Inspection on 15/12/06 for Bishopsteignton House

This inspection was carried out on 15th December 2006.

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

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

CARE HOMES FOR OLDER PEOPLE Bishopsteignton House Forder Lane Bishopsteignton Devon TQ14 9SE Lead Inspector Susan Samways Unannounced Inspection 15th December 2006 13:00 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 Bishopsteignton House DS0000067788.V315193.R01.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. Bishopsteignton House DS0000067788.V315193.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bishopsteignton House Address Forder Lane Bishopsteignton Devon TQ14 9SE 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) 01626 770383 Coastal Care Homes Limited Peggy Johnson Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Bishopsteignton House DS0000067788.V315193.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28/02/06 Brief Description of the Service: Bishopsteignton House is a well maintained, converted Victorian property situated in the small village of Bishopsteignton. The home is set in attractive secluded gardens and is approximately two miles from the seaside town of Teignmouth. The home is arranged over two floors and can be accessed by stairs or passenger lift. There are grab rails and ramps within the home and outside the property. Communal space comprises: a large dining room with estuary views, quiet lounge, conservatory and a large entrance hall where service users often sit. The home provides personal care to a maximum of 25 service users of either gender who are over the age of 65. Community health services are accessed via local General Practitioners. The care staff are led on a day to day basis by the Registered Manager. Fees charged range from £305 to £585. Bishopsteignton House DS0000067788.V315193.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which took 4.5 hours. This was the first inspection to take place since the home changed hands. The registered manager, Mrs Peggy Johnson, was on duty for the first half of the inspection and the responsible individual from the company which owns Bishopsteignton House, Mrs Nikki Rogers, who is also a director of the company, was able to join the inspection after about an hour. A pre-inspection questionnaire had been completed by the responsible individual and the registered manager prior to the inspection. Twelve survey forms were received from residents, five comment cards and a letter from relatives and four survey forms completed by staff. A visiting health care professional was spoken to during the inspection. Several residents and a relative were spoken to during the inspection and the files for three residents and three staff were examined. Other records that the home is required to keep were checked. What the service does well: Residents who commented in survey forms or who were spoken to during the inspection praised the registered manager and the staff. They said that they were like members of their extended family and were very thankful that they had remained working in the home when it changed hands. They said that their privacy and dignity were respected, that they were never rushed and that they were enabled to remain as independent as possible. They said that the manager was easy to talk to and that she quickly sorted out any problems that they might have. They said that they could always have a good laugh with whoever was on duty. The residents said that they had a good social life. They particularly liked the trips out in the minibus and looked forward to them. They generally liked the activities provided and appreciated the considerable communal space which enabled them to sit quietly on their own if they wished or spend time with others. Comments about the meals were positive, with appreciation for the efforts of the cook to accommodate their preferences being expressed. A resident with poor eyesight said that the consideration shown by the staff enabled them to manage their daily life as independently as possible and to maintain contact with family and friends. Bishopsteignton House DS0000067788.V315193.R01.S.doc Version 5.2 Page 6 Relatives expressed their appreciation of the service provided by the staff describing them as dedicated and caring. They said that the manager kept them informed of the well-being of their relative. The home is comfortably furnished and spotlessly clean. The home has a low turnover of staff, which provides continuity for the residents. The staff know the residents well. Staff are trained in safe working practices. The staff said that they feel well supported by the registered manager and by each other and they work well together as a team. There are good relationships with local GPs and other health care professionals. 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. The summary of this inspection report can be made available in other formats on request. Bishopsteignton House DS0000067788.V315193.R01.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 Bishopsteignton House DS0000067788.V315193.R01.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): 1,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have a comprehensive assessment and are provided with sufficient information to enable them to decide whether Bishopsteignton House is the right home for them. EVIDENCE: As part of the registration process, the company that now owns Bishopsteignton House was required to produce a Statement of Purpose and Service Users Guide to inform present and prospective residents of the services the home provides. Copies of these were seen to be available in the entrance lobby to the home. Many of the residents or their families are from the local area and knew of the home’s good reputation prior to considering moving in. They also said that they had been able to visit the home if they wished and stay for a trial period before making a final decision. A relative said that they Bishopsteignton House DS0000067788.V315193.R01.S.doc Version 5.2 Page 9 had been made very welcome and that the manager and other members of staff had been very willing to answer any questions that they had had. They were also able to make more than one visit if they wished before deciding whether the home was suitable. The files for three residents were examined one of which was a recently admitted resident. All had detailed assessments covering all aspects of the resident’s life including likes and dislikes, their preferred name and key information about their past history. Bishopsteignton House DS0000067788.V315193.R01.