Inspection on 30/09/05 for Korniloff

This inspection was carried out on 30th September 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 12/04/05

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 30 September 2005 th 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 V237129 300905 Stage 4.doc Version 1.40 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 V237129 300905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 12/04/05 Brief Description of the Service: Kornilloff is a care home registered to provide care for 17 older people who may also have physical disabilities or dementia. The accommodation comprises 11 single and 3 double rooms. All of the rooms are currently used as single rooms. None has en suite facilities. The property is a detached three storey building with the bedrooms situated on the lowerground floor and the first floor These can be accessed by two chair lifts. There are 3 spacious lounges and a dinining room. Korniloff is situated in Bigbury on Sea and has extensive sea views. Korniloff D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on 30 September 2005 over 6 hours. Margaret Crowley and Megan Walker regulation inspectors carried out the inspection. A tour of the premises took place and service users were spoken with. Service user and staff records were inspected. Staff were observed and spoken with in the course of their daily duties. 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 proprietor has failed to meet requirements and recommendations made in previous inspection reports to make Korniloff a safer and more comfortable place for the service users. Fire doors into the lounge and service users rooms were again wedged open, despite an immediate requirement that this should cease, made at the last inspection. The proprietor has not provided the Commission for Social Care Inspection with a plan of when she will make essential improvements to the accommodation, as agreed at the last inspection. Service users are not provided with a safe environment because central heating radiators are not guarded to prevent the risk of service users receiving a burn. Hot water provided to baths and washbasins does not have the temperature controlled to prevent the risk of scalds. Systems and testing is not in place to prevent the spread of Legionella. The cracked wash hand basin in Bedroom 2 has still not been replaced. Korniloff D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Version 1.40 Page 6 Some bedrooms on the first floor were cold and draughty because the heating was turned off and windows would not close tightly. Central heating radiators have not yet been connected in the sun lounge. The carpet in the main lounge again required urgent attention on the day of the inspection to prevent a trip hazard. The lounge requires new carpet, redecoration and improved lighting. The wall tiles at the side of the assisted bath were loose and required urgent attention. Although service user’s care plans have improved, the lack of a clear system of care planning and monthly reviews does not ensure that service users needs are met. There is no night duty staff awake to regularly monitor service users at risk of falls or wandering from their room. 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. Korniloff D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Version 1.40 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 V237129 300905 Stage 4.doc Version 1.40 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) 1,3,4 Improved information is now available for prospective service users to help them in making their decision to live at Korniloff. Although new service users needs are now assessed it was not evident that their needs could be met. EVIDENCE: An improved service user guide/statement of purpose has now been produced. A copy of these should be sent to the CSCI. New service users were spoken with and records were inspected, which contained assessments of their needs. The inspectors were concerned that the level of physical disability and dementia of some service users cannot be adequately provided for by the staff, particularly at nighttime, when there is no staff awake to regularly monitor service users at risk of falls or wandering from their room. There was no evidence that either the service users’, or their representatives, had been informed in writing that the service users’ assessed needs could be met. Korniloff D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Version 1.40 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) 7,8,9,10 Although service users care plans have improved, there is a lack of attention to processes to ensure that all service users have care plans and that these are reviewed monthly, to ensure that their health, personal and social care needs are met. EVIDENCE: The records inspected showed that the quality of care plans had improved since the last inspection. However, one service user admitted recently did not have a care plan and no care plans had been reviewed monthly. Each service user has a daily record book, which records any concerns or appointments. One service user had sustained several falls, but five falls were not recorded in the appropriate accident records and there was a lack of additional measures put in place for her safety, particularly during the night. Service users spoken with said they were satisfied with the standard of care they receive from the care staff and said that staff were helpful and respected their privacy. Staff have not received updated training in how medicines are used and their administration. This was a requirement at previous inspections. Medicine records were in order but the methods of secondary administering the medicines rather than dispensing them directly from the medicines trolley should cease. The proprietor must ensure that that the policies and Korniloff D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Version 1.40 Page 10 procedures for the receipt, storage, administration and disposal of medicines comply with the guidance provided by the Royal Pharmaceutical Society, The Administration and Control of Medicines in Care Homes (2003). Korniloff D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Version 