Inspection on 23/06/05 for Averlea

This inspection was carried out on 23rd June 2005.

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 20/03/07

Averlea 30/11/05

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 PL25 4AD Lead Inspector Mike Dennis Announced 23 June 2005 09:30 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 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 D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Averlea Address Fore Street Polgooth St Austell PL26 7BP 01726 66892 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) Mr David Evely Mrs Beverley Easdon CRH 14 Category(ies) of OP, 14 DE(E), 4 registration, with number of places Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Total number of service users not to exceed 14 Date of last inspection 5th January 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 D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on the 23rd. June 2005 over a six hour period. The inspector met with the Registered Provider ,Mrs. Evely, the Registered Manager, Mrs Easdon, 5 of the staff on duty and with 5 service users. During the course of the day the inspector observed the service users being attended to by staff in a courteous and professional manner. Service users informed the inspector that their expectations of being in a care home were being fully met. Various records, policies and procedures were inspected and found to be satisfactory. The inspector visited all parts of the building and noted a satisfactory standard of hygiene. Service users expressed satisfaction with all aspects of the home. What the service does well: What has improved since the last inspection? The last report listed a number of statutory requirements and recommendations, all of which have been complied with, which mark improvements to this service. The format and information contained in care plans has been revised and improved. Service users are involved in the planning process. Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 Page 6 Food choice is more prevalent and service users indicated that that they were consulted re: choice of menu, likes and dislikes etc. More attention has been paid to staff training and the management of the home feel this is improving competencies. An additional cook has been employed. A refrigerator, solely for the storage of medication has been purchased. 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. Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3, 5 and 6 Each service user has a written contract/statement of terms and conditions. Service users are fully assessed prior to admission to the home. Prospective service users and relatives are afforded the opportunity to visit the home to assess it’s suitability as to meeting their needs This home does not provide Intermediate care EVIDENCE: Four service user files were inspected and case tracked. All contained information pertaining to pre-admission assessment. Assessments are undertaken within 5 days of admission in the case of emergency placements. Service users files contained signed contracts/ terms and conditions of the home. The contracts include details of fees to be paid. Annual increases in fees are normally in line with the increase of inflation Service users informed the inspector that the home meets their personal care needs. Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 Page 9 Policy documents indicate that prospective service users can visit the home before making the decision to move in. This was confirmed by service users and staff. Standard 6 is not applicable as the home does not provide intermediate care. Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8,9,10,11 The health care needs of service users are identified, planned for and met. Service users are treated with dignity and respect. Medication policies and procedures are comprehensive and followed by Trained staff EVIDENCE: The care planning system has been redesigned by the manager since the last inspection and is now comprehensive. The new system contains all the relevant information required to include a photo of the service user, past experiences/interests etc. Risk assessments cover falls, breathing, eating, moving and handling and health and safety. Care staff maintain the personal and oral hygiene of service users who require assistance with such matters. Service users are assessed regarding the risk of obtaining pressure sores; with appropriate preventative equipment provided as required. The incidence of any pressure sores are recorded and reviewed. All service users are registered with a GP. The home will refer to the District Nurse / Psychiatric Nurse for support and advice as required through the GP practice. Dental and chiropody services are provided Medication storage and processes were inspected. Records were properly maintained. One service user is able to self medicate through a risk Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 Page 11 management framework. A dedicated fridge solely for the staorage of medication has been provided. Staff were observed to treat service users with dignity and respect. Those service users spoken with confirmed this. Based on discussion with the manager, the inspector considers that the care of service users toward the end of their lives would be appropriate and conducted with sensitivity and respect. Service users wishes are recorded. Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15 The routines of daily living and activities made available are flexible and varied. Service users receive visitors at any reasonable time throughout the day Service users dietary needs are well catered for with a balanced and varied selection of food and drink available that meets tastes, and choices EVIDENCE: Service users discussed their individual interests with the inspector and explained the activities available to them. A record is now available detailing what activities take place and when. Flexibility in daily routines was observed. Service users assured the inspector that they can receive visitors at any time. This was also confirmed by the visitors book. The food prepared on the day of inspection was appetising and enjoyed by all. Choices are available and service users are asked what their preferences are. Questionnaires are employed. Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The complaints procedure is well publicised and would be used when required. The registered persons ensure that service users are protected from all forms of abuse with staff having knowledge through training of Adult Protection issues which helps to protect service users EVIDENCE: The home has a complaints policy that meets all the requirements of Regulation 22. A complaints log is available to ensure that a record of all complaints is recorded and kept. Details of the complaints policy are available in the statement of purpose and a full copy included within the service users guide The home has a policy in relation to adult protection, which includes information on whistle blowing. This policy references the Department of Health No Secrets guidelines and physical / verbal aggression by service users. Staff are made aware of this policy during induction and training sessions at staff meetings. Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 to 26 The location and layout of the home is suitable for it’s stated purpose and provides a safe environment. Comfortable indoor and outdoor communal facilities exist. Sufficient bathing and toilet facilities are available. The home was clean, hygienic and free from offensive odours providing a homely place to live Bedrooms are comfortable and contain the personal possessions of the occupant EVIDENCE: The inspector visited all parts of the Care Home meeting with staff from all departments and service users. The building presented as being homely, well decorated and maintained with good levels of personalisation throughout. Communal areas were satisfactory to include two lounges, a compact dining room and pleasant sitting out areas in the garden. Three communal bathing areas with a supply of aids and hoists are in use. Individual bedrooms vary in size and appearance. All are adorned by the occupants personal possessions. Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 Page 15 The home was clean and hygienic with no pervading odours present. Service users expressed satisfaction with their accommodation. Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30. Recruitment policies and procedures are implemented. All staff are supported and Inducted through improved training opportunities. A positive number of staff are on duty to meet the service user’s needs EVIDENCE: The home has a duty rota that accurately reflected the number and skill mix of staff on duty during the inspection. Two care staff are on duty at all times plus the owner and or manager, domestics and cooking staff. Currently at night there is one waking staff member and one sleep in staff. Evidence that 45 of the staff team have now achieved NVQ level 2 was presented at the inspection. Several other staff are now enrolled on NVQ training so the target of 50 may well be reached by the end of the year.. The home’s employment policies and procedures are implemented. 2 written references were evidenced within a random selection of staff files. CRB checks and POVA checks are completed. Staff training, induction and development programmes are undertaken. Service users commented that staff were helpful and pleasant. Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 34, 36 and 38. The registered manager is competent and qualified. Quality monitoring systems are in place. Expansion of existing systems is recommended. The home would appear to be financially viable. Positive employment policies are adopted. As far as is practicable the health, safety and welfare of service users is maintained EVIDENCE: The Registered Manager has completed the Registered Managers Award National Vocational Qualification Level 4 and has over fifteen years of experience in care. The manager is a qualified D32 and D32 Assessor and Manual Handling Trainer. She has undertaken Health and Safety and Safe Handling of Medicines training. Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 Page 18 Management have embarked on obtaining quality assurance feedback by way of questionnaires distributed to service users. It is now recommended that feedback information is also sought from relatives, and outside professionals. It is thought that this business remains financially viable based on the fact that considerable inward investment is planned. Employment policies and procedures are in place and were seen to be implemented. Staff files presented the evidence that supervision and appraisal of staff is undertaken as confirmed by those staff spoken with. The home ensures that the health, safety and welfare of service users and staff are promoted and protected as far as is practicable. Training and maintenance records were available for inspection. Other records required by legislation were available. Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 3 x 3 x 3 Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 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 Not at this inspection 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 OP33 Good Practice Recommendations expand the current quality assurance surveys to include relatives and other interested professionals ie. district nurse, social worker, GP. etc. Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell PL25 4AD 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 Averlea D52-D04 S8946 Averlea V224311 230605 Stage 4.doc Version 1.30 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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