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): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health and social care needs are well met and regularly reviewed with staff, resident and, where relevant, their relatives. EVIDENCE: The care plans for three residents were examined. Since the change of ownership a new style of care plan has been introduced. The manager said that she and the staff were still getting used to the new paperwork and ways of recording information but they would soon be familiar with it. All the required information was found to be included in the care plans. Two of the care plans had been signed by relatives on behalf of the residents concerned, the third had not been signed but the manager stated that the resident was aware of the content and agreed to ask the resident to sign. Regular reviews of each of the care plans had been recorded and daily records were in place. Bishopsteignton House DS0000067788.V315193.R01.S.doc Version 5.2 Page 11 The twelve residents who completed surveys all said that they always get the medical attention that they need. They said that their GP will visit them at the home or they can go to the surgery if they wish. One surgery sends a GP to the home once a week to deal with non-urgent problems. This has resulted in a good relationship developing between the surgery and the home. A district nurse visiting a resident at the time of the inspection said that the care staff were aware of their capabilities and did not attempt to deliver care that was beyond their level of expertise. She also said that she had confidence that the staff would carry out her instructions and follow any advice that she gave them. Medication records were found to be correct and complete. Only named staff who have had the required training are permitted to administer medication. All the residents who were spoken to during the inspection or who commented on the survey forms were complimentary about the manager and the staff. They described them as being helpful and caring, more like members of an extended family than staff. They said that their privacy and dignity were respected and that only the help they actually needed was provided, which enabled them to maintain as good a level of independence as possible for as long as possible. Relatives also praised the staff saying that they were welcoming, friendly and dedicated to those they cared for. They also said that they were kept well informed regarding the well being of their relative. One relative described the manager and staff as excellent. Bishopsteignton House DS0000067788.V315193.R01.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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a varied social life both in the home and in the local community. The dietary needs and preferences of the residents are met with the provision of nutritious and varied meals. EVIDENCE: Most of the residents who commented said that they enjoyed the activities and entertainments provided. Several made particular mention of the trips out in the minibus saying how much they appreciated them. Some residents said that they would like some more mentally stimulating sessions. A survey has been conducted of all the residents to ascertain the range of activities that they would like, the results of which are to be used for future planning. During the inspection four residents set up a card table in the hall and started to play whist. They explained that they played every day, usually in the Bishopsteignton House DS0000067788.V315193.R01.S.doc Version 5.2 Page 13 morning but if not then they made sure they had a session in the afternoon. This was something that they arranged themselves and clearly looked forward to. Other residents were observed reading, knitting or sitting in small groups having a chat. The manager said that a communion service was held at the home once a month, which was attended by five or six residents while others attended the church of their choice. The manager stated that visitors were welcome at any time and this was confirmed by residents and relatives who said that they were always made welcome. One resident who has poor eyesight said how much they appreciated the manager and staff taking time to read them their correspondence which enabled them to maintain contact with family and friends and keep a degree of control over their affairs. All the residents spoken to praised the standard of the meals, some saying that they realised how difficult it must be for the cook to accommodate all their preferences. They said that if there was something on the menu that they did not like the cook would offer them an alternative. A resident with poor eyesight said that meals are presented in a way that enables her to see what food is on her plate. This reduces the possibility of embarrassment when eating with other residents. Bishopsteignton House DS0000067788.V315193.R01.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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are safeguarded from abuse by staff being made aware of adult protection procedures. EVIDENCE: The home has a complaints procedure a copy of which was displayed in the entrance hall. Residents said that they knew what to do if they were to have a complaint but that they had never had cause to complain. They said that if they had a problem they only had to speak to the manager or one of the staff and it was quickly sorted out. They said that they liked living at Bishopsteignton House as it was like being part of one large family. Most of the relatives also said that they had never had to make a complaint however one said that they had complained to the new owners about a failure in communication by them. Most of the staff have received training regarding the protection of vulnerable adults and recognising the different forms of abuse. The manager has had additional training in this subject. Consideration should be given to ensuring that all staff have refresher training in the near future. Bishopsteignton House DS0000067788.V315193.R01.S.doc Version 5.2 Page 15 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): 19,20,21,22,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Bishopsteignton House provides an attractive and comfortably furnished environment, which is clean and hygienic with varied communal space. EVIDENCE: Bishopsteignton House is a Victorian building that has been converted to its present use. It has considerable communal space including a lounge and dining room, which have views over the Teign River and estuary, and a large central hall, which is used as a sitting area by many of the residents. These are furnished in a homely way. The home also has attractive grounds, which are well used by residents and their visitors when the weather permits. The provision of garden furniture and sun umbrellas encourages them to sit outside Bishopsteignton House DS0000067788.V315193.R01.S.doc Version 5.2 Page 16 in the fresh air. The new owners are planning to lay a patio area to make