Inspection on 01/09/06 for Cann House

This inspection was carried out on 1st September 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

Cann House 03/11/05

Cann House 22/04/05

Cann House 30/11/04

Cann House 07/04/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Cann House Tamerton Foliot Road Tamerton Foliot Plymouth Devon PL5 4LE Lead Inspector Mandy Norton Unannounced Inspection 10:00 1 September 2006 st 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 Cann House DS0000003577.V303063.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. Cann House DS0000003577.V303063.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cann House Address Tamerton Foliot Road Tamerton Foliot Plymouth Devon PL5 4LE 01752 771742 01752 771742 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) Premiere Health Limited, Vacancy Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (6), Physical disability (5), Physical disability of places over 65 years of age (50) Cann House DS0000003577.V303063.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Home is registered as a Care Home with Nursing for a maximum of 60 Service Users in the categories of PD(E) 50, OP 6, TI(E) 4 To admit 5 service users in the PD category between the ages of 18 and 65 years. 3rd November 2005 Date of last inspection Brief Description of the Service: Cann House is a country house originally built in 1863, situated on the edge of Tamerton Foliot, approximately 4 miles from Plymouth city centre. There is access to public transport and local facilities within the village. The house has been modernised to provide a care home for a maximum of 60 persons over the age of 65 years (the home is able to take a maximum of 5 persons between the ages of 18 - 65). The home is registered to provide care for persons requiring nursing and/or personal care with physical frailty/illness or disability. The accommodation comprises of 38 single bedrooms and 11 double bedrooms, all bedrooms have en-suite WC and wash hand basin. The communal rooms consist of one large lounge with sun lounge attached, one smaller lounge on the 1st floor, one dining room and a chapel. Cann House has 9 acres of attractive grounds with lawns, woodlands and a walled garden. The home is owned and administered by Premiere Health limited. Cann House DS0000003577.V303063.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place with the manager and one of the providers. It included a tour of the home, examination of documentation and speaking with a number of service users. Following the inspection relatives/friends surveys were sent to out to contacts of those Service Users who were case tracked, the results of which are reflected in the following report. A completed pre inspection questionnaire (August 2005) was also used when completing the report. The provider stated that the fees charged range from £385 to £510. What the service does well: What has improved since the last inspection? What they could do better: Cann House DS0000003577.V303063.R01.S.doc Version 5.2 Page 6 There were no recommendations and requirements made following this inspection. 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. Cann House DS0000003577.V303063.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 Cann House DS0000003577.V303063.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective clients and/or their representatives have the information needed to choose a home which will meet their needs. EVIDENCE: The manager said she visits prospective clients in their current setting where possible to assess whether the home can meet their assessed needs. Policies and procedures relating to admissions and emergency admissions are accessible to staff at all times. (Then new manager has yet to review the policies and procedures since she has started in post). A new client arrived during the inspection and the manager explained that she had visited the client in hospital and had written information relating to their needs prior to admission that will be used as the basis for the care plan. A man called at the home ‘on spec’ looking to see if it would be suitable for his wife. He was made to feel welcome, although the staff were busy. He was given information about the home and its facilities verbally and in written form Cann House DS0000003577.V303063.R01.S.doc Version 5.2 Page 9 (by the manager), it was explained that his wife would need to be assessed prior to them agreeing that they could meet her needs and he was shown around by the provider. A statement of purpose is displayed in the entrance hall at all times. The new manager is soon to update the document to reflect the recent changes in the home. Cann House DS0000003577.V303063.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 at least once during a 12 month period. 