Inspection on 01/11/05 for Little Oldway

This inspection was carried out on 1st November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Little Oldway 09/08/07

Little Oldway 02/06/06

Little Oldway 16/11/04

Little Oldway 10/06/04

Similar services:

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Fairfields Country Rest Home

Poldhu

Queensmount

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

CARE HOMES FOR OLDER PEOPLE Little Oldway Little Oldway Torquay Road Paignton Devon TQ3 2TD Lead Inspector Rachel Proctor Unannounced Inspection 1st November 2005 09:30 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 Little Oldway DS0000018389.V268053.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. Little Oldway DS0000018389.V268053.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Little Oldway Address Little Oldway Torquay Road Paignton Devon TQ3 2TD 01803 527156 01803 663670 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) Mr Barry Michael Privett Mrs Jacqueline Ann Privett Vacant Care Home 35 Category(ies) of Dementia - over 65 years of age (35), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (35), Old age, not falling within any other category (35), Physical disability over 65 years of age (35) Little Oldway DS0000018389.V268053.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th April 2005 Brief Description of the Service: Little Oldway is a large, listed building, which provides accommodation for up to 35 service users on two levels. The home is surrounded by a large, level attractive garden, and is adjacent to Oldway Mansion and its grounds. The home provides personal care for elderly service users with or without a physical and/or mental health frailty. Little Oldway DS0000018389.V268053.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The commission for social care inspection has introduced key standards to be inspected over each inspection year. Therefore, unless it is felt necessary by the inspector, some standards will not be inspected. To obtain a full picture of the home it is recommended that previous reports also be taken into consideration. This was an unannounced inspection and took place on the 1st November 2005 between 10:20 a.m. and 2 p.m. A tour of the home was completed and some records were checked. The inspector spoke to some residents and staff during the inspection. Discussion with the acting manager and registered provider took place. What the service does well: What has improved since the last inspection? What they could do better: Not all the radiators that are accessible to the residents have guards fitted. However a program to guard the radiators using a risk assessment process remains in place. Not all new staff had had a CRB check completed before they started work at the home. This practice may put the residents at risk from unsuitable staff. The laundry drying area had been cluttered with equipment and old furniture. There was very little room for the laundry person to fold clothes. The floor was dusty and there were cobwebs on the ceiling. The lack of cleanliness in the laundry may put residents at risk of infection. Little Oldway DS0000018389.V268053.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. Little Oldway DS0000018389.V268053.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 Little Oldway DS0000018389.V268053.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): 3, The residents can have confidence that their personal preferences and choices will be taken into account by the staff who care for them. EVIDENCE: The three residents plans of care view during the inspection had a comprehensive initial assessment completed from which a care plan had been developed. The assessments and care plans included information about the resident’s likes and dislikes. The acting manager advised that the way the residents assessments and care planning is recorded is in the process of being changed. Examples of the new care plan documentation were available. She also commented that the new care plan system would provide more information and enabled the resident’s care planning to be more clearly defined. Residents spoken to during the inspection told the inspector that the staff consulted them about their care. The acting manager advised that those residents who are able to sign the plans of care. Little Oldway DS0000018389.V268053.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9, 10, The residents can have confidence their individual care needs will be met by staff team who understand them and have the best interests at heart. EVIDENCE: The residents care plans continue to be linked to their assessment. Instructions are provided for staff to ensure all aspects of health, personal and social care are met. One residents care plan whose care needs had changed had this reflected in their plan of care. A comprehensive risk assessment processes is in place to assess the activities the residents choose to undertake. Falls risk assessments have been completed and where risk has been identified the care plan provides instruction to reduce the risks. One resident identified as at risk of falling told the inspector they enjoyed going out and would like to do so more often. The plan of care identified that the resident should be accompanied outside the home. The three care plans seen during the inspection had been reviewed monthly. The acting manager provided examples of the new care planning system that was to be introduced in the home. She commented that these would enable clearer recording of care plan reviews completed. Little Oldway DS0000018389.V268053.R01.S.doc Version 5.0 Page 10 One resident was taken to a hospital appointment escorted by a carer during the