Inspection on 20/06/07 for Cornerways, Paignton

This inspection was carried out on 20th June 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

Cornerways, Paignton 08/08/06

Cornerways, Paignton 09/11/05

Cornerways, Paignton 21/06/05

Cornerways, Paignton 04/03/05

Cornerways, Paignton 30/06/04

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 Cornerways, Paignton Cornerways 14-16 Manor Road Paignton Devon TQ3 2HS Lead Inspector Michelle Finniear Unannounced Inspection 20th June 2007 08:30 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 Cornerways, Paignton DS0000049076.V336799.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. Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cornerways, Paignton Address Cornerways 14-16 Manor Road Paignton Devon TQ3 2HS 01803 551207 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) www.peninsularcarehomes.co.uk Peninsula Care Homes Ltd Mrs Gillian Irene Plastow Care Home 50 Category(ies) of Dementia - over 65 years of age (50), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (50), Old age, not falling within any other category (50), Physical disability over 65 years of age (50) Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th August 2006 Brief Description of the Service: Cornerways is a long established detached property, situated on the level to local facilities at Preston and Paignton. The home is a large building over three floors, and is registered to care for up to 50 service users who are older people with or without a physical or mental frailty or disability. The home has three shared rooms, with the others being for single occupancy, and with the majority having en-suite facilities. There is a shaft lift to all floors. There are several lounge areas and a large dining room where service users can choose to have individual tables. The home has limited outside space and no real garden area, but is close to the sea front at Preston beach and local facilities such as pubs, cafes and local shops, and there is seating available on the homes patio. There is limited parking at the home, but plenty of on street parking nearby, although some of this may be time limited in the summer due to the closeness of the sea front. Fees range from £289 to £510 per week. Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report reflects a summary of a cycle of Inspection activity at Cornerways since the last key inspection in August 2006. A random inspection was also carried out in February 2007, and information about that visit will be contained within this report. To help CSCI make decisions about the home the manager gave us information in writing about how the home is run; documents submitted since the last inspection were examined along with the records of what was found at the last inspection; two site visits totalling 11 hours were carried out with no prior notice being given to the home as to the specific date and timing of the first visit; discussions were held with the responsible individual from Peninsula care homes Ltd, the home manager and staff on duty; various records were sampled, such as care plans and risk assessments; questionnaires were sent to the people who live at the home (some of which were completed by relatives) and staff who work at the home; a tour was made of the home; time was spent with the people who live at the home both individually and in groups observing interactions; and discussions were held with a visitor met on one site visit. This approach hopes to gather as much information about what the experience of living at the home is really like, and make sure that residents experience of the home form the basis of this report. This is especially important when, as at Cornerways, many residents suffer from moderate to severe memory loss. Seventeen members of staff and four relatives returned questionnaires about the home. What the service does well: The home provides comfortable accommodation, which is currently going through a programme of redecoration and renovation. Most rooms have ensuite facilities, and there is a choice of communal space in three lounges. An excellent menu is prepared with evidence of several choices for both the main course and dessert, ensuring people can enjoy a varied and nutritious diet. Specialist information has been obtained on mealtimes and menus for people with memory loss. The home is in an excellent location, level to local shops, facilities and the sea front. Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 6 A relative who responded to a questionnaire said “The manager is excellent and this is evident through all levels and aspects of the way Cornerways operates. It is a lovely home for the residents with superbly caring staff –top marks”. Another said “The home supplies a good selection of home cooked foods. Also they encourage the residents to participate in quizzes and other activities to keep their minds active.” The home is compiling life histories for people living there. This information is important as it helps staff understand the whole person they are caring for, their life experiences interests and relationships to people and places. It can also help in placing particular behaviours in context if the person is no longer able to verbalise their needs or wishes. The home undertakes a falls audit, which is good practice. This looks at every accident on a monthly basis attempting to identify patterns in order to prevent future incidents. Staff seen were well qualified and very knowledgeable about the people in their care. A high number of staff at the home are undertaking management level qualifications in care. This should help to ensure people living at the home have access to highly qualified staff at all times. What has improved since the last inspection? The home manager or administrator are writing to each person planning to move in confirming that the home can meet their needs as identified in the homes pre-admission assessment. This is so that the person and the home are aware of any agreements made prior to moving in, and what they can expect to receive for their fees. The manager has reviewed the lighting levels in the interior bathrooms to ensure they are safe to work in and provide a comfortable environment for people to bathe in. The manager has replaced the stair gate to the second floor fire escape with a new fire door following discussions with the Fire Officer. This is to ensure that the fire escape is still safe to use in an emergency. The home manager has increased the amount of information gathered on peoples life histories. This information is important as it helps staff understand the whole person they are caring for, their life experiences, interests and relationships to people and places. It can also help in placing particular behaviours in context if the person is no longer able to verbalise their needs or wishes. The home manager has reviewed the programme of activities with the specific needs of people with memory loss in mind. This is to ensure that the social needs of all residents are assessed and met. Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 7 A copy of the homes service user guide has been given to each person living at the home who requested one. This should ensure they have access to up to date information about the home. The home manager is considering whether the homes service user guide could be made available in additional formats to meet the needs of the people living at the home. This might for example be in large print or Braille. A falls risk assessment is being undertaken for all people living at the home with a more detailed assessment based upon best practice undertaken for those people most at risk. When additions need to be made to the printed medication administration record chart these are now being hand written, the person making the entry signs and dates it and then gets it checked and signed by a second person. This is to ensure that changes to medication records are completed in a way that ensures peoples medication is safely recorded. A list of the signatures of staff giving out medication has been obtained. This helps to ensure that staff who have given out medication can be easily traced. Medication requiring refrigeration is now being kept in a refrigerator which is lockable. This means that peoples medication can be kept safely at lower temperatures. The manager has made arrangements for the recording and safe administration of all medicines received into the care home. This ensures that a record is made of the receipt of all medicines: it also refers to the need to record the supply of medicines to those service users looking after any of their own medicines What they could do better: Each person living at the home must have an up to date care plan, specifying how their needs in respect of their health and welfare are to be met. This is to ensure that peoples changing needs are understood and that staff can respond in a consistent way. The registered person must establish and maintain a system for reviewing and improving the quality of care provided. This is so that the organisation can see what is working well at the home and where they can improve. The system will also include a process of consultation with the people living at the home, so that they can influence the way the home operates. Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 8 Supervision systems need to be emended so that it provides for staff development as well as a monitoring and appraisal system. This will help make sure that staff are working to their full potential and consistently to support people living at the home. Guidance on best practice in environmental design and adaptation should be examined to ensure that the work being undertaken on the building best supports for people with Dementia or memory loss and physical disabilities. This might for instance include using different colours, clear signs and easy access . Staffing levels should continue to be monitored to ensure that the changing needs of people at the home are being met. The manager is recommended to source training or information for staff on supportive and positive communication with people with memory loss. This is so that staff can communicate effectively with people with increasing levels of disability. The registered person should examine the locked door policy in the light of new legislation and the lack of individualised risk assessments. This is to ensure that peoples rights are being protected and that any restrictions are limited to those people for whom this is a clearly documented need. The home manager should complete a first aid risk assessment for the home. This helps to ensure that the right level of first aid cover is always available. 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. Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 9 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 Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 10 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): 3, 4, 6 Quality in this outcome area is good. People are assessed before they move into Cornerways to ensure their needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Files for the two most recent admissions were seen, and discussion held with the manager on the processes that had been followed. These demonstrated that in both instances a full assessment had been carried out by the home manager before any decision was made on whether to offer the person a place at the home. This means that the home can be sure that they can meet the persons needs, can arrange for any specialist equipment or alterations to be made and that the person can be sure the place is the right place for them. Discussions held before the admission had included a discussion on fees to be paid, and people were given copies of the homes service user guide, which Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 11 includes a copy of the homes contract. This helps people to understand any restrictions placed by the home and see what services are available. For one person there had been no assessment carried out by Social Services, but the home had received a hospital referral letter confirming their recent past care needs and any rehabilitation and medication required. Both people had either visited the home themselves, or their relatives had done this on their behalf before they came in. This had allowed them to look at accommodation on offer and make a decision about which room would suit them best. Care costs at Cornerways are based on a combination of the room and care needs, so are very individual. Cornerways does not provide intensive programmes for rehabilitation known as intermediate care. This means that the home aims to provide a continuing home rather than return people to their own homes. Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 Quality in this outcome area is good. Peoples health and personal care needs are being met. Some care plans needed minor updating to ensure peoples changing needs are reflected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The people living at Cornerways have considerably varying needs, and many have high levels of disability, with both physical and mental frailty. A sample group of four people were chosen to reflect a range of needs, and their care plans were examined in detail, along with other records such as risk assessments and accident records linked to these plans. Other care plans were seen, but not in such detail. Discussions were held with one of these people about the care they were given and for another discussions were held with two staff about the care they gave them. This related well to the descriptions of care identified in the plan which Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 13 helps to show that this persons plan was accurate. However, two of the plans seen had not been reviewed very recently and one no longer reflected the individuals needs due to recent changes in their health. This showed that not all plans were being reviewed on a monthly basis, even though there is a system to do so. Evidence could be seen of the involvement of local medical support services including district nurses, community psychiatric nurses and speech therapists for one person living at the home , although the manager confirmed they also support many others as needed. Other services include continence advisors, chiropodists, dentists, opticians, hearing services and general practitioners. Staff who completed questionnaires described the care they gave as very good, but there were some concerns raised about the accessibility and suitability of hoisting equipment, the levels of disability of some of the people living at the home who are very frail and first aid practices. These issues were shared with the manager and group manager from the company owning the building and discussion was held on a re-assessment of the environment and equipment available to make sure that it now reflects the changing needs of the people at the home. The manager agreed to reinforce first aid practices with staff. Medication practices at the home were satisfactory, but the home is not keeping a running balance of a controlled medication for pain relief that is kept in liquid format. This is important so that a clear audit trail can be carried out and the home manager can see that medication is not missing. Medication storage is secure and staff who give out medication have received training. A concern had been raised that some medication was being taken out the blister pack in the morning to be given in the afternoon, and the manager agreed to make sure this did not happen. This could have led to errors in medication or contamination of the medication being given. People spoken to at the home said they were well cared for and that staff, although very busy, were kind and helpful. One said “ Staff have received recent training in end of life care, which means they have an understanding of good care for people who are dying. Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 – 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is adequate. Some areas were excellent. People living at the home have some flexibility in lifestyle and control over their lives. Meals served are excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living at Cornerways have opportunities to follow their chosen lifestyles and make choices in their lives, but these are in many cases limited by their physical condition or mental frailty. Cornerways, as any group living establishment has a structure to the day but there is some flexibility to the routines. For example people wishing to go out during the day can have a main meal set aside for them for when they return. Some people spoken to said they could get up and go to bed when they wish. Staff said they were aware of people who liked to ‘lie in’ and did not go in to get them up at an early hour. One person living at the home outlined their ‘getting up routine’ which involved them getting up and being partly ready before staff came in with a cup of tea at 7.30am, as they didn’t want to ‘upset the staffs routine’. Staff confirmed that the night staff assisted several people Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 15 who got up very early in the morning rather than having them wait until the day staff came in to help them dress and bathe. Discussion was held on restrictions placed on people living at the home. This includes currently the front door being locked and other doors being alarmed so that if people leave the building staff are aware. Many people who live at the home and are able have keys to the front door, so that they can come and go as they please. However others are much more frail and the home manager expressed concerns for their safety should they leave the home unaccompanied. This is not however fully documented in an individual risk assessment for each person. Assessments of risks have been undertaken for other areas and these have included the use of bed rails, moving and handling and mobilising. Risk assessments help the staff to identify and minimise any risks to people living at the home. People can also choose to take part in activities provided or not. The home has an activities co-ordinator who visits several days a week and works with groups of people and on a 1:1 basis with those who are more frail. During the first site visit, time was spent observing a group of people in the lounge for a period of two hours. This was to get an idea about how their lives were spent and the quality of the interactions they received. During this period it was seen that although there was a good level of interaction between people living at the home and the staff, much of it was aimed at giving information or instructions. Some people received a lot of staff time and interaction, but three people received very little positive contact in that time. One person had difficulty attracting staff attention. This was discussed with the manager and a number of ways of addressing