Inspection on 21/09/06 for Patron House

This inspection was carried out on 21st September 2006.

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

Patron House 24/02/06

Patron House 09/08/05

Patron House 12/02/05

Patron House 06/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Patron House 212 Stoke Lane Westbury On Trym Bristol BS9 3RU Lead Inspector Vanessa Carter Key Unannounced Inspection 10:00 21 September 2006 st 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 Patron House DS0000026513.V310689.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. 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. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Patron House Address 212 Stoke Lane Westbury On Trym Bristol BS9 3RU 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) 0117 9682583 0117 9691973 sam.hawker@blueyonder.co.uk Ablecare Homes Miss Emma-Louise Marshall Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. May accommodate up to 12 persons aged 65 years and over requiring personal care The Flat should be shared by couples that have expressed a clear wish to share and who are: a) married couples b) living as a couple prior to admission c) living together in the community prior to admission May accommodate one named person aged 59 for one week requiring respite care 24th February 2006 3. Date of last inspection Brief Description of the Service: Patron House is a residential care home providing accommodation and personal care for a maximum of 12 persons aged 65 years and over. There is a flat within the homes that can be offered to couples needing care, who wish to share. The home is a detached property in a residential suburb in the city of Bristol. Accommodation is arranged over two floors, and a stair lift is provided. The home has a very homely feel and is comfortably furnished. Well-kept gardens surround the property. Ablecare Homes Ltd. own and operate four homes in the Bristol area, Patron House being one of those. The other homes are Rosewood House and Belvedere Lodge, also in Westbury-on-Trym and Crossley House in Winterbourne, South Gloucestershire. The business is a family concern overseen by Mrs Sam Hawker, one of the directors of the company. The registered manager of the home is Miss Emma Marshall. The cost of placement at the home is between £400 – 520.00 per week and is dependent upon assessed need. Additional costs are made for a range of services and these are detailed in the Homes Brochure. Prospective residents are able to find about the home by requesting a copy of this from the Home Manager. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place over 4.5 hours and was completed in one day. The manager was present during the inspection and participated in the process. Evidence was gained from a whole range of different sources, including: • Information provided by the manager in the pre-inspection questionnaire • Information taken from resident survey forms • Directly speaking with residents • Case tracking a number of residents • A brief look around the home • Examination of the homes records • Observation of staff practices and interaction with the residents. The overall analysis is that the home is a good place in which to live and to work. What the service does well: What has improved since the last inspection? The home continues to provide residents with good care and a safe and comfortable home in which to live. No requirements or recommendations were made following the last inspection in February. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 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 Patron House DS0000026513.V310689.R01.S.doc Version 5.2 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): 1, 2, 3, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Placement is only offered to those whose needs can be met and prospective residents are provided with written information about the home, and can therefore make an informed choice about choosing the home. EVIDENCE: The home’s statement of purpose and service user guide is unchanged since the last inspection and therefore continues to meet the standard required. Copies of both documents are available in the main hallway of the home. Those resident’s who completed the CSCI survey, said they had been provided with information about the home prior to taking up residency. Each resident is provided with a statement of terms and conditions at the start of their stay in the home. The manager explained that in the main residents who come to live at Patron House are privately funded. When a resident is funded by the local authority a contract would be set up with the funding authority – currently this is in place for only one resident. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 9 The home will not admit anyone into the home until after an assessment of the prospective residents needs has been undertaken. The manager will visit a prospective resident in either their own home, or the hospital. A number of residents have moved to live at the home, to be near their Bristol relatives – in these circumstances the manager will obtain as much information as possible from family and social workers, in order to be able to make a judgement that the home can meet the person’s needs. This is good practice and ensures that placement is only offered to those people whose needs can be met. The home offers placement to older people. It cannot accommodate those with any form of dementia however, will continue to care for those who develop mild memory problems and confusion, as long as the home can meet their needs and there is no detrimental affect upon the other residents. The home currently has 11 residents – the double flat accommodating just one person. Where appropriate, people are encouraged to visit the home prior to moving to live at the home. One resident stated that they had visited the home the previous year when they were planning their future, and had instantly liked the home for its “family-run” feel. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 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 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes care planning processes ensure that residents are well cared for and their needs are met. EVIDENCE: Three care plans were looked at, including that of the most recently admitted resident. They each contained a detailed assessment of the person and identified the specific care needs and how these should be met. The plans were person-centred, evidencing that the home looks at each resident as an individual. Where this was appropriate the resident had signed their agreement to the care plan. The home maintains a record of any visits by healthcare professionals. Examination of the daily records evidenced that the GP is contacted and visits, when residents are ill. Also chiropodists, opticians, and the district nursing services, are regular visitors to the home. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 11 The home has safe procedures in place for the ordering, receipt, storage, administration and disposal of medicines. Staff will not administer medications to the residents until they have been trained and have been deemed as competent to do so. Evidence of those who have completed the training was seen. Staff were observed going about their duties in a friendly and calm manner and responding to the residents in a familiar style. Each resident was treated with respect. One resident said, “they are all so kind and helpful”, whilst another said, “we have a good laugh”. The manager explained that the home would try and look after any resident whose health had deteriorated, including that of someone with palliative care needs. Each case would be considered on its own merits. The home would need to be supported by district nursing services and hospice nurses, in meeting the healthcare needs. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can participate in a number of differing social activities and are provided with nicely presented, home cooked meals. EVIDENCE: Two residents went out in the afternoon, on the day of the inspection, to a local club – one had recently started attending the club and said they looked forward to going. One other resident went into the village prior to the lunchtime meal and their meal was kept back for them. This evidences that the home encourages the residents to be as independent as possible and to retain their involvement in the community. In addition, the home arranges some activities using external entertainers. Residents can choose not to participate in any activity if they so wish. The hairdresser calls into the home each week – one person said it was important to them to have their hair done every week. Three residents have recently had a trip out to the Zoo. A number of the residents said they liked to sit quietly and read their newspapers. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 13 Residents are provided with a well balanced diet, and they made very positive comments about the food, “The food is really good”. A gong is sounded when lunch is ready. On the day of inspection, steak and kidney pie with fresh vegetables and potatoes was served followed by a trifle. One resident commented on the CSCI survey form that there had initially been a few “hiccups” in getting their dietary requirements met, but these were now resolved, and everything was fine. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 14 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be assured that they will be listened to and acted upon and that they will be safeguarded from harm. EVIDENCE: The homes complaints procedure is included in the homes statement of purpose and displayed in the main reception area. Residents spoken with during the course of the inspection said they would talk to the staff if they were not happy about anything. The home has not received any complaints since the last inspection, and maintains good relations with not only the residents, but also their families. One resident said, “there is nothing to complain about” whilst another said, “this is my home and I am very happy here”. The home had just received a complimentary letter, and this evidenced the good relationship the home had established with the family. During the course of the inspection visit, it was obvious that all the residents felt able to express themselves and conversed easily with the staff. The home has policies and procedures in place to ensure that the residents are safeguarded from any form of abuse. Some staff have attended adult abuse awareness training delivered by the Bristol City Council, whilst others will be attending training that the home has arranged for later in the year. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 15 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is safe, comfortable and well furnished. EVIDENCE: The home is a detached residence with accommodation provided over two floors. The shared communal space is on the ground floor and consists of a lounge, dining room, and a quiet area, that leads out into the patio and rear gardens. All areas viewed were clean, tidy and domestically furnished. There is a stair lift in place to enable the residents to access to first floor. Despite the installation of this equipment, it is still possible for those able to walk up and down the stairs to do so. A number of the residents are able to use this independently, whilst others needs some assistance. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 16 The home looks well maintained and any repairs and alterations are reported to the owners. Ablecare Homes have their own maintenance team, who look after all four homes. The home has two bathrooms, one on each floor, but the ground floor bathroom is little used and has no adaptations. However, the home does have a battery operated bath seat that can be made available for residents. The bathroom upstairs is fitted with a swivel bather seat, and this meets the needs of the current residents. There is one toilet located on the ground floor. A number of aids and adaptations were observed throughout the home, including raised toilet seats, grab rails, a call-bell system, walking frames and the stair lift. There is level access to the front of the home, and just one small step out on to the patio. There are a number of steps down to the rear gardens but grab rails are fitted. Apart from the double flat, the ten other bedrooms are for single occupancy, each having their own ensuite toilet, and wash hand basin. The rooms are comfortably furnished. Residents are encouraged to have their own belongings around them. The home was warm, well lit, clean and tidy and free from any malodour. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 17 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are cared for by skilled staff who are trained and competent to meet their care needs. EVIDENCE: The staffing levels at the home are appropriate to meet the needs of the current residents, many of whom are still fairly independent. The staff rota’s show that each morning there are two care staff, two in the afternoon and evening, and over night one waking member of staff. On the day of inspection, the home manager plus one other care staff and the cook were on duty. The home currently has only one member of staff who is trained to NVQ level 2 (10 ), but four are working towards achieving the award (50 ). The home should continue to commit to the NVQ training programme to ensure they meet the 50 target. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 18 The home has good recruitment procedures in place to ensure that the right type of people are employed at the home, who will care for the residents, in line with the home’s policies and procedures. Since the last inspection there has been very little changes in the staff team. One member of staff had transferred to work in the home from another of the Ablecare homes – their personnel file had not been transferred over to the home, but the evidence that safe vetting procedures had been followed have subsequently provided to CSCI. Alongside the NVQ training programme, other training sessions are arranged. A look at the staff training files evidenced that the team have attended course in manual handling and moving people, food hygiene, first aid and fire training. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 19 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, 33, 35, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is well managed and run in their best interests. EVIDENCE: The home manager Emma Marshall has been in post for a number of years and has already achieved the registered managers award. She has recently received an “Avon Young Care Manager” award from the Care Learning Network. During this inspection she demonstrated a good understanding of her role, each of the residents particular needs, and a commitment to providing a good service for the residents. Since the last inspection the manager has recruited a senior care assistant to support her in the management of the home. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 20 Observations of the working practices, and the interactions between manager, residents and staff, evidenced that the home is run in the resident’s best interests, their views are important, that they are listened to and any concerns are acted upon. Ablecare Homes completed a ‘customer service satisfaction’ questionnaire survey in April and the results showed that in general the residents were happy with the service received. The survey covered meals, choice of activities arranged, home arrangements, involvement in care planning and ability to express any concerns or complaints. The director completes monthly reports for CSCI, visiting the home on a regular basis and monitoring the standards of resident and staff satisfaction and dealing with any management issues. The home holds monies for a number of residents. An examination of the accounts for a sample of residents were checked and tallied with amounts held. The home is well maintained both inside and out, and no reasons to suggest that the health, safety and welfare of residents and staff is in any way compromised. The home has a good reporting mechanism in place to ensure that any repairs or maintenance tasks get completed. The fire records were checked and evidenced that all the necessary checks of the alarm system, emergency lighting and fire fighting equipment have taken place. Fire instruction and drills are carried out with the staff team on a regular basis. Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 21 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 3 3 Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Patron House DS0000026513.V310689.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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