Inspection on 30/01/07 for Collamere

This inspection was carried out on 30th January 2007.

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

Collamere 18/10/05

Collamere 17/05/05

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 Key Unannounced Inspection 30th January 2007 09:30 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 Collamere DS0000009005.V325727.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. Collamere DS0000009005.V325727.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Collamere Address Grenville Road Lostwithiel Cornwall PL22 0RA 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) 01208 872810 01208 872823 Pinerace Mr Russell Stevens Care Home 45 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 DS0000009005.V325727.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Total number of service users not to exceed a maximum of 45 Date of last inspection 18th October 2005 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 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 DS0000009005.V325727.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of approximately 5 hours on the 30th January 2007. The inspector met with the registered manager, staff, and residents, and toured the premises, as well as inspecting relevant documentation. Overall, there is a good outcome for residents, with an evident commitment from staff and management to resident welfare and protection. What the service does well: What has improved since the last inspection? What they could do better: The home must ensure that the care needs of all prospective residents are assessed prior to admission. The home could do more to ensure the identified care needs of residents are fully met by increasing the level of nursing staff provided at peak periods. Staff could do more to record the residents’ daily lifestyle. Collamere DS0000009005.V325727.R01.S.doc Version 5.2 Page 6 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. Collamere DS0000009005.V325727.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 Collamere DS0000009005.V325727.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): Quality in this outcome area is good. National Minimum Standards 3 and 6 were inspected. This judgement has been made using available evidence including a visit to this service. The home could do more to ensure that residents and their representatives know that the home has the facility to meet their needs. The home does not provide intermediate care. EVIDENCE: Some resident admissions have occurred on the basis of recommendations, and some residents staying for respite care have moved in permanently. Home did not ensure that one recent respite admission to the home was fully assessed prior to arriving. The home has a fax facility, which the registered manager undertook to make available at all times, and a pre-admission assessment form. The care plan for this resident was incomplete, reflecting the Collamere DS0000009005.V325727.R01.S.doc Version 5.2 Page 9 incomplete assessment. The registered manager must ensure that all prospective residents are fully assessed prior to admission to the home. The home enjoys good links with other healthcare professionals, (e.g. tissue viability nurses). The Registered Manager states that it may be possible for prospective service users to visit for meals, or to stay for a day. One resident confirmed that they had the option of staying for a week before making the decision to move in permanently. Collamere DS0000009005.V325727.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): Quality in this outcome area is good. National Minimum Standards 7, 8, 9, and 10 were inspected. This judgement has been made using available evidence including a visit to this service. Residents’ care needs are set out in individual plans of care, and the home enjoys close links with other health care professionals to ensure the care needs are met. Residents are protected by the home’s adherence to an appropriate medicine policy and procedure. Residents spoken with said, without exception, that they felt that staff respected them. EVIDENCE: All residents have a care plan. Care plans were seen to be informative, without being overly complicated. Care plan review is inconsistent, as is the involvement of residents or their representatives in this process. The inspector is aware that the registered manager has already identified this matter as an issue. One care plan was seen to provide incomplete information due to an incomplete pre-admission assessment. The registered manager should ensure Collamere DS0000009005.V325727.R01.S.doc Version 5.2 Page 11 that all care plans are reviewed monthly, and that the resident or their representative is regularly involved in this process. Residents’ health care needs are generally well met. There is a wide variety of aids available to assist in meeting residents’ care needs. All residents are registered with a GP. The home has a number of link nurses. There are currently link nurses in place for dementia care, tissue viability, infection control and continence care. The home maintains good links with visiting health care professionals. Residents were complimentary about the care and attention of staff. The home has a medication policy in place, referencing the Royal Pharmaceutical Society (RPS) Guidelines. The home uses a monitored dosage system. The medication administration records (MAR) were signed and dated appropriately and each sheet contained a photograph of the resident. The Controlled Drugs (CD) were stored securely and recorded correctly. Trained nurses only administer the medication. Medication was seen to be administered appropriately, using a medicine trolley and two personnel during the morning. The morning medication round can take anything from 2-3 hours, dependent in interruptions and other demands placed on the nurse on duty. Comment is made later in this report about the pressures on the nursing staff, especially on morning shifts. Residents confirmed that staff always knock before entering rooms, and all felt that their privacy and dignity were protected. Without exception, all the residents spoken with were complimentary about the kindness and consideration of the staff. All residents have access to a telephone, though some have their own telephone in their rooms. Collamere DS0000009005.V325727.