Inspection on 01/12/05 for Penlee

This inspection was carried out on 1st December 2005.

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

Penlee 06/12/08

Penlee 11/05/07

Penlee 27/06/05

Penlee 07/12/04

Penlee 04/05/04

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 Penlee 56/57 Morrab Road Penzance Cornwall TR18 4EP Lead Inspector Richard Coates Announced Inspection 1st December 2005 09:15 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 Penlee DS0000008917.V258872.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. Penlee DS0000008917.V258872.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Penlee Address 56/57 Morrab Road Penzance Cornwall TR18 4EP 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) 01736 364102 Mr Robert David Putterill Mrs Kathleen Mary Lucy Putterill Care Home 22 Category(ies) of Dementia - over 65 years of age (6), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (6), Old age, not falling within any other category (22) Penlee DS0000008917.V258872.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. No more than 6 service users must be in the category DE(E) and MD(E) in total. Service users to include up to 22 adults of old age (OP) Service users to include up to 6 adults over 65 with dementia (DE{E}) Service users to include up to 6 adults over 65 with a mental illness (MD{E}) Total number of service users not to exceed a maximum of 22 Date of last inspection 27th June 2005 Brief Description of the Service: Penlee is a substantial Victorian building formed from two houses in Morrab Road, a pleasant residential area between the town centre and the promenade. The registered providers are Mr and Mrs R. Putterill, who live on the premises. Penlee is close to the town, local GP surgeries and to the public library. Penlee offers personal care and residential accommodation to older people. The home is registered to provide accommodation for 22 older persons including six who may have dementia or a mental disorder, which is not learning disability. There are 18 single rooms and two double rooms. The providers intend that a double room would only be used as a double for two partners or relatives. The access at the front has a small granite step at the gate and two granite steps at the main door, which has a ramp. The gardens are small but pleasantly laid out with sitting areas. The provider describes the aims, services and facilities clearly in the Statement of Purpose. The home sets out to provide a high quality service that responds to individual needs and preferences. Mr and Mrs Putterill are generally able to take the residents to hospital and medical appointments. Penlee DS0000008917.V258872.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a planned announced inspection. The aim was to review compliance with the recommendations set in the last inspection report, dated 27 June 2005, and to focus on key standards in the areas of care planning, protection and staffing. The last unannounced inspection report included the national minimum standards not inspected in this report; some standards have been included in both reports. The inspector was on the premises for over seven hours. The methods used were discussion with the providers, staff and residents, inspection of records and documents and inspection of the premises. The inspector is grateful to the providers, staff and residents for their assistance in completing the inspection. What the service does well: The service provides clear written information to enable people to make a decision about whether the home can meet their needs and suit their preferences. The provider carries out detailed assessments and considers carefully if the home can meet the needs of prospective residents. There is an attention to detail in care planning and risk assessment with individual residents and in responding to their lifestyle preferences and choices. Residents report that they are well cared for, they have confidence in the registered providers, and the staff are kind and skilled and respect their privacy and dignity. The providers monitor the healthcare needs of service users and ensure access to appropriate services. The providers support residents to manage their own medication with a written agreement. Residents reported that they were satisfied with how their healthcare needs were met. The management of the home is effective and ensures that the aims and objectives as set out in the statement of purpose are met. The home is kept in good decorative order. Equipment and systems receive regular maintenance and refurbishment. The providers actively consult residents individually and obtain their views about the services provided. The providers regularly evaluate the service provided and take action to secure improvements. There is a structured training programme, which covers induction, required statutory training and NVQ at levels 2 and 3. Staff report that they are well supported and supervised. There are arrangements in place to ensure compliance with health and safety legislation and promote the health and safety of staff and residents. Penlee DS0000008917.V258872.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. Penlee DS0000008917.V258872.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 Penlee DS0000008917.V258872.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): 2 and 3. Penlee House does not offer intermediate care – standard 6 Prospective service users and their families and representatives receive information about the home and services provided. The needs of service users are assessed so that they can be assured that the home can provide adequate care. EVIDENCE: Recently admitted residents reported that they had received information material about the home. The records of two recently admitted residents were case tracked. These records contained copies of terms and conditions which comply with the standard and were signed and dated. The commissioning authority for one resident had provided a community care assessment and care plan, and a copy of its standard service specification. The registered provider had carried out a moving and handling assessment, a nutritional screening and a basic admission assessment/information record. The second new resident is privately funded and the registered provider had recorded an assessment, an admission information and medical record, a moving and handling assessment, a nutritional screening and a self-medication agreement. The provider’s assessment format complies with the standard and permits flexibility in Penlee DS0000008917.V258872.R01.S.doc Version 5.0 Page 9 recording the complexity and detail of the assessment. Both residents were satisfied with how their admission had been managed. Penlee DS0000008917.V258872.