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Inspection on 21/11/06 for Penhill Residential Home

Also see our care home review for Penhill Residential Home for more information

This inspection was carried out on 21st November 2006.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Admission procedures were resident focussed and supportive to residents. Care plans accurately reflect the residents` needs and how they will be met. Residents and their families are involved in this process wherever possible. Systems are in place to help ensure that there is consistency in assessing, planning, implementing and evaluating the resident`s care at the required times. Staff have a good awareness of individuals` needs and treat the residents in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. There are safe systems of medication. Residents benefit from a varied activities programme, which is both enjoyable, stimulating and meets individual preferences and expectations. Meals were well presented and menus verify a healthy well balanced diet for all residents who benefit from a wide variety of choice. The home is comfortable, tastefully decorated and furnished. It provides a safe, peaceful and well-maintained environment for the residents. Adequate staffing levels help to ensure that resident`s needs are met. Staffing levels are increased should the dependency levels of the residents change. The recruitment procedure is robust and serves to protect vulnerable residents. The home was well organised and managed by an effective, stable management team that promoted the views and interests of the residents. Penhill provides a very high standard of care to its residents, who appear to be happy with the service they receive and are content with their daily lives.

What has improved since the last inspection?

As a result of a previous requirement from the last inspection staff have received specialist training appropriate to meet the care needs of residents, which has raised their knowledge and competence. Training has included Mental Health of Older People particularly Dementia, Managing Continence and Dealing with Challenging Behaviour. Since the last inspection the kitchen has been redecorated and the worktops have been renewed, a large opening has been made in the kitchen wall, which opens out onto the dining room. The opening has allowed for a much lighter brighter feel to the kitchen and dining room and it was nice to see the cook and the residents joining in conversations throughout the day. The dining room has also been redecorated and new tablecloths have been provided. The activities programme has increased including outings, events, and general activities in the home.

What the care home could do better:

All of the National Minimum Standards assessed at this inspection were met. No statutory requirements have been made as a result of this inspection.

CARE HOMES FOR OLDER PEOPLE Penhill Residential Home 81 Station Road Shirehampton Bristol BS11 9TY Lead Inspector Wendy Kirby Key Unannounced Inspection 21st November 2006 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 Penhill Residential Home DS0000026623.V318131.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. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Penhill Residential Home Address 81 Station Road Shirehampton Bristol BS11 9TY 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 9822685 0117 9822685 jon@penhill.com Mr Stephen Francis Ann Mrs Barbara Ann Mr Stephen Francis Ann Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 17 persons aged 65 years and over requiring personal care. 24th March 2006 Date of last inspection Brief Description of the Service: Penhill is a privately owned and operated care home located in a residential suburb of Bristol. The proprietors are Mr Steven Ann and Mrs Barbara Ann, who is also the registered manager. The home is registered with the Commission for Social Care Inspection (CSCI) to provide accommodation and personal care for 17 persons aged 65 years and over. The property is a large, detached and extended house. The accommodation is arranged over two levels and is surrounded by well kept-gardens. Accommodation is provided in one shared and 15 single rooms. Communal space includes a lounge, conservatory and extended dining room. A lift and assisted bathing facilities are also provided in the home. The cost per week to reside at Penhill ranges from £410.00 to £475.00. Fees are reviewed annually. This weekly fee does not include provision for items such as hairdressing, chiropody, dental, ophthalmic, or audiology services. Prospective residents can be provided with information about the home by accessing the Service Users Guide, which will detail the services and facilities available at the home. Penhill Residential Home DS0000026623.V318131.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 inspection conducted as part of the annual inspection process. The inspection lasted one day. The inspector sent questionnaires “Have your say” to all residents in the home prior to the inspection and thirteen were completed and returned. “Comment Cards” were also sent to relatives, visitors and visiting health and social care professionals, nineteen of these were also completed and returned. Information from these has been collated and is detailed throughout the report. The inspector spent time throughout the visit in discussions with Mr and Mrs Ann the registered providers, Mrs Ann is also the registered manager. Their sons Mr Jonathan Ann and Mr Christopher Ann were also present as the deputy managers each having various roles and responsibilities, which are detailed later in the report. A number of records and files relating to the day-to-day running and management of the home were examined. Three residents were case tracked. Their care plans and care files were examined. The inspector had discussions with the residents and observed them indirectly going about their daily routines. The inspector toured the premises accompanied by the family. Feedback was given on the outcome of the inspection. What the service does well: Admission procedures were resident focussed and supportive to residents. Care plans accurately reflect the residents’ needs and how they will be met. Residents and their families are involved in this process wherever possible. Systems are in place to help ensure that there is consistency in assessing, planning, implementing and evaluating the resident’s care at the required times. Staff have a good awareness of individuals’ needs and treat the residents in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. There are safe systems of medication. