Inspection on 06/10/05 for 2 Seymour Terrace

This inspection was carried out on 6th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

2 Seymour Terrace 28/01/09

2 Seymour Terrace 07/02/07

2 Seymour Terrace 20/01/06

2 Seymour Terrace 21/10/04

2 Seymour Terrace 14/09/04

2 Seymour Terrace 04/03/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 2 Seymour Terrace 2 Seymour Terrace Totnes Devon TQ9 5AQ Lead Inspector Graham Thomas Announced 6 October 2005 th 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 2 Seymour Terrace Address Totnes, Devon, TQ9 5AQ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01803 867506 enquiries@thepriory.org.uk Katherine H L Finnigan The Very Rev Archpriest Benedict Ramsden, Mr Simeon Ramsden, Mrs Lilah Ramsden Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21 October 2004 Brief Description of the Service: 2 Seymour Terrace belongs to the Community of St. Anthony and Elias which specialises in the care and support of people with mental health needs. The Community has a number of homes in the Plymouth and South Hams areas of Devon. The premises are close to the centre of Totnes where there is a range of shops as well as cultural and recreational amenities. Although the home has remained registered as a care home it has until recently been used by the Community for office and training accommodation. The home reopened for residential care in August 2005 after a reconfiguration of the accommodation and general refurbishment. Places are now provided for a maximum of two service users in a homely environment. Service users are supported to maintain and develop their social contact, activities and interests. 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector spoke with both service users, two staff and the Manager. A tour of the home was conducted. Care plans were examined as well as a variety of other documents such as staff files and health and safety records. The Inspector joined staff and service users for lunch. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Thorough assessments are conducted of prospective service users’ needs, aspirations and interests. EVIDENCE: At the time of inspection, one service user had been fully admitted. The other was in a period of transition and living at the home for part of the week whilst arrangements are being finalised for full admission. Professional assessments were contained on both care plan files and the Community’s own assessments were also seen. These included the interests and aspirations of each service user. Care plans with clear goals were in place for both service users. Risk management plans had been formulated on the basis of individual assessments of risk. These clearly identified actual / potential restrictions on freedoms and choices. 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 Service users can be confident that their individual needs and choices are well understood and supported by the home’s staff and management. EVIDENCE: Both service users had clear plans based on a thorough assessment of their individual needs, aspirations and interests. These included risk management plans based on individual assessments of risk. The risk management plans contained details of actual and potential restrictions on freedoms and choices. As neither service user had been at the home for longer than two months, no reviews of the plans had yet taken place. Discussion with the service users indicated that they were aware of the roles of the home’s staff and external professionals involved in their care and support. Advocacy information had been provided with the Service Users’ Guide. Both service users were able to exercise a high degree of independence. Discussion with staff and service users and an examination of care plans showed that the service users were well supported to make choices and decisions about their lives. This was evident in the daily routines of the home (e.g. planning and preparing meals) and the choices of activities and social relationships which were being supported. Arrangements for service users’ finances promote as much autonomy as possible for individual service users. 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 9 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 ,15, 16 and 17 Service users are well supported to pursue their own lifestyle choices. EVIDENCE: Both service users enjoy a relatively high degree of independence. Access to the Community’s commendably well developed activities programme includes outdoor activities, arts and crafts and music. In each case qualified workers are employed by the Community to work with individuals and groups. Both service users have an interest in playing music. A music theory session was taking place in the home on the afternoon of the inspection. One service user had been supported to pursue an interest in organic gardening through a local organisation. Other interests in yoga, massage and spiritual development were also being supported using resources in the wider community. The arrangement of the staff shift system enables a flexibility in supporting activities during the day and evening. Information concerning local activities was posted on a notice board in the dining room. At the time of inspection a holiday was being planned to coincide with the fitting of a new heating system. Service users’ rooms are lockable and keys are made available to their occupants. Individual choices to be alone or in company were seen to be 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 11 respected by staff and this was confirmed in discussion with service users. Service users open their own mail. Interaction between staff and service users was relaxed and supportive. Meals are chosen by discussion with staff and service users on a shift by shift basis. Individual dietary preferences, which are recorded in the care plan, were respected. A lunch was taken with service users and staff in the home’s kitchen / dining room. This was a relaxed and congenial occasion in which all discussed the day’s events. Fresh ingredients are used in a wholesome and nutritious diet. 