Inspection on 17/11/08 for Innisfree Residential Home

This inspection was carried out on 17th November 2008.

CSCI found this care home to be providing an Excellent service.

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

Innisfree Residential Home 09/01/07

Innisfree Residential Home 01/03/06

Similar services:

Manor Lodge

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Innisfree Residential Home 15-17 Polsham Park Paignton Devon TQ3 2AD     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michelle Finniear     Date: 1 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Innisfree Residential Home 15-17 Polsham Park Paignton Devon TQ3 2AD 01803552269 Telephone number: Fax number: Email address: Provider web address: innisfreeresthome@tiscali.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Linda Mary Wilbraham Type of registration: Number of places registered: Mrs Jacqueline Glenning care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Innisfree is a large detached property situated on the level and within walking distance of local facilities including library, park and shops. Accommodation is provided in single rooms, all with en-suite facilities. The home offers a choice of communal areas; the ground floor has a day room, sun room and a dining room; and on the first floor there is small quiet lounge. To facilitate access within the home, there is lift to the first floor and a stairlift for a short internal flight of steps between levels. The home is situated near to the local facilities of Paignton town centre and beaches. The fees for the home ranged from 395 pounds per week. Additional charges were made for toiletries, and hairdresser. No charges are made for outings and trips out. The homes service users guide is regularly updated and a copy of the last inspection report could be found in the entrance to the home or on request from the manager. 0 Over 65 16 Care Homes for Older People Page 4 of 26 Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: To complete this inspection the home sent us their Annual Quality Assurance Assessment which gave us information about how the home is run and what they are working on developing in the coming year; a series of questionnaires was sent out to people living at the home, their relatives and other stakeholders such as staff to gain their view of the service; a site visit of five and a half hours was carried out with no notice being given to the home as to the exact date or timing; records and policies were sampled; a tour was made of the home and discussions held with the people who live and work there. This helps us to get a rounded view of what it is like to live at the home. Care Homes for Older People Page 6 of 26 Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? Since the last inspection the home have: Improved their assessments, so that they can be sure before someone is admitted to the home what their needs are and that they can meet them. Updated the storage and recording of non prescription or over the counter medication that people may take. This helps to ensure that people are taking remedies that do not react with other prescribed medication they may be taking. They have developed a system for recording staff training needed. This helps to ensure Care Homes for Older People Page 8 of 26 that training such as first aid which needs to be kept updated does not become overdue. Provided risk assessments for the environment, and fitted a sink valve device to regulate the temperature to ensure it does not present a scalding risk. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is available about the home to help people make a judgment about whether it is that right place for them. Full assessments are completed before anyone is admitted to ensure the home is able to meet their needs. Evidence: The home has a statement of purpose and service user guide. The service user guide contains information for people considering moving to the home or people already living there about the services of the home provides. It includes for example information on who to make a complaint to, and information about the homes policies and procedures. This helps people make a decision about whether Innisfree is the right home for them. During the inspection site visit we looked at the last admission to the home and the process that had been followed before they were admitted. A full assessment had been Care Homes for Older People Page 11 of 26 Evidence: completed prior to a decision being made that the home could meet this persons needs. The manager could describe the full admission process, which normally includes trial visits, discussions with carers and the person themselves concerning their needs and how they like them to be met. Trial visits also give the person the opportunity to meet with people already living at the home. A contract, or statement of terms and conditions of residency is provided at an early stage which enables people to understand the fees they would be paying and what they could expect to receive in return. People who completed questionnaires indicated that they received sufficient information about the home before making a decision to move in. People spoken to on the visit confirmed this. One person said I knew what the home was like before I came and I havent been disappointed. Another who completed a questionnaire said the manager discussed our needs thoroughly and answered all our questions, showing genuine interest in our needs and requirements. We were made to feel very welcome from first contact, with plenty of time to find out about the home over cups of tea! The home does not cater for intermediate care. This means they do not provide specialist intensive rehabilitation with the aim of returning the person to their own home. