Inspection on 14/03/06 for Coombe House

This inspection was carried out on 14th March 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

Coombe House 05/07/07

Coombe House 05/06/06

Coombe House 12/07/05

Coombe House 27/01/05

Coombe House 15/06/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE Coombe House Coombe Lane Lamellion Liskeard Cornwall PL14 4JU Lead Inspector Alan Pitts Unannounced Inspection 14th March 2006 10:00 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 Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 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. Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Coombe House Address Coombe Lane Lamellion Liskeard Cornwall PL14 4JU 01579 346819 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) anngray@clara.co.uk Ms Ann Elisabeth Gray Care Home 16 Category(ies) of Dementia - over 65 years of age (9), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (9), Old age, not falling within any other category (16) Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Service users to include up to 16 adults of old age (OP) Service users to include up to 9 adults aged over 65 with a mental illness (MD(E)) Service users to include up to 9 adults aged over 65 with dementia (DE(E)) Total number of service users not to exceed a maximum of 16 Date of last inspection 12th July 2005 Brief Description of the Service: Coombe House is situated in a quiet rural setting at the head of the Looe Valley. It is one mile from the centre of Liskeard, which provides a range of shops and community facilities. Coombe House provides accommodation and personal care for up to 16 older persons, some of whom may also have a mental disorder/dementia. Accommodation is provided on two floors. A stair lift is available to assist service users with access to the upper floor. Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 14th March 2006 over a period of approximately 5 hours, commencing at 09.30am. The registered provider was present throughout. The inspection comprised meeting with 4 service users, a tour of the premises, discussion with staff and the registered provider, and inspection of care documentation and other records. Coombe House is an established home offering a relaxed, comfortable setting in which service user’s care needs are appropriately met. What the service does well: What has improved since the last inspection? The registered provider has responded positively to the recommendations identified at the previous inspection, amending risk-assessments to reflect the need for bed rails where appropriate, recording her hours spent at the home, and providing appropriate fire safety signs. Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 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. Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 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 Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 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): 2, 5, 6 A contract/Statement of Terms and Conditions is provided only to privately funded service users. Prospective service users and their representatives do have opportunities to visit the home prior to making any decision about permanent residence. The home does not offer intermediate care. EVIDENCE: A contract/Statement of Terms and Conditions is provided only to privately funded service users. The registered provider must provide each service user with a Statement of Terms and Conditions, setting out the fees paid and the identification of the accommodation offered, as well as any restrictions on the service user’s freedom of choice, liberty of movement, and power to make decisions. Prospective service users may visit for coffee, meals, or stay for the day. The registered provider ensures that all prospective service users or their representatives are aware of this at the time of carrying out the home’s preadmission assessment. Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 Page 9 The home does not offer intermediate care. Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 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): 10, 11 Service users are treat with dignity and their right to privacy is respected. The home has suffered a recent service user death and the registered provider was observed to be understanding when dealing with relatives. EVIDENCE: Service users spoken with confirmed that they are happy with the care provided and the manner in which it is provided, they said that the staff were considerate and polite. The service users felt that their privacy was respected. The registered provider was observed and heard to be very empathetic with the relative of a service user who had recently died. The registered provider liaises well with service users and their families to ascertain their wishes in this respect. Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 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 the following standard(s): 14, 15 The home could do more to demonstrate that service users are able to exercise choice and control over their lives. The home offers freshly cooked meals and a balanced, attractive diet. EVIDENCE: Social/recreational records tend to show where a service user was on any given day, rather than what they were doing. The registered provider should ensure that the care records more clearly show the options available to service users and the choices made on a daily basis. Service users spoken with did not express a preference in respect of social/recreational activities, and similarly did not say they were happy or unhappy with the options available. A weekly menu is in operation. A record of food provided, including whether a service user eats well or not, is kept. Alternative meals are available to service users, and the registered provider said she would ensure that all service users were asked on a daily basis if the alternative would be preferred. The home is undertaking a ‘Making Food Safely’ programme and this involves the frequent attendance of the Environmental Health Officer. The service users were complimentary about the quantity and quality of the food provided. Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 Page 12 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): 17 Service user’s legal rights are protected, and where possible, they are able to participate in civic processes. EVIDENCE: Service users spoken with confirmed they receive their mail unopened. The service users are entered on the electoral roll and are therefore able to participate in civic processes, where possible. The registered person lives on premises adjacent to the home and works at the home on a daily basis. This ensures she is available to monitor standards and support service users and staff as required. Service users are supported in maintaining their personal finances and affairs through relatives and Power of Attorney processes. Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 Page 13 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): 24, 25, 26 Service users live in safe, comfortable, clean accommodation and a homely environment, enhanced by their own possessions around them. EVIDENCE: The premises were clean throughout on the day of the inspection. The lavatories and bathrooms were seen to have hand-washing provisions. Heating, lighting, and ventilation are domestic and suitable to the home. Radiators have protective guards and are individually controlled. Restrictive window opening devices have been installed in all bedrooms to protect service users. All the hot water outlets are provided with mixing valves to reduce the risk of scalding. Communal areas are light, spacious and suitable for a range of activities, with plants and pictures in all areas. Downstairs, there is two lounges, a dining room, and a large office used for visiting relatives and service users. The gardens are maintained and a patio has been built with extending views across the surrounding countryside. Service user’s rooms were seen to be comfortably Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 Page 14 and pleasantly furbished and furnished, appropriate to the care needs of the service users, and were personalised to varying degrees. Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 Page 15 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): 28, 30 There is an evident commitment to staff training and service user safety in an active and ongoing staff training programme. EVIDENCE: There are 20 care staff employed, of which 6 have achieved NVQ Level 2 or above, and a further 6 are doing this training. Each member of staff has an individual training record. Recent and planned training includes: manual handling, infection control, activities for dementia, medication, communication and swallowing, food hygiene, and 1st Aid. All staff have been provided with General Social Care Council handbooks. The registered provider must make arrangements for new staff to undertake a National Training Organisation (Skills for Care – www.skillsforcare.org.uk) compliant induction programme. Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 Page 16 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): 32, 34, 36, 37 The home’s leadership, management, and policies and procedures benefit and protect service users. The home has achieved Investors in People status. Staff are appropriately supervised. EVIDENCE: There is a clear management hierarchy, with the registered provider taking day-to-day control and therefore being available to service users and their representatives. The registered provider does not handle any service user money, any transactions being invoiced to the service user or their representative as appropriate. Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 Page 17 Staff are regularly supervised and a record is kept. The supervision is further complemented by an annual appraisal for all staff and frequent staff meetings. The home has achieved the Investors in People Award. The home’s policies and procedures are comprehensive, and as issues arise for discussion the relevant policy is brought to the attention of staff. Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 Page 18 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 2 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 X X X X X X 3 3 3 STAFFING Standard No Score 27 X 28 3 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X 3 X 3 3 X Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 Page 19 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 OP2 Regulation 17 Requirement Timescale for action 01/05/06 2. OP30 18 The registered provider must provide each service user with a Statement of Terms and Conditions, setting out the fees paid and the identification of the accommodation offered, as well as any restrictions on the service user’s freedom of choice, liberty of movement, and power to make decisions. 01/05/06 The registered provider must make arrangements for new staff to undertake a National Training Organisation (Skills for Care – www.skillsforcare.org.uk) compliant induction programme. 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 OP14 Good Practice Recommendations The registered provider should ensure that the care records more clearly show the options available to service DS0000009004.V263638.R01.S.doc Version 5.1 Page 20 Coombe House users and the choices made on a daily basis. Coombe House DS0000009004.V263638.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection St Austell Office 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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