1.40 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) 12,14,15 Korniloff provides a resource for local older people that require care and contact with family, friends and the local village community is encouraged. EVIDENCE: Service users live a flexible lifestyle and choose whether to spend time in their own room or communal areas. Some have relatives and friends within the local village and those who are able to do so, like to go out for walks. Service users have some activities provided by external providers. Coffee mornings are held monthly on the premises. However, there is no daily activities programme for service users to enjoy. Activities should be tailored to meet the needs of the service users, particularly those with dementia. Although a majority of service users said that the meals were of a satisfactory standard, some commented on the lack of choice and said that the standard of cooking was variable. Korniloff D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Version 1.40 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) 16,18 Although procedures are in place to enable service users to complain and to protect them from abuse, all staff have not received training in the protection of vulnerable adults. EVIDENCE: There is a complaints procedure which is accessible to service users. No complaints have been received since the last inspection. There is an adult protection policy and a copy of the local Alerter’s Guide. The proprietor and the senior care assistant and one care assistant have attended adult protection training, but no other staff have yet received training. Korniloff D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Version 1.40 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 standard(s) 19,20,24,25,26 Service users do not live in an environment that is safe and well maintained. EVIDENCE: Requirements made at previous inspections concerning the environment remain unmet. At the last inspection the proprietor was required to submit an improvement plan to the CSCI, with timescales, to show how these were to be addressed. However no improvement plan has been received. Little improvement could be seen in the premises other than new floor coverings fitted in the bathroom and toilets. The following continue to require attention: The main lounge is in need of redecoration, improved lighting and a new carpet. Radiators placed in the sun lounge have still not been connected to the central heating system. This room is large and can be cold, and does not currently have a fixed form of heating. Service users commented previously on the low temperature in the main lounge and adjoining sun lounge. Covers have not been fitted to radiators and pipe work in service users rooms and some communal areas. Korniloff D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Version 1.40 Page 14 Thermostatically controlled valves have not been fitted to hot water outlets to baths and hand basins accessible to service users, placing them at risk of scalds. Design solutions and testing to prevent the risk of legionella is not in place. Lockable storage is not available in all service users rooms. During this inspection the inspectors found that some bedrooms on the first floor were cold and draughty because the heating was turned off and windows would not close tightly. Although the premises were clean, there were odours of urine in three rooms and the entrance hall. The toilet by the front door was used for the emptying of a commode. Korniloff D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Version 1.40 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) 27,29,30 There is a lack of staff time to meet the needs of the service users with physical disabilities and dementia. EVIDENCE: An inspection of the duty rota showed that there are two care staff on duty from 8am until 10pm and a third from 8am to11am. There were eleven service users in residence. The proprietor is included routinely in the rota to provide care. No domestic staff are employed other than on one day per week. Care staff undertake domestic duties and laundry. There is a cook employed, who was on leave. The proprietor or her husband undertakes the cooking in the cook’s absence. There is one member of staff who sleeps- in on call at nighttime and the proprietor is contactable in her flat on the premises. The inspectors were concerned that the level of physical disability and dementia of some service users cannot be adequately provided for by the staff, particularly at nighttime. The proprietor said that she continues to have staffing difficulties due to the location of the home. She must review the staffing levels, particularly at night time. There is now a staff training plan displayed in the office, but this did not show that all the required training in safe working practices are addressed. Since the last inspection staff have received training in first aid and manual handling. Staff have not received training in food hygiene and the administration of medicines. The proprietor and senior carer have attended training in caring for people with dementia and care staff are now undertaking this by distance learning. This needs to be reinforced with practical application in the context of Korniloff. Three of the eight care staff now have NVQ level 2 or above. Records were inspected of staff recently employed and provided satisfactory evidence of the recruitment and the induction processes. Korniloff D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Version 1.40 Page 16 Korniloff D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Version 1.40 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 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 The registered provider does not have a good understanding of management practices to ensure that service users receive the quality of care they should expect. Service users do not live in an environment where health and safety standards are met and maintained. EVIDENCE: Mrs Phillips, the registered provider, has not commenced training leading to the registered managers award, and said that it is unlikely that she will undertake this training. Much of her time continues to be spent in