use. We also saw assessments about people and their eating. These included comments about peoples appetites, their ability to chew and swallow as well as their ability to use utensils and cups. We talked to a lady whose assessment said that she had difficulty chewing and swallowing as well as having a reduced appetite. She told us that she enjoyed her meals and had a good appetite. However, we saw that she ate very little at lunch time and we watched and heard staff quietly encouraging her to eat. The staff on duty told us that this was normal for this lady at meal times. We looked at the records that showed that this issue had been reviewed monthly. We saw that people with such problems could have their food liquidised to help them and when this was necessary it was noted in their records. We talked to some of the staff preparing and serving the meals and they were fully aware of these instructions. We saw written assessments of each persons skin care needs. We saw that these were also reviewed regularly. We saw that those at risk had records in their rooms, close to their beds, which detailed how people should be turned and how often so that pressure areas would not break down. We saw that the staff had completed the records so as to show who had taken the action and at what time. We saw that the records included information about such things as continence, peoples ability to maintain their own personal hygiene and individuals weights. Other records included information about visits by healthcare professionals, why these visits took place and what action was necessary as a result. During the inspection advisors from the pharmacist that supplies medication to the home. They told us that they were carrying out one of their advisory visits that they carry out on a regular basis for their customers. We talked with them and they confirmed that they review areas of practice that they and the local Primary Care Trust consider to be important in the handling and administration of medication. When they had completed their review they reported that the storage of medication was appropriate and secure and records were being kept appropriately so that it could be seen that the right person was being given the right medication at the right time. They told us that they would want warning stickers put on the door to each of the rooms where oxygen is in use so that the Fire Service would be warned should the need arise. Care Homes for Older People Page 13 of 26 Evidence: At the start of this visit the nurse on duty was giving out the morning medication. We heard him asking people who may have been in pain if they wanted the painkillers that they had been prescribed showing that they are only given if they are necessary. We spoke to one of the people who he had spoken to and she told us that this was what they normally did with her. Care Homes for Older People Page 14 of 26 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 in this home are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet their expectations. They receive a healthy, varied diet according to their assessed requirement and choice. Evidence: We talked with the Activities Organiser and she showed us the records that she had developed to help her focus her activities on what people were interested in. She told us that she had talked with each person and looked at their records to see what they had been interested in before they came to live in the home. These had been completed in some detail and, she said, were still being developed and added to. She showed us the records of various activities that had taken place in the home. She talked about one such that involved people reminiscing about various points in their lives and we spoke to a service users who said that she thought that people showed a genuine interest in what she talked about. She told us that another activity that she did was the Shopping Trolley which is where she would take a trolley round to those who stay in their rooms and they could buy such things as sweets from it. Care Homes for Older People Page 15 of 26 Evidence: We saw that the Activities Organiser was taking this round on the day of the inspection and she had also stopped a while with one lady who was confined to her bed so that she could manicure her fingernails for her. We were told by staff and some of the people who live in the home that there is an eight seat vehicle that they can use to go out in for meals and visits to local beauty spots. They told us that they enjoyed this. The Activities Organiser also showed us the homes monthly magazine that she was responsible for and this contained information about the activities that had or were about to take place in the home. We talked to a number of the people who live in the home about the food that they are offered. All were complimentary about it. We saw that a number of people were offered assistance of varying levels by the staff and that food had been prepared that made it easier to eat for those with problems either chewing or swallowing. The manager told us that special meals could be prepared for people who need them for either medical or cultural reasons. Care Homes for Older People Page 16 of 26 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 people who live in this home have access to a robust and effective complaints procedure, are protected from abuse and have their legal rights protected. Evidence: We looked at the homes complaints policy and this was seen to contain information on how and with whom issues of concern could be raised. We spoke to a number of the people who live in this home and their relatives who all said that they knew how to raise any issues that might arise and that they were confident that they would be dealt with. We talked with the manager and looked at records about a number of issues that had been referred through the local procedures that deal with allegations of the abuse of vulnerable people. We saw that the home had cooperated with these processes and addressed the issues raised. We talked with a number of the staff and looked at their training records but it was unclear whether or not they had all received training in the procedures that they are required to follow should they observe the abuse