inspection. System for recording GPs/health professional visits are in place. The acting manager advised that she was part of a community link nurses training programme. The dates of the forthcoming sessions were available. A system for assessing the resident self care ability for their medication is in place. The acting manager advised that none of the current residents have been assessed as able to manage their own medication. Staff observed giving medication at lunchtime were giving this to individual residents and signing their medication record as this was given. Two records of medication viewed had been completed as required. The senior carer giving the medication during the inspection advised that none of the current residents are taking controlled drugs at present. Four residents spoken to during the inspection told the inspector that staff are always polite to them and are supportive and friendly. Little Oldway DS0000018389.V268053.R01.S.doc Version 5.0 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 the following standard(s): 12, 15, The residents have their personal choices and preferences taken into account when activities are planned. EVIDENCE: An activity co-ordinated visits the home every two weeks. She was visiting the home during the inspection. The residents spoken to tell the inspector that they looked forward to these visits and had particularly enjoyed the opportunity to reminisce this week. The acting manager provided completed forms from previous weeks, which identified which activities, had taken place and who had participated. Minutes of previous residents meetings evidence that the residents are asked what type of activities they would like. The acting manager advised that she intended to continue with the residents meetings. One resident told the inspector that she had found the residents meetings very useful and had been disappointed that they have not been one for a few months. The residents preferred choices for activities and meals have been recorded in their plans of care. One resident who requested a different sweet at lunch time to the one on offer, was given this during the inspection. Little Oldway DS0000018389.V268053.R01.S.doc Version 5.0 Page 12 The inspector shared the lunchtime meal with the residents in the dining room. The meal was attractively presented and nutritionally balance. The Cook told the inspector that the meals were prepared daily using fresh ingredients. The residents asked said the meals were always good and plenty of it. And there were choices they didnt like what was on offer. Very little wastage was seen at the lunchtime meal. Those residents who required assistance were being given this discreetly by the staff. Some residents had chosen to eat a meal in their own room. The resident’s rooms entered during the inspection had been personalised with items of their choice. Little Oldway DS0000018389.V268053.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): 18, By not applying for CRB checks on new staff appointed prior to them starting work, the registered provider may be putting residents at risk from unsuitable staff. EVIDENCE: The training records provided shows that 19 staff had received training in challenging behaviour. The acting manager confirmed the training provider was planning to provide protection of vulnerable adult training for the staff. The acting manager advised that this training organisation provided the training morning and afternoon to target as many of the staff as possible. The complaints procedure, which contained a contact number for the commission, is easily available. The inspector looked at three new Staff files during the inspection. These staff had not had a new CRB check applied for prior to them starting work. Copies of CRB checks from previous employment were however available. Little Oldway DS0000018389.V268053.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, 25, 26 The homes environment is pleasant and welcoming for the residents. The provision of radiator guards will ensure that the residents are protected from possible accidental burns. The lack of cleanliness in the drying area of the laundry may put residents at risk of infection. EVIDENCE: The home has a well-presented pleasantly decorated environment for the residents. Ongoing repairs renewals and redecoration had taken place since the last inspection. There are two lounge areas, a conservatory and the dining room available for the residents use. All these areas were being used during the inspection. The large lounge provides space for entertainment and activities for the resident’s. The small lounge and conservatory provide quiet space. The dining room has the capacity to seat all the residents at one sitting. The grounds of the home are attractively presented. Several residents commented how much they liked the gardens; two commented that they liked watching the squirrels. Little Oldway DS0000018389.V268053.R01.S.doc Version 5.0 Page 15 As at last inspection not all radiators are covered. However, a risk assessment has been completed and a programme to cover radiators is continuing. Where new residents have been admitted their personal rooms have been risk assessed for hot water in the sinks and radiators cover. The acting manager advised that the owner was continuing to cover the radiators using the risk assessments to prioritise, which were done first. Separate areas are provided for clean and dirty laundry. However the drying area for the laundry was cluttered with equipment and old chairs. Cobwebs were on the ceiling and the floor was dusty. There was very little space for the laundry person to fold clothing once it had been dried. The handy man/gardener also shared the space for laundry was dried. Gardening equipment and tools were being stored in this area. The rest of the home was clean and fresh and free from odour. The residents spoken to advise that the home is always fresh and clean. The inspector was provided with a list of staff who had attended infection-control training. Staff observed during the inspection had gloves and aprons available to them when they provided care. Little Oldway DS0000018389.V268053.