Inspection on 10/08/05 for Ismeer

This inspection was carried out on 10th August 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 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

Ismeer 17/06/08

Ismeer 03/01/08

Ismeer 17/07/07

Ismeer 23/05/06

Ismeer 12/01/06

Ismeer 09/03/05

Ismeer 24/06/04

Ismeer 01/10/03

Ismeer 19/09/02

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Ismeer Trewollack Lane Gorran Haven St Austell PL25 6NT Lead Inspector Mike Dennis Unannounced 10 August 2005 10:00 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. Ismeer D52-D04 S9040 Ismeer V234110 100805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ismeer Address Trewollack Lane Gorran Haven St Austell Cornwall PL26 6NT 01726 843480 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) Mrs Margaret Yvonne Wriglley Mrs Barbara Anne Thompson CRH 27 Category(ies) of Old age not falling within any other category registration, with number (27) of places Ismeer D52-D04 S9040 Ismeer V234110 100805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 9th March 2005 Brief Description of the Service: Ismeer is a comfortable, tastefully decorated, extended detached property situated within walking distance of the village of Gorran Haven. The home is registered to provide care for 27 older people in need of personal care.Service users accommodation is currently located on three floors. Each floor is serviced by a stair lift. Although twin rooms are available all rooms are presently used for single occupancy. All bedrooms have washbasins and many have separate en-suite facilities.The property has spacious, well-tended landscaped gardens that over look the bay of St Austell and adequate parking facilities Ismeer D52-D04 S9040 Ismeer V234110 100805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 10th. August 2005 over a six hour period. The inspector met with the Senior staff on duty, Ann Carthew and Lisa Thomas, 4 of the staff on duty and with 6 service users. During the course of the day the inspector observed the service users being attended to by staff in a courteous and professional manner. Service users informed the inspector that their expectations of being in a care home were being fully met. Various records, policies and procedures were inspected and found to be satisfactory. The inspector visited all parts of the building and noted a satisfactory standard of hygiene. Service users expressed satisfaction with all aspects of the home. Ismeer does not have a Registered Manager at this time. An application has been received from Mrs. Carthew and is being processed. What the service does well: What has improved since the last inspection? The recommendations made at the time of the last inspection have been addressed. Specific improvements are noted in the following areas:Ismeer D52-D04 S9040 Ismeer V234110 100805 Stage 4.doc Version 1.30 Page 6 Care plans are now reviewed at regular intervals and contain more relevant and up to date information. The management of medication practices within the home. Quality assurance audits have been implemented. A Key worker system has been introduced. 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. Ismeer D52-D04 S9040 Ismeer V234110 100805 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 Ismeer D52-D04 S9040 Ismeer V234110 100805 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) 1, 3, and 6. Information concerning the home is made available. Service users are fully assessed prior to admission to the home. This home does not provide Intermediate Care EVIDENCE: Up to date Statements of Purpose and Service User Guides were readily available. These documents have been recently reviewed. Four service user files were inspected and case tracked. All contained information pertaining to pre-admission assessment. Service users informed the inspector that the home meets their personal care needs. Standard 6 is not applicable as the home does not provide intermediate care. The home does however have a dedicated Respite care bed. Ismeer D52-D04 S9040 Ismeer V234110 100805 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 health care needs of service users are identified, planned for and met. Medication policies and procedures are adhered to. Service users are treated with dignity and respect. The standard of care planning set is high and is being maintained EVIDENCE: From discussion with service users, staff and inspection of documentation it was evident that individual care needs are identified appropriately. From inspection of service users files, and in discussions it is evident that Ismeer encourages service users and their representatives to express their views in the formation of their care plans. The care plan specifies what actions staff should take to ensure that the care need is approached in a consistent manner. Care planning formats have improved. Health needs were not inspected in detail, however service users commented that health needs are met by the staff at the home and by external professionals. Records of all health professional visits are recorded in detail. The administration, storage and disposal of medication processes were inspected. It was noted that these systems are now more organised. Records required were filled out correctly. Staff administering drugs have been trained. Ismeer D52-D04 S9040 Ismeer V234110 100805 Stage 4.doc Version 1.30 Page 10 An audit of Controlled Drugs was conducted and quantities tallied with the written record. Staff were observed to treat service users with respect and it was noted that staff knocked at bathroom and bedroom doors before entering. General practitioners examine and treat all service users in the privacy of their own bedrooms Ismeer D52-D04 S9040 Ismeer V234110 100805 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, and 15 The routines of daily living and activities made available are flexible and varied. Service users receive visitors at any reasonable time throughout the day. Dietary needs are provided for. EVIDENCE: The routines of daily living within the home appear to be flexible to suit individual preferences. The home offers various activities including trips in the mini bus. Outside entertainment is brought to the home. Service users confirmed the above. The inspector held a discussion about ‘life history’(Social Profiling) and how information gathered could promote individual service users interests. (Active Care). The visitors book indicated that a steady stream of visitors attend the home. Service users confirmed that they were