Inspection on 14/03/07 for Mount Tryon Care Home

This inspection was carried out on 14th March 2007.

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

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

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 HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Mount Tryon Care Home Higher Warberry Road Torquay Devon TQ1 1RR Lead Inspector Rachel Proctor Unannounced Inspection 14th March 2007 10:00 X10029.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 Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 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 and Care Homes for Adults 18 – 65*. 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. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mount Tryon Care Home Address Higher Warberry Road Torquay Devon TQ1 1RR 01803 292077 01803 299416 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) Barchester Healthcare Homes Ltd Carol Vivien Robins Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (50), Physical disability (10), Physical disability of places over 65 years of age (50) Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Mount Tryon is a purpose-built care home situated in a quiet residential area of Torquay, and is owned by one of the countries largest providers of residential and nursing home care in the UK. It is registered to provide personal and nursing care for up to 60 physically disabled clients, of either gender. An experienced Registered Nurse who also has professional management qualifications manages the home and Registered Nurses are on duty 24 hours a day, their duties being coordinated by the Head of Care. The accommodation is provided on two floors, the first floor being accessible by a 13-man passenger lift or internal stairway. It is a pleasantly decorated home throughout offering a homely environment even in the disabled bathing and shower rooms. All of the client’s bedrooms are single occupancy and have ensuite facilities and a nurse call system. The home also has nursing equipment such as hoists and specialist beds and mattresses to meet the individually assessed needs of the clients. The home has a selection of communal accommodation spread over the two floors. There is a lounge on the first floor with its own balcony offering glimpses over Torquay and the bay. The large lounge on the ground floor has direct access to the well-appointed dining room. The home also has its own “Pub” with the atmosphere of a small bar decorated to provide the character and charm of a small country pub in the 60’s. The home also provides a activities room and employs a full-time activities coordinator who offers a wide range of activities to individuals and groups of clients including the Gardening Club and the Friday Club that provides a weekly opportunity for clients to air their views about the whole service they experience at the home. There is a bus that is used for trips from the home and also to take clients to appointments if other transport is not available. The exterior of the home has ample parking and level access to the front door. There is also a garden area with sensible wheel chair access. The clients have access to visiting professionals such as the chiropodist, dentist and optician. The Statement of Purpose is displayed in the reception area of the home and is easily accessible for residents and visitors. The fees stated on the 14.03.07 were from £454.00 to £1000.00 and were dependant on the assessed care needs of the residents. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection, which took place on 14.03.07 between 10:00 am and 4pm. The inspector spoke to residents, staff and the management team at Mount Tryon during the inspection. Four residents had their care followed. A tour of the home was completed and some records were inspected. Prior to the visit to the home the inspector received five residents comment cards and five relatives comment cards. Some of the comments made in these and comments made during the inspection have been incorporated into this inspection report. What the service does well: What has improved since the last inspection? What they could do better: Although the statement of Purpose is readily available for residents and visitors; this had not been up dated to reflect the changes in registration or the new manager. The manager should ensure that the information provided for the residents is up to date. The majority of the medication management practices in the home are good. However the failure to provide individual residents with suitable lockable storage for their own medication; may put other residents at risk from accidental ingestion of the medication. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good, (Older People) 3, 6, (Adults 18 to 65) 2. This judgement has been made using available evidence including a visit to this service. The assessment processes adopted by the home manager should ensure that the residents receive the care they need. EVIDENCE: The statement of purpose and service users guide was easily available for the residents and visitors in the reception area of the home. However this had not been updated since the change of manager. This did not include the registration change of category to include younger adults and the change of company name. The inspector was informed that the statement of purpose Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 9 and service users guides were in the process of being updated. A draft copy of Statement of Purpose had been provided prior to the inspection. The manager confirmed that residents have a copy of the service users guide available for them. The residents asked said there had been given information about the home and its services. Since the last inspection the assessment process information has been updated and improved. The residents whose care was followed had completed assessments of their care needs within their care