Inspection on 27/07/05 for Levanto Care Home

This inspection was carried out on 27th July 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

Levanto Care Home 13/11/07

Levanto Care Home 18/12/06

Levanto Care Home 09/02/06

Levanto Care Home 23/02/05

Levanto Care Home 13/07/04

Levanto Care Home 23/03/04

Similar services:

5 Seafield Road

Honeybourne House

Longrun House

Bodley Community Care Support Centre

Thomas Pocklington Trust

Chantry Gardens

Penkelly House

25-27a Alexandra Road

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

CARE HOMES FOR OLDER PEOPLE Levanto 7-9 The Riviera Paignton Devon TQ4 5EX Lead Inspector Peter Wood Unannounced 27 July 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. Levanto D54-D07-34256-Levanto-V227402-270705-Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Levanto Address 7-9 The Riviera Paington Devon TQ4 5EX 01803 554728 01803 559039 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) Mr Anthony Robert Cousins Mrs Marion Hazel Cousins Mrs Marion Hazel Cousins Care Home 20 Category(ies) of Dementia (20), Physical disability (20), Sensory registration, with number impairment (20) of places Levanto D54-D07-34256-Levanto-V227402-270705-Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23/02/05 Brief Description of the Service: Levanto is a semi-detached residential home that provides 24 hour care for up to 20 persons. The home is registered to provide places for persons in the categories of dementia, physical disability and sensory impairment. It was agreed that the new Commission for Social Care Inspection Certificate would not include the sensory impairment category, which is designed for those homes which specialise in service users who are blind, deaf, or both. The home has fourteen single rooms and three doubles, five of the single rooms and one of the double rooms are equipped with en-suite facilities. There are two communal lounges available; meals are taken in a separate dining room. A stair lift is provided for service users that have mobility issues and toilet and bathroom aids are available if required. A large garden area is situated at the front and side of the building, which includes an area of lawn with seating provided for service users. At the side of the home is a large car park, which has the capacity to take several vehicles. The home is a short level walk to the shopping centre of Paignton and the facilities of the town. Levanto D54-D07-34256-Levanto-V227402-270705-Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over one day in July 2005. The owner / manager was on holiday, but just happened to be at the home at the beginning of the inspection. She was able to confirm action taken to comply with the requirements and recommendations of the previous inspection, and to discuss some issues, before leaving me in the capable hands of the experienced staff. By coincidence virtually the whole of the staff complement, including night staff, turned up to undertake Moving and Handling training delivered by an external company. This was therefore a near unique opportunity to discuss with virtually every member of staff. I undertook a tour of the home, but examined few records. I joined residents during lunch in the dining table and also spoke to some in the lounges or in their own bedroom and asked for their views of their experience of living at this home. What the service does well: What has improved since the last inspection? The two requirements made at the last inspection have been actioned: • • The provider has now connected the new Medication fridge to the mains supply so as to properly store medications that need refrigeration. The provider is currently in the process of refurbishing the downstairs toilet including fitting a wash hand basin. Action has also been taken with regard the two recommendations: • The owner has bought suitable locks to fit to bedroom doors, and has fitted one or two that have been specifically requested. Others will be fitted over time unless the reason for not doing so in a particular case is recorded in the service user’s care plan. An appointment for an occupational therapist to visit was made but could not be kept. Another will be made. D54-D07-34256-Levanto-V227402-270705-Stage 4.doc Version 1.40 Page 6 • Levanto 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. Levanto D54-D07-34256-Levanto-V227402-270705-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 Levanto D54-D07-34256-Levanto-V227402-270705-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, 5 Thorough and comprehensive systems for admission allow service users and their relatives to be confident that their needs can be met. The Registered Manager meets Service Users’ needs flexibly within the resources of the Home. EVIDENCE: Residents interviewed confirmed that new service users are admitted only on the basis of a full assessment and are invited to visit the home and to move in on a trial basis before they make a decision to stay. The registered manager undertakes a pre-assessment prior to a resident’s admission, followed by detailed assessments that generate comprehensive care plans. Residents confirmed that prospective residents and their relatives are given good information about the home, including a Statement of Purpose and a Service Users’ Guide, which I inspected at the last inspection. Levanto D54-D07-34256-Levanto-V227402-270705-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, Service users health, personal and social care needs are being met and service users are treated respectfully. The home’s practices relating to medication administration protect the service users from risk. EVIDENCE: Care plans are generated from comprehensive assessments and residents have good