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 6 Residents benefit from a varied activities programme, which is both enjoyable, stimulating and meets individual preferences and expectations. Meals were well presented and menus verify a healthy well balanced diet for all residents who benefit from a wide variety of choice. The home is comfortable, tastefully decorated and furnished. It provides a safe, peaceful and well-maintained environment for the residents. Adequate staffing levels help to ensure that resident’s needs are met. Staffing levels are increased should the dependency levels of the residents change. The recruitment procedure is robust and serves to protect vulnerable residents. The home was well organised and managed by an effective, stable management team that promoted the views and interests of the residents. Penhill provides a very high standard of care to its residents, who appear to be happy with the service they receive and are content with their daily lives. What has improved since the last inspection? What they could do better: Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 7 All of the National Minimum Standards assessed at this inspection were met. No statutory requirements have been made as a result of this inspection. 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. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 8 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 Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents or their families have all relevant information to make a decision about the nature of the home. Residents receive a contract/statement of terms and conditions. Prospective residents’ needs are assessed prior to admission to determine the suitability of placement to ensure that their needs can be met. Trial visits give prospective residents an opportunity to assess the nature of the home. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 10 EVIDENCE: A brochure containing a service user guide and statement of purpose is made available to prospective residents and their families. All thirteen residents stated in their surveys that they and their families had received adequate information about the home prior to admission. One relative stated, “We were given a brochure, which provided us with valuable information about the services available”. The Inspector looked at pre-admission assessments, which were fully completed and informative. Mrs Ann and Mr Jonathan Ann explained the process they follow and that the prospective resident, family and carers are involved in the pre-assessment. The information is used to determine the suitability of the placement. Where possible the home also obtains comprehensive assessments and care plans from other professionals involved for example, social workers and hospital staff. The information gathered preadmission should provide a sound benchmark of the resident’s ability and state of health prior to admission. Residents’ files contained contracts and terms and conditions, which are signed on admission. All residents confirmed in their surveys that they had received a written contract and that the information was very clear. Prospective residents and families are encouraged to visit the home either for the day or perhaps for lunch dependent on their wishes. Residents confirmed in their surveys that, “I spent some time at the home before I decided to move in” and “When I visited the home I felt the atmosphere was just right for me”. Relatives comments included, “We visited other homes but instantly felt the friendliness and warmth with this one. We knew there and then that this was the right place” and “ I visited several homes for my mother but felt that Penhill stood out from them all”. A month’s trial period on both sides is usually undertaken to ensure that everyone is happy with the arrangements and to ensure that the placement is suitable. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has good systems for meeting and monitoring residents’ health and personal care needs in consultation with residents. There are safe systems of practice in receiving, storing, administering, and disposing of drugs. Staff were able to demonstrate a good awareness of individuals’ needs and treat the residents in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 12 EVIDENCE: From the pre admission assessments the staff are able to develop a set of care plans based on identified needs. During the first months trial period the residents’ plans are reviewed weekly and developed accordingly. Plans were completed with regards to social needs including, psychological, emotional, and cultural needs which demonstrate that the home takes a holistic approach to the provision of care. These plans were relatively new to the home and the staff had worked extremely hard in developing them with the residents. All plans were detailed and personalised including personal preferences, likes and dislikes. The plans demonstrated that the homes philosophy centralises on empowering residents and encourages residents to maintain independence, autonomy and choice. All records evidenced consistency in assessing, planning and evaluating the resident’s care on a regular basis. The home conducts regular care review meetings for each resident, which includes the involvement of family members and key worker wherever possible. This allows the opportunity to discuss and evaluate residents’ care plans and any issues or concerns they may have. Relatives informed the inspector in their comment cards that, “We are always kept informed of any matters concerning my mother and what arrangements have been made” and “The owners and all the staff treat all residents as individuals and have planned my relatives care appropriately to her needs. There is always a solution found for any problems that may arise”. All staff were able to demonstrate good