Inspection on 12/04/05 for Korniloff

This inspection was carried out on 12th April 2005.

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

Korniloff 09/09/09

Korniloff 22/07/08

Korniloff 18/01/08

Korniloff 16/01/07

Korniloff 15/06/06

Korniloff 30/09/05

Korniloff 10/11/04

Korniloff 06/05/04

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Korniloff Warren Road Bigbury-on-sea Kingsbridge TQ7 4AZ Lead Inspector Margaret Crowley Unannounced 12 April 2005 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. Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Korniloff Address Warren Road, Bigbury-on-sea, Kingsbridge, Devon, TQ7 4AZ 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) 01548 810222 01548 810222 Mrs Georgina Suzanne Phillips Care Home 17 Category(ies) of Dementia (17), Old age, not falling within any registration, with number other category (17), Physical disability (17) of places Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th November 2004 Brief Description of the Service: Kornilloff cares for 17 0lder people and has 11 single and 3 double rooms. All or the rooms are currently used as single rooms. None have en suite facilities The property is detached and accommodation is provided on three floors. There are two chair lifts. There are 3 spacious lounges and a dinining room. lt is situated in Bigbury on Sea and has extensive sea views. Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which took place on 12th April 2005 between 11.30pam and 6 pm. A tour of the premises took place, and service user and staff records were inspected. Eight of the 12 service users were spoken to. Discussions took place with Mrs Phillips, the proprietor who manages the home, and with Mr Phillips who undertakes the maintenance and refurbishment of the premises. What the service does well: What has improved since the last inspection? What they could do better: The registered provider has failed to meet the requirements and recommendations made in previous inspections. Service users do not have important information regarding the facilities and services which they can expect at Korniloff. Service users are not provided with a safe environment because central heating radiators in bedrooms have hot surfaces; the hot water temperatures throughout the premises are not regulated and fire doors are wedged open. The sun lounge is not centrally heated and service users complained about the Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 Page 6 low temperature in two of the three lounges. The carpet in the main lounge required urgent attention on the day of the inspection to prevent a trip hazard. Service users are placed at risk because pre-admission assessments, risk assessments and care plans have not been completed for service users admitted recently. These documents have not been reviewed for service users who have lived at Koniloff for some time. The lack of care staff and training for staff also place service users at risk. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 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 Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 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 4 Insufficient information is available for prospective service users to help them in making their decision to live in the home. Service users may be placed at risk because admission procedures to ensure that service users needs are assessed and met are not always followed. EVIDENCE: Mrs Phillips, registered provider, has still not produced a service user guide despite this being required at previous inspections. A draft of the statement of purpose has now been produced, which must be sent to the Commission for Social Care Inspection. Records of new service users that were inspected did not contain full assessments of their needs. Information available was sparse. Neither the service users, nor their representatives, had been informed in writing that the service users assessed needs would be met. Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 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) 7,9 There is a lack of attention to care planning and review procedures to ensure that service users health, personal and social care needs are met. EVIDENCE: There were no care plans available for inspection for the 3 service users most recently admitted. Since the inspection in November 2004, the senior carer who was responsible for the completion of care plans and reviews has been off sick. The registered provider has not ensured that these tasks have been undertaken. Each service user has a daily record book, which records any concerns or appointments. However this does not provide adequate guidance for staff as to how all the service users needs should be met. It does not allow service users to be involved in discussions regarding their plan of care. Service users spoken to were satisfied with the standard of care they receive from the care staff and said that staff were helpful. Staff have not received updated training in how medicines are used and their administration. This was a requirement at the previous inspection. Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 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 standard(s) 13 and 15 Korniloff provides a resource for local older people that require care and contact with family, friends and the local village community is encouraged. Meals are of a good standard and enjoyed by the service users . EVIDENCE: During the inspection service users were seen receiving visits from family and friends and they confirmed that visitors are made welcome. Several have contacts within the local village and those who are able to do so, like to go out for walks. One service user regularly uses a local gym. Coffee mornings and charity fund raising events are held on the premises. The Home has its own page in the village magazine. Several service users said that the meals were of a good standard. There is a varied rotating menu, and the day’s choice of menu was seen displayed on a board in the dining room. Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 Page 11 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) 18 Arrangements for the protection of service users are not fully satisfactory which may place them at risk of harm. EVIDENCE: There is a vulnerable procedure in place. The proprietor and the senior care assistant have attended multi agency adult protection training, but care staff have not yet received this training. Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 Page 12 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, 20,24,25,26 The environment is not safe and comfortable because requirements and recommendations from previous inspections have not been addressed. EVIDENCE: There is no clear improvement plan for the premises. Since the last inspection two bedrooms have been redecorated and re-carpeted and one wash hand basin has been replaced. The upstairs hall has also been redecorated and re-carpeted. One bedroom was being refurbished at the time of the inspection. However, the following remain outstanding: The main lounge is in need of redecoration and improved lighting. The carpet seams required urgent attention to prevent a trip hazard. These were repaired with tape on the day of the inspection. Radiators have not yet been fitted in the sun lounge. This room is large and can be cold, and does not currently have a fixed form of heating. Service users commented on the low temperature in the main lounge and adjoining sun lounge. The cracked hand basin in Room 2 has not been replaced. Lockable storage is not available in all service users rooms. Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 Page 13 Covers have not been fitted to radiators and pipe work in service users rooms and some communal areas. Thermostatically controlled valves have not been fitted to hot water outlets to baths, and hand basins accessible to service users at risk of scalds. Design solutions and testing to prevent the risk of legionella is not in place. The inspector was informed that the hot water systems in the Home needed be adapted in order to meet the requirements. However, as these matters have been repeatedly outstanding at previous inspections, the registered provider is required to submit to the CSCI an improvement plan, with timescales, to show how these safety matters are to be addressed. Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 Page 14 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) 27,30 The number of care staff available in the Home during the morning is not sufficient to meet the needs of the service users. There is a lack of a coordinated approach to staff training to ensure that the workforce is adequately trained to meet the safety and changing needs of service users. EVIDENCE: On the morning of the inspection there were 2 care staff present to provide care for the 11 service users. Mrs Phillips, the registered provider was out, taking a service user to a G.P surgery approximately 7 miles away. There was too few staff present to attend to the needs of the service users living in the Home, some of whom have dementia, or are physically frail. The inspector observed that the front door, which has open access from the outside, took several minutes to be answered. Care staff were very busy responding to call bells. Service users said that staff always responded if called and were kind and helpful, but sometimes they might have to wait if staff were busy. No domestic staff are employed other than one day per week. Care staff undertake domestic duties and laundry. The registered provider is now included routinely on the care rota to provide care. The senior care assistant has been off sick for four months and is not yet due to return to full time duties. There are 10 care staff employed and only the senior care assistant has an NVQ qualification. Two care staff are currently undertaking NVQ2. There was no systematic training plan for staff in: safe working practices, first aid, the administration of medicines and the protection of vulnerable adults. Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 Page 15 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) 31,32,37,38 The registered provider does not have a good understanding of management practices and service users are not receiving the quality of care they should expect. EVIDENCE: Mrs Phillips, the registered provider, has not commenced the training leading to the registered managers award, and said that it is unlikely that she will undertake this training. Much of her time during the past year has been spent in providing day to day care of service users, rather than in managing the Home, supervising staff and ensuring that assessment and care planning systems are in place to enable service users needs to be met. She said that she was reviewing the management arrangements within the Home with a view to employing a registered manager. An inspection of service user and staff records showed that these did not contain all of the elements required in the Schedules. An inspection of the fire log showed that the record of tests was not fully maintained. There were 3 fire doors wedged open. An immediate requirement was given. Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. 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 1 x 1 1 x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 1 2 x x x 2 1 3 STAFFING Standard No Score 27 1 28 x 29 x 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 1 2 x x x x 1 2 Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 Page 17 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 5 Requirement Timescale for action 12/06/05 2. 3. OP1 OP3 5 14 4. OP4 14 The registered person must produce a Statement of Purpose which contains allof the elements required by schedule 1 of the Care Regulations 2001 (timescale of 09/01/05 not met) The registered person must 12/06/05 produce a Service User guide (timescale of 09/01/05 not met) Service Users must receive a 12/05/05 comprehensive assessment of their needs which is recorded in writing. Service users, or their 12/06/05 representatives, must be informed in writing that the service users assessed needs will be met. All Service Users must have up to date care plans, generated from a comprehensive assessment of their needs which is drawn up with each Service User (or their representative) and provides the basis for the care to be delivered. Service User’s Plans must set out in detail the actions which needs to be taken by care staff to ensure that all aspects of the health, D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc 5. OP7 15 12/06/05 Korniloff Version 1.20 Page 18 6. OP9 13 7. 8. OP21 OP25 23 23 9. 10. 11. OP21 OP18 OP19 23 13 23 12. OP27 18 13. 14. OP30 OP31 18 9 personal and social care needs of the Service User are met. Service User Plans must be reviewed every month, or sooner if necessary, and updated to reflect changing needs. Staff must receive training in how medicines are used and their administration.(timescale of 09/01/05 not met) The cracked hand basin in room 2 must be replaced.(timescale of 09/01/05 not met) The Registered Provider must submit an improvement plan to the CSCI with timescales to show when the following are to be addressed:1.Thermostatically controlled valves to be fitted to baths and hand basins 2.Design solutions and testing to prevent the risk of legionella 3.Covers installed to all radiators Timescale of 09/01/05 not met Lockable storage must be provided in service users rooms timescale of 09/03/05 not met Staff must receive training in the protection of vulnerable adults The Registered Provider must submit an improvement plan to the CSCI with timescales to show when the following are to be addressed:1.Fit radiators in the sun lounge.2.Decorate the main lounge.3.Provide additional lighting in the main lounge The staffing ratio must be increased from 8am to 2pm to meet the assessed needs of service users. A staff training and development programme must be produced The registered provider must commence training leading to the registered managers award,or appoint a registered manager D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc 12/06/05 31/07/05 12/05/05 12/06/05 12/07/05 12/05/05 12/05/06 12/06/05 12/06/05 Korniloff Version 1.20 Page 19 15. 16. 17. OP38 OP38 OP37 23 23 17 Immediate Requirement: Fire Doors must only be held open by approved hold- open devices. Immediate Requirement:The record of fire tests and drills must be accuratley maintained All records required by the regulations and identified in Schedule 2,3,4,of the Care Homes Regulations are maintined as described in the schedules 12/04/05 12/04/05 12/06/05 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 Good Practice Recommendations Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 Page 20 Commission for Social Care Inspection 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 Korniloff D54-D07 S3732 Korniloff V212230 120405 Stage 4.doc Version 1.20 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. 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