Inspection on 28/02/06 for Frank Cowl House

This inspection was carried out on 28th February 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Frank Cowl House 27/11/07

Frank Cowl House 28/02/07

Frank Cowl House 26/07/05

Frank Cowl House 22/02/05

Frank Cowl House 19/08/04

Frank Cowl House 11/02/04

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

CARE HOMES FOR OLDER PEOPLE Frank Cowl House Frank Cowl House Park Avenue Devonport Plymouth Devon PL1 4BG Lead Inspector Sheila Giblin Unannounced Inspection 08:00 28 February 2006 th 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 Frank Cowl House DS0000030792.V264826.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. Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Frank Cowl House Address Frank Cowl House Park Avenue Devonport Plymouth Devon PL1 4BG 01752 668000 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) Plymouth City Council Susan Debra Wills Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21), Physical disability (5), Physical disability of places over 65 years of age (5) Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 1st Floor - To be used for long term residential care only Ground Floor - To be used for short term residential care only Service Users with the category PD and PD(E) to be accommodated in room numbers 12,13,14,15 and 18 only. Service Users may be admitted aged 50 in the category of PD One extra room to be registered to long stay accommodation - total 11 beds 26th July 2005 Date of last inspection Brief Description of the Service: The home is a large purpose built detached building, built in the 1970s, located in the Devonport area of Plymouth, and managed directly by Plymouth City Council Social Services Department. A full range of amenities and facilities are within either a walk or short bus ride of the home. The home can accommodate up to twenty one residents over two floors. The ground floor is specified for short stay residency and the first floor is specified for permanent residency. The building has both physical disability accessible bath and shower facilities. It also has a shaft lift, automatic front door and front entrance ramp giving full physical disability access to all parts of the building. However six large appropriately shaped rooms on the ground floor are specifically allocated for physical disability use. There are two lounges and a dining room on each floor. In addition a smoking room has been created on the ground floor. In total the home has seven communal rooms of various sizes and uses. Being in central Plymouth the home does not have a garden area but there is an outside seating area to the front of the building. The home is located beside the large parkland area of Devonport Park. All the accommodation in the home is in single bedrooms. None of the bedrooms in the home have en suite toilet facilities. The service offered by the home is primarily for older people with some mobility difficulties. The residents have a mixed range of abilities and there is an active community amongst the permanent residents group. Frank Cowl House DS0000030792.V264826.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 which took place on the morning of Tuesday 28th February 2006. The assistant manager was on duty. There were 22 residents in the home. The inspector toured the building, met and talked with 10 residents, 2 family members and saw all the residents either in their rooms, or in the lounges. Training records, care plans, and residents’ personal files were inspected. The visiting Community Nurse was asked to comment on the care services being provided at Frank Cowl House. A teaching assistant accompanied a group of children from a secondary school who were on their weekly visit to the home to meet and talk to residents. The purpose of this inspection was to monitor the requirements from the previous inspection and to meet with residents and gather their views about the quality of care being provided in the home. What the service does well: What has improved since the last inspection? What they could do better: An extractor fan must be installed in the smokers’ lounge. The risk of passive smoking to non-smokers is increased in cold weather when the windows are not opened. Residents’ Care plans, preadmission assessments, and risk assessments must be improved upon to provide essential information to ensure residents’ health and care needs can be met in a consistent way by all staff. Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 Page 6 The management of residents’ finances is still being reviewed to avoid the use of pooled accounts and cash. In the absence of the clerical officer who deals with this matter, this standard was not fully inspected. 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. Frank Cowl House DS0000030792.V264826.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 Frank Cowl House DS0000030792.V264826.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, Not every resident admitted to the short stay unit can be sure their care needs will be assessed prior to admission. EVIDENCE: A newly admitted resident for short term care with a fractured bone in her foot had not been assessed before or since being admitted a week earlier. There were no risk assessments or a comprehensive assessment of need undertaken by the staff in the home. Hospital discharge notes were seen on file. Other files seen showed risk assessments had been undertaken. Frank Cowl House DS0000030792.V264826.