of vulnerable people. However, we spoke to the staff and they explained who they would report such issues to and how they would record it. Care Homes for Older People Page 17 of 26 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. The physical design and layout of the home gives anyone living there a safe environment which encourages independence but this would be enhanced by the addition of more communal space. Evidence: We looked around the home and we saw that there were three main communal areas. Two of these were lounges and the third was the dining room. The furniture in each room was seen to be clean and in good condition. We talked to maintenance man who explained how he checked the homes furniture for damage on a regular basis and removed and reported damaged items of furniture. We also looked at a number of the bedrooms used by people who live in this home. We saw that the decor and furniture in each room was also in good condition and that the home was generally clean and tidy. We saw that the people in wheelchairs who were waiting for lunch were lined up in a regimented way. We spoke to the manager about this and she explained that this was due to the restricted space in that part of the home. She told us that the owner planned to build a conservatory of that area so that the area would feel less cramped. The owner later contacted us and confirmed that work on the foundations for the conservatory would start in the following December. Care Homes for Older People Page 18 of 26 Evidence: We saw that work on a small area that could be used for private meetings with relatives or people like the visiting chiropodist was near completion with only the decorating and furnishing to finish. We looked at the homes laundry area and we saw that this contained the equipment needed to keep the clothes and bedding of the people who live in this home clean and hygienic. Care Homes for Older People Page 19 of 26 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. Staff in the home are trained, skilled but in insufficient numbers to fill the aims of the home and meet the changing needs of people who live in this home. Evidence: We watched and listened to the staff as they went about their duties. We saw that they were polite, friendly and professional with the people who live in this home. We heard them chatting to the people who they were helping them or as they passed. We talked to a number of people, including people who were visiting their relatives and they were all complimentary about the attitude of the staff. People said such things as, first rate, lovely girls and do anything for you. We looked at the staffing rota and this showed that there were enough staff on duty to meet the needs of the people who live in the home. We talked to the staff and they said that the rota was an accurate record of who had been on duty. We talked to a number of the people who live in the home and they told us that they received help from the staff promptly when the asked for or needed it. We looked at the recruitment records of four new staff. We saw that these contained evidence that the home had carried out the background checks that are necessary to Care Homes for Older People Page 20 of 26 Evidence: ensure that people who wish to work with vulnerable people are fit to do so. We looked at the records provided by the home before the inspection and these showed that more than 60 of the staff had achieved a National Vocational Qualification that was relevant to their meeting the needs of the people who live in this home. Care Homes for Older People Page 21 of 26 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 management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. Evidence: We talked to the manager and she confirmed that she was a registered nurse and had also completed the Registered Managers Award which is a qualification that is considered to be appropriate for someone who manages an organisation such as this. She also confirmed that she is in the process of applying to be registered with the Care Quality Commission as manager. At the start of the visit the managers line manager visited the home. She told us that she had recently carried out a monthly quality assurance inspection and showed us the record of the result of this which she was delivering to the manager. We also saw the records of previous visits and they showed that these visits take place on a regular basis. Care Homes for Older People Page 22 of 26 Evidence: We also saw other records that showed how the homes management try to monitor how successful they are in meeting the needs of the people who live there. We saw the minutes of the relatives meetings as the results of a survey of the views of the people who live in the home and their relatives. The manager told of how the home had been involved in the local procedures that are designed to protect the human rights of people who lack the capacity to do so for themselves. She told us that the rights of someone to leave the home without the assistance of the staff had been established. We asked for and were shown the records of the regular testing of such things as hot water temperatures, fridge/freezer temperatures and fire alarm systems. We saw that these records were clearly and regularly maintained showing that the safety of the people who live in this home is monitored on a regular basis. We looked for records of staff training. We saw that records did not contain comprehensive information of what training staff had received. The manager told us that she was in the process of collecting this information from individual members of staff so that formal training programmes could be arranged. Care Homes for Older People Page 23 of 26 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 24 of 26 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 38 18 The staff must be trained in 19/02/2010 manual handling, fire safety, first aid, food hygiene and infection control to meet the needs of the people who live in this home 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 25 of 26 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 26 of 26 - 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. 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