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. The health and personal care, which a client receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Each client has a care plan, involving residents in the development and review of the plan is variable depending on the client’s abilities. Clients representatives are asked to be involved if this is appropriate. The plans examined (4) included information necessary to plan the individuals care and included risk assessments (nutrition, skin and manual handling) and a daily statement. They were regularly reviewed and updated. Residents have access to health care services that meet their assessed needs both within the home and in the local community. Some residents are able to choose their own GP and all have access to dentists, opticians and other Cann House DS0000003577.V303063.R01.S.doc Version 5.2 Page 11 community services. Contact information and a record of visits was seen in care plans examined. During the inspection 2 GP’s and a psychiatrist visited and were assisted by trained nursing staff. One GP spoken with said he had a good relationship with the home and was able to work well with them for the benefit of the clients. Another GP does a weekly ‘round’ in the home and both he and the staff said this works really well. The care plans examined showed that client’s health is monitored (regular weight, urine tests and blood pressure as necessary for example) and appropriate action taken. The home seeks professional advice on health care issues (e.g. GP, tissue viability nurse, dietician) and acts upon it. The home has a medication policy which is accessible to staff. The deputy matron explained the medication systems in place in the home and records seen were up to date including recording of medicines received, administered and disposed of. Staff are aware of the need to treat clients with respect and to consider dignity when delivering personal care (policies and procedures and induction). Staff were seen and heard knocking on doors before entering rooms and were carrying out personal tasks in private. Staff were observed interacting appropriately with clients being courteous but also enjoying lively conversation. Completed relatives surveys indicated that they are ‘satisfied with the overall care provided’. Cann House DS0000003577.V303063.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 at least once during a 12 month period. 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. Social, cultural and recreational activities provided help to meet residents expectations. Clients are offered a healthy, varied diet according to their assessed requirements and choice. EVIDENCE: The home takes residents feedback seriously and makes changes where possible. The matron showed the inspector the informative newsletter she had produced to keep clients informed of any changes that are being introduced since she took over the role and what actions the home can take following comments made at the recent clients meeting. Showing that staff listen to residents and make efforts to provide a flexible service. A 30 hours a week activities co-ordinator is employed allowing time for activities. A clothes show was taking place during the inspection, giving clients the opportunity to choose items they might like to buy, staff were available to help clients try clothes on in private. The home also operates a key worker Cann House DS0000003577.V303063.R01.S.doc Version 5.2 Page 13 system, which enables closer resident staff relationships where likes, dislikes and needs are shared. The home displays information about community events and activities on a board near the main office. This staff also remind clients about activities on the day of the event. When residents have particular interests every effort is made by staff to help the resident maintain their interest and keep up any community involvement. Completed surveys indicated that family and friends can visit the home at any time and are made to feel welcome. There is plenty of seating within the communal areas of the home where residents can entertain their visitors, in addition to the privacy of their own room. Food and mealtimes are treated as an occasion and a large dining room is available for those wishing to leave their room for their meals. There is a new cook who is responsible for providing quality nutritional meals that meet the cultural and dietary needs of the clients. The matron stated that the cook is to meet regularly with clients and listen to their choices and suggestions for the menu, as some comments about the meals were made during the clients meeting. The matron said that staff are sensitive to the needs of those service users who find it difficult to eat and give assistance with feeding. Drinks are available and regularly offered to clients although staff will always make a drink at any time when asked. A man that came to look around the home was also offered a drink whilst he waited to speak with the matron. Clients spoken to said they enjoyed the food and for those that had meals in their rooms the meal was warm enough. Cann House DS0000003577.V303063.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents have access to an effective complaints procedure and the systems in place in the home help protect them from abuse. EVIDENCE: The complaints procedure is displayed within the home. Residents spoken to said they knew who to approach if they wanted to complain. Two (2) of the three (3) completed relatives surveys indicated that they are ‘aware of the homes complaints procedure’ and only one (1) had ever made a complaint. The complaints log examined had details of t5he 2 complaints made since the last inspection andnd the actions taken to resolve it. The policies and procedures regarding protection of residents are satisfactory and available to staff at all times. Since the last inspection the deputy matron had cause to discuss an incident with the adult protection team and was able to get appropriate advice from them. When discussing an issue with the matron she demonstrated an awareness of safeguarding (adult protection) issues and know what immediate action to take and when and who to refer any incident on to. Cann House DS0000003577.V303063.