providing day to day care of the service users, rather than in managing Korniloff. In discussion she said that she was in the process of appointing a new member of staff who has NVQ 3 to take this role. However, the person concerned does not have experience in the care of older people and would not meet the registered manager’s criteria. Korniloff D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Version 1.40 Page 18 Fire doors into the lounge and service users ‘rooms were again wedged open. This was despite an immediate requirement notice having been issued at the last inspection for this lack of fire safety precautions. Where a hold open device had been fitted, a soft toy had been placed beneath it to inactivate it. An immediate requirement notice was again issued. The proprietor must ensure that any hold open devices are of an approved design and correctly installed The proprietor said that staff receive fire prevention training annually, and last training took place 8 months ago. It is recommended that they receive this training a minimum of six monthly. Accident records were inspected, but from evidence in service users daily records, they did not contain a full record of all accidents that had occurred. The cracked hand basin in Bedroom 2 has still not been replaced, despite previous assurances that this would be addressed before a new service user was admitted to the room. The wall tiles at the side of the Parker bath are again in need of attention. They are loose and in danger of falling. An immediate requirement notice was issued. The carpet in the main lounge again required urgent repair to prevent a trip hazard. An immediate requirement notice was issued. Freestanding electrical appliances were seen in some bedrooms for supplementary heating. These must be subject to risk assessment. Korniloff D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 2 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 2 COMPLAINTS AND PROTECTION 1 2 x x x 2 1 2 STAFFING Standard No Score 27 2 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 2 x x x x x x 1 Korniloff D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Version 1.40 Page 20 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 OP3 Regulation 14 Requirement Service users, and /or their representative must be informed in writing that their assessed needs can be met.Previous timescale of 12/06/05 not met. All service users must have care plans which are reviewed monthly, or sooner if necessary, to reflect the service users changing needs.Previous timescale of 12/06/05 not met The proprietor must ensure that that the policies and procedures for the receipt, storage, administration and disposal of medicines comply with the guidance provided by the Royal Pharmaceutical Society, The Administration and Control of Medicines in Care Homes (2003). Staff must recive training in the administration of medicines Previous timescale of 12/06/05 not met All staff should receive training in the protection of vulnerable adults.Previous timescale of12/07/05 not met. The lounge carpet must be repaired to prevent a trip hazard.Immediate Requirement D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Timescale for action 30/10/05 2. OP7 15 30/10/05 3. OP9 13 30/10/05 4. 10/05OP9 13 30/12/05 5. OP18 13 30/12/05 6. OP19 13 1/10/05 Korniloff Version 1.40 Page 21 given 7. OP25 13 Service users bedrooms must be warm and comfortable, and the heating able to be controlled in the service users own rooms. The registered provider must provide a plan and programme for achieving compliance with the following:Hot water outlets to baths and handbasins must be fitted with thermostatically controlled valves providing water close to 43c to prevent scalding Design solutions must be in place to ensure that water is stored at a temperature of at least 60c, distributed at 50c to prevent risk from Legionella. Covers must be installed to radiators and pipework to prevent risk of burns.Previous timescale of 12/05/05 not met. The cracked wash hand basin in Bedroom 2 and must be replaced. (Previous timescale of 31/07/05 not met). The registered provider must provide a plan and programme for achieving the following: Connect the radiators in the sun lounge Decorate the main lounge Improve the lighting in the lounge. Provide a new carpet in the lounge :Previous timescale of 12/05/05 not met. Lockable storage must be provided in service users’ rooms.Previous timescaleof 12/06/05 not met. The wall tiles at the side if the assisted bath must be replaced. An immediate requirement was given Staffing levels must be reviewed Staff must receive regular D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc 1/10/05 8. 0P19 13 30/10/05 9. OP38 23 30/12/05 10. OP19 13 30/10/05 11. OP21 23 30/12/05 12. OP38 23 30/10/05 13. 14. Korniloff OP27 OP30 18 18 30/10/05 30/12/05 Version 1.40 Page 22 training in safe working practices 15. OP4 14 Staff must individually and collectively have the training, skills, and experience to deliver services for people with physical disabilities and dementia Fire doors must only be held open by approved hold -open devices and installed correctly. .An immediate requirement was given A full record of all accidents must be kept and appropriately recorded. The premises must be kept free from unpleasant odours The registered provider must commence training leading to the registered managers award or appoint a registered manager. The use of free standing electric fires in service users rooms must be suject to risk assessment 30/12/05 16. OP38 23 30/09/05 17. 18. 19. OP38 OP26 OP31 Schedule3 13 9 30/09/05 30/10/05 30/12/05 20. OP38 23 30/10/05 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. 2. 3. Refer to Standard OP15 OP1 Good Practice Recommendations Service users should have a choice of menu and meals which are appealling in texture and appearance The registered provider should provide the CSCI with a copy of the revised Statement of Purpose and Service User Guide Korniloff D54-D07 S3732 Korniloff V237129 300905 Stage 4.doc Version 1.40 Page 23 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 V237129 300905 Stage 4.doc Version 1.40 Page 24 - 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!