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 Service users’ personal and healthcare needs are clearly identified and well supported. EVIDENCE: Little personal support is required by either service user. Each was dressed in the style of their choice, reflecting their own tastes and personality. Care plans included details of health needs and records of the involvement of healthcare professionals. One service users’ interest in complementary therapies was being supported. Independence was being promoted by supervised self-medication at the time of inspection. All medicines were securely stored. No controlled drugs were in use. A list had been obtained of approved homely remedies. Records relating to the monitored dosage system in use were found to be up to date and in good order. 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Service users can feel confident that their concerns are taken seriously and that they are adequately protected from abuse EVIDENCE: No complaints had been made to the home or Commission at the time of inspection. A complaints procedure was in place which had been made available to service users. This included details of how to complain directly to the Commission. The size of the home and degree of individual attention enable individual concerns to be dealt with informally before they might escalate. Policies and procedures were in place concerning the protection of vulnerable adults from abuse and whistle blowing by staff. The staff training programme includes elements of understanding and managing aggression. All staff are trained in de-escalation techniques as well as physical restraint. The Community’s Finance Officer has stated that all service users’ monies are held independently of the Community’s business accounts. 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 Service users’ comfort, safety and convenience are well provided for by the home’s environment. EVIDENCE: Since the last inspection, the home has been reconfigured and refurbished to provide accommodation for two service users. On the lower ground floor there is an office with a screened-off staff sleep-in facility. The kitchen / diner on this floor overlooks the rear garden. A small separate laundry also sited on this floor has cleanable walls, a washable floor and hand washing facilities. The home’s washing machine has adequate programming facilities for the current service user group. A lockable cupboard on this floor provides secure storage for hazardous cleaning substances. On the ground floor level a very spacious, airy and comfortable lounge provides for relaxing, watching the television and the pursuit of hobbies and interests. The two service users’ bedrooms and another staff sleep-in room are sited on the first floor. There is also a bathroom on this floor. All areas of the home were found to be clean, and comfortably furnished in a domestic style. Lighting and ventilation were adequate in all areas. A completely new heating system was about to be installed. Service users’ own rooms had individual character and contained many personal items. The second floor of the home is now only used for 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 15 storage and not by service users. It is recommended that the registration should be reduced from three to two places to reflect this reconfiguration. 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Staff supporting the service users are adequately trained. EVIDENCE: Staff training within the Community is planned and organised centrally. Evidence has been seen of structured induction training which includes issues specific to the service user group as well as the principles of care, health and safety topics, and the worker’s role. Training needs are identified as part of the system of regular staff supervision and appraisal and form the basis of an individual training plan. 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 Systems for service users’ involvement in the monitoring and development of the home are not adequately developed. The health and safety of staff and service users is generally well promoted and protected EVIDENCE: The Manager of 2 Seymour Terrace is experienced and qualified to NVQ level 4 in Care. He has also completed the Registered Managers Award. He has yet to apply for registration with the Commission. Evidence form this inspection including discussion with service users, staff and the Manager, and the examination of records indicate that the home is well run. The Community of St. Anthony and St. Elias has developed a quality assurance system though this has not yet been fully implemented in the home. However, a high degree of individual attention enables service users’ suggestions to be heard informally. Records concerning fire safety were satisfactory in respect of risk assessment, staff training and of systems and equipment. Risk assessments for safe working practices were seen. Fridge and freezer temperatures are regularly 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 18 monitored. Hazardous substances are securely stored and data sheets are available for staff reference. Records were seen of recent checks of gas safety and electrical systems and equipment. Regular water temperature checks are conducted and water temperature is regulated to prevent the risk of scalding. A risk assessment concerning legionella has yet to be completed. Staff are trained in health and safety topics including, for example, fire safety, first aid and food hygiene. A system is in place for the recording of accidents and incidents. 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 4 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 2 Seymour Terrace Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x 2 x D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard 25 37 39 42 Good Practice Recommendations It is recommended that the number of places for which the home is registered should be reduced to two to reflect changes in the accommodation. The Manager should present an application for registration with the Commission. A quality assurance system should be fully implemented in the home A risk assessment concerning legionella should be completed. 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 2 Seymour Terrace D54-D07 S3629 2 Seymour Terrace V241921 061005 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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