Inspection on 17/05/05 for Collamere

This inspection was carried out on 17th May 2005.

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

Collamere 30/01/07

Collamere 18/10/05

Collamere 10/11/04

Collamere 20/07/04

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 Collamere Grenville Road Lostwithiel Cornwall PL22 0RA Lead Inspector Alan Pitts Announced 17 May 2005 10:00 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. Collamere DD52 D04 9005 Collamere V214865 170505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Collamere Address Grenville Road, Lostwithiel, Cornwall, PL22 0RA 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) 01208 872810 01208 872810 Pinerace Ltd Mr Russell Stevens Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (45), Physical disability (6), Terminally ill over of places 65 years of age (6) Collamere DD52 D04 9005 Collamere V214865 170505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10/11/04 Brief Description of the Service: Collamere is a large traditional house with purpose built extension, registered to provide nursing and social care for a maximum of 45 people to include elder care, care for the terminally ill and care for a maximum of 6 physically disabled people. The home offers both permanent and respite care. A registered nurse is on duty at all times.The property is situated just on the outskirts of Lostwithiel. Most accommodation is provided on the ground floor but there is a passenger lift for access to first floor rooms. The home is currently operating at reduced capacity whilst en-suites are added to the 1st floor rooms. The home has two lounges and a large dining room. Twenty -eight of the single; and four of the double rooms have en-suite toilets; building is in progress to provide en-suites throughout. Assisted bathing facilities are available. The majority of corridors are wide and most have handrails. There is good wheel chair access on the ground floor. The grounds can also be accessed by wheelchair and extend around the home. There is a sheltered central courtyard with seating. There is a car park with good wheelchair access to the main front door. Collamere DD52 D04 9005 Collamere V214865 170505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home has undergone a period of significant change and this continues with ongoing building works and additional proposed developments. There has been a significant and noticeable change in ethos at this home. There is an evident commitment to service user welfare and happiness, staff training and the development of services. What the service does well: What has improved since the last inspection? Prospective and current service users have the information they need to make informed choices. The home has made efforts to improve the social/recreational life available to service users and this improvement is still ongoing. Staffing levels and staff training demonstrate an increasing commitment to the welfare of service users and the value of staff. The Registered Manager has introduced a healthy atmosphere of inclusion within the home and this is demonstrated by service user involvement. Collamere DD52 D04 9005 Collamere V214865 170505.doc Version 1.30 Page 6 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. Collamere DD52 D04 9005 Collamere V214865 170505.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 Collamere DD52 D04 9005 Collamere V214865 170505.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) 1, 2, 3, 6 Prospective and current service users have the information they need to make informed choices. EVIDENCE: The home has produced a combined Statement of Purpose and Service Users Guide, which provides all the required information and was evident in service user rooms. Each service user is provided with a Statement of Terms and Conditions, and the home keeps a record of the date of issue. The Statement of Terms and Conditions includes the room to be occupied and a breakdown of the fee. The home has fax facilities. Two sample pre-admission assessments inspected. The home does not provide intermediate care. Collamere DD52 D04 9005 Collamere V214865 170505.doc Version 1.30 Page 9 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, 9, 10, 11 EVIDENCE: All service users have a plan of care and the plans inspected identified accurate needs and capabilities: physical, social and psychological. A daily record was maintained in each case. Service users have been consulted about the storage of care plans in service user meetings, which are minuted. The home has a medication policy in place, based on the Royal Pharmaceutical Society (RPS) Guidelines. The home uses a ‘blister pack’ medication system. The medication administration records (MAR) were signed and dated appropriately and each sheet contained a photograph of the service users. Trained nurses administer medication. Arrangements have been made for a full medication review of all service users next week. Staff were observed to interact with service users in a considerate and professional manner. Staff were seen to knock on service user doors before entering. Collamere DD52 D04 9005 Collamere V214865 170505.doc Version 1.30 Page 10 The home’s ‘privacy and dignity’ policy and ‘care of the dying’ policy have been rewritten and copies provided to the Commission for Social Care Inspection. The Registered Manager should ensure that service user wishes in respect of death and dying are ascertained and recorded. The inclusion of this at the point of pre-admission was discussed. Collamere DD52 D04 9005 Collamere V214865 170505.doc Version 1.30 Page 11 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, 14, 15 The home has made efforts to improve the social/recreational life available to service users and this improvement is still ongoing. EVIDENCE: There appeared to have been significant improvement since the last inspection with regard to service users daily lives being flexible. The Registered Provider stated that an Activities Co-ordinator would soon be in post so further improvement is anticipated. A record of activities is now maintained including the participants and their comments. Social and recreational activities have also been the subject of discussion at service user meetings. A plan of activities coming soon is displayed clearly for the service users. Service users are able to handle their own financial affairs for so long as they wish and are able to do so. Service users are entitled to bring personal possessions with them and this is indicated in the Service User Guide and Statement of Purpose. The Registered Manager provides information regarding advocacy and access to personal records in the Service Users Guide. A 3-week menu is in operation. Two hot meals a day are provided, though the Registered Manager stated that if a service user requested an additional hot snack this would also be provided. The days menu is displayed in the dining Collamere DD52 D04 9005 Collamere V214865 170505.doc Version 1.30 Page 12 area, choice is evident. Service users are able to enjoy a glass of wine, etc with meals if they so wish. The menu shows that an evening snack meal is available on request. Collamere DD52 D04 9005 Collamere V214865 170505.