relationships with individuals and were knowledgeable about the care needs of the residents living in the home. Records of the General Practitioner (GP) visits with residents and the outcomes were documented. Specialist referrals and visits from other professionals including District Nurses, Chiropractors, Dentists and Opticians were also seen. All residents’ surveys stated that they always felt that they received the medical support they needed. Visiting health professionals comment cards stated, “Residents are treated with respect and individual preferences are always catered for”, “This home has very caring staff, who promote continuity of care” and “I would be more than happy for my relative to stay in this home, staff are pleasant and friendly”. One relative stated, “ My relatives overall health has improved and they are happy and content to be living at Penhill” Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 13 The inspector spent time with the senior care assistant to discuss the policies and procedures for ordering, storing, administering and disposing of medications. All systems in place are effective and well managed. Each care file includes a medication profile which details prescribed tablets, their purpose and any possible side effects. This is good practice. Opportunity was taken to inspect the medication system. The home operates a monitored dosage system for the administration of medication, which is supplied at regular intervals by the local pharmacist. The GP conducts a medication review for all residents every six months. The home also keeps an accurate stock check of medicines given on an as required basis. Fridge temperatures are recorded daily. All staff receive “Medication Competency” training annually. Three residents stated in their surveys “ medication is always given on time”. Staff were witnessed knocking on residents doors before entering confirming respect for the residents individual privacy and dignity at all times. Relatives stated, “Residents always look so nice and well groomed” and “Residents are always treated with dignity and respect”. All rooms have a telephone point from which residents can make and receive calls. Private telephone lines can be installed. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are encouraged and supported to live a lifestyle, which is both enjoyable, stimulating and meets individual preferences and expectations. Residents maintain family contact and staff encourage family and friends to join in with activities and any outings. Relatives feel they can advocate openly on behalf on their relative. Residents receive a varied and wholesome diet that they are able to influence. EVIDENCE: In consultation with the residents’ staff develop a monthly timetable of activities and forthcoming events. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 15 The home has introduced an innovative idea on how to provide residents with this information and much more whereby it can be accessed through their televisions on a selected channel. This channel is also available on the homes television in the two lounge areas; the inspector witnessed two residents in one of the lounges looking at the channel to find out what was for lunch. There is also a flat screen television tuned into the information channel throughout the day in the reception area by the visitors’ book. The channel provides residents, relatives and visitors valuable information including, forthcoming events, staff working in the home with photographs, daily menus, daily activities, the weather forecast and the homes complaints, comments and compliments policy and procedure. Weekly trips are arranged and residents like to go to local public houses for lunch, Harry Ramsdens, shopping at The Mall and places of interest. The residents also enjoy regular musical entertainers who visit the home and activities provided throughout the week include, bingo, indoor games, quiz time, and reminiscence therapy. Special events are arranged throughout the year. This year the home had a family barbeque on bonfire night where seventy guests attended which was a great success and thoroughly enjoyed. Other events arranged this month include a Christmas Party, a performance of Swan Lake at the Hippodrome, children from a local school will perform a carol concert, and the brownies visit to deliver Christmas gifts to the residents. All residents’ surveys confirmed that there is a varied activities programme and comments included, “The activities are 100 ” and “I am very contended with everything on offer”. One relative informed the inspector, “During the year the home arranges various social activities and meals for the residents and their families, which are greatly enjoyed”. The home operates an open door policy for visitors to the home. Residents are welcome to invite visitors to join them for a meal and can arrange for private celebrations with families and friends for example a birthday party. Relatives stated, “We are always made to feel welcome when visiting” and “We are always informed of what activities and events have been arranged in the home”. As stated in the service users guide residents are supported to attend their local place of worship. Methodist services are held fortnightly and a member of the local Church visits monthly for a communion service. Residents are free to worship as they wish and any arrangements for services or communal prayers within the home are made in accordance with residents’ wishes and are entirely voluntary. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 16 Staff use their expertise and knowledge of the residents, personalities, preferences and ability to eat independently, when seating them for lunch. All dining areas were light, spacious and the tables were attractively laid with tablecloths and condiments. The inspector spent time with the cook and kitchen assistant who demonstrated a competent awareness of individual requirements and needs of the residents, including personal preferences. They spend time with the residents on a daily basis to see if they have enjoyed their meal and if they are happy with the menus. The menu rota displays traditional meals and choice is available at each setting. The menus are reviewed to reflect seasonal trends and availability of produce. Extras are ordered on request for birthdays and special occasions. Fresh fruit and vegetables are delivered daily and fruit is on offer throughout the day. The inspector enjoyed a cooked meal during the inspection, which was chicken casserole with rice and vegetables followed by treacle sponge, and custard, it was delicious. Surveys confirmed that residents were very satisfied with the meals provided. Comments included, “The food is perfect, excellent choice of meals and well presented” and “The meals are varied, satisfying and I am given a daily alternative choice”. The kitchen was clean and spacious and stores exhibited a good range of foods. Documentation was provided to show the inspector that required temperature checks were being carried out on fridges and freezers and that food was also being probed after being cooked before serving. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are robust policies in place to manage complaints or allegations of abuse. There are good arrangements in place for staff training and awareness of protection of vulnerable adults. EVIDENCE: As mentioned previously a copy of the complaints procedure is on display in the reception area, which means people will know how to obtain the required information if they want to make a complaint. There have been no complaints received. All residents stated in the surveys that they knew who to talk if they were not happy and how to make a complaint. Comments included, “I would be happy to speak to several people, my son, my key worker or Mr and Mrs Ann” and “I have never had cause to complain and am always very happy, I have seen the complaints procedure which is in my room and also on display in the hallway”. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 18 All relatives confirmed in the comment cards, that they were aware of the homes complaints policy and procedure. One relative stated, “As a family we are so happy with how everything is dealt with we have no complaints whatsoever”. The inspector was informed that the home actively promotes staff training and education in the protection of vulnerable adults on induction and by attending training on the Protection of Vulnerable Adults through Bristol City Council. Staff training records evidenced this commitment. A number of staff are undertaking the National Vocational Qualification in care award, and a component of the award addresses issues around the topic of the protection of vulnerable adults from abuse. There are procedures as well as a range of guidance information on the topic of protection of vulnerable adults from abuse’ including the Local Authority “No Secrets” document. The availability of this information should increase staff awareness and understanding of their role in protecting vulnerable adults who live at the home. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,24,26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Penhill is well-maintained and is decorated and furbished to a very high standard. It provides a safe, homely, peaceful environment for all the residents. The home is clean, pleasant and hygienic. EVIDENCE: As Penhills brochure states the home was built in 1926 and is situated conveniently close to local amenities including shops, a library and churches. It has been extended with a newer wing that houses eight rooms, joined to the main house. An accessible passenger lift has also been installed to enable less mobile residents to access the first floor. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 20 Where possible the home has been made accessible to disabled older people and grab rails in all corridors and bathrooms were seen. All areas of the home are tastefully decorated, furnished to a high standard, and well maintained. Great attention has been given to ensure that all areas are homely. Residents are supported to personalise their bedrooms with pictures and ornaments and are able to bring items of furniture should they wish. A conservatory adds a pleasing space for residents to use and overlooks a large mature garden. The gardens have well-stocked flowerbeds, established trees and shrubs, a large fishpond with waterfalls and a well-tended lawn. There are various semi-private seating areas with plenty of sun screening, including a pergola. The gardens provide peace, tranquillity and enjoyment for the residents and visitors throughout the year. Residents were making full use of these areas and their bedrooms on the day of the inspection. The home has adequate bathing facilities that have been fitted with equipment to encourage the independence and the safety of the residents living in the home. The home was clean and smelled fresh and pleasant throughout. The home employs domestic staff on a daily basis. Residents’ surveys confirmed that the home is always fresh and clean and comments included, “There are very high standards of cleaning in all rooms” and “The home is spotless all the time. Kristopher Ann the deputy manager conducts a monthly audit of the premises in order to identify any issues/shortfalls within the environment for example painting and decorating and any repair work required. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Adequate staffing levels help to ensure that resident’s needs are met. Residents are supported and protected by the homes recruitment policy. The residents are cared for by caring staff that are trained and supported by management. EVIDENCE: The manager ensures that staffing levels are indicative of the needs and levels of care required by the residents twenty-four hours a day. The workforce at Penhill is relatively small due to the size of the home. Staff are very loyal to the home and its residents and have worked there a long time. The Ann family are actively involved within the home twenty-four hours a day and the atmosphere between staff and residents on the day of the inspection was that of an extended family. All residents’ surveys agreed that staff were always available when they needed them and listened and acted upon what the residents say. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 22 Comments from residents included, “Staff always have time to listen to what I have to say” and “Everyone is so helpful and always try their best to help me in anyway they can”. Several residents’ and relatives expressed very positive views about staff and the care they receive providing comments, “There are caring and supporting attitudes from all staff at all levels”,” We are very satisfied with all the care provided” and “We cannot praise the staff enough and only hope that this level of care is available should we ever need it”. The recruitment process was examined and all staff records examined showed that the home follows a robust recruitment procedure. Records contained application forms, references, and a CRB (Criminal Records Bureau) disclosure. Jonathan Ann is responsible for targeting training needs for the staff and has devised a system whereby all mandatory updates are arranged, attended and levels of the effectiveness of the training are sought. There is an induction programme, which covers all mandatory training, including Fire, Manual Handling, Health and Safety, COSSH and the Protection of Vulnerable adults. The home has a mentor system where all new staff are linked with and shadow a senior staff member during each shift to enable continuity and continued training throughout the induction process. As a result of the previous inspection the home has been conscientious to target courses for staff that relate specifically to the needs of the residents. These courses include “Dementia Care”, “Caring for the elderly who suffer with depression”, “Management of continence”, “How to look after residents with behaviour that challenges” and “Coping with bereavement and loss”. When discussing the courses they attended staff stated that they were “very enjoyable” and “The courses opened my eyes”. Ninety two per cent of staff now have the NVQ2 equivalent or above and the home continues to support their staff with their NVQ training. Future courses have also been targeted for the managers in the home and dates have been booked for specialist training on developing risk assessments and the assessor’s course for manual handling. These courses should enable them to cascade their knowledge and expertise to all the staff in the home. The training folder was looked at which contained a training matrix and staff certificates for achievement and attendance were on file. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents’ needs and best interests are central to the management approach in the home. Good accounting methods are adopted and policies and procedures are followed correctly when handling residents’ personal money. Staff receive appropriate supervision. The health and safety of residents, staff, and visitors is protected. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 24 EVIDENCE: It was evident from discussions with the management team and their staff that the home has a stable team that supports a commitment to providing quality care for the benefit of the residents. The management team encourages innovation within the staff team and ideas that are generated are respected and actioned, which demonstrates an open and inclusive atmosphere. There was a high degree of satisfaction expressed by all of the residents, relatives and visitors who stated, “The carers are excellent and the management is faultless we are very impressed with the quality and level of care provided”. Based on the comments made and through the inspectors observation it is evident that the home is run in their best interests and to ensure their needs are being met. The home continues to work hard developing formal quality assurance and has completed an audit this year to assess the satisfaction of residents with regards to the service that the home provides by asking residents, relatives and GP’s to complete surveys. The results and comments from the surveys were very positive. Information from the surveys was collated and documented effectively. The results have enabled the home to identify all strengths and any weaknesses within the service they provide, which is acted upon in a development plan for the coming year. The policy and procedure for holding residents personal money was examined and four individual accounts were looked at. It was evident that good accounting methods are adopted which account for all transactions documented and receipts for sundries were available to see. Residents’ accounts are audited on a weekly basis. There is an annual appraisal process, which ties in with the supervision arrangements. The management have established a formal recorded supervision procedure for all staff. A plan is devised for discussion relating to the residents, work issues, staff issues, personal development and training. The recorded outcomes of the supervision evidenced the effectiveness of the sessions. Christopher Ann is also an assistant manager at the home and is responsible for the maintenance of the home and its grounds and in ensuring that Health and Safety in all aspects are kept up to date and regularly maintained. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 25 Some of the Health and safety records in the home were examined. Documentation showed that relevant checks were maintained correctly and at the required intervals including all fire alarms and equipment and emergency lighting. The homes records showed all necessary service contracts were up to date including, gas and electrical services and the passenger lift. The fire logbook evidenced compliance to the weekly, monthly and annual checks alongside records of staff training and drills completed, records clearly identified that all members of staff have been present during fire drills as recommended by the Fire Prevention Officer. All night staff undertake this on a three-monthly basis, and day staff six-monthly. Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 26 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 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 3 3 X 4 X 4 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 4 X 4 X 3 X 3 4 Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 27 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 Penhill Residential Home DS0000026623.V318131.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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. 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