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The design and layout of the home enables residents to live in a safe, wellmaintained and comfortable environment. EVIDENCE: A tour of the home confirmed it is comfortable and well maintained, the full time handyman was seen working around the home during the tour. The grounds are extensive also well maintained and accessible to clients. Aids and equipment to meet the care needs of the clients was seen distributed around the home. The home was clean and tidy and hygienic. (The infection control policies were not discussed at this inspection). Several clients were seen making their own way around the home unassisted either in wheelchairs or independently. Cann House DS0000003577.V303063.R01.S.doc Version 5.2 Page 16 Clients rooms seen were individualised with personal belongings and small items of furniture. All rooms have the benefit of en-suite facilities. The matron said that carpets are being renewed wing by wing and a curtains and bedding are being renewed. The shared areas consist of a large lounge/conservatory with good views of the grounds, a smaller lounge, a large dining room and a chapel on the ground floor and a small lounge on the first floor. Several clients were using the large lounge, some were chatting to each other, some had visitors and others were reading a newspaper. In the afternoon there was a clothes show held in the large lounge. There is a choice of bathing facilities, both assisted and unassisted, showers and baths and there are a number of toilets strategically placed around the home. Cann House DS0000003577.V303063.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 at least once during a 12 month period. 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 in the home are trained, skilled and in sufficient numbers to meet the assessed needs of the clients. EVIDENCE: Duty rotas show that sufficient numbers of staff are working in the home with more staff at peak times of activity. There are trained nurses on duty 24 hours a day. Training records (3) were examined and contained certificates for courses/study days relevant to the client group. All staff receive statutory training in fire safety and manual handling. The service has a good recruitment procedure that clearly defines the process to be followed. The home is currently advertising for some care staff and a person rang to enquire about application. She was invited for an informal interview, where she could fill in an application form. It was explained that she would need to supply 2 references and be subject to an enhanced CRB check. Three (3) staff files were examined and they contained all of the required documentation. There is some use of agency staff to cover vacant carer posts, but the proprietor said that they try to use the same staff for consistency. Cann House DS0000003577.V303063.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 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 management and administration of the home is based on openness and respect. The systems in place in the home ensure the health, safety and welfare of the clients and staff is maintained. EVIDENCE: The matron has the required qualifications and experience and is competent to run the home. She has been in post since April 2006 and will undertake a ‘fit person ‘ assessment with CSCI in the near future. There is a strong ethos of being open and transparent in all areas of running of the home. The matron has kept the clients and /or their representatives informed of changes she is implementing via an informative newsletter and by Cann House DS0000003577.V303063.R01.S.doc Version 5.2 Page 19 holding a clients meeting. She showed the inspector newsletter no.2 that was not yet complete but had responses to comments made in the meeting and how any issues could be and were going to be addressed. For example senior staff are to have badges so clients and their representatives can identify who people are. The matron said that the activities co-ordinator is to distribute questionnaires about the meals and the cook is to meet with clients about their specific needs so that the menus can be ‘revamped’ . The home has policies and procedures in place, which the matron has plans to review in the future. The home has a clear health and safety policy and the home has a good record of meeting relevant health and safety requirements and legislation. Records examined were of a good standard and stored securely. Equipment seen around the home was in a good condition and the provider said a new hoist is on order as one was not working and it is more cost effective to replace it with a new one. The home has all the necessary insurance cover in place and the up to date certificate is displayed in the home. There is a safe available to store valuables. Where the home is responsible for holding small amounts of money for clients there are clear records that are routinely kept up to date and can be used to track individual residents finances. These records have been examined in the past and found to be accurate. Cann House DS0000003577.V303063.R01.S.doc Version 5.2 Page 20 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X 3 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 3 X 3 X X 3 Cann House DS0000003577.V303063.R01.S.doc Version 5.2 Page 21 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. 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. Refer to Standard Good Practice Recommendations Cann House DS0000003577.V303063.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cann House DS0000003577.V303063.R01.S.doc Version 5.2 Page 23 - 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!