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) 18 Service users are protected from abuse and the staff have received relevant training. EVIDENCE: A protection of vulnerable adults policy is in place, which includes whistle blowing and references ‘No Secrets’. Protection of vulnerable adults training has been provided to all staff. The protection of vulnerable adults policy should provide staff with clear instruction about the steps to be taken if an allegation of abuse is made, including the involvement of other agencies and the relevant contact details. Collamere DD52 D04 9005 Collamere V214865 170505.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) 22, 26 These standards were not inspected fully as there is a considerable amount of refurbishment underway in parts of the building. The premises are safe and clean. EVIDENCE: Service users were seen to be safe and not affected by the building works being carried out in parts of the building. The home provides various walking aids/equipment and has assisted toilets and baths. The home has purchased a considerable amount of new equipment recently, including hoists and other lifting aids. There is a passenger lift to the first floor for those with mobility problems. Grab rails are located in most areas of the home. The Registered Manager and the senior nurse (matron) have undertaken the Lifting and Handling Training for Trainers course. All staff have received Lifting and Handling training. A new call-bell system is in use, which records response times. Collamere DD52 D04 9005 Collamere V214865 170505.doc Version 1.30 Page 15 The premises were seen to be clean throughout, with no undue odours apparent. The Registered Manager should audit the communal bathing and toilet facilities to ensure that there is a hand washing facility available. Collamere DD52 D04 9005 Collamere V214865 170505.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, 28, 29, 30 Staffing levels and staff training demonstrate an increasing commitment to the welfare of service users and the value of staff. EVIDENCE: Staffing levels are generally: 7am – 1pm: 1 RN 6 care staff 1pm – 7pm: 1 RN 4 care staff 7pm – 7am: 1 RN 2 care staff Staff are enabled to work additional hours to reflect service user dependency levels at different times of the day. The new nurse-call system records response times. Staffing levels are appropriate to the care needs of the service users. Approximately 50 of care staff have achieved NVQ Level 2 or greater. Two staff personnel files were inspected, which showed a robust employment procedure in operation. Two induction records for new staff were inspected. These did not demonstrate training being provided and understood over a period of time. The Registered Manager has obtained National Training Organisation compliant induction programmes, but these have yet to be implemented. The Registered Manager should implement a National Training Organisation compliant induction programme. Collamere DD52 D04 9005 Collamere V214865 170505.doc Version 1.30 Page 17 Collamere DD52 D04 9005 Collamere V214865 170505.doc Version 1.30 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 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, 35 The Registered Manager and the senior nurse were seen to manage a health emergency and liaise effectively with other health agencies at the time of the inspection. The Registered Manager has introduced a healthy atmosphere of inclusion within the home and this is demonstrated by service user involvement. EVIDENCE: The Registered Manager anticipates completing the Registered Managers Award by the end of 2005. The Registered Manager is a registered nurse. The Registered Provider should ensure that much more detail is provided in the Regulation 26 monthly reports. The Registered Manager has introduced 4-6 weekly service user meetings; two have happened. The meetings are minuted and show service user involvement in the day-to-day running of the home. The Registered Manager has also introduced a quarterly (or more often) newsletter that helps communication Collamere DD52 D04 9005 Collamere V214865 170505.doc Version 1.30 Page 19 within the home. Responses to a recent quality assurance questionnaire were seen, and the Registered Manager has undertaken to publish a summary of the responses and any action taken in the Service Users Guide. Individual records of service user monies were inspected and seen to be in order. Receipts support records. The Registered Manager should consider the use of individual service user duplicate books for any financial transaction. The Registered Provider has agreed to provide the Commission for Social Care Inspection with a letter from his accountant confirming financial viability of the business. A 1st Aider is on duty at all times. Entrance to the home is via one door only, and visitors are asked to sign the visitor’s book. Collamere DD52 D04 9005 Collamere V214865 170505.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION x x x 3 x x x 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 2 x 3 3 2 x x x Collamere DD52 D04 9005 Collamere V214865 170505.doc Version 1.30 Page 21 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 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. 2. Refer to Standard 11 18 Good Practice Recommendations The Registered Manager should ensure that service user wishes in respect of death and dying are ascertained and recorded. The protection of vulnerable adults policy should provide staff with clear instruction about the steps to be taken if an allegation of abuse is made, including the involvement of other agencies and the relevant contact details. The Registered Manager should audit the communal bathing and toilet facilities to ensure that there is a hand washing facility available. The Registered Manager should implement a National Training Organisation compliant induction programme. The Registered Provider should ensure that much more detail is provided in the Regulation 26 monthly reports. The Registered Manager should consider the use of individual service user duplicate books for any financial transaction. 3. 4. 5. 6. 26 30 31 35 Collamere DD52 D04 9005 Collamere V214865 170505.doc Version 1.30 Page 22 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall, 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. 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