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, 28, 29, 30, The acting manager has introduced a system, which should ensure that all staff receive the training they require to care for the residents. However the failure to apply for CRB checks for new staff prior to them starting employment may put residents at risk from unsuitable staff. EVIDENCE: A colour-coded duty rota, which identifies the capacity the staff are employed in has been introduced since the last inspection. This gives at glance information regarding how senior carers are deployed throughout the week. Additional staff are on duty these included cleaners, laundry personnel, Cook and maintenance man. The numbers of staff on duty appeared to be meeting the needs of the residents in the home. The acting manager advised that additional staff would be provided if the resident’s dependency increased. The staff files reviewed contained a list of training they had completed. This included the dates and the type of courses attended. Copies of certificates received were kept in the staff files. Three new staff files viewed during the inspection had completed application forms reference request references and CRB checks from previous employers. The inspector was advised and these staff were working supervised at present. Little Oldway DS0000018389.V268053.R01.S.doc Version 5.0 Page 17 The acting manager had accessed training for care home acting managers provided by the lead nurse educator from the PCT. The acting manager advised that she was completing modules for supervising staff, safe handling of medication, infection control and managing sickness. Little Oldway DS0000018389.V268053.R01.S.doc Version 5.0 Page 18 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, 35, 38 A manager who stays and further promotes the progress already made will continue to improve the resident’s overall experience of care. The provision of radiator guards will ensure that the residents are protected from possible accidental burns. EVIDENCE: The acting manager is in the process of completing an NVQ award and is applying to complete the registered managers award. The commission is awaiting a completed application form to enable the registration of the manager. The acting manager provided information about the courses she had completed to enable her to keep her practice to date. The acting manager advised that the resident’s pocket money is kept individually and separate records are kept. These records were not available for inspection on this occasion. However they have been seen in previous Little Oldway DS0000018389.V268053.R01.S.doc Version 5.0 Page 19 inspections and the acting manager confirmed that the system remained unchanged and continues to be managed by the registered provider. A record of statutory training was provided. This included fire training, manual handling and health and safety. The acting manager advised that by having a checklist she was able to ensure that all staff received updates in a timely way. One resident had a fall during the inspection; the staff member completed the accident book with an account of the accident soon after it happened. The actions taken following the accident were discussed with the acting manager. The staff induction template in place covers the area is expected. The acting manager confirmed that staff receive paid training or funding from training providers for their NVQ training. She also advised that the supply pharmacist as well as the local college were providing medication training. She confirmed that the staff had access to a distance-learning course for medication practices. 15 of the radiators in the residents areas are still to be covered. The acting manager advised that these were being completed on a risk priority basis. The inspectors saw some radiators in resident’s rooms had furniture positioned in front of them to reduce the risk. Little Oldway DS0000018389.V268053.R01.S.doc Version 5.0 Page 20 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 1 3 X X X X X 2 2 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 3 X X 2 Little Oldway DS0000018389.V268053.R01.S.doc Version 5.0 Page 21 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 OP18 19(5)(d)(i i) 2 3 OP26 OP29 19(5)(d)(i i) 23(2) (d) Regulation Requirement CRB checks must be completed for all new staff prior to their starting work. An action plan/evidence of completion must be provided. The laundry drying area must be cleaned and space provided for the laundry person to work. (As OP18 above) CRB checks must be completed for all new staff prior to their starting work. An action plan/evidence of completion must be provided. Timescale for action 31/12/05 31/12/05 30/12/05 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 OP25 OP31 Good Practice Recommendations All radiators in the resident areas should be covered, the covering of these radiators should continue as planned The new manager should complete the commissions fit person processes Little Oldway DS0000018389.V268053.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Ashburton Office 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 Little Oldway DS0000018389.V268053.R01.S.doc Version 5.0 Page 23 - 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!