access to health care services. Residents can self medicate subject to a satisfactory risk assessment, though in practice few residents who would be suitably placed in this home would be considered safe to do so. Those who are able should be provided with a locked compartment in their room, which should be fitted with an approved lock. Residents were observed to be, and reported that they were, treated with respect by staff. Levanto D54-D07-34256-Levanto-V227402-270705-Stage 4.doc Version 1.40 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) 12, 13, 14, 15 The routines of daily living are flexible according to the wishes and needs of the residents. Meals are appealing, nutritious and varied. EVIDENCE: Times for getting up and going to bed, and mealtimes if necessary for an individual, are flexible according to the wishes and needs of the residents. Visitors can come at any reasonable time, service users are encouraged to exercise choice, and menus are good. Staff undertake some activities with service users, but an outside professional comes in every week to organise activities. Resident’s rooms reflected their personality. Some residents said they would like more activities. The lunchtime meal taken in the very pleasant dining room was attractive, with choice offered, and nutritious. Levanto D54-D07-34256-Levanto-V227402-270705-Stage 4.doc Version 1.40 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) 16, 18 Complaints and suggestions from service users, relatives or other visitors to the home, are treated seriously. Service users are listened to and issues resolved as promptly as possible. EVIDENCE: The home’s complaints policy and procedure is on display in the entrance hall. The owners are aware of abuse in all its forms and have literature, policies and procedures to prevent it. Staff were able to discuss abuse issues and those with whom I discussed and observed understood the importance of treating their residents with kindness, dignity and respect, even when this was not always reciprocated. Levanto D54-D07-34256-Levanto-V227402-270705-Stage 4.doc Version 1.40 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, 21, 22, 23, 24, 25, 26 The service users live in a pleasant, well-maintained home that is comfortable and warm and which provides sufficient facilities to meet their needs. EVIDENCE: Levanto comprises a large corner house now joined together with its neighbour. The home therefore benefits from two staircases, one of which is fitted with a chairlift to assist residents with mobility difficulties. The home is still being renovated by the relatively new owners. Hazards from hot water and hot radiator surfaces are now minimised by the installation of thermostatic valves. The downstairs toilet is the current renovation project and is currently out of action during the refurbishment which includes the installation of a wash hand basin. Other toilets have been fitted with raised toilet seats replacing the unsightly and inefficient Mobrays. General decoration throughout is also being undertaken. The lounges, for example, are now bright and attractive. Despite many residents’ incontinence there was no odour on the day of the inspection. Levanto D54-D07-34256-Levanto-V227402-270705-Stage 4.doc Version 1.40 Page 13 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, 28, 30 Service users are cared for by well-trained and motivated staff in sufficient numbers to meet the needs of those currently living in the home. EVIDENCE: The home’s staffing levels at the time of the inspection were appropriate for the number of residents and their levels of dependency. According to the Preinspection Questionnaire prepared for the last inspection, 60 of the staff had undertaken NVQ 2 or above, exceeding the 50 target. By coincidence virtually the whole of the staff complement, including night staff, turned up to undertake Moving and Handling training delivered by an external company. This was therefore a near unique opportunity to discuss with virtually every member of staff and to observe their positive and enquiring attitude towards training. It was also a good opportunity to observe staff’s skill in the practical aspects of moving and handling residents, together with discussions covering abuse, dignity and respect towards residents Levanto D54-D07-34256-Levanto-V227402-270705-Stage 4.doc Version 1.40 Page 14 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, 33, 36, 37, 38 Service users live in a well managed home. The owners and their staff team strive to provide a homely, safe environment that respects and protects residents. EVIDENCE: The registered manager / owner is very experienced and is currently undertaking the Registered Manager’s Award and NVQ level 4 qualification in Care. The home has an open, positive and inclusive atmosphere. Staff were being well trained in Moving and Handling during the inspection. During discussions initiated by this training it was apparent that the home adopts and promotes safe systems of work. Several staff have the First Aid at Work qualification. Levanto D54-D07-34256-Levanto-V227402-270705-Stage 4.doc Version 1.40 Page 15 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 3 3 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 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 4 28 3 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 3 3 Levanto D54-D07-34256-Levanto-V227402-270705-Stage 4.doc Version 1.40 Page 16 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 Good Practice Recommendations Levanto D54-D07-34256-Levanto-V227402-270705-Stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton Devon 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. 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