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health care needs were being met. Medication is handled and administered safely. Evidence: Each person living at the home has an individual plan of care, which identifies the support that they need and how they wish this to be delivered. Plans were being reviewed regularly, with the person concerned (or their relatives if they wished). The plan for one person was discussed in detail, and was found to be an accurate reflection of the care actually delivered to that person. People who completed questionnaires said I receive all the help I require and that Inisfree is the best home in Paignton. The home has sufficient aids and adaptations to meet peoples health care needs, and these included hospital beds where required, raised toilet seats, grab rails, specialist bathing facilities and hoists to support peoples mobility. Evidence was seen of the involvement of district nursing staff and General practitioners as well as attendance at hospital appointments. People spoken to on the visit felt they received all the support Care Homes for Older People Page 13 of 26 Evidence: they needed. The medication systems seen were safe and included a thorough recording of all medication received into the home and administered to people living there. Some people take care of their own medication, although they prefer the home to order this for them. Risk assessments are undertaken to make sure that this is managed safely. Senior staff who have received training in care of medication administer the system, which consists of a series of blister packs prepared by the local pharmacy. This helps to ensure that the risk of errors is reduced, and it is easy for staff to check that medication has been taken. Care plans include assessments of risk. These help to ensure that for example where a person is prone to falling everything has been done to minimise the risk of injury and serious accident occurring. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to develop new skills and make choices about their lifestyle. Meals are home-cooked and nutritious. Evidence: Discussions with the manager, deputy manager and people living at the home evidenced a high level of activity, choice, involvement in the management of the home and commitment to lifelong learning. People living at the home confirmed that they were able to follow their chosen lifestyles, in particular with regards to routines. As an example the manager confirmed that people are able to have their breakfast any time between 6 a.m. and 10 a.m. as they wish. Visitors are encouraged to visit the home at any time and also to participate in the resident and relatives group where comments and suggestions on developing the service are welcomed. Minutes of this group was seen, along with minutes of the staff group. A newsletter and magazine has also been developed, which contains information about the home, forthcoming activities and helps to develop a sense of community. The home also has two electric mobility scooters available for people living at the home to use to enable them to get around in the local community. Care Homes for Older People Page 15 of 26 Evidence: A wide variety of activities are provided at the home. One person who completed a questionnaire said musical activities, art classes, meet the animals, barbecues, occasional outings are all provided. One person spoken to on the site visit could show a number of artworks they had completed at the homes art class and thank you cards they had been shown how to make on the laptop computer which is provided. There is a a commitment to lifelong learning for the people living at Innisfree and people are encouraged not only to continue with pre-existing hobbies and interests, but also to develop new ones. In the last year a new summer house has been provided with raised planted beds in the garden, and the manager hopes to encourage people to develop further gardening skills in the coming year. The meals at the home were said to be very good, and people confirmed that choices are available. The meal on the day of the inspection was cottage pie, and there was a full choice of lighter meal for the evening. People living at the home who were spoken to confirmed that meals were good home cooking. People living at the home are also encouraged to make cakes on occasion with staff support. One person who completed a questionnaire said that meals were fantastic. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the homes policies on complaints and safeguarding. Evidence: People living at the home who were spoken to or who completed questionnaires indicated that they were clear as to the homes complaints procedure but had no complaints to make. The homes complaints procedure is on display within the home and is also available within the service user guide. This also contains a form for people to use to complain in confidence if they so wish. No complaints have been received during the last year. Staff working at the home have received training in adult protection and safeguarding. This should help to ensure that people are protected from abuse and abusive practices. It ensures that staff are aware of how to report abuse and who to report it to. Discussions with the manager indicated that additional staff training is being provided in future to ensure staff receive updated information and a reminder of previous training. The home has information available and an adult protection policy and procedure, however the Whistle blowing policy needed some updating and expansion to ensure staff are aware of protection provided to them under legislation if they raise concerns in all good faith. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe and comfortable environment to live and work in. Evidence: During the site visit a tour was made of all areas of the home, apart from some bedrooms where people were resting. Records in relation to the maintenance of the building were seen. Innisfree provides a comfortable and homely environment, which has been converted from two semi-detached houses. The home is close to Victoria Park, the local library, British Legion club, day centre for older people and the sea front as well as town centre shops. The home has some parking to the front, and a rear enclosed patio garden with summerhouse and raised beds. There is a lift to access first-floor rooms and chairlift. All of the areas of the home seen were clean warm and comfortable. People who completed questionnaires indicated that the home was always fresh and clean. Information is available about infection control practices, and protective equipment such as gloves, aprons and sluicing facilities for laundry are in place. This helps to protect people from the risk of cross infection. Care Homes for Older People Page 18 of 26 Evidence: People have been able to personalise their rooms with items of the room furnishings, and the manager confirmed that when a room falls vacant it is decorated to the choice of the incoming resident for example with a choice of carpet or wall colour. This helps people to feel at home. Regular audits are undertaken to maintain safety at the home, for example the home has recently employed a professional to review the fire risk assessments in place. This helps to ensure that the home is a safe place to live and work in. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are well trained and staffing arrangements protect people and ensure staff are able to care for them well. Evidence: During the site visit time was spent looking at the recruitment and selection processes at the home, staff training, and numbers of staff on duty. The home has a high level of staffing, and many staff have worked at the home for well over six years. The manager has been at the home for over 10 years. This helps to provide continuity of care for the people living at the home. 21 staff are employed for 16 people living at the home. Files were examined and discussion held on the recruitment processes followed. The home follows a full recruitment process including the taking up of references and a criminal records bureau check. Records are kept of every stage of the process. This helps to ensure that people living at the home are protected from being cared for by people who may be unsiuitable to work with potentially vulnerable people. There is a comprehensive programme of core staff training in place, which was highlighted on a spreadsheet. This helps the manager identify which training needs to Care Homes for Older People Page 20 of 26 Evidence: be updated at a glance. Staff who completed questionnaires also commented that training in other areas was available to them. One wrote We all keep on top of the training we need. There is an Induction programme for new staff to follow, but this is not always being followed through when staff are very experienced or have qualifications. People living at the home commented that the staff listened to them and responded to their needs. One person wrote I am very comfortable and well cared for here. The staff are cheerful, pleasant and helpful. This was confirmed in conversations with the people living at the home on the site visit. One person said I am so lucky to be here the staff are wonderful and cant do enough for me. Staff who completed questionnaires expressed satisfaction with the working environment. One wrote Innisfree is the best well run home I have ever worked in. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being well managed. Evidence: The manager of the home is experienced and very well qualified. She has been at the home for 10 years and provides excellent leadership and direction for the staff team and for the development of the home. She has achieved a level 5 award in Leadership and management. She is complemented by the Deputy manager and staffing structure which allows senior staff to take responsibility in particular areas, for example medication. The home has an effective quality assurance system which incorporates a series of questionnaires for people living at the home, relatives, staff and other stakeholders such as a visiting healthcare professionals. Their responses are collated and added to information from internal and external audit systems to provide an annual development plan for the home. This helps the home see what is working well and Care Homes for Older People Page 22 of 26 Evidence: what can be improved. On the site visit time was spent looking at the way in which the home handles small amounts of peoples money handed to the home for safekeeping. An accounting system is maintained for each individuals money, and receipts are obtained for example for instances where money may be spent on the persons behalf to settle an account with the hairdresser who visits the home. The balance on an account was checked and found to be correct. The manager provides supervision for care staff, which is a system for ensuring that staff are working consistently to their best ability. This system is being delivered to all staff at least six times a year. It provides opportunities for staff to spend time with the manager or deputy on a one-to-one basis looking at their performance, any problems they have and any areas they feel the home can improve. It also identifies any training needs. Time was also spent looking at the health and safety issues at the home. The home has a full series of risk assessments and policies and procedures in relation to health and safety. The manager confirmed that water temperatures are regulated to help prevent people being scalded, and window openings are restricted to ensure people cannot accidentally fall from a window opening. Radiator covers are provided to protect hot surfaces. Electrical applicances are regularly tested to ensure their safety. Moving and handling assessments help to ensure staff do not injure themselves when moving objects or people. Training is provided for staff in health and safety. It is understood that the home has for the second time been awarded the Investors in people award from November 2008. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 18 The homes Whistle blowing policy should be updated to ensure it contains information on legislation which protects staff when raising concerns about abuse or abusive practice in all good faith. The Induction programme should be followed through by all new staff. this is to ensure that staff are all working in the same way. The home should provide a first aid risk assessment. 2 30 3 38 Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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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