Random inspection report
Care homes for older people
Name: Address: Trevaylor Manor Newmill Road Gulval Penzance Cornwall TR20 8UR three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Lynda Kirtland Date: 2 9 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Trevaylor Manor Newmill Road Gulval Penzance Cornwall TR20 8UR 01736350856 01736360370 trevaylor@swallowcourt.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Janet Prela Type of registration: Number of places registered: Conditions of registration: Category(ies) : Swallowcourt Limited care home 73 Number of places (if applicable): Under 65 Over 65 24 24 73 0 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Conditions of registration: 0 0 0 24 Dementia over 65 years of age, excluding learning disability or mental disorder, (DE(E)) Maximum 24 The Home may accommodate up to 5 service users aged between 50 - 65 years for respite or permanent care. These service users may be across the registered categories, depending on need. Care Homes for Older People Page 2 of 10 Date of last inspection Brief description of the care home Trevaylor Manor is large detached manor house standing in spacious landscaped grounds approximately two miles outside of Penzance. It is registered under the terms and conditions set out in the Care Standards Act 2000 and Care Homes Regulations to provide nursing and residential care to 73 people in need of nursing and personal care (24 of whom have a dementia or a mental disorder past or present and are accommodated mainly on the lower ground floor of the home.). Residents rooms are spread out over three floors with a shaft lift to access all floors. Residents bedrooms are a mixture of single and double with most of the rooms having ensuite facilities. Bathrooms and toilets with aids and adaptations are located on each floor. Communal facilities consist of a spacious lounge dining room with a decked area adjacent to this room. The home has its own mini-bus and on Tuesdays and Thursdays will pick up family members from their private homes if they dont have transport. There are extensive landscaped gardens around the home, which are much enjoyed by all with a tarmac drive that leads to a sun house for the residents to enjoy. Medical cover is provided by several general practitioners practices from Penzance. There is ample parking to the front and rear of the home. There are qualified nurses on duty throughout the twenty-four hour period and the staffing ratios are determined to meet the range of needs of the residents that are accommodated. Management have established a very successful carers group for the dementia wing. The manager describes the aims, services and facilities clearly in the Statement of Purpose. The home sets out to provide a high quality service that responds to individual needs and preferences. Fees range from £750.00 to £795.00 per week. Additional charges are made for, hairdressing, private chiropody. Care Homes for Older People Page 3 of 10 What we found:
An inspector visited the service to undertake a Random Inspection on the 29 June 2010. The inspection lasted seven hours. I met with the Registered Manager, Jan Prela, Sue Godfrey Head of Dementia Services, Stephen Baber, Head of Quality and Care Performance and Christine Allerton, Nominated Individual and Managing Director (hereafter referred to in the report as the management team). I also spoke with staff, people who use the service and relatives to gain their views and experiences of working, living, or visiting Trevaylor Manor. In addition I later went to visit the new training school and meet with the Chief Executive and staff team there. At the time of this inspection 67 people were using the service. Due to the field force model being implemented the Random Inspection was directed to focus on the following areas: review of the records of the last two people referred to the service, review of the last two staff members appointed to the service, review Controlled Drugs medication, review of the premises and review of the notifications. In addition I was shown Quality Assurance Reports that have recently been completed plus visited the new training school where staff files are kept to inspect. From inspection of the two mostly recently admitted people to use the service, it was evident on both files that a robust admission process is in place. One person was an emergency admission however information from relevant health professionals were sought and this assessment was then incorporated in to the persons care plan. The other case demonstrated that a full assessment of the persons care needs were undertaken again taking into account assessments from other relevant professionals and family. The care plans were satisfactory, did cover all the persons care needs and were factual in identifying what the care needs of the individual are. In discussion with the management team they acknowledged that the care plans could be expanded further so that they inform, direct and guide staff members to enable staff to be clear about what is expected of them so that consistent interventions are then provided to a person in the delivery of their care. We also discussed that there are currently no care plans in relation to a person social and leisure needs. However through the life story work this information is gained. The home needs to show that they are taking into account the persons individual social needs and how they will meet them. During this inspection it was evident that social needs are met as I observed people socialising in the garden, lounge, meeting with visitors, nail care being undertaken, reading newspapers, watching Wimbledon, music playing, people dancing and was told of how staff meet particular leisure needs such as running, with particular individuals. We also discussed to improve the care plans further to look at peoples aspirations wishes and goals in more detail. The management team took on board all these comments and stated they would address them. Risk assessments were completed and identified clearly if a person was at risk and what action should be taken. In the main these cross referenced to the care plan. Information from health professionals were evident on files and showed that there is good communication between the staff at the home and relevant agencies i.e. SALT,