free to receive visitors at any time. Service users informed the inspector that they were satisfied with the food and that their dietary needs were met. Ismeer D52-D04 S9040 Ismeer V234110 100805 Stage 4.doc Version 1.30 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 standard(s) 16 and 18 The complaints procedure is well publicised and is used when required. The registered manager ensures that service users are protected from all forms of abuse with staff having knowledge through training of Adult Protection issues which helps to protect service users EVIDENCE: The home has a complaints policy that meets all the requirements of Regulation 22. A complaints log is available to ensure that a record of all complaints is recorded and kept. Details of the complaints policy are available in the statement of purpose and a full copy included within the service users guide The home has a policy in relation to adult protection, which includes information on whistle blowing. This policy references the Department of Health No Secrets guidelines and physical / verbal aggression by service users. Staff are made aware of this policy during induction and at training sessions. Service users informed the inspector that they were fully aware of the homes complaints procedure and stated that they were quite prepared to use it. The homes Abuse policy requires some additions to fully explain the action to be taken when an allegation of abuse is made. The process of contacting Social Services to instigate a strategy meeting under the Protection of Vulnerable Adults Procedure (POVA) needs to be included. Ismeer D52-D04 S9040 Ismeer V234110 100805 Stage 4.doc Version 1.30 Page 13 Ismeer D52-D04 S9040 Ismeer V234110 100805 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 location and layout of the home is suitable for it’s stated purpose and provides a safe and well maintained environment. The home was clean, hygienic and free from offensive odours providing an attractive and homely place to live EVIDENCE: There is level access to the home, with car parking close to the main entrance. Grounds are kept tidy and appeared well maintained. There is easy access to the main garden area although the property does stand on a slight incline. Tables and chairs are arranged for the use of the service users. Stair lifts provide access to all floors for those with mobility problems. The home is homely and domestic in nature. The home was clean, hygienic and free from offensive odours. Disposable gloves and aprons are available as required. Hand washing facilities were satisfactory. The home has an Infection Control policy. Ismeer presents as a well looked after property. Staff and service users seem to have a vested interest in keeping it that way. Bedrooms were seen to be individualistic in appearance, the occupants stating their satisfaction. Ismeer D52-D04 S9040 Ismeer V234110 100805 Stage 4.doc Version 1.30 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 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 Recruitment policies and procedures are implemented. All staff are supported and Inducted through training opportunities. A positive number of staff are on duty to meet the service user’s needs EVIDENCE: The home has a duty rota that accurately reflected the number and skill mix of staff on duty during the inspection. Additional staff are on duty at busier times of the day. This usually amounts to 5 care staff in the mornings, 4 in the afternoon and 3 in the evening. A manager is also on duty each day as are domestic, catering and maintenance staff. At night there are 2 waking staff on duty. Senior staff may be contacted if needed. There has been an increase in the number of staff holding NVQ qualifications from 18 at the last inspection to 33 at the present time. A further 7 staff are enrolled which represents positive steps in the right direction. The home’s employment policies and procedures are implemented. Two written references were evidenced within a random selection of staff files. CRB checks and POVA checks are completed. Staff training, induction and development programmes are undertaken Ismeer D52-D04 S9040 Ismeer V234110 100805 Stage 4.doc Version 1.30 Page 16 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) 31, 33 and 36 The management team are committed to providing a good standard of care. Professional quality audit surveys are undertaken. Staff are regularly supervised EVIDENCE: Changes in the management structure have taken place following the retirement of the previous registered manager. Ann Carthew has applied to be the new registered manager and her application is being processed. Ann has worked at Ismeer since 1999. She has obtained the NVQ level 4 in care and is about to complete the Registered Managers Award and the A1 and A2 assessors award. She is assisted by Lisa Thomas who has joined the staff more recently. Lisa is qualified to NVQ level 3 in care and NVQ level 4 in management. She also holds the A1 and A2 assessors awards. Ismeer D52-D04 S9040 Ismeer V234110 100805 Stage 4.doc Version 1.30 Page 17 Management have devised a professional quality audit questionnaire which has been sent to service users and relatives. The results have been analised and acted upon. This process will be repeated in due course. Staff are now supervised at approximately 2 month intervals as evidenced by the records and confirmed by them. Ismeer D52-D04 S9040 Ismeer V234110 100805 Stage 4.doc Version 1.30 Page 18 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 3 x 3 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 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 x 3 x x 3 x x Ismeer D52-D04 S9040 Ismeer V234110 100805 Stage 4.doc Version 1.30 Page 19 no 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 Regulation Requirement Timescale for action 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 OP18 Good Practice Recommendations Include information, in your Adult Protection/Abuse Procedures, detailing the action to be be taken when an allegation of abuse is made, ie. to contact Social Services to instigate a strategy meeting under the Protection of Vulnerable Adults Procedure (POVA) Ismeer D52-D04 S9040 Ismeer V234110 100805 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell 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. Extracts may not be used or reproduced without the express permission of CSCI Ismeer D52-D04 S9040 Ismeer V234110 100805 Stage 4.doc Version 1.30 Page 21 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!