Inspection on 30/05/06 for Fistral House

This inspection was carried out on 30th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Fistral House 01/09/08

Fistral House 03/09/07

Fistral House 07/03/06

Fistral House 22/09/05

Fistral House 03/03/05

Fistral House 07/09/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Fistral House 3 Esplanade Road Pentire Newquay Cornwall TR7 1PY Lead Inspector Alan Pitts Unannounced Inspection 30th May 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 Fistral House DS0000008927.V294335.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. Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Fistral House Address 3 Esplanade Road Pentire Newquay Cornwall TR7 1PY 01637 878423 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) Mr Geoffrey Ernest Dowling Mrs Rita Gladys Dowling Mr Geoffrey Ernest Dowling Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include accommodation for two named persons only outside of the age range and other category of the home. 7th March 2006 Date of last inspection Brief Description of the Service: Fistral House is a care home providing personal care and accommodation for up to thirteen older people. The home is located in a residential area of Newquay directly opposite Fistral beach. The home provides a conservatory for service users to enjoy the views. The home has all en suite (toilet and wash hand basin) bedrooms on the ground and first floor. There is a stair lift facility to all the bedrooms on the first floor. Communal accommodation is on the ground floor and consists of a lounge, dining room and conservatory. The home has a spacious level back garden and car parking is available at the front of the home. Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of care standards at Fistral House, which took place over a period of approximately 6 hours commencing at 9am on 30th May 2006. The inspector met with 2 service users, a relative, a number of staff and the registered provider, and toured the premises. The service users and the relative were complimentary about the home generally, and the kindness and consideration of the care staff. The small number of requirements and recommendations made in this report should not detract from the overall high standard of care provided at this small, ‘homely’, care home. What the service does well: What has improved since the last inspection? The registered provider has had new double-glazed windows fitted throughout the home, including a new porch to the front of the building. New carpet has been fitted in the hall, landing, staircase, and lounge. A new washing machine and dryer have been fitted. Fistral House DS0000008927.V294335.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. Fistral House DS0000008927.V294335.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 Fistral House DS0000008927.V294335.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): 3, 6 The inspector is satisfied that usually no service user would move into the home without a pre-admission assessment, but in the most recent instance this requirement was overlooked by the registered provider. The home does not provide intermediate care. EVIDENCE: There was no pre-admission assessment evident for the home’s most recent admission, neither was a care plan in place. Pre-admission information and care plans were seen to be evident for other service users admitted to the home. The registered provider must ensure that a pre-admission care needs assessment is completed prior to accepting any admission to the home. The home does not provide intermediate care. Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9, 10 Care plans are generally excellent, though this impression was spoilt by the lack of a care plan for the most recent admission to the home. Care plans were seen to be informative and comprehensive, indicating service user’s health care needs being met as appropriate. Medicines are handled properly, and stored securely. Service users confirmed that all the staff protected their privacy and were respectful. EVIDENCE: The home would have gained ‘top marks’ from the inspector for the quality of the care plans in use, had it not been for the one service user who did not have a care plan. Care plans are informative and comprehensive, providing clear instruction to the care provider. Care plans are reviewed monthly with the respective service user, who signs the care plan where possible. The care plans are supported by generally detailed daily records, which prompt the writer to make an entry about a number of criteria, such as mobility, diet, etc. The involvement of other healthcare professionals is recorded in detail for each service user. One service user had a hospital appointment on the day of the inspection. Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 Page 10 Medicines are appropriately stored and administered, in line with the medicines policy in use. A Control Drug book is kept and was seen to be in order. Medicines are stored securely. A record is kept for the receipt and return of medication. Medicine Administration Records were seen to be accurate and current, though when it is necessary to hand-write a prescription on to these the registered provider should ensure that two staff initials are entered to show that the entry has been checked as correct. The service users and relative spoken with could not speak highly enough of the consideration of the staff, and confirmed that the service users were respected and their privacy upheld. Fistral House DS0000008927.V294335.