Care Homes for Older People Page 4 of 10 Parkinsons specialist, Hospital departments and GPs. An inspection of the Controlled Drugs showed that there is a robust process in place. A tablet count tallied with the records kept in the home and records were kept appropriately. Two most recently recruited staff files were inspected. They showed that a robust recruitment process is in place with relevant application, health, CRB , references and identity checks being undertaken prior to employment at the service. Interview notes are kept and it is recommended that at the time of interview any gaps in employment should be recorded to evidence the persons work history. These files also showed that a thorough induction process is carried out with all new staff. Staff attend a two week induction at the organisations training center, they are then in the home shadowing other staff members for two weeks before commencing duties unsupervised. All mandatory training is kept up to date and it is evident that the organisation places training of its staff as a high priority. Seventy percent of staff has a minimum of NVQ level 2 qualification. In discussion with staff they felt that access to and the quality of training was positive. Nursing staff felt that if they needed more specialist training that they could access the health service for this. In addition regular formal recorded supervision of staff is undertaken. From a tour of the home it was evident that the home provides clean, safe accommodation that is attractive in appearance and in its furnishings. The Registered Manager showed me plans as they are intending to redesign the layout of the home which will create for example more rooms for people who use the service to use i.e. a sensory room, designated activity room and pamper room plus two new bedrooms, kitchen to be relocated and a additional lift to be installed. During the inspection decorators were painting communal corridors. The Registered Manager informs the Commission of all incidents under regulation 37 of the Care Standard Act. I was shown the Quality Assurance Surveys recently completed. The conclusions from this report were that people who use the service were very satisfied with the food, the care support they receive from staff, their daily living routines and with the effort made by staff to continue with their interests. For staff they were positive regarding the support they receive and training. Professionals feedback was likewise positive in how the staff at home delivers good care to people who use the service and felt that relationships with the home were very good. All stated that they could approach the manager and felt the environment at the home was very good. There is an action plan that the management team are currently addressing in the areas of focusing on developing social activities, to ensure the maintenance of the home is kept good and that the quality of training is kept high. What the care home does well:
From discussion with the people who use the service and their relatives they were all very satisfied with the care and support they receive at the home. Some comments included: marvelous, nothing is too much trouble, no concerns, cant do better and first class. In March 2010 the Commission received 10 surveys from people who use the service, all were complimentary regarding the care received. No one could identify areas for improvement.
Care Homes for Older People Page 5 of 10 In March 2010 the Commission received five surveys from staff. The only comments made were five staff identified to improve the activities on offer, and two said bedroom furniture needed improving. However both of these have since been addressed. From discussion with staff all stated they were happy to work at the home. They felt that the manager was approachable, that there was enough staff on shift and that access to training was good. Staff said the manager was flexible, that she was a good listener and was fair. No one could identify areas for improvement. The management team have invested a lot of finance to ensure that it can continue to provide an excellent service. Some examples of this are, the Statement of Purpose and Service Users guide are now available in CD format as well as written format, implementation of quality assurances systems, monthly regulation 26 visits take place (and was occurring on the day of inspection), policies and procedures have been reviewed, meal books have been provided and the creation of the training school and Human Resource department. There have been numerous improvements to the environment, one of which is the installation of external soft surfacing to enable residents with mobility constraints to be able to access out door activities and enjoy the sensory gardens with significantly reduced risk to injury from falls. In respect of recruitment they have increased the staffing hours in the areas of kitchen and recreational staff and are hoping to employ an Occupational Therapist to join the team. The Kitchen department was awarded the Gold award at the last Environmental health Inspection. The Registered Manager keeps us informed of all events in the home and completed the AQAA to assist in this inspection process. 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 2.
Care Homes for Older People Page 6 of 10 Care Homes for Older People Page 7 of 10 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 10 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, 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 38 fire doors should not be wedged open to ensure that peoples safety is not compromised. Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 10 of 10 - 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!