using the garden easier for those with mobility problems. Some residents expressed concern about the effect proposed building work would have on their day-to-day lives. They were also upset that a bathroom was out of action and they did not know what was being done to repair it. In discussion with the responsible individual it was stated that when the plans for extending the home are finalised everyone concerned would be invited to view the plans and ask questions. A special, height adjustable bath has been ordered to replace the one that is beyond repair. It was suggested that this information should be conveyed to staff and residents to allay residents’ anxieties. Various improvements to the environment are underway. These include redecorating the dining room and repairing the conservatory. Some equipment has had to be replaced such as a dishwasher, washing machine and fridge and repairs carried out to the gas boiler. Residents and relatives all commented that the home is spotlessly clean. Residents can choose to look after their own rooms and make their own beds if they wish and are able to retain that level of independence. Bishopsteignton House DS0000067788.V315193.R01.S.doc Version 5.2 Page 17 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff recruitment procedures and staff training safeguard residents. The stable staff team have developed good relationships with the residents. EVIDENCE: Bishopsteignton House has a very stable work force, many of whom live in the village. Residents spoken to said that they had been anxious when the home changed hands that the staff would change and had been thankful that this had not happened. They consider the staff to be part of their extended family and observation showed that they have a good relationship. The files for three members of staff were examined one of which was newly appointed. These showed that an appropriate staff recruitment procedure had been followed with references being taken up and police checks obtained. Training records were seen which showed that since April many of the staff had received training in manual handling, health and safety, fire safety, food hygiene, infection control and challenging behaviour. Plans for future training were in place and dates when refresher training is due were identified. Five of the staff have NVQ level 2 in care and one member of staff has expressed the Bishopsteignton House DS0000067788.V315193.R01.S.doc Version 5.2 Page 18 wish to undertake NVQ level 3 in care. All the senior staff are designated firstaiders. Residents were full of praise for the staff describing them as kind and helpful. They said that call bells are answered promptly and that they are allowed to do things at their own pace and are never rushed. Staff commented that they work well together as a team and support each other. Bishopsteignton House DS0000067788.V315193.R01.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): 31,32,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager’s style is open and receptive to the views of the residents and others involved with the home. Safe working practices provide protection for both residents and staff. EVIDENCE: The registered manager has worked at the home for many years and is well respected by the residents, relatives, staff and others connected with the home. She knows the residents and their families well and encourages a family atmosphere within the home. Residents commented that they were very thankful that she did not leave when the home changed hands as they did Bishopsteignton House DS0000067788.V315193.R01.S.doc Version 5.2 Page 20 not know what they would do without her. They expressed their sadness at the previous owners leaving as they had considered them to be friends but said that the manager and staff staying the same had been helpful and reassuring. The manager was observed to have an open style of management and that residents and staff approached her freely. Residents said that she was easy to talk to and sorted out any problems they might have promptly. Staff said that they felt well supported by her. Relatives said that the manager kept them informed regarding their relatives condition and was always ready to answer any questions they might have. Comments were made by residents, relatives and staff about the lack of information from the new owners. As already stated, residents have anxieties about proposed changes to the building. Relatives said that they would like to be informed of any changes in the running of the home before they are made so that they can prepare their relatives. Staff said that lack of information meant that they were unable to answer residents’ and relatives’ questions and provide reassurance when it was required. They also felt that their views about the home were no longer valued. These are issues that the new owners need to address in order to maintain the happy, positive atmosphere that has always been characteristic of Bishopsteignton House. Residents’ financial affairs are managed by themselves or by their families. The home looks after money for ten of the residents who use their money for personal spending e.g. hairdressing, toiletries, newspapers. This money is kept under lock and key in individual containers. A record is made of all transactions and receipts are kept. Once a month the records, receipts and remaining cash are checked to make sure that they balance. These records are available for residents and their relatives to check at any time. Only senior staff have access to this money which reduces the risk of errors occurring. Quality assurance systems need to be established but a start has been made by surveying residents regarding the sort of activities they would like the home to provide. As already stated, staff have had training in safe working practices, dates when refresher training is due have been recorded and more training is planned. Staff have access to a file containing information about all the potentially hazardous substances used within the home and what to do should an accident occur with one of them. Equipment within the home has had safety checks carried out since the change of ownership. Fire safety checks had been carried out at the required intervals and accident records had been completed correctly. Bishopsteignton House DS0000067788.V315193.R01.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 3 X 3 3 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 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 2 3 X 3 X X 3 Bishopsteignton House DS0000067788.V315193.R01.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 OP32 Good Practice Recommendations The registered provider should consider ways of improving their communication with all those involved with Bishopsteignton House. 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