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, 10 Residents’ care needs are met by staff who don’t always have the depth of information required to provide personal care and emotional support consistently. EVIDENCE: Care plans had been amended to include emotional support and mental health needs but the information gathered was brief and incomplete eg ‘low mood’. Risk assessments were also brief and incomplete. When a resident who becomes upset, needs a particular approach to ensure a cooperative attitude and relationship with staff, there were no written guidelines for staff to follow but a note for ‘staff to follow the approach of a particular carer who has a good relationship with the resident’. All the residents interviewed said they were treated with the utmost respect and they felt their privacy was fully respected. Staff were observed working and talking with residents in a quiet and personal way. Residents’ requests for assistance were met in a dignified professional manner. Staff were observed knocking on residents’ bedroom doors before entering. Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 Page 10 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): 13, 14, Residents can be sure that they will be encouraged to make choices about their personal lifestyle at Frank Cowl House. EVIDENCE: A number of visitors were seen during the inspection. Residents received them either in their own rooms or in one of the lounges. Residents able to go out and about with family or unaccompanied said they enjoyed living in the area and still feeling part of the local community. A small group of children from a school in Plymouth visited the home every week and had befriended some residents. The residents enjoyed the visits and had been pleased with knitting wool the children had brought with them. Residents were asked about their personal choices about what time they got up and went to bed. The responses were that they chose when to go to bed. Some said they sometimes stay up to watch a late film or to sit chatting with other residents. The night before this inspection some residents had stayed up til 3am socialising in the smoker’s lounge. Other residents said they go to bed after supper and watch TV in their rooms. Everyone said they felt free to choose what they wanted to do. Those who needed assistance to go to bed said staff asked them when they’d like to go. They felt there was no pressure to be in bed by a certain time. The same attitude was repeated in the morning when they got up. Most residents said they liked to be up in time for breakfast but said that if they wanted a lie in occasionally they could do so. Residents said the lifestyle in the home was very relaxed. Staff respected their right to Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 Page 11 choose what they wanted to do, where they wanted to sit, what they wanted to eat and who they wished to see as visitors. Residents felt that they had a voice in what went on in the home and were able to make their wishes known either directly to the manager and staff or in the regular residents meetings. Minutes of the meetings were seen to confirm this. Some residents in the short term unit said they had little to do that interested them other than read and watch TV. Some said they didn’t want to join in with the regular programme of activities on offer. Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 Residents can be confident that their concerns and complaints will be taken seriously. EVIDENCE: The CSCI has not received any complaints about this home since the previous inspection. Frank Cowl House has a history of empowerment and respecting residents’ rights to seek legal advice if they wish. Some residents living in the home feel passionately about their rights as citizens to live a contented life in a place of their choice. Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23, 24, 26 Residents living in Frank Cowl House are assured of warm, safe, clean and comfortable accommodation that is well maintained. EVIDENCE: During the tour of inspection all the residents’ rooms, living rooms and bathrooms/toilets were seen. Bedrooms were clean and tidy, lounges and dining rooms were warm and comfortable. Bathrooms, toilets, the laundry room and the sluice were all scrupulously clean, fresh smelling and hygienic. Residents and visitors said it was always the same and that staff take a great pride in keeping the home looking good for the residents to live in. Residents’ rooms were comfortably furnished with a mixture of their own things and those provided by the home. Carpets and floor coverings were clean and safe. The non-slip floor in the 1st floor dining room was attractive and safe. A lounge on the 1st floor has become an ironing room/store room. Staff and residents said they hadn’t been using the room. The relocation of the smoking lounge to the ground floor freed up the cosier small lounge where residents said they could sit and see what was going on in the home and it had better views to the front of the building. The staff notice board held a number of information leaflets regarding infection control and avoiding the spread of infection re MRSA and D&V. Procedures on Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 Page 14 safe handling of soiled linen and appropriate protective clothing were available in the sluices and laundry room. The smoking room has been changed and occupies a room on the ground floor. The room was very well used during the inspection by residents who smoke. There was no extractor fan to ensure the smoke does not affect other non smoking residents. Being a very wintry day the windows were shut to maintain a warm albeit smoke filled atmosphere. Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Residents living in this home are assured of receiving care services from experienced competent staff to ensure their care needs are met. EVIDENCE: There were 22 residents living in the home on the day of the inspection. There were 4 care assistants, 1 domestic assistant, a cook, a kitchen assistant, a laundry person, a handyman, 1 volunteer, and the Assistant Manager in charge. The visiting hairdresser was also present. Usually a clerical officer is on duty to deal with admin but was on leave on this occasion. Staff seen on duty spoke with confidence and were knowledgeable about the residents’ care needs, personal wishes and preferences. The routines of the home were conducted in an organised way with residents being offered care services in a polite and respectful manner. Four new staff have been employed since the previous inspection. Two transferred from another Plymouth City home and two were new employees. Their personal files showed records of proof of identity, a photograph, correspondence re terms and conditions, a CRB disclosure number, health screening declaration. Application forms and references were not held on the files seen in the home. The matter of a volunteer who helps out in the home on a regular basis was raised with regards to a CRB and other checks to ensure residents are fully protected by the recruitment procedures. The assistant manager informed the inspector that the Plymouth Volunteers Bureau had been involved in the placement. Plymouth City Council has a corporate training programme available to all. The home taps into this and also arranges its own schedule of briefing sessions for Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 Page 16 the staff group. These were recorded in a plan for 2006 and included topics such as Person Centred Care relevant to the care of the residents and their specific needs. Fire safety training and awareness is provided regularly in house. The registered Manager and three Assistant Managers have completed the First Aid at Work 4 day course and all other staff have undertaken a one day course covering emergency first aid. NVQ training has been promoted in the home for staff at all levels. Two assistant managers are undertaking the Registered Managers’ Award, one assistant manager has completed the Assessor’s Award, 5 staff have NVQ3 and 1 has just started the course. 13 care staff have completed NVQ2 and 2 more staff have applied for places. Staff training is the responsibility of one assistant manager who has planned and recorded the training programmes seen. The high profile of training and staff development reflects the attitudes of staff and management to being committed to providing high levels of care by an informed staff team. Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 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 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, 32,35 Residents benefit by living in a home that is well run by an effective team of managers who have the best interests of the residents at heart. EVIDENCE: The Registered Manager was not present in the home for this unannounced inspection. The duty officer in charge was in contact with her about an issue concerning the use of an unregistered room which took the numbers of residents in the home (22) over the Registered Number of residents to be accommodated as stated on the home’s Registration Certificate (21). The apparent misunderstanding regarding the use of this room was discussed and will be resolved by the Commission for Social Care Regulatory Manager. The atmosphere at Frank Cowl House was positive, warm and welcoming. Staff and the officer in charge were helpful and cooperative towards the inspector and gave every assistance with the inspection process. Residents’ personal monies and the system for safe keeping and banking residents’ savings has been an ongoing issue with Plymouth City Council for some time. The assistant manager on duty informed the inspector that progress had been made in Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 Page 18 setting up individual savings accounts for some long-term residents but cash held on the premises was still being pooled. In the absence of the clerical officer and the Registered Manager who deal with these matters the standard was not fully inspected and the score awarded at the previous inspection and the requirement has been carried over. Residents said they felt the home was very well run. They said they could approach the managers for help and assistance if needed. Every resident said they liked living in the home and had no wish to move. Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 1 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X 3 X X X 3 2 X 2 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 2 3 X X 2 X X X Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? YES 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 Every prospective resident admitted to the home must have an assessment of need carried out prior to admission. All the residents should have a comprehensive and detailed care plan and individual risk assessment. A record of monthly reviews should be kept. Additional external ventilation should be put in place in the smoking room to ensure that cigarette smoke is extracted out of the building. Residents’ personal money must not be paid into a pooled bank account. Residents’ personal money must not be pooled within the home. Bedroom no.17 must have a wash hand basin fitted and the intervening door into the adjoining unused area must be permanently removed. Timescale for action 01/03/06 2 OP7 15 01/03/06 3 OP25 23 01/05/06 4 OP35 20 01/06/06 5. OP24 23 26/06/06 Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP24 OP26 Good Practice Recommendations All the over door corridor bedroom windows should be blacked out and only uncovered when individually requested by residents. The supply of hot water to the first floor should be assisted in order to allow the first floor enclosed sluice and walk in shower to return to full use. Till enclosed sluicing facilities are available on each floor all necessary protective equipment should be made available to staff engaged in open sluicing. Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. Extracts may not be used or reproduced without the express permission of CSCI Frank Cowl House DS0000030792.V264826.R01.S.doc Version 5.1 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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