Inspection on 03/03/09 for Averlea

This inspection was carried out on 3rd March 2009.

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

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 20/03/07

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 18/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Averlea Fore Street Polgooth St Austell Cornwall PL26 7BP     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michael Dennis     Date: 0 3 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 24 Information about the care home Name of care home: Address: Averlea Fore Street Polgooth St Austell Cornwall PL26 7BP 0172666892 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): averleahome@aol.com Mrs Julia Evely,Mr David Evely Name of registered manager (if applicable) Mrs Beverley Easdon Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: 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) Total number of service users not to exceed a maximum of 14 Date of last inspection Brief description of the care home 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 Care Homes for Older People Page 4 of 24 care home 14 Over 65 4 14 0 0 Brief description of the care home 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 Care Homes for Older People Page 5 of 24 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: This unannounced inspection took place on the 3rd. March 2009 over a period of approximately 7 hours. We were accompanied by an Expert by Experience who spent approximately 3 hours on the premises. We spoke with the registered manager, staff and residents, toured the premises and inspected the care documentation, policies and procedures and records required by legislation. Averlea is an established small home with an established staff team, and the benefits to the residents are evident in the individual attention provided as confirmed by the residents. Care Homes for Older People Page 6 of 24 Care Homes for Older People Page 7 of 24 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 set out 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 24 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 24 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. 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. Residents are assessed regarding their care needs prior to moving into the home. All have contracts of care. Evidence: We 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. This document is in the process of being updated to reflect recent changes. It can also be found on the homes web site. 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. Care Homes for Older People Page 10 of 24 Evidence: 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 and completes a pre admission needs assessment. Residents spoken with confirmed they feel they know whats going on. Contracts and statements of terms and conditions are held on the residents files. People are encouraged to visit the home before making the final decision to be admitted. Care Homes for Older People Page 11 of 24 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. 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: We 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 that reviews of the care plans have taken 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. We noted that of late the frequency of reviews has lapsed. Care plans should be reviewed on a monthly basis. Care Homes for Older People Page 12 of 24 Evidence: 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. We were impressed with the ambulance information record. Should a resident have to be admitted to hospital, a concise information document is given to the paramedics detailing their medication and health history. 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. A medicine policy is in place. Only staff who have been appropriately trained, administer medicines. An audit of the controlled drugs was undertaken and proved to be correct. Care Homes for Older People Page 13 of 24 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. 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. We 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 had a variety of life style options to choose from. The daily record sheets are generally well maintained, containing information of care provided and, perhaps to a lesser extent, information regarding visits and activities undertaken. During the morning most of the residents were sitting in the day room with music playing. There was no apparent interaction between the residents but one Care Homes for Older People Page 14 of 24 Evidence: lady continually shouted out which seemed to annoy some residents. There was a lack of supervised activities during this period although it is appreciated that staff were busy attending to various tasks. There was no sign of magazines and just one copy of The Sun newspaper. We did notice that the ladies had their nails painted, a nice touch to make them feel attractive and at the time there was a hairdresser at the home who was busy with several of the residents. During the afternoon a bingo session occurred followed by a sing along led by a member of staff. 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. Some 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 was positive and contributes to the pleasant environment at the home. Residents confirmed that the staff and management are approachable and pleasant. Residents were seen to have personal possessions, and all agreed that they are free to determine their own lifestyle. One resident said that she had been upset when a special sweater had gone missing but after several weeks it was found. It appears that the residents clothes are not labelled. 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. The choices on the day of inspection included roast pork and chicken. 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. Buns, cakes etc. are regularly freshly cooked at the home. Based on observation, perhaps more fresh fruit could be on offer. Care Homes for Older People Page 15 of 24 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. 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 homes 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 verbally described the procedure to be followed should an allegation of abuse be raised. The homes aims and objectives include the rights of residents. Residents are supported to live as independently as possible, exercising their rights to make choices and decisions with assistance when needed. All the residents have family or someone acting in their interests. Care Homes for Older People Page 16 of 24 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 adequate quality outcomes in this area. We have made this judgement using a range of 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. Water temperatures need urgent attention. 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. Residents bedrooms are comfortable, furnished and decorated to a reasonable standard, and are personalised to varying degrees to reflect the individuality of the resident. Personal possessions were evident in residents rooms to varying degrees. We talked to several of the residents and two of them showed me their rooms. The first resident shared a room, which could be divided by pulling a curtain across. There was one sink directly in front of a window and in the half of the room occupied by the other resident. We ran the hot water for some time but it continued to run cold. We Care Homes for Older People Page 17 of 24 Evidence: asked the resident if there was ever hot water and she replied no. We asked how she managed to wash in the mornings and she said that she emptied her hot water bottle in the sink which gave her warm water to wash in. The window did not have a net curtain so without pulling the main curtain and putting the light on she would have been exposed to neighbouring properties and also exposed to her room mate. This resident did not have privacy and could not retain her dignity. The room was cold and the radiator off, it would be uncomfortable for the resident to have a sleep during the day or spend time watching TV or reading. The second resident showed us her room which was single occupancy but again there was no hot water and the sink was positioned in front of a large window with no net curtain, the radiator was also cold. We asked the resident if she had any photos that she could show us. A member of staff was in the room at the time and took a very dusty folder from the top of the cupboard which contained photos of family, friends and dogs that she had owned for many years. The residents face lit up when we looked at the photos, we felt it would have been nice for her to have them on show to remind her of some memorable times in her life. There were few personal possessions in the rooms to make them feel homely. We did like the way the rooms were identified by a photo of the occupant with their name on the door. The home was seen to be reasonably clean. There was a slight odour during the morning but this was not discernable during the afternoon. 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. Maintenance and refurbishment continues. New fire door closers have been fitted as has a new fire alarm system. A substantial area of the home has been re carpeted since the last inspection. The outside of the building is being painted. We are concerned that there was no hot water available to outlets on the first floor. The manager was sourcing professional help to rectify this matter by the end of the inspection. On arrival there was a slight odour in the home. This was not prevalent later in the day. Care Homes for Older People Page 18 of 24 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 training is ongoing to ensure that the staff have the skills to care for the residents. The homes 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, 10 of which have achieved NVQ Level 2 or above. 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. The homes employment policies and procedures were inspected. All staff employed had the appropriate documentation in their individual files. This included application forms, records of interviews, references, police checks and evidence of identity. Care Homes for Older People Page 19 of 24 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. 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 has achieved the NVQ Verifiers Award, and the assistant manager has achieved NVQ Level 4 and the NVQ Assessors Award since the last inspection. This in addition to qualifications previously held. Residents confirmed that they would feel able to speak to staff and management about any concerns. The registered manager has worked at the home for a number of years. Residents handle their own finances or have representatives able to do so. The home keeps small amounts of ready cash in respect of some residents. Appropriate accounting systems are in place. Care Homes for Older People Page 20 of 24 Evidence: We inspected the staff supervision records. They indicate that staff do receive supervision and annual appraisals. The frequency of supervision should be more frequent to ensure that all staff are seen at least six times per year. There are comprehensive policies and procedures in operation, and there is documentary evidence of regular and frequent equipment checks and maintenance. Care Homes for Older People Page 21 of 24 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 22 of 24 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 21 23 The hot water supply to all wash basins must be restored with all haste. The Registered Person shall provide wash basins fitted with a hot and cold water supply 15/04/2009 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 2 7 36 All care plans should be reviewed at monthly intervals. Supervision of all staff should occur at least six times per year Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - 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!