CARE HOMES FOR OLDER PEOPLE
Penberthy House 111 Mount Wise Newquay Cornwall TR7 2BT Lead Inspector
Mike Dennis Unannounced Inspection 22/11/05 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Penberthy House Address 111 Mount Wise Newquay Cornwall TR7 2BT 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) 01637 873845 01637 852891 Cornwall Care Limited Mrs Sharon Colston Care Home 35 Category(ies) of Dementia - over 65 years of age (16), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (10), Old age, not falling within any other category (25), Physical disability (7) Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. 6. Service users to include up to 25 adults of old age (OP) Service users to include up to 7 adults aged 50 years and over with a physical disability (PD) Service users to include up to 16 adults aged over 65 years with dementia (DE{E}) Service users to include up to 10 adults aged over 65 with a mental illness (MD{E}) To include one regular respite service user under the age of 65 years Total number of service users not to exceed a maximum of 35 Date of last inspection 1st June 2005 Brief Description of the Service: Penberthy House is a Care Home operated by Cornwall Care Ltd. The home is situated close to the town centre of Newquay. It is a period property with a more modern extension. The home offers long term and respite care for 35 older people some of who have dementia. In addition limited day care is offered and there is a six-bed rehabilitation unit. A separate staff group operates a domiciliary care agency service from an office in the home. The home operates a no smoking policy and accommodation is provided on three floors in the extension, and two in the original building. A lift provides access from the ground floor to the first and second floors. A stair lift is provided on a small stairway in the rehabilitation area. There is one large sitting room on the first floor. There are two sitting rooms on the ground floor and a dining room with another sitting area at one end. There are ample toilets and bathing facilities. All rooms have call bells. Meals are prepared in a well-equipped kitchen on the ground floor and served in a well-furbished dining room on the ground floor, it is accessible to all service users. There is a hair dressing salon that provides an important service. The grounds are kept tidy and are accessible to service users. Wooden seating and tables are provided. Limited car parking space is provided at the front and to the side of the home. Suitably qualified care staff provide personal care within a relaxed, friendly atmosphere. There are opportunities for socialising and visitors are openly encouraged.
Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 22nd. November 2005 over a six hour period. The inspector met with the Acting Manager and one assistant manager. A selection of staff from all departments were spoken with and eight service users. Two relatives also stated their views concerning the home which proved to be positive. During the course of the day the inspector observed groups of service users engaged in a number of activities. Staff were observed to be tending to service user needs whilst respecting their dignity. Various records, policies and procedures were inspected. The inspector visited all parts of the building and noted a satisfactory standard of hygiene and maintenance. Service users commented favourably on the overall service received, and acknowledged the dedication of staff. Positive outcomes were noted. The Registered Manager is currently on secondment to another of the Cornwall Care Homes. The Acting Manager is Linda Vokins. Some internal reconfiguration of room usage has occurred since the last inspection resulting in the redeployment of the administration office, Domiciliary Care office and treatment room (physio/OT) . What the service does well:
Cornwall Care as a company have established sound and comprehensive policies and procedures which aim to ensure those in their care are fully protected with their needs being met. Training opportunities remain positive, especially in dementia care with all staff progressing through the different levels of the courses available. The Intermediate Care Unit was seen to be functioning at full capacity. Service users of this facility all commended the service as being an essential part of their rehabilitation. Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 6 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. Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Service users are fully assessed prior to their admission to the home. Service users are assessed and referred solely for the intermediate care unit. EVIDENCE: Four service user files were inspected and case tracked. All contained information pertaining to pre-admission assessment. The information provided included :- continence assessment, pain assessment, risk assessments and general details of daily care requirements, medication and health care requirements. The pre-admission assessments form the basis of the initial care plan. Training is supplied to support this programme. The assessment process is undertaken by the managers of the home and is now facilitated by I.T. programmes. Assessments are undertaken with the service users family or representatives, health professionals, and a copy of the social services assessment is obtained where applicable. The assessment includes a scoring system for calculation of dependency. Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 9 There is a dedicated unit on the first floor of the home for the provision of intermediate care. Up to six service users can be cared for at any one time and stay for a maximum of six weeks. The unit was full on the day of inspection. This unit is staffed separately to the home, during the daytime. The homes’ night staff care for the service users overnight. There is Coordinator and 4 care staff all of whom had achieved the NVQ level 2 in care and have received specific rehabilitation training. They undertake statutory training with the homes’ staff. The unit comprised of a large lounge with a dining area, a kitchen, a bathroom, another toilet and a gym. Each bedroom had a lockable facility for the storage of medicines. The Coordinator stated that service users were helped to maximise their independence. This statement was confirmed by the service users themselves. A Physiotherapist and an Occupational Therapist are employed on a part time basis and were very much involved in the rehabilitation process. Exercise sheets are developed and records kept. There were files maintained for each service user, which were comprehensive, and informative and daily records were maintained. Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 The health care needs of service users are identified, planned for and met. Comprehensive policies and procedures for dealing with medicines are followed Service users are treated with dignity and respect EVIDENCE: Four Individual Plans of Care were inspected. The care plans follow on from the pre-admission assessments and are reviewed monthly. Managers and key workers are responsible for the upkeep of the plans of care. Service users, their families and other professionals are involved in the review process. They were seen to contain full and relevant information, to include Risk Assessments, pertaining to the health, personal and social care needs of that individual. In addition information is gathered regarding the service users past life experiences and interests. This information is used to promote an Active Care programme for that individual. Appropriate professionals from other disciplines frequently visit the home to provide for general health care, ie. G.P’s, Community Nurses, Opticians, Dentists etc.
Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 11 The home’s medication policies are adhered to by all staff. The manager and assistant managers are the nominated persons who administer medication. The majority of the drugs are in blister packs. All medication including controlled drugs was recorded correctly as received, administered and disposed. . The controlled drugs were stored to comply with drug regulations. Service users were observed being treated with respect and dignity by staff Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 The routines of daily living and activities made available are flexible and varied EVIDENCE: The service users individual care plan has a detailed section regarding their interests and choice, and activities are planned to encompass these interests. The home arranges and facilitates visiting entertainment and in-house activities. An activities coordinator plans events following consultation with service users. Planned activities are displayed on a notice board. Social Profiling or Active Care is promoted at this home. This in turn allows staff to target individual service users with activities most likely to provide stimulation Various organised activities were taking place throughout the day of inspection. Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 Service users legal rights are protected EVIDENCE: The postal voting system is used at the home. Service users can visit the polling station if able. Advocacy services are accessible via age Concern. Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The location and layout of the home is suitable for it’s stated purpose and provides a safe and well maintained environment. The home was clean, hygienic and free from offensive odours providing an attractive and homely place to live EVIDENCE: The home provides a safe and well-maintained environment for the service users. The registered manager discusses refurbishment and development issues with the company at the annual finance meeting. This results in a maintenance and improvement plan being implemented. The home employs a general assistant who deals with minor defects and maintains general standards within the home. Re-decoration of bedrooms occurs when each room becomes vacant. All bedrooms have received new curtains and bedcovers. It was noted that, on inspection of the premises, all was found to be clean and tidy. Equipment was working correctly and in order. Policies and procedures
Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 15 for the control of infection were available and in order. Service users stated they were happy with the accommodation and their surroundings. Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 Robust recruitment policies and procedures are implemented. All staff are supported and Inducted through good training opportunities. A positive number of staff are on duty to meet the service user’s needs. EVIDENCE: The staff team shows a positive regard for service users and appears very organised. Additional staff are on duty at peak times of activity during the day. In addition to care staff there are 2/3 domestics and 1 laundry staff member on duty each morning. The duty rota indicates that 5 care staff are on duty during the mornings, 4 throughout the afternoon and 3 on duty in the evenings. Waking night staff number 2. In addition managers, domestic and catering staff are on duty Staff recruitment is conducted in line with the home’s policies and procedures. Evidence obtained from staff files indicates that references, CRB and POVA checks are taken up prior to interview. All staff undertake Induction Training. . NVQ training is encouraged as demonstrated by the majority of staff having obtained awards at various levels. Individual training profiles for staff are kept up to date with accurate information of progress made. Staff are receiving supervision and an appraisal system is in place. Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their quality of life.
Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 17 Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 18 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, and 33. The management of Penberthy House strive to maintain and improve a good quality of care and lifestyle for the service users and promote their health, safety and welfare. EVIDENCE: The Registered Manager, Sharon Colston, is currently on secondment to another home within Cornwall Care Ltd. Linda Vokins is acting up and fulfilling the managers role. Linda’s qualifications include: an NVQ level 3, D32 andD33 assessors award and a NEBBS management certificate. She has considerable experience at management level. A recent quality assurance was undertaken, the results of which were positive. Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X X X Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 20 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 Penberthy House DS0000008940.V256343.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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