Inspection on 20/03/07 for Averlea

This inspection was carried out on 20th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Averlea 03/03/09

Averlea 30/11/05

Averlea 23/06/05

Averlea 05/01/05

Averlea 14/09/04

Averlea 23/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Averlea Fore Street Polgooth St Austell Cornwall PL26 7BP Lead Inspector Alan Pitts Unannounced Inspection 20th March 2007 09:30 X10015.doc Version 1.40 Page 1 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 Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 2 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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery 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. Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Averlea Address Fore Street Polgooth St Austell Cornwall PL26 7BP 01726 66892 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr David Evely Mrs Julia Evely Mrs Beverley Easdon Care Home 14 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (14) of places Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users to include up to 14 adults of old age (OP) Service users to include up to 4 adults aged over 65 with dementia (DE{E}) Total number of service users not to exceed a maximum of 14 Date of last inspection 30th November 2005 Brief Description of the Service: Averlea offers accommodation and personal care for up to fourteen Service Users (Old age, not falling within any other category) and to include up to four Service Users who have Dementia and are over 65 years of age.Averlea is situated centrally in the small village of Polgooth approximately five miles from St. Austell. There is a small shop and post office within walking distance from the home. Accommodation is provided on two levels, with a stair lift to the first floor.There is an assisted bathroom on the ground floor.There are patio areas to the front and rear of the building.The home offers a limited number of day care places, often from the local community so that Service Users can keep in touch with the local community. Meals on wheels are provided from the Home and the Proprietors operate a Domiciliary Care independently from the Home. There is a small car park to the front of the home.Due to the central location of the Home, there are often visitors from the local community who know several of the Service Users Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 20th March 2007 over a period of approximately 5 hours. The inspector spoke with the registered manager, staff and residents, toured the premises and inspected the care documentation. Averlea is an established small home with an established staff team, and the benefits to the residents are evident in the individual attention provided (confirmed by the residents). What the service does well: What has improved since the last inspection? What they could do better: The home could do more to demonstrate choice, and the lifestyle of the residents. They could improve the quality assurance systems. Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 3 and 6 were inspected. This judgement has been made using available evidence including a visit to this service. The registered manager is proactive in ensuring the residents are well informed. Prospective residents may visit the home prior to making a decision about admission. The home does not offer intermediate care. EVIDENCE: The inspector examined care documentation and spoke with residents and staff. Most of the residents at Averlea have lived there for some years now. The home has a Statement of Purpose and Service User Guide, which are provided to all the residents. The residents confirmed that there are frequent informal meetings when the registered provider informs them of any likely changes or events that may affect their lives at the home. Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 9 Admissions to the home only take place if the registered manager is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. The registered manager considers the application together with the resident and/or their representative, and other relevant agencies. Residents spoken with confirmed they feel they ‘know what’s going on’. The home does not offer intermediate care. Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 7, 8, 9, and 10 were inspected. This judgement has been made using available evidence including a visit to this service. Care plans are in place for each resident. Medicines are handled and administered safely. The registered manager maintains a close relationship with the residents to ensure that their care needs are met, and their wishes known. EVIDENCE: The inspector spoke with the registered manager and residents, and inspected the care documentation. Each resident has in place a detailed care plan, which identifies care needs and how these are being met. The care plan identifies all religious, cultural and social needs with information included on dietary needs and requirements. Evidence is in place of monthly reviews taking place, and, where possible, resident involvement in this process is clearly recorded. Feedback and involvement is a continuous ongoing process, staff spend time with individual residents to ensure they understand decisions and actions. Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 11 The care plans identify the health care needs of the residents with evidence of health care professional involvement for example chiropody and optician visits. Care documentation is written in clear language. During the course of the inspection all the residents spoken to gave positive comments on the standard of care delivery at the home. Staff promote the residents’ right of access to the health and remedial services that they need, both within the home and in the community. There are systems in place to make sure residents are reminded of appointments, and appointments are not missed. Records show that the home arranges for health professionals to visit frail residents in the home and provides facilities to carry out treatment. The storage of medication is secure. The home uses a monitored dosage system. The Medicine Administration Records were seen to be in order, though where instructions are hand written the registered manager should ensure that the records show two initials, indicating that the instruction is correct. A medicine policy is in place. The registered provider, and one other designated member of staff, administers medicines. Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 12, 13, 14, and 15 were inspected. This judgement has been made using available evidence including a visit to this service. Residents confirmed that they are free to receive visitors and often do so, and that they are free to determine their own lifestyle. The residents were complimentary about the quality of the food provided. All were positive in their comments about life at Averlea. EVIDENCE: Visitors are encouraged into the home and visitors were observed at the home during the course of the inspection. The inspector met with one visitor who expressed a high opinion of the home, its staff, and the care provided. Residents confirmed that they are free to receive visitors and often do so, and that they are able to keep in contact with family and friends living in the community. Residents can choose to entertain visitors in their own rooms or perhaps a lounge or garden areas. Residents confirmed that they a variety of life style options to choose from. The registered manager could do more to ensure that entries in the daily care Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 13 notes reflect the residents’ lifestyle. Routines are very flexible and residents said that they can make choices in major areas of their life. Residents are encouraged to be responsible for their own money for as long as they wish, and are able to maintain their independence, for example, collecting their own pension, paying for shopping and managing their own bank accounts. Two of the residents spoken with confirmed that they make use of the facilities in the local area. Residents will often do some shopping for each other. Staff give help when it is needed. The service is very clear about the rights of residents