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): 12, 13, 14, 15 Service users confirmed that the home meets their social/recreational needs, that they are free to determine their daily lives, and that there is no restriction on receiving visitors. A wholesome, diet is provided, and service users confirmed that the standard of food provided was very good. EVIDENCE: There is a list of activities that the home can provide, and the inspector was advised that an activity is offered every day, but the daily records could better reflect this. The registered provider should ensure that service user’s, generally very good, daily records show how the service user spent their day and what options were available to them (e.g. “declined playing cards in the lounge”). The daily records are otherwise very informative about the service user’s daily life at the home. There is a visitor’s book in the entrance, which shows regular and frequent visitors to the home. Service users, a staff member, and a relative confirmed that there are no restrictions on service users receiving visitors. The inspector was advised that drinks, snacks and meals were also made available to visitors. A number of service users have their own telephone lines in their bedrooms, but calls can be made and received in private without this facility. The service users and a visiting relative also said that service user’s right to Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 Page 12 make choices was also respected. Staff were seen to interact with service users in a comfortable, familiar and caring, but professional manner. All the service users have relatives or representatives available to act in their interests. A 2-week menu is used as a guideline, though meals may vary from this according to what has been locally available to the cook. There is a record of food provided. A wide choice of options is offered at the evening meal. The inspector was advised that service users could have an alternative at lunch if they said they would like something else, though the menu does not demonstrate that a lunchtime choice is available. The registered provider should ensure that a lunchtime choice is offered, and recorded, on a daily basis. The service users, and relative, spoken with were complimentary about the quality of the food provided. The lunchtime menu on the day of the inspection was seen to be well presented and appetising. Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 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 the following standard(s): 16, 18 There is a complaints policy, and service users, and a relative, said that they would feel able to raise any concerns with the home’s staff and management. A number of staff have undertaken Protection Of Vulnerable Adults training, and there is a Protection Of Vulnerable Adults procedure. EVIDENCE: There is a complaints policy in use, though this is written more from a staff than from a service user perspective. The procedure specifies that a response to a complaint will be made within 10 days. The registered provider should review and amend the complaints procedure to give clear information to service users, or their representatives, how to make a complaint and what the process is once the complaint is received. The registered provider should ensure that the procedure includes a 28-day response period, and also provides contact information for the local Adult Social Care office and the Commission for Social Care Inspection, whom service users, or their representatives, can contact at any time. Service users and a visiting relative expressed confidence in the home’s staff and management, and said that they would feel able to express any concerns should the need arise. Four staff have undertaken Protection Of Vulnerable Adults training, and another two staff are booked on this course. There is a Protection Of Vulnerable Adults procedure in place, though the registered provider should review and amend this to ensure that the procedure includes relevant contact details (Adult Social Care office), clear instruction as to the steps to take in the Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 Page 14 event of an allegation of abuse, and to show adherence to the Cornwall Protection Of Vulnerable Adults procedure. Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Fistral house is a large domestic dwelling, which is suitable to its stated purpose. The property is well maintained and provides a safe environment for service users. The home is clean, pleasant, and hygienic. EVIDENCE: All service user rooms are en-suite, and all but three offer a shower or bath). There is one communal lavatory and one communal bathroom. The baths have mixing valves to control the supply of hot water. The home generally offers level access, stair lifts, pressure relieving equipment, call bell system, moving and handling aids and a variety of grab rails are provided. Access between floors is aided by the provision of a stair-lift. Various bedrooms have been redecorated and the gardens are well maintained. The heating is provided through radiators in each room with individual controls and protective guards. Appropriate ventilation and window restrictors in bedrooms are provided. The home is clean, well decorated and furbished throughout and service users were seen to enjoy personal possessions in their rooms. The registered provider has Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 Page 16 had new double-glazed windows fitted throughout the home, including a new porch to the front of the building. New carpet has been fitted in the hall, landing, staircase, and lounge. A new washing machine and dryer have been fitted. There is a record of maintenance kept. There are beautiful views over Newquay beach from some bedrooms and from the main lounge and conservatory. Service users and a visiting relative said that they thought the home and service user rooms to be very pleasant, and they were very happy with the accommodation provided. Communal bathing and lavatory areas are provided with liquid soap and paper towels, and all the staff carry their own alcohol solution for hand washing. All areas of the home were seen to be clean, and there were no undue odours evident. Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Service users are well cared for and are kept safe. The home has a low staff turnover, and adopts a thorough recruitment procedure when needed. The home is committed to staff training. EVIDENCE: At the time of the inspection there were 4 care staff, and a cook and a cleaner on duty. There is 9 care staff employed by the home, of which 6 have achieved NVQ Level 2 or above. The home maintains a training record, which includes: 1st Aid (5 staff); Fire training (all); Moving and Handling (all but one); Food Hygiene (7 staff); Protection Of Vulnerable Adults (4 staff); Medication (8 staff); and Health & Safety (6 staff). Service users said that they were well cared for and this was supported by the positive comments of a visiting relative. The numbers and competencies of the staff meet Service user’s care needs. A duty rota is used, which accurately reflects the staff numbers on duty (no Tippex please). The home enjoys a low staff turnover, which benefits the service users, and inspection of a staff personnel file showed that the home adheres to a robust employment procedure when appointments are made. The home has National Training Organisation induction programme information and documentation, though this is not currently in use as there has not been any new staff employed since the last inspection. The registered provider is Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 Page 18 aware of the need to use a National Training Organisation induction programme. Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 The registered provider is in day-to-day control, and there is a clear hierarchy in place at the home. The home is run in the best interests of service users, as evidenced by their comments during the inspection. Service user financial interests are safeguarded, and the home has minimal involvement with service user monies. The welfare and safety of service users and staff is protected. EVIDENCE: The registered provider is in day-to-day control and is supported in her duties by two senior staff members. Both these senior staff members have achieved the Registered Managers Award. Service users were aware of who was in charge at the home. The registered provider has commenced a quality assurance programme and has started to publish a summary of the responses in the Service User Guide. This would benefit from expansion: with the inclusion of the questions asked, Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 Page 20 and to whom (e.g. service user, GP, District Nurse); a summary of the responses; and any action taken as a result. The home handles only a small amount of money for service users, and this is kept secure. The registered provider has no involvement with service user’s pensions or benefits. A record is kept for each service user, which includes the money received and the money spent (e.g. hairdresser), but this record should be improved with a supporting receipt wherever possible. The home is well maintained, and records of regular maintenance work and other records were inspected, including: • Environmental Health Officer – April 2005 • Gas Safety certificate – January 2006 • Fire Equipment - February 2006 • Fire System – October 2005 • Electrical Inspection report – January 2006 • RIDDOR • COSHH • Accident Book The home was seen to be clean, safe, and in good order throughout. Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X X X X X 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 3 X 2 X X 3 Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 Page 22 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 OP3 Regulation 14 Requirement The registered provider must ensure that a pre-admission care needs assessment is completed prior to accepting any admission to the home. Timescale for action 01/06/06 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 OP9 Good Practice Recommendations When it is necessary to hand-write a prescription on to Medicine Administration Records the registered provider should ensure that two staff initials are entered to show that the entry has been checked as correct. The registered provider should ensure that service user’s, generally very good, daily records show how the service user spent their day and what options were available to them (e.g. “declined playing cards in the lounge”). The registered provider should ensure that a lunchtime choice is offered, and recorded, on a daily basis. The registered provider should review and amend the complaints procedure to give clear information to service DS0000008927.V294335.R01.S.doc Version 5.1 Page 23 2. OP12 3. 4. OP15 OP16 Fistral House 5. OP18 6. OP35 users, or their representatives, how to make a complaint and what the process is once the complaint is received. The registered provider should ensure that the procedure includes a 28-day response period, and also provides contact information for the local Adult Social Care office and the Commission for Social Care Inspection, whom service users, or their representatives, can contact at any time. There is a Protection Of Vulnerable Adults procedure in place, though the registered provider should review and amend this to ensure that the procedure includes relevant contact details (Adult Social Care office), clear instruction as to the steps to take in the event of an allegation of abuse, and to show adherence to the Cornwall Protection Of Vulnerable Adults procedure. Service user financial records should be improved with a supporting receipt wherever possible. Fistral House DS0000008927.V294335.R01.S.doc Version 5.1 Page 24 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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