Inspection on 24/02/06 for Patron House

This inspection was carried out on 24th February 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 21/09/06

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 Unannounced Inspection 24th February 2006 09:45 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.V283660.R01.S.doc Version 5.1 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.V283660.R01.S.doc Version 5.1 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 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.V283660.R01.S.doc Version 5.1 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 9th August 2005 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 set in 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 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. Patron House DS0000026513.V283660.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection as part of the annual inspection programme to examine the standards of care, and to check on the homes progress in meeting the requirements and recommendations issued following the last inspection in August 2005. This inspection took place over one day and not all standards were assessed. Evidence was gained from observation, discussions with some of the residents, one staff member and the manager. Some of the homes records were examined. What the service does well: What has improved since the last inspection? 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.V283660.R01.S.doc Version 5.1 Page 6 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.V283660.R01.S.doc Version 5.1 Page 7 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 The homes written information and admissions procedures, ensures that prospective residents are able to make an informed choice about the home and placement is only offered to those whose needs can be met. EVIDENCE: The home’s statement of purpose and service user guide has not been changed since the last inspection and is available within the home. A copy is provided to all service users, and includes a sample copy of the contract of terms and conditions. The home has an admissions procedure that involves the manager visiting any prospective resident in either their own home, or the hospital. The most recent person admitted into the home came from “out-of-county” and in this case the manager had obtained a care management assessment and had liaised with the local family members. This is good practice and ensures that placement is only offered to those people whose needs can be met. Patron House DS0000026513.V283660.R01.S.doc Version 5.1 Page 8 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 had visited the home with their daughter, and had then chosen to live at Patron House. Patron House DS0000026513.V283660.R01.S.doc Version 5.1 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 and 10 Care planning processes ensure that individual needs are identified and residents can expect to have their needs met. Improvements have been made in the management of medications. EVIDENCE: The care planning files for three people were looked at, and evidenced that the home looks to address each persons needs on an individual basis. The home records the overall objective of the care plan, the options explored, and the views of the service user and carers. The plans are comprehensive and detail the assistance required with personal care, mobility, safety issues, mental and emotional needs, any health needs and social networks and daily living needs. Where possible the resident had signed their agreement to the plans. In reading the plans, it was easy to get a clear picture of the residents needs and what actions the staff are required to take. Patron House DS0000026513.V283660.R01.S.doc Version 5.1 Page 10 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. Residents confirmed they were happy with the standard of care provided. “They look after us very well”. One resident was very complimentary about how the staff team were helping her to settle in at the home. The home’s policy and procedure for ‘safe administration of medication’ is unchanged. However, the home has reviewed the way in which each resident’s medications are stored, following a good practice recommendation in the last inspection report. The majority of medications are supplied by the pharmacist in blister packs, but those that are not, are now stored in individually named containers. Medication training is provided by the pharmacist, and medicine is only administered by those staff who have undertaken the training and have then been deemed competent to do so. One resident has chosen to be independent and “self-administer” her own medications. The appropriate risk assessments and consent were in place, and the home has procedures in place to oversee arrangements. During the course of the inspection the staff were observed to interact well with the residents, being attentive and friendly. One resident said that “everyone is so kind”, whilst another said “that nothing was too much trouble”. All residents spoken with said that when they were assisted with personal care tasks, this was done with respect to privacy. Staff were seen knocking on doors before entering. Patron House DS0000026513.V283660.R01.S.doc Version 5.1 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, 13, 14 and 15 Recreational activities are organised by the home but residents are also encouraged to continue with any outside interests they may have. Residents are provided with home cooked, nutritious and well presented meals. EVIDENCE: A number of the residents continue to attend clubs and activities outside of the home, having previously lived in the local vicinity. Two residents said that they often go out with family members. One resident likes to go out on a daily basis to collect their newspaper. This evidences that the home encourages the residents to be as independent as possible and to retain their involvement in the community. On the other hand, residents can choose not to participate in any of the activities arranged by the home. One person, who said that they liked a peaceful life and no noise, chose to remain in her own room every day. 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, a fish lunch was served followed by fruit crumble and custard. The new resident said, “the carer has asked me what sort of food I like”. Residents can choose to take their meals in their own rooms, but most had lunch in the dining room Patron House DS0000026513.V283660.R01.S.doc Version 5.1 Page 12 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): This section was not assessed on this inspection. EVIDENCE: The home met the standards required, at the previous inspection in August 2005. Patron House DS0000026513.V283660.R01.S.doc Version 5.1 Page 13 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 Residents are cared for in a warm, homely, and comfortable environment, that is furnished with quality furniture and fittings. The home is well maintained, clean and tidy. 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 the quiet area, that leads out into the patio and 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.V283660.R01.S.doc Version 5.1 Page 14 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. One resident has a door key to her room, but all doors are lockable. The home was warm, well lit, clean and tidy and free from any malodour. Patron House DS0000026513.V283660.R01.S.doc Version 5.1 Page 15 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 Residents are cared for by staff who are competent and able to meet their needs. EVIDENCE: On the day of inspection, the home manager plus two other care staff and the cook were on duty. This is adequate to meet the needs of the current residents. The cook only works part time, so at other times when she is not working, another member of care staff will work. The home has a programme of NVQ training in progress, and also a programme of other training sessions. 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. 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 philosophy of care. The home completes pre-employment checks on all prospective staff but must ensure that written or email confirmation is received, prior to the commencement of employment. One such issue was discussed with the manager during the inspection. Patron House DS0000026513.V283660.R01.S.doc Version 5.1 Page 16 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, 33 and 35 Residents live in a home that is well managed and run in their best interests. EVIDENCE: The home manager has been in post for a number of years and has already achieved the registered managers award. She is currently work towards the NVQ skills assessor A1 award – this will enable her to assessor her staff who are working on the NVQ level 2 awards. During this inspection she demonstrated a good understanding of her role, and a commitment to providing a good service for the residents. The manager is hoping to recruit a senior care assistant to support her in the management of the home. The role of this person will be discussed at the next inspection. Patron House DS0000026513.V283660.R01.S.doc Version 5.1 Page 17 Abelcare Homes have just sent out their annual ‘customer service satisfaction’ questionnaire. The director completes monthly reports for CSCI, visiting the home and monitoring standards. It is evident that resident’s views are valued, and the home is run in their best interests. The home holds monies for a number of residents. An examination of the homes accounts for three residents tallied with the monies held. A full health and safety inspection was not carried on this visit, however there were no reasons to suggest that the health, safety and welfare of residents and staff are in any way compromised. The fire records were checked though, since a requirement had been issued after the last inspection. The annual check, of the fire alarm system, by an external contractor, is due again in March, and the fire officer last visited the home in December 2005 – all was found to be satisfactory. The fire log 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.V283660.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 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 X 17 X 18 X 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X X Patron House DS0000026513.V283660.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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.V283660.R01.S.doc Version 5.1 Page 20 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. Extracts may not be used or reproduced without the express permission of CSCI Patron House DS0000026513.V283660.R01.S.doc Version 5.1 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!