to be able to read their records and staff may regularly spend time with them making sure that they are fully aware of the information which the home keeps. Observation of the interaction between the residents and the staff (including the registered provider and her husband) was very positive and contributes to the very pleasant environment at the home. Residents confirmed that the staff and management are approachable and pleasant, one saying, “speaking to Carole and Dave is like speaking to family”. Residents were seen to have personal possessions, and all agreed that they are free to determine their own lifestyle. Dietary needs, and likes and dislikes, are included in the residents’ care plans. Records are maintained of the food provided. Residents spoken with confirmed that they would be able to have an alternative if they wanted, but they are not routinely asked. All were complimentary about the standard of cooking at the home. The cook in the home is qualified and experienced in cooking for older people. Mealtimes are relaxed, and allow residents the time they needed to finish their meal comfortably. The registered manager should ensure that residents are actively offered a choice at meals, and ensure that the menu shows the options available. Although it is recognised that an alternative is available and the current residents are more than able to say if they do not like or want what is offered, the registered provider should do more to ensure that residents are offered a choice at meals every day. Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 16 and 18 were inspected. This judgement has been made using available evidence including a visit to this service. Residents confirmed that they are treated with respect and that their rights are protected. The registered provider is proactive in ensuring the welfare of the residents. EVIDENCE: Residents confirmed that the staff and the registered manager are respectful and that their rights are protected. The complaints policy is included in the home’s Service User Guide and Statement of Purpose, which is provided to each resident. Residents also confirmed that they would feel able to express any concerns should they have any. The registered manager has contact with the residents every day. Relevant training is provided. There is a Protection Of Vulnerable Adults policy. The registered manager should ensure there is a procedure, which provides clear practical instruction to staff (and relevant contact information) as to what to do in the event of an allegation of abuse, which references ‘No Secrets. The homes aims and objectives include the rights of residents. Residents are supported to live as independently as possible, exercising their rights to make Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 15 choices and decisions with assistance when needed. All the residents have family or someone acting in their interests. Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 19 and 26 were inspected. This judgement has been made using available evidence including a visit to this service. Averlea is a well maintained home externally and internally. The home is clean, pleasant and hygienic and suitable for its stated purpose. EVIDENCE: The shared areas provide a choice of communal space with opportunities to meet relatives and friends in privacy or in their own rooms. The decor is domestic and homely, providing a relaxed and comfortable environment for residents. The registered manager liaises with other health care agencies to ensure the provision of specialist equipment according to the individual needs of the residents. Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 17 Residents’ bedrooms are comfortable, furnished and decorated to a high standard, and are personalised to varying degrees to reflect the individuality of the resident. Personal possessions were evident in residents’ rooms. The home was seen to be clean, pleasant and odour free throughout. There is industrial-type laundry equipment in use, and the kitchen was seen to be clean and orderly. There is an infection control policy in operation and appropriate hand washing facilities and infection control aids are provided. Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 27, 28, 29, and 30 were inspected. This judgement has been made using available evidence including a visit to this service. Staff training is ongoing to ensure that the staff have the skills to care for the residents. The home’s working practices, staff numbers and skill mix protect residents. EVIDENCE: At the time of the inspection there were 14 residents living at the home, with the registered manager and 2 care staff on duty. The staff numbers and skill mix meet the care needs of the current residents. There are 11 care staff employed, 7 of which have achieved NVQ Level 2 or above, and the remaining 4 staff are undertaking this training. Staff turnover is low, which benefits the residents. The registered manager is aware of, and has the necessary documentation, for implementing a National Training Organisation compliant induction programme for any new staff. The staff records show evidence of regular training, supervision and appraisals, and adherence to a robust employment procedure. The home has purchased an externally verified training package to assist with ongoing staff training. Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. National Minimum Standards 31, 33, 35, and 38 were inspected. This judgement has been made using available evidence including a visit to this service. Averlea has an effective registered manager in day-to-day control that ensures good standards are maintained by means of working practices and close liaison with the residents. EVIDENCE: The registered manager is undertaking the NVQ Verifiers Award, and the assistant manager is doing NVQ Level 4 and the NVQ Assessors Award. Residents confirmed that they would feel able to speak to staff and/or management about any concerns. The registered manager has worked at the home for a number of years. Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 20 Two residents have their finances managed by the home, and accurate receipts and records support these. The remaining residents handle their own finances or have representatives able to do so. A quality assurance questionnaire remains in use, and a sample of the feedback received was seen. As discussed, the registered manager should expand the current quality assurance surveys to include relatives and visiting professionals, and publish a summary of the findings (possibly in the Service User Guide). This recommendation is carried over from the previous inspection. There are comprehensive policies and procedures in operation, and there is documentary evidence of regular and frequent equipment checks and maintenance. Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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. 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. Refer to Standard OP9 Good Practice Recommendations Where instructions are hand written on Medicine Administration Records, the registered manager should ensure that the records show two initials, indicating that the instruction is correct. The registered manager should do more to ensure that entries in the daily care notes reflect the residents’ lifestyle. The registered manager should ensure that residents are actively offered a choice at meals, and ensure that the menu shows the options available. The registered manager should ensure there is an Adult Protection Procedure, which provides clear practical instruction to staff (and relevant contact information) as to what to do in the event of an allegation of abuse, which references ‘No Secrets. The registered manager should expand the current quality assurance surveys to include relatives and visiting DS0000008946.V325715.R02.S.doc Version 5.2 Page 23 2. 3. 4. OP12 OP15 OP18 1. OP33 Averlea professionals, and publish a summary of the findings (possibly in the Service User Guide). Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Averlea DS0000008946.V325715.R02.S.doc Version 5.2 Page 25 - 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. 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