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Inspection on 04/10/05 for Liskeard Eventide Home Limited

Also see our care home review for Liskeard Eventide Home Limited for more information

This inspection was carried out on 4th October 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides good care for the service users who were most fulsome in their praise for the staff, their rooms and the food. The home attracts people who are still reasonably independent and enjoy company. Service users described the entertainments that are provided regularly and the activities that are arranged amongst themselves. These included word games and puzzles that service users said they enjoyed as it kept their minds active. The committee members, especially the chairlady, play an active role in the home and are well known to the service users and the staff.

What has improved since the last inspection?

The inspector noted that the recommendations of the previous report had been addressed in relation to medication training and the protection of vulnerable adults (PoVA) training. Because of the more important matters in the home at the time of this inspection staff records and recruitment was not inspected.

What the care home could do better:

Service users care plans would benefit from being refreshed. The majority of service users are remarkably able but it is still important to note their abilities and limitations more fully in order to monitor their progress, as many have been in the home for several years. An issue with controlled medication (CDs) was drawn to the registered manager`s attention.

CARE HOMES FOR OLDER PEOPLE Liskeard Eventide Home Limited 14 Castle Street Liskeard Cornwall PL14 3AU Lead Inspector Philippa Cutting Unannounced Inspection 4th October 2005 10.15a X10015.doc Version 1.40 Page 1 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 Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 Page 2 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. Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Liskeard Eventide Home Limited Address 14 Castle Street Liskeard Cornwall PL14 3AU Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01579 342676 01579 340728 eventidehome@btconnect.com Liskeard Eventide Home Limited Mrs Elizabeth Anne Wilkins Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd November 2004 Brief Description of the Service: Liskeard Eventide Home is a voluntary care home run by a committee with the care being overseen by a registered manager. It is situated near the centre of Liskeard within walking distance of the town’s facilities for anyone with reasonable mobility. Accommodation comprises all single rooms, half of which have en suite facilities of a toilet or a toilet and shower. Rooms are situated on the ground and first floor which is accessed by stairs or a through floor lift. There are communal rooms on the ground floor, which comprise a large sitting room, a smaller sitting room and a dining room. There is a sun lounge on the first floor which is next to three bedrooms that are reached via two additional steps. At the rear of the property a patio/sitting area and car parking is provided. The gardens in the front of the house have rails and steps. The entrance to the home is sited at the rear of the property but is clearly signed. Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that, by chance, coincided with the birthday of the home’s oldest resident who was 100. Celebrations had been planned for him, therefore the inspector only spent time talking with the service users, inspecting the premises, looking at care plans and a limited number of records as staff and committee members were busy with the service users who were looking forwards to the planned party. What the service does well: What has improved since the last inspection? What they could do better: Service users care plans would benefit from being refreshed. The majority of service users are remarkably able but it is still important to note their abilities and limitations more fully in order to monitor their progress, as many have been in the home for several years. An issue with controlled medication (CDs) was drawn to the registered manager’s attention. Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 Page 6 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. Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 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 the following standard(s): 2,3,4,5 Information is provided for service users, and sought about prospective service users, to enable them to make an informed decision about entering the home. EVIDENCE: Documentation detailing the terms and conditions of residency at Eventide was seen in service users’ files. Information about the home was available in the reception area and in rooms. The registered manager visits people who have enquired about vacancies to assess their needs and gauge whether Eventide can meet these. The home is well known locally and other agencies may guide people whose needs are compatible with the services available. A number of service users had had respite stays in the home before seeking permanent accommodation. Once resident, service users can be referred to other agencies or specialist as needed. The staff appeared as a team who have received training to meet the service users’ needs. Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 Page 9 Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 7,8,9,10,11 The care that service users receive was felt to be good but a review of care plans is needed to support this. EVIDENCE: Service users’ records were seen to include an initial assessment and plan of care. Possibly because so many of the service users are still independent and only need limited help, the care plans have become brief. Whilst ‘independent, knows her own mind, has bowel problems’ may reflect the nature of care required, it is not sufficient as a care plan. Equally care plans need to be reviewed monthly. If a person’s condition remains static and no changes are needed, ‘no changes needed’ should be recorded. A number of service users told the inspector that they had been in the home for two or more years. It would be a good idea to reassess these people fully in order to monitor whether or how their circumstances and abilities have changed in that time. Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 Page 11 Daily recording does not necessarily take place if there is little of significance to report but it was noted that where a service user was unwell there were several detailed, timed entries for the same day. Medication is administered via monitored dose system. The home’s written polices and procedures are updated regularly by the registered manager and made available for all staff. The medication administration record sheets were seen to be completed. There was however a discrepancy in the CD book. Medication that had been returned to the pharmacist had not been entered in the CD book, so the record suggested that there was still an amount of a controlled drug in the home rather than a nil balance. The ‘returned medication’ book was not immediately available to verify this. The home needs to give strong consideration to including any risk assessments in the records where, for example, a service user holds and administers her own medication. Eight senior staff and others who may be responsible for administering medication, are currently undertaking a distance-learning course on the safe administration of medication. The service users were very positive about the care that they received from the staff and said the help that they received was excellent. Records noted when people had chosen not receive care (such as a bath) etc. and what alternatives were offered. The home aims to support service users until the end of their life with help from the community nursing services if needed. Cards from relatives of deceased service users expressing their thanks and appreciation were noted. Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 12,13,14,15 Independence and choice is promoted amongst the service users, who take advantage of this in a positive way. EVIDENCE: Service users described activities and outings that are arranged for people both individually and in groups. These include religious services, regular bus trips to local places of interest, entertainment in the home, word games (such as Scrabble & Upwords) and Bridge foursomes. The Residents’ Notice Board displayed details of events both in the home and in the town. It was seen that the majority of people choose to sit in the lounge where they chat freely with each other. On the day of the inspection it was noted that most of the service users took a daily paper, which they read rather than have the television on. Music was available but people were not afraid to turn it off if something else occurred. Visitors are encouraged and there are other rooms where people can entertain them. The service users said that the food was good. A choice was noted on the menu board with a lot of extra ‘goodies’ being prepared for the afternoon celebrations. Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 16, 17,18 The home has a complaints procedure in place and is taking steps to update the staff on issues of abuse, to ensure the well being of the service users. EVIDENCE: The complaints procedure is included with the Residents’ Handbook. It was noted that the telephone number of the Commission for Social Care Inspection needs amending. Further documentation relating to complaints was not sought on this occasion. Records indicated that service users have access to Solicitors or other people if needing help with their affairs. Staff are booked to attend a seminar on Whistle Blowing & PoVA shortly which will supplement the home’s polices and procedures on adult protection. Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 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 the following standard(s): 19,20,21,22,23,24,25,26 Service users are provided with a well-maintained environment that is equipped to meet their needs. EVIDENCE: Eventide is well maintained and decorated with first impressions being good. Rooms are all for single occupation and are well furnished with service users being encouraged to bring in their own items of furniture and decorations if they wish. People expressed satisfaction with their accommodation although one lady said she missed seeing the sea as she lived by the coast previously. Thirteen of the 24 rooms are en suite with sufficient bathrooms and toilets throughout the home, although a shower room is currently used for storage. Keys are available for people to lock their doors but no one chooses to exercise this option at present. Equipment to promote independence was noted and this included toilet frames, raised seats and handrails. Hoists are used if needed. Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 Page 15 The seating in the main sitting room is arranged around the walls and the inspector and service users had a discussion about this and whether they would prefer chairs to be grouped? Service users said they had their preferred seats and were happy with the current arrangement. Several said that whilst they did have a favourite spot they felt quite able to move their chair if they wished. The home was seen to be clean and tidy. The laundry was not inspected on this occasion. The chairlady of the committee said that the home had recently purchased a number of new items and were constantly looking to upgrade equipment as needed. The registered manager is currently investigating improved lighting & lamps to help a person with poor sight. Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 Page 16 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 The staff were enthusiastic about their work and appeared to be well liked by service users. EVIDENCE: The staff on duty were observed going about their duties. Everyone had worked hard to finish all the required tasks in the morning so that they could turn their attention to the afternoon party. Consequently staff records were not inspected on this occasion. One waking staff and one sleeper provide night cover. The registered manager lives next door to the home. She said that no one is employed until Criminal Records Bureau checks and PoVA clearances have been obtained. Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,37 Service users’ interests are at the heart of the home’s management. EVIDENCE: Again because of the celebrations and expected visits by the press and Mayor, these standards were not fully inspected on this occasion. The registered manager is a qualified nurse and experienced home manager. She liaises with the committee for the wellbeing of the service users and staff. The chairlady is closely involved in the home and works with the registered manager. The accident records and fire training and maintenance log were inspected and found to be in order. Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X X 3 X Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? no 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 OP7 Regulation 15 Requirement Care plans for service users must be revised and contain full information about all aspects of health, personal and social care needs of each service user. Care plans must be reviewed on a monthly basis. The registered manager must ensure that any controlled medication accords with the CD book. Timescale for action 31/03/06 2 3 OP7 OP9 15 13(2) 31/03/06 05/10/05 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 Refer to Standard OP7 OP16 Good Practice Recommendations Risk assessments should be included in service users’ care plans where necessary. The complaints policy should be amended to change National Care Standards Commission to Commission for Social Care Inspection and with the correct telephone number Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall 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 Liskeard Eventide Home Limited DS0000009187.V252722.R01.S.doc Version 5.0 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. 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