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): Quality in this outcome area is good. National Minimum Standards 12, 13, 14, and 15 were inspected. This judgement has been made using available evidence including a visit to this service. One resident made the conscious decision to live at Collamere because of the lifestyle, balanced with care needs, afforded. Residents confirmed that they are free to determine their own lifestyle, and to maintain contact with family and friends. Residents said that they were at liberty to make choices for themselves. All were complimentary about the standard of food provided. EVIDENCE: Residents confirmed that their waking day is flexible, and determined by their own wishes. Residents’ interests are known, and encouraged. The activity coordinator is leaving, but the registered manager advised the inspector that the home hopes to appoint a new person in the next couple of weeks. There is a monthly activity plan and a record of those activities having occurred, including whether residents participated and enjoyed the event. Care staff could do more to ensure that entries in the daily records also give a picture of the resident’s lifestyle at the home. The registered manager should ensure that staff record the residents’ lifestyle as well as care needs in the daily records. Collamere DS0000009005.V325727.R01.S.doc Version 5.2 Page 13 Residents spoken with confirmed that visiting is open and free from restrictions, and many residents are from the local community in and around Lostwithiel. A visitors’ book is kept in the entrance, which shows regular and frequent visitors to the home. Residents are able to handle their own financial affairs for so long as they wish and are able to do so. Residents are entitled to bring personal possessions with them and this was evident in some rooms. The home invoices for personal costs retrospectively, rather than accessing residents’ money. The registered manager advised the inspector that only a small number of residents have small amounts of money held at the home, and all residents have their own bank accounts. The home’s administrator was not available at the time of the inspection and it was not possible to inspect the financial records at this time. These have been inspected at previous inspections and were found to be in order. The cook confirmed that residents are able to choose, and at the time of the inspection was preparing cooked breakfast for those residents who wished one. The menu clearly offers a choice at lunch and evening meal. A member of kitchen staff asks the residents individually each day what they would like from the choices available. In addition to the two specified options available the home also has standard options available such a jacket potatoes with a variety of fillings, salads, or omelettes. Residents spoken with confirmed that they had been asked that morning for their menu choices, and all were complimentary about the standard of food provided. The lunch menu on the day of the inspection offered stew and dumplings or turkey casserole. Kitchen stores were seen to be properly stocked and rotated. Collamere DS0000009005.V325727.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): Quality in this outcome area is good. National Minimum Standards 16 and 18 were inspected. This judgement has been made using available evidence including a visit to this service. Residents were confident that any concerns would be listened to and action taken as needed. Residents are protected from abuse by the home’s adherence to local adult protection procedures. EVIDENCE: He home’s complaints procedure is on display in the entrance to the home, and is included in the Statement of Purpose. The latter was seen to be provided in individual residents’ rooms. The registered manager undertook to include the contact information for the local Adult Social Care office in the complaints procedure. The Commission for Social Care Inspection has not received any complaints since the last inspection. The home maintains a record of all complaints received themselves, and any action taken as a result. Residents spoken with felt that they would be able to express any concerns, and were confident in the staff and the home’s management to act appropriately. The home has adhered to local adult protection procedures on two recent occasions, in both cases the home and its staff acted appropriately and in the interests of the resident concerned. The registered manager and matron have a good understanding of adult protection issues. Collamere DS0000009005.V325727.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): Quality in this outcome area is good. National Minimum Standards 19 and 26 were inspected. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, well maintained, clean, and hygienic environment, which is suited to its stated purpose. EVIDENCE: Collamere is a clean, well-maintained and easily accessible home. The home has a spacious feel with a large dining room near the main entrance, and a large lounge. There are safe internal areas where residents can sit or wander around as they wish. There is an internal courtyard, which affords seating in more clement weather. Furnishings within the communal areas were appropriate and of a good standard. The communal areas are smoke free. Wheelchair users can access the grounds. The corridors are wide and internal access is level. The home provides various aids/equipment and has sufficient assisted toilets and baths. Grab rails are located in most areas of the home. Rooms are individually and naturally ventilated and are centrally heated (gas). Collamere DS0000009005.V325727.R01.S.doc Version 5.2 Page 16 Heating can be controlled in each room. Residents’ rooms were personalised to varying degrees and all offered comfortable, spacious, pleasant accommodation. Emergency lighting is provided throughout the Home. Staff were seen to carry their own alcohol solution for hand washing, in addition to the facilities provided in lavatories and bathrooms. The kitchen is spacious, clean, and well organised, with a storage area adjacent. The laundry is very small, but suffices for the moment. An industrial washing machine and dryer is provided, clean laundry being placed on a trolley for distribution to the residents. The laundry person has worked at Collamere for a few years, and confirmed that they are able to manage with the existing small space. An external contractor is currently used to launder bedding. The registered provider should consider options for relocating the laundry to provide a larger facility more capable of fully servicing a 45 bed care home. Collamere DS0000009005.V325727.