CARE HOMES FOR OLDER PEOPLE
Penhill Residential Home 81 Station Road Shirehampton Bristol BS11 9TY Lead Inspector
Jon Clarke Unannounced Inspection 24th March 2006 10:00 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.V280004.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. Penhill Residential Home DS0000026623.V280004.R01.S.doc Version 5.1 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 Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Penhill Residential Home DS0000026623.V280004.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. May accommodate up to 17 persons aged 65 years and over requiring personal care. 1st November 2005 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. Penhill Residential Home DS0000026623.V280004.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day, the manager and deputy manager were present during this inspection. As part of this inspection a number of records were examined including care plans, training, recruitment and documents relating to health & safety practice in the home. A number of residents were spoken to get their views about the quality of care provided at the home. 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. Penhill Residential Home DS0000026623.V280004.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 Penhill Residential Home DS0000026623.V280004.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): Standards 3 & 6 were examined on the last inspection and were both met. EVIDENCE: Penhill Residential Home DS0000026623.V280004.R01.S.doc Version 5.1 Page 8 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 Individual care plans provide the necessary information about the health and social cares needs of residents so that staff are able to meet care needs in an efficient and competent way. EVIDENCE: Care plans examined gave good information about the tasks required of staff to assist and support staff in providing personal care. Included were preferences about individual’s likes and dislikes, social interests. Reviews are held on a regular basis. Risk assessments are completed in one instance where a resident has panic attacks this also identified action to be taken by staff. Weight monitoring is also undertaken monthly. Penhill Residential Home DS0000026623.V280004.R01.S.doc Version 5.1 Page 9 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): 13,14 The home has good arrangements in place to encourage and support residents maintain their links with family and friends and the local community. Residents are able to exercise choice in their daily lives. EVIDENCE: In discussion with residents they confirmed that the home “welcomes” visitors and is staff are “friendly and welcoming”. Where able residents are encouraged to use local community facilities one resident attends a local day centre. Residents spoke of their ability to “spend the day as I like” “don’t feel there any restrictions on me”. When asked about routines such as getting up and going to bed a resident said “ I can do as I would like don’t feel I have to do anything particularly” “do what you like when you like”. Penhill Residential Home DS0000026623.V280004.R01.S.doc Version 5.1 Page 10 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): The training of staff helps to protect residents from abuse. EVIDENCE: All staff have received Adult Protection “Awareness” training which provided them with the knowledge and skill to identify potential abuse. The manager has not undertaken “Investigators” training this would give them the knowledge of how to respond to any allegations of abuse. Penhill Residential Home DS0000026623.V280004.R01.S.doc Version 5.1 Page 11 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): Standards 19 & 26 were looked at on the previous inspection and were both met. EVIDENCE: Penhill Residential Home DS0000026623.V280004.R01.S.doc Version 5.1 Page 12 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): 29,30 The homes recruitment policy and practice helps to protect residents and ensure suitable individuals are employed by the home. Staff would benefit from specialist training to increase their skills and knowledge to meet specific needs of residents. EVIDENCE: Staffing recruitment records were seen and showed good practice. Full information was obtained about previous employment, two references were obtained, medical declaration and all staff have the required Criminal Record checks. Staff receive 6-week appraisals. Training records showed that staff receive the necessary mandatory training: moving & handling, first aid, fire safety. A domestic assistant had not received COSHH training. In talking with staff they commented on the training in the home and felt that there was good training, over 50 have NVQ qualification. However no training had been provided on more specific areas relating to the needs of residents in the home particularly: Mental Health, Managing Continence and Dealing with Challenging Behaviour. Staff when asked agreed that they would benefit from such training. This was discussed with the managers of the home at the time of the inspection and they recognised the need and importance of such training. It was also discussed the benefit and need for a senior staff member to undertake Moving and Handling assessment training.
Penhill Residential Home DS0000026623.V280004.R01.S.doc Version 5.1 Page 13 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): 33,38 The homes provides opportunity through a Quality Assurance questionnaire for residents to express their views about the quality of care they receive. The health and safety practices of the home help to make sure the welfare of residents and staff are protected. EVIDENCE: Regular residents meeting are held to discuss aspects of the home’s life particularly activities and social events. They also provide an opportunity for residents to make suggestions and comment on the care they receive such as the food provided in the home. Penhill Residential Home DS0000026623.V280004.R01.S.doc Version 5.1 Page 14 A copy of a Quality Assurance survey undertaken in January 2006 was also seen. This showed very positive comments about various aspects of the home’s daily routine. Residents and some relatives (total of 21 respondents) commented on the homes environment: 19 strongly 2 agreed warm and homely environment, 19 strongly 2 agreed Penhill kept to high standard of cleanliness, free from offensive odours. Activities in the home: 16 strongly 5 agreed see regular activities and events. Meals and food provided: 15 strongly 5 agreed enjoyed the food, 14 strongly 3 agreed meals well presented, 15 strongly 1 agreed, 1 disagreed meals always served hot (this was later addressed ) As result of response to availability of snacks residents were advised in residents meeting that snacks and fresh fruit was always available form the breakfast room. Perhaps fruit could be available in the communal lounge and dining area? A relatives survey was also undertaken however with low response (4) however there was 100 positive feedback about the welcome, the professional courteous staff and the professional nature of the care received. Some comments: ‘I am very happy living at Penhill. Everyone is so helpful and there is no time To ‘sit and stare’.’ ‘-------- (resident) is very very happy and feels very loved here.’ ‘The love my ---------- receives is first class. The staff are first class and so caring. I could not ask for a better place for my ---------- to be’. ‘Very friendly and welcome place to come.’ Records about the health and safety practice in the home were looked at and show good practice in this area. Fire Alarms weekly tests, Fire equipment serviced 2/11/05 with fire risk assessment for the home’s environment. Fire drills are held on regular basis. Equipment is maintained with hoists and lift serviced yearly. Penhill Residential Home DS0000026623.V280004.R01.S.doc Version 5.1 Page 15 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 3 Penhill Residential Home DS0000026623.V280004.R01.S.doc Version 5.1 Page 16 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. 1 2 Standard OP30 OP30 Regulation 18 (1a,c) 18 (1a,c) Requirement Ensure appropriate staff receive COSHH training. Ensure staff receive specialist training so that they have the necessary skills and knowledge to meet the needs of residents. Ensure senior member of staff undertakes training to complete risk assessment and advise on moving handling practice for individual residents. Timescale for action 30/06/06 30/09/06 3 OP30 18 (1,c) 30/09/06 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.V280004.R01.S.doc Version 5.1 Page 17 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
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