Inspection on 05/05/05 for Drake House

This inspection was carried out on 5th May 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Drake House 18/11/05

Drake House 04/11/04

Drake House 11/05/04

Similar services:

Fairfields Country Rest Home

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Fairfax House

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

CARE HOMES FOR OLDER PEOPLE Drake House 4 Nelson Gardens Stoke Plymouth PL1 5RH Lead Inspector Doug Endean Announced 5 May 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Drake House Address 4 Nelson Gardens, Stoke, Plymouth, PL1 5RH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01752 551859 01752 564525 Mr George Marshall Vacant Care Home 32 Category(ies) of Dementia - over 65 years of age (32), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (32) Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Registered for max 32 DE(E) service users 65 years and over Registered for max 32 MD(E) service users 65 years and over The home may from time to time admit persons between the ages of 60 to 65 years of age. Date of last inspection 4th November 2004 Brief Description of the Service: Drake House Nursing Home is situated in Stoke, a suburb of the City of Plymouth, which is a short distance away by road. It is a large semi-detached property built on four floors. Nelson Gardens is a private road that offers some parking at the front of this building accessed directly from the road. The Service Users accommodation is provided on the first three floors each accessed by stairs or the shaft lift that runs up through the centre of the home. The forth floor has a staff room. The property has been totally refurbished by the present owner to provide clean, well-decorated and adapted accommodation for the Service Users who live there. The rear garden offers a safe space for the Service Users to sit in during good weather.The home is registered to provide nursing care for up to Thirty-two (32) Service Users over the age of sixty-five (65) years, of either sex, who suffer from a mental illness or dementia. The accommodation is provided in a variety of single and double rooms. Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over a five-hour period. Present were the Registered Person, the Manager and Deputy Manager and the Administrator. The Commission for Social Care Inspection received a completed pre-inspection questionnaire and comments from four relatives prior to the inspection. The inspection included a full tour of the home, discussion with three visiting relatives, four members of staff and several client’s. It should be noted that due to the nature of the disease process suffered by the client’s, being dementia, obtaining an informed opinion from the client’s was understandably difficult. The clients were seen to be appropriately dressed and comfortable by the inspector during the inspection. There were 31 client’s resident in the home at this point in time. As part of the inspection four clients records were reviewed including the preadmission assessments, care plans and medication records. The personnel files of three employees’ were inspected at, maintenance records examined and the audit file looked at during the inspection What the service does well: What has improved since the last inspection? The general audit trail of care, training and maintenance. Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, standard 6 is not applicable to this home. The clients in the home are appropriately placed and the staff are skilled in meeting their specific needs. EVIDENCE: The home is staffed registered nurses, skilled in assessment, who establish the suitability of prospective clients using a comprehensive assessment format. Complete pre-admission assessment forms were seen in a sample of client files that were looked at during the inspection. The care plans and daily record of activity of each client were read in the sample of client files. They state that the staff are able to provide an appropriate level of care to the clients and manage the issues identified in the care plans. The descriptions of clients in their files related to how they presented to the inspector during the tour of the home. The clients spoken to and observed during the course of the inspection appeared to be settled and did not display any challenging behaviour. The relatives spoken to during the inspection were complimentary about the care provided by the staff and the suitability of the placement. Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. The staff team, including visiting professionals, provide the care required by the clients that is identified in their individual care plans. EVIDENCE: Three individual care plans were read and the information cross-referenced with the pre-admission and ongoing risk assessments in the files. The care plans held information suitable to allow appropriate care to be delivered as planned. Each care plan read had evidence that it had been reviewed at least once a month. The clients are reviewed by the homes visiting General Practitioner on at least a weekly basis. The General Practitioner visited on the day of the inspection and was seen to have a good rapport with the staff whilst attending to the needs of the clients. The client’s files provided evidence of visits from paramedical services to meet the needs of the clients. Other supporting evidence was seen in clients finance records where payments were made for chiropody other than when National Health Service Chiropody is provided. Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 10 The medication procurement, administration and disposal systems were inspected and found to be well organised. The recordings made for each clients medication showed a trail from delivery to disposal where this had occurred. There was visual evidence that the staff were mindful of the issues of dignity and respect when caring for the clients. Clients were appropriately dressed, spoken to using a name that the client appeared comfortable with and personal care was provided in private areas. Where assistance was given to clients at dinnertime who needed to be fed or supervised this was unhurried and took into account the clients behaviour and attention span. The relatives that were spoken to also made comments that suggested that they were happy with the approach the staff have with the clients. There is evidence in the staff-training chart supplied to the inspector that the staff receive a range of training to prepare them to meet the assessed needs of the clients. Training received includes Manual handling, Health and Safety, first aid, continence care and fire and safety training. Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15. There is a safe environment provided where the clients can express themselves and exercise choice. EVIDENCE: The assessment process identifies the social, cultural, religious and recreational interest the client had during their life and evidence of this was seen in the sample of files that were read by the inspector. The staff have recorded information obtained from the client and his relative or advocate about what interests remain and are achievable and these were seen to be recorded in the client profiles. The sample of care plans that were read stated how the home intended to meet the achievable needs. There was written evidence in client’s files that showed individual clients had attended activities, such as pottery and painting, local football matches and walks to local shops supervised by staff. In addition there was written and photographic evidence that the clients are entertained by a musician each month and have a regular move to music session. The photographs also show staff involved in themed parties at the home and entertainment from a visiting theatre group. The clients generally have difficulty in expressing verbally what their views are on such things as choice of clothing or where they wish to sit. However the continual assessment process and information gathered from relatives and advocates, that was seen to be recorded in the clients files, inform the staff as Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 12 to what the clients views may possible be, their likes and dislikes for food, choice of company and music, etc. Clients do also express their views at any moment in time through behaviour and where this is a main method of communication this is recorded for staff to plan care. Evidence of this was seen in care plans that describe how staff are to move a client’s who may become agitated and distressed if not correctly supported in a hoist. There is evidence that all the catering staff and some of the care staff have completed the “Basic Food Hygiene” course. There was a total of nine staff with this certificate. Food was seen to be prepared in a centrally located kitchen by catering staff. The most recent Environmental Health report for the kitchen only questioned the storage of eggs. Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. The atmosphere allows relatives, advocates and professionals visiting the home to voice their opinions and concerns without fear of prejudice. Where this is not felt there is a clear complaints procedure displayed. EVIDENCE: There is a complaints procedure displayed in the foyer and also in the Statement of Purpose. There is a complaints book on display in the foyer for use by anyone who wishes to express a view. The book was inspected and no entries found. Three relatives that were spoken to had no complaints to make and did feel that they could discuss any concerns with the staff. There has been no formal training in abuse. There is evidence that staff will begin “Elder Abuse” training by an external trainer from 24th May 2005. The procedure for recruitment was seen to be followed in the sample of staff files that were seen. Each file had the required information including two references, photographs and Criminal Records Bureau check. A Protection of Vulnerable Adults list first check is made on any prospective staff member before they commence work. Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26. The Registered Person and staff have taken steps to provide a clean and safe environment for the clients to live in and the staff to work in. EVIDENCE: There is a complete assessment of the premises by an Occupational Therapist with experience of the elderly with a mental health problem that gives recommendations that have been acted upon such as non-slip ramping to the rear garden and grab rails. The premises receive constant attention to the fabric from the owner who is a builder. The inspector toured the home and found it to be clean, well decorated and appropriately furnished. The carpet in the dining room was seen to be heavily soiled and in need of replacement. Records were seen that showed that there is a program and record of maintenance on items requiring the attention of a competent person such as the shaft lift and hoists, electrical appliances and the house wiring. Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 15 The Office Manager has supplied details to the inspector of all the dates that equipment has been serviced over the last twelve months. The Commission now holds this information on file. Staff were seen to be provided with uniforms, disposable gloves, aprons and alcohol wipes as method of protection and infection control. There was evidence of boxes of disposable gloves and aprons in many areas, including toilets, around the premises. Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30. There are staff employed at the home with sufficient skills and in sufficient numbers to meet the assessed needs of the clients. The recruitment process is robust enough to identify suitable staff. EVIDENCE: The duty rosters provided evidence that the Manager has provided a sufficient skill mix of staff, in sufficient numbers, during the week prior to this inspection to meet the assessed needs of the clients. There is a recruitment procedure that was seen in the procedures file in the main office. The fitness of each member of staff is established through a robust recruitment procedure. Staff files were inspected and found to include references and a Criminal Records Bureau. Staff at the home receives training appropriate to the task they are employed to do. Evidence was seen in staff files and the training chart supplied to the inspector. This showed all the catering staff and some care staff have a certificate in basic food hygiene. The training chart supplied to the inspector provided evidence of other training such as fire, first aid and manual handling. The most recent training undertaken by care staff was the basic food hygiene and first aid. There has been no formal training in abuse. There is evidence that staff will begin “Elder Abuse” training by an external trainer from 24th May 2005. Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 38. The home is a clean, well-decorated and maintained environment for the clients to live in and the staff to work in. EVIDENCE: The audit file seen provided evidence that questionnaires had been completed by relatives and advocates of clients that comment on the service provided. There is also a six monthly General Practitioner questionnaire obtaining an opinion on the service provided to the clients. The result of an annual Health and Safety audit was made available to the inspector and it provided evidence of risk assessments having been undertaken with action plans to resolve any problems. The Office Manager showed how client’s money is handled. The inspector saw evidence of bank accounts for clients money to be held securely in and a trail of records that showed how money that is spent is recorded and backed up with receipts. Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 18 The staff training records provided evidence that they are prepared to carry out the tasks required of them in their job descriptions. The client’s files provided information about their needs and who they were planned to be met. This information was held in such things as tissue viability assessments and manual handling assessments. The equipment inventory and maintenance reports and invoices that were seen provided evidence that the staff have available a range of aids to safely meet the assessed needs of clients such as moving and handling or bathing. Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 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 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 Drake House D52-D04 S3584 Drake House V215279 040505 Stage 4.doc Version 1.30 Page 20 Yes 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 OP19 and OP26 Regulation 23(2)(d) Timescale for action The Registered Person shall 1st having regard to the number and September needs of the service users 2005 ensure that all parts of the care home are kept clean and reasonablly decorated. The dining room carpet was heavily soiled at the time of the inspection and may need replacing. Requirement 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 OP29 Good Practice Recommendations The Manager should continue to pursue vulnerable adults training for all members of staff. 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