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): Quality in this outcome area is good. National Minimum Standards 27, 28, 29, and 30 were inspected. This judgement has been made using available evidence including a visit to this service. The numbers of staff meets the residents care needs, but this and the skill mix could be improved at times. Staff confirmed the availability of training opportunities. Personnel files were not inspected on this occasion, though the home has previously been seen to adopt a rigorous employment procedure. EVIDENCE: At the time of the inspection there was one nurse and six care staff on duty, with additional support staff (laundry, cleaners). There were 37 residents living at the home. The matron came on duty at 9am, bolstering the qualified staff to two, though the matron is also allocated administrative time and is not always available to assist with care provision. The nurse on duty told the inspector that the morning medicine round could take anything from 2-3 hours depending on interruptions and other demands on the nurse’s time. Such a lengthy medicine round can impact on the next prescribed dose of medicine. There are a number of regular demands on qualified staff time, especially in mornings. In addition the home currently employs only six nurses to cover all day and night shifts, which is insufficient allowing for sickness and holidays. The registered manager should increase the qualified staff provision to ensure that care needs are met promptly and safely, increasing the number of nurses to two at peak times. Collamere DS0000009005.V325727.R01.S.doc Version 5.2 Page 18 The duty rota shows that the home employs 18 care staff, of which 14 (approximately 75 ) have achieved NVQ Level 2 or above. Recruitment files were not inspected at this time due to the unexpected absence of the administrator who controls access to the relevant files. These files were inspected on previous inspections and found to be in order. The registered manager advised the inspector that all employees undergo relevant checks, and two references are always obtained. New staff undertake a National Training Organisation compliant induction programme, a sample of which was seen at the time of the inspection. Staff spoken with confirmed that there are regular and frequent training opportunities, relevant to the position held. Collamere DS0000009005.V325727.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): Quality in this outcome area is good. National Minimum Standards 31, 33, 35, and 38 were inspected. This judgement has been made using available evidence including a visit to this service. The good management and leadership evident at Collamere protect the residents, as does the home’s commitment to staff training and supervision. The health, safety, and welfare of residents, staff, and visitors are protected. EVIDENCE: The registered manager has been in post for approximately 2 years now. The registered manager and the senior nurse were cooperative and informative throughout the inspection. The registered manager has introduced a healthy atmosphere of inclusion within the home and this is demonstrated by residents’ comments. Residents confirmed that the manager of the home was accessible Collamere DS0000009005.V325727.R01.S.doc Version 5.2 Page 20 and they were complimentary about the attitude of the staff and the care provided. There are regular quality assurance questionnaires, the results of which are published in the (at least) quarterly ‘Collamere Times’ newsletter. Quality assurance includes service provision, and an audit of the premises, and is extended to residents and their representatives. Policies and procedures are comprehensive and reviewed regularly. Residents are able to handle their own financial affairs for so long as they wish and are able to do so. The home invoices for personal costs retrospectively, rather than accessing residents’ money. The registered manager advised the inspector that only a small number of residents have small amounts of money held at the home, and all residents have their own bank accounts. The home’s administrator was not available at the time of the inspection and it was not possible to inspect the financial records at this time. These have been inspected at previous inspections and were found to be in order. Maintenance and service records show that the home is well maintained and safe. There are contracts in place for the regular and frequent maintenance/checks of the building and its equipment. Appropriate safety equipment (hot water valves, fire extinguishers) are fitted and serviced. Staff receive relevant and appropriate training, in areas such as: Induction, Fire and 1st Aid. Accidents and incidents are recorded and properly reported. Collamere DS0000009005.V325727.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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 X X X X X X 3 STAFFING Standard No Score 27 2 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 Collamere DS0000009005.V325727.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. 1. Standard OP3 Regulation 14 Requirement The registered manager must ensure that all prospective residents are fully assessed prior to admission to the home. Timescale for action 01/03/07 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. 3. 4. Refer to Standard OP7 Good Practice Recommendations The registered manager should ensure that all care plans are reviewed monthly, and that the resident or their representative is regularly involved in this process. The registered manager should ensure that staff record the residents’ lifestyle as well as care needs in the daily records. The registered provider should consider options for relocating the laundry to provide a larger facility more capable of fully servicing a 45 bed care home. The registered manager should increase the qualified staff provision to ensure that care needs are met promptly and safely, increasing the number of nurses to two at peak times. DS0000009005.V325727.R01.S.doc Version 5.2 Page 23 OP12 OP26 OP27 Collamere Collamere DS0000009005.V325727.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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