this were identified. Since the last site visit the home has organised a small mobile shop and is planning a barbeque, cream tea and various visiting attractions such as the donkey sanctuary. People living at the home grew many of the flowers in the tubs outside the home from seed as part of a recent activity group. Meals at the home are of a high standard with choices available each day. The home has two sittings for people at mealtimes which means that people who are frailer and need assistance with feeding have the opportunity to eat at their own pace and not feel pressurised by people who may be able to eat quicker than they can. On the day of the first visit the meal served was Roast pork and fresh vegetables, or omelette or cold meat salad or pasta. Dessert was rhubarb crumble, butterscotch mousse, key lime pie or pears and ice cream. The evening meal was a selection from soup, cheese sandwiches, melon and mandarins, eggs on toast or turkey salad. The chef and homes management have had access to a specialist video and menu planning system to ensure that people with dementia have an appropriate diet. Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 – 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. People are protected by the homes policies on complaints and adult protection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Cornerways has a clear complaints procedure that is available in the service user guide and in the hallway of the home. The procedure spells out how to make a complaint and that the home will investigate all concerns raised. Residents relatives who completed questionnaires indicated that they were clear about who they would go to if they were concerned about something at the home or wished to make a complaint, and this was backed up in discussions with people living at the home. No complaints have been received by CSCI about the home since the last inspection visit. Many of the people living at Cornerways would find it difficult to make a formal complaint, which makes it very important that staff are aware of clues that indicate that a resident may be unhappy about something. Most staff at Cornerways have received training in the protection of vulnerable adults, and questionnaires completed by staff indicated that they were aware of an Adult protection policy and would know what to do if they saw something happening that they knew was wrong or abusive. Other staff are due to receive training shortly. There are policies and procedures available to staff to clarify Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 17 issues such as a policies on gifts to staff and two signatures are required for any financial transactions. This helps ensure everyone is clear about personal behaviour at work. The home has responded robustly to a concerns about an ex carer in the last year and acted appropriately to ensure people who might be vulnerable are fully protected. Discussion was held with the manager on a complaint that was received by the home during the last year. This complaint was managed successfully within the home, and in accordance with the homes complaints procedure, and provided a satisfactory outcome for the person who raised the concern. Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 Quality in this outcome area is adequate. Cornerways provides a comfortable environment for older people. There are some problems with access around the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Cornerways is a long established home over three floors, with lounges and communal areas on the ground floor. The home is situated close to the sea front in Preston and with level access to local shops and services. There is limited outside space and rooms vary considerably from those which are quite small with restricted outlooks to those which are large, bright and attractive providing sitting and sleeping areas. All rooms have some en-suite facilities, some with just a toilet others with baths or showers in addition. Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 19 There is a choice of lounge areas on the ground floor, so people have a choice of where to sit, and there is a large dining room with small tables where people can choose to eat on their own if they wish. The building is over three floors with a passenger lift to access the upper levels. Wheelchair access can be provided through patio doors in the lounge. There are assisted bathrooms and toilets or wheelchair accessible showers on each floor. However some corridors have sharp turns and are narrow which makes the movement of wheelchairs and large hoists difficult. This was confirmed by staff in questionnaires and also a relative. Discussions with the group manager indicted that there may be some opportunities to alter the corridors in some areas to improve this. Discussion was also held on ways to make the premises more suitable for people with memory loss as currently this is not in place. Rooms are comfortably furnished and are being updated, as are the corridors which have suffered from damage from wheelchairs and equipment. There is a programme of refurbishment and development of the home, which includes the upgrading or rooms as they become vacant. This helps to ensure the overall upkeep of the building and helps people to live in an attractive environment. There is a large laundry to the rear of the home and discussions with staff indicated that proper conditions on infection control were present. Staff have access to policies and procedures and protective clothing such as gloves and aprons to make sure the risk of cross infection is reduced. Clinical waste bins are provided and these are locked to ensure this is stored safely until collected by the contractor. Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. The staffing arrangements are satisfactory. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing rotas showed an appropriate staffing level on duty. Dedicated domestic and housekeeping staff are on duty as well as a handyman and administrative staff. Staff who completed questionnaires indicated that they felt at times more staff were needed to enable them to give people the attention they needed. This seemed to be due to the disability level of the people they were caring for. On the site visit three staff recruitment files were selected at random to be inspected. The files contained evidence of the recruitment process followed when new staff are being appointed. Files seen showed that a full recruitment process is followed, with staff completing application forms, providing references and undertaking a criminal records bureau check. This helps protect people living at the home from being cared for by people who are unsuitable to work with vulnerable adults. Discussion was held on the induction process followed for new staff. Induction books are completed for new staff which detail the training that new staff are given when they start working at Cornerways. One could be see to have been Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 21 completed for a new staff member. This helps to ensure that people working at the home are working to the same standard and in the same way. The staff seen on the inspection had a good understanding of the needs of older people living at the home and have received both core training and some service user specific training relevant to the home. For example this has recently included training in Dementia training. Half of the staff at the home have achieved an NVQ level2, and at the time of the site visit five staff were undertaking NVQ level 4, which is a management level qualification. NVQ’s are a nationally recognised award reflecting the level of competency of the staff. Risk assessments are available for working practices including a pregnancy risk assessment, to ensure that staff who are pregnant can safely carry out their work. Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38 Quality in this outcome area is good. The home is being well managed. Work is still required to fully implement the supervision and quality assurance systems. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of the home, Gillian Plastow has worked at Cornerways for over 20 years and has been the registered manager for nearly three years. She is well experienced and knowledgeable about the home and is a strong advocate for the people who live there. Quality assurance systems at the home have been started with a questionnaire having been circulated to people living at the home and their relatives to gain their views on the running of the home. These will need to be incorporated into Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 23 a full quality assurance report on the home. This helps people who live there influence the way that the home is run and helps the owner identify what is working well and what needs to change. The finance systems seen provided a good protection for service users, some of whom have deposited small amounts of cash for day to day purchases, such as newspapers and chiropody services. Balances held for two people were seen and checked against receipted accounts, and were found to balance correctly. The manager has been implementing a new system for supervision and appraisal of staff. Supervision is a system which combines performance appraisal and personal development for staff. The system requires further development to ensure that it provides a system that ensures staff are working consistently and to the best of their ability to support the people living at the home. A recent health and safety audit has been carried out at the home, and the manager confirmed that the environmental risk assessments have been updated as a result. The home could provide copies of gas safety certificates and maintenance contracts such as for the lift and hoists. The building has been tested for Legionella and asbestos, the manager confirmed window openings are restricted to prevent people falling from them accidentally and all radiators are covered so that people are prevented from accidental burns. Water temperatures are regulated to ensure that people living at the home cannot be accidentally scalded. Portable electrical appliances are tested for electrical safety and a full wiring test is due next year. The home has a full Health and safety policy and manual which was seen. Regular tests are carried out on the fire alarm system along with fire drills, practices and instructions. Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 24 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 3 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 2 13 3 14 2 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 3 3 3 3 3 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 2 x 3 2 x 3 Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 25 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 OP7 Regulation 15 (2) (b) Requirement Each person living at the home must have an up to date care plan, specifying how their needs in respect of their health and welfare are to be met. The registered person must establish and maintain a system for reviewing and improving the quality of care provided. Timescale for action 20/08/07 2. OP33 24 20/09/07 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. Refer to Standard OP36 Good Practice Recommendations It is recommended that the developmental side of supervision be looked at in addition to the current performance evaluation systems, so that a full system is achieved. Guidance on best practice in environmental design and adaptation should be examined to ensure that the work being undertaken on the building best supports for people with Dementia or memory loss and physical disabilities. Staffing levels should continue to be monitored to ensure DS0000049076.V336799.R01.S.doc Version 5.2 Page 26 2. OP19 3. OP27 Cornerways, Paignton 4. 5. 6. OP12 OP14 OP38 that the changing needs of people at the home are being met. The manager is recommended to source training or information for staff on supportive and positive communication with people with memory loss. The registered person should examine the locked door policy in the light of new legislation and the lack of individualised risk assessments. The home manager should complete a first aid risk assessment for the home. This helps to ensure that the right level of first aid cover is always available. Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. Extracts may not be used or reproduced without the express permission of CSCI Cornerways, Paignton DS0000049076.V336799.R01.S.doc Version 5.2 Page 28 - 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. 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