plan. These showed that the residents care needs had been holistically assessed. The assessments included health care needs, personal care needs and social care needs. The assessment process also included comprehensive risk assessments. The risk assessments completed included manual handling risk, falls risk, pressure sore risk, nutritional risk and continence care. Where potential risk had been identified a care plan had been put in place to reduce the risk. One residents family spoken to during the inspection told the inspector that the staff had spoken to them about the care needs of their relative who was unable to communicate clearly. They commented that they felt this had enabled the staff to understand the needs of their relative and what was important to them. The assessment for this resident included a written account of what was important to them. The manager advised that they had introduced daily assessment checks for the residents admitted for short-term care. An example of this was seen during the inspection. This showed that the residents receiving short-term care had the opportunity to discuss their care needs and what was important to them on a daily basis. The inspector was informed that the area in the home designated for Younger Adults was still undergoing improvements to provide additional facilities for this resident group. These included the provision of a domestic style kitchen and computer area. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good, (Older People) 7, 8, 9, 10. (Adults 18 to 65) 6, 9, 16, 18, 19, 20. This judgement has been made using available evidence including a visit to this service. The residents have their health and personal care needs comprehensively assessed and planned by staff team who have their best interests at heart. However by not insuring that residents who manage their own medication have suitable lockable storage, this may put other residents at risk. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 11 EVIDENCE: Five residents had their care followed as part of the inspection. Each had a comprehensive care plan in place, which had been developed from their assessment of care needs. The care plan set out details of the action staff should take to ensure that the care needs of the residents were met. The five plans of cared viewed had been reviewed monthly or sooner if the residents care needs have changed. The way the care plans are recorded supports that the residents and/or their representatives were involved in the development of the plan of care. The residents spoken to during the inspection told the inspector that staff had talked to them about their care needs and what was important to them. The residents have their care needs assessed by registered nurses who have the skills and abilities and understand the needs of the residents. The way the resident’s health care needs are recorded and planned gives a clear picture. One resident who had pressure sore had a plan of caring place, which showed how wound healing had progressed. These included photographs and measurements of the wound and the type of dressings used to promote wound healing. The registered nurse spoken to advised that these assessments are used for all the residents who require wound care. The inspector saw pressure-relieving equipment in use for the residents who required this. These included high dependency air flow mattresses and pressure relieving cushions. Continence assessments had been completed in the five plans of cared viewed. Continence aids were available for those residents who required them. During the inspection staff were observed assisting residents to go to the toilet or use the commode. One resident told the inspector that they use their call bell to call staff to assist them to get to the toilet. They also told the inspector that staff usually respond promptly when they rang. The care plans contained information about what was important to the individual residents. This included the resident psychological health and how this was promoted. The care plans included the residents life story, which had been completed with the residents and/or their representative. These gave a clear picture of the resident. One relative spoken to during the inspection said they were pleased with the care of their relative was receiving. One comment card received from residents indicated the support being very good when asked do you receive the care and support they need. One relative comment card indicated, maintains (my relatives) independent but steps in at appropriate times to help when asked what you feel the care home does well. Nutritional screening is an integral part of the care planning process. The registered nurse spoken to advise that the meals are planned around the residents needs. Nutritional monitoring had been completed and included a Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 12 record of the resident’s weight and their food preferences and dietary needs. Nutritional supplements were available for the residents who required them. During the inspection a GP visited one of the residents. The resident was seen in the privacy of their own room. The registered nurse advised that a record of GP visits was recorded in individual residents care plans. Examples of these were seen in the care plans. Where the GP had changed treatment or advised different medication this had been recorded in the daily evaluation and where required the care plan had been changed. The manager advised that each resident has an assessment by an NHS nurse to establish their nursing care funding. Records of these assessments taking place were available. The resident’s medication is stored in two separate treatment rooms. One on the first four and one on the ground floor. The controlled drug record for two residents has checks against stock as correct. How medication is ordered and return was discussed with a registered nurse. A clinical waste disposal company provides containers. A record of medication disposed of was being kept; two members of staff had signed this. The medication records for the residents whose care was followed were viewed. These had been completed as expected. When medication had not been given the reasons for this had been recorded. One resident who managed their own medication had all their medication on a tray on top of a small chest in their room. They told the inspector this enabled them to manage their medication easily. They also commented that they had had difficulty on occasions getting their medication and had arranged to speak to their GP. The inspector raised concerns with the manager about the way medication was being stored for this residence and the potential risk to other residents who may enter the room and take the medication. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good (Older People) 12, 13, 14, 15. (Adults 18 to 65) 12, 13, 15, 17. This judgement has been made using available evidence including a visit to this service. The staff team endeavour to provide and encourage activities that the residents are able to participate in. The residents can have confidence that when activities are planned their personal preferences and choices will be taken into account by the staff wherever possible. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 14 EVIDENCE: The home employs a full-time activities coordinator. A copy of the activities programme for a month had been provided with the preinspection information. During the inspection the inspector saw copies of that months activities programme in individual residents rooms. One resident told the inspector that they enjoyed the activities provided for them. The Friday club has continued since the last inspection. This provides the opportunity for the residents to express their views and opinions about the services and activities provided for them. Copies of minutes from past meeting showed how suggestions and requests made by the residents had been implemented. These included the type of meals provided and the type of activities arranged. The inspector was told that the minibus continues to be available for trips out and also to take clients to appointments if necessary. The trips out included visits to local attractions. Visitors were coming and going throughout the period of the inspection. They were seeing the residents in the privacy of their own rooms or in one of the communal areas. One resident’s relative spoken to told the inspector they are “always made to feel welcome”. A comment card, received from one relatives comment card indicated has companionship when * want it but can also be left alone to read quietly when asked to as the care service support people to live the life they choose. They also commented about the external events programme when asked what do you feel the care home does well. One relatives comment card indicated the staff get the balance right between being friendly and yet allowing the residents to feel independent and maintain dignity when asked is there anything else that you would like to tell us. During the inspection the inspector saw residents being given drinks. Those residents who were unable to access the drinks themselves were being given assistants by the staff. The dining room the residents use had been refurbished since the last inspection. The manager advised that new furniture is being provided for the dining room. The inspector joined the residents in the dining room for the lunchtime meal. The residents had been given a copy of the days menu and staff were also seen speaking to individual residents about the food. The staff observed assisting the residents to eat their meals were doing so in a friendly supportive manner. Residents were being asked if they wanted more when they had finished the meal. Four residents spoken to told the inspector that they look forward to the meals. Another resident told the inspector that theres always plenty to eat. The manager confirmed that the menus are changed regularly after consultation with the chef and the residents. Two residents told the inspector that they had been able to influence the menu choices provided. The lunchtime meal observed was unhurried with the residents eating their meals at their own pace. When a resident didnt appear to like the food they were given the staff offered alternatives. One staff Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 15 member observed during the lunchtime meal told one of the residents they could have a hot meal later in the day as they didnt feel like eating the lunchtime meal. The residents can also choose to have a drink in the authentic homes pub before the meal if they wish. One comment card received from a resident indicated, chef sometimes times cooks extra as I need building up when asked do you like the meals at the home. Another comment card received from a resident indicated that they sometimes liked the meals at the home and commented not enough variety and very processed. The residents asked personally during the inspection about the meals told the inspector that they look forward to mealtimes and enjoyed the meals provided. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good (Older People) 16, 18. (Adults 18 to 65) 22, 23. This judgement has been made using available evidence including a visit to this service. The open approach the manager has developed ensures the residents are able to freely express their concerns and wishes. They can have confidence that any concerns raised dealt with sensitively. EVIDENCE: The homes manager has introduced to clear complaints policy, which is easily available for the residents and staff. The residents spoken to during the inspection told the inspector that they knew who to complain to if they had any concerns. They also said they felt confident that any concerns they had will be dealt with sensitively. The Friday club continues to be a venue for the residents to discuss any issues they have or meet with the person who can offer them a solution or look into a problem as soon as possible. One resident told the inspector that they found these meetings very useful and a way of getting their views across. Two complaints have been received since the last inspection. The records of these complaints and the actions taken to address the concerns raised were Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 17 being kept in a complaints file. These showed that the home manager had acted promptly to try and address the concerns raised. One of these complaints was substantiated and the other partially substantiated by the investigation process. The manager confirmed that staff had received adult protection training. Records of training received by staff were contains in their individual staff files. Two staff spoken to the inspection confirmed that they had received Adult Protection training and had access to training packs in the training room. The home benefits from a training room where staff can have access to a computer and reference material to assist their learning. The manager confirmed that staff have access to this training room and have used it to complete some of the coursework for NVQ qualifications. The manager has clear recruitment policies in place. The recruitment processes in place should protect the residents from unsuitable staff. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent, (Older People) 19, 26. (Adults 18 to 65) 24, 30 This judgement has been made using available evidence including a visit to this service. The homes environment is well maintained, clean and comfortable; this provides the residents with a safe homely place to live. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 19 EVIDENCE: Since the last inspection several of the residents rooms have been redecorated and refurbished. The furniture and carpets had been replaced in some resident’s rooms. During the inspection the maintenance man was in the process of decorating one of the residents rooms. They advised that with the residents agreement that they are moved into a different room were their own room is decorated. The communal areas in the home had also been redecorated since the last inspection. The manager confirmed that further improvements were plans in the communal areas to give them a homely feel for the residents. The furniture provided for the residents was domestic in character and suitable for their needs. The residents rooms entered during the inspection had been personalised with items of the resident’s choice. The manager confirmed the individual residents are encouraged to bring things to the home that will personalise their room for them. The home employs a full-time maintenance man who keeps a record of all the work that is undertaken in the home. The grounds are well maintained and provide wheelchair access to the garden area where there are views across Torquay and the bay. A patio area has been created where residents can enjoy a barbecue with their relatives if they wish. There is also a wheelchair accessible greenhouse where residents who wish to can participate in gardening tasks. One resident told the inspector that they really enjoyed sitting out in the garden during the summer months. A tour of the home revealed that the home is kept clean fresh and free from odour for the residents. The residents spoken to during the inspection said the home is always fresh and clean. The inspector saw a team of domestic staff working in the home during the inspection cleaning individual residents rooms, the communal areas and bathrooms. One comment card received by a resident indicated, the communal areas always clean, but individual rooms are not very clean. The resident’s rooms the inspector entered during the inspection appeared to fresh and clean. The laundry area is sited away from the resident’s areas. Laundry personnel are employed to manage the laundry. The laundry floor and walls are easily cleanable. Policies and procedures are in place for managing infection control within the home. A clinical waste management company is employed to dispose of clinical waste. Gloves and aprons are readily available for staff dealing with clinical spillages. The home has a sluice on each floor where commodes and bedpans can be empted and cleaned. This should ensure that the residents are protected from infection. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent, (Old People) 27, 28, 29, 30. (Adults 18- 65) 32, 34, 35. This judgement has been made using available evidence including a visit to this service. The level of, and commitment to training is high, the residents should benefit from a motivated well-trained staff team. EVIDENCE: The staff rota was provided prior to the inspection. This showed the number of staff on duty and what capacity they were employed. It covered the registered nurses, care staff and ancillary staff. The manager confirmed that the number of care staff provided could be increased if the needs of the residents require this. The duty rota showed more staff on duty at peak times of activity during the day, such as mealtimes. A housekeeper and a team of domestic staff ensure the home is kept clean and fresh for the residents. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 21 The preinspection information indicated that 57 of the health care assistants employed had achieved an NVQ (National Vocational Qualification) level 2 or above in care. This exceeds the 50 expected. The home has clear induction policies, which is linked to Skills for Care and provide staff with the foundations for work in the care. The management organisation of the home has provided clear recruitment policies and procedures. These should ensure that the residents are protected from unsuitable staff. A selection of staff files were viewed during the inspection. These contain the information required to support at all preemployment checks had been completed prior to the staff starting work. These included two written references and a police check. The staff files viewed contained copies of certificates of courses they had completed. There is an excellent commitment to training and development of the staff team from the homes management. Staff have access to a training room with reference material and computer with Internet access. Examples of an induction training pack used by staff during their induction was provided. This covered the Skills for Care recommendations for induction. The induction workbooks included self-assessment for individual students to complete as they progress through their induction training. The information provided supports that staff receive induction training within the first six months of appointment. The staff spoken to during the inspection confirmed that they receive paid training days and are supported to improve their skills through training. One staff member spoken to said they had been able to access training that help them understand. They also commented that the specialist healthcare professionals who visited the home offered advice and support. One comment card received from a resident indicated some of the staff are very caring and take time, but unfortunately a few of the staff (especially night staff) and not caring, in fact a quite brusque. The inspector spoke to residents during the inspection they said staff were friendly and supportive towards them, although one commented that sometimes the night staff are very busy. Two other comments received from resident’s relatives through the comment cards raised concerns about the standard of English and some of the care workers. They commented they felt their relative may find it difficult to understand some of the foreign staff and would therefore not they be able to sit and talk to them. During the inspection three residents told the inspector that the foreign staff were very friendly and caring and although they had had difficulty initially understanding them they now found this easier. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good, (Older People) 31,33,35,36,38. (Adults 18-65) 37,39,42. This judgement has been made using available evidence including a visit to this service. The residents live in a home, which is managed by a registered manager who promotes the health, safety and welfare of the residents and staff. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 23 EVIDENCE: Since the last inspection a new registered manager has been appointed. The previous manager has moved to a senior position within the organisation and continues to support the new manager of Mount Tryon. The new registered manager is the first level nurse with several years experience in the care home industry. She confirmed that she had undertaken training to update her knowledge, skills and competence. There are clear lines of accountability within the home and with the external management. The inspector receives regular updates (regulation 26 reports), which are completed by a senior person within the organisation. These provide information about how the home is meeting the needs of the residents it cares for. The inspectors saw the minutes of the Friday club where residents are able to express their concerns and wishes. The residents spoken to confirmed that they enjoyed the meeting and being part of the home. The organisation completes anonymous resident satisfaction questionnaires. The inspector was told that residents or their representatives are invoiced for individual expenditure and they dont hold money or valuables for residents except in exceptional circumstances. Information for individual residents was available for inspection. The pre-inspection information indicated at 10 of the current residents handle their financial affairs. The preinspection information indicated that the manager does not act as appointee for handling financial affairs for any of the residents. Three staff spoken to during the inspection told the inspector that they felt well supported to do their job and received regular supervision. The supervision records were available for inspection. These showed that staff receive regular supervision, which covers all aspects of practice, philosophy of care in the home and career development needs. Not all records were inspected on this occasion. The records that were reviewed had been kept appropriately were up-to-date and contain the information required. These included the resident plans of care, medication records, the accident book, fire logbook and some maintenance records. The maintenance man told the inspector had he completes the health and safety checks for the home and keeps the records up to date. Maintenance records contained information about the monthly checks completed for hot water temperatures. A service record for the hoists used in the home is also available. Pre inspection questionnaire included information about other health and safety and maintenance checks completed. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 24 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 2 X 3 3 4 X 5 X 6 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 4 20 X 21 X 22 X 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 3 34 X 35 3 36 3 37 X 38 3 Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 25 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 OP9 Regulation 13(2) 23(2)(m) Requirement Suitable lockable storage must be provided for service users who manage their own medication. Timescale for action 01/07/07 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 OP1 Good Practice Recommendations The Statement of Purpose should be up dated to reflect changes in registration and the new manager. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. Mount Tryon Care Home DS0000069235.V331725.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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