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 Detailed written care plans direct and inform staff about how to meet the residents’ health, personal and social care needs. The healthcare needs of residents are thoroughly monitored and addressed so that their needs are met. The arrangements for the management of medicines protect service users. EVIDENCE: The three residents’ records case tracked all had written care plans. The provider draws up an individual care plan for each care need, activity and risk. The plans include personal, health and social care needs. Each plan sets out a stated objective, the action to be taken and regular dated evaluations. Residents sign their care plans, and there is evidence of their participation in the ‘Resident’s Preferences’ record and agreement for frequency of checks at night. Care staff record consistent daily notes; these are factual, legible and signed. The care plans for a resident who has been in the home for some years had regular evaluations and reviews which documented the changes in the care plan. However, the objectives and interventions for those areas where there has been change over time need revising and rewriting to provide staff with clear current directions and information in one place. Penlee DS0000008917.V258872.R01.S.doc Version 5.0 Page 11 Care plans and daily records provide evidence that residents are registered with local surgeries and the provider promotes access to healthcare services. Residents discussed the arrangements for chiropodists, dentists, and opticians. During the inspection, a physiotherapist was working with one resident and a chiropodist was visiting another. The provider refers issues of tissue viability to the community nursing service. One resident who spoke with the inspector had equipment for pressure relief. The medication policy and procedure, ‘Drugs – Rules and Procedures’, complies with the standard and is based on the Royal Pharmaceutical Society guidance. The storage facility is a locked cupboard in the kitchen. This does not comply with the standard for controlled drugs. The provider stated that they would obtain a suitable metal cabinet if the home needed to store more than the current small amount, or a more diverse range, of controlled drugs. The provider supports residents to take responsibility for their medication if they wish to do so. Four residents were currently doing this, with a written agreement. The home uses the monitored dosage system. The registered provider checks all incoming medicines. The pharmacist last visited the home on 29 November 2005 and the report does not identify any concerns. Samples of medication stocks, including controlled drugs were checked against the records and found to be accurate. The medicine administration records included a few gaps in signing. It is recommended that staff use appropriate codes when medication is not administered. Staff receive training in the management of medicines from the registered provider at induction. Most staff have completed the Boots training in the safe handling of medicines. Two staff have also completed a certificated course in the safe handling of medicines, and the provider intends that all staff will complete this course. Residents were very satisfied with the care they receive. They felt that staff were courteous and respected their dignity and privacy when assisting with personal care. A member of staff was clearly aware of the issues of sensitivity and respect for the individual in providing care. Residents see GPs and community nurses in their own rooms. They have access to a telephone in the small conservatory, and some have installed their own telephones in their rooms. Penlee DS0000008917.V258872.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): These standards were included in the last, unannounced inspection. EVIDENCE: Penlee DS0000008917.V258872.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): 16 and 18 The home has a satisfactory complaints procedure that would ensure that complaints are listened to and acted upon. There are arrangements in place to protect service users from abuse. EVIDENCE: The complaints procedure complies with the standard. No formal complaints have been recorded in the last year. The providers actively consult residents individually and obtain their views about the services provided. The residents who spoke to the inspector were very satisfied with the service and none had felt the need to make a complaint. The home’s policy and procedure on the prevention of abuse complies in general with the standard. The reference to the Social Services Procedure needs to be amended to refer to the recently launched revised Local Multiagency Code of Practice for the Protection of Vulnerable Adults. It is recommended that the provider obtain a copy of the code of practice from the Department for Adult Social Care. Staff receive training in the protection of vulnerable adults during induction. The provider reported that she had experienced difficulties in obtaining places for staff on the multi-agency ‘alerter’s training’, which is in great demand. The provider needs to review the provision of regular refresher training for staff. The home provides a secure storage facility for small amounts of cash. There is a policy statement on financial relationships with residents. Penlee DS0000008917.V258872.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): These standards were included in the last unannounced inspection. EVIDENCE: These standards were not inspected in detail. The registered provider has continued with regular refurbishment – re-carpeting and redecoration. There are new pictures in the communal areas. Thermostats and radiators have been replaced. The premises are well maintained and clean and hygienic. Penlee DS0000008917.V258872.R01.S.doc Version 5.0 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 The staffing and training arrangements ensure that the needs of residents are met. Recruitment procedures have not recently ensured complete protection to the service users. EVIDENCE: Following a period of stability in the staffing of the home, there have been changes during the year and the appointment of new staff. The roster shows that there is a minimum of two care staff on duty during the day, with Mr and Mrs Putterill either on duty or on call on the premises. There is a cook every day and domestic staff on weekdays. There is one waking night staff, with Mr and Mrs Putterill on call on the premises. There is an activity worker. There are no staff aged under 18 at present. The pre-inspection questionnaire states that seven out of eleven care staff are qualified to NVQ level 2 or above. The provider reported that newly appointed staff have registered for their NVQ level 2, and a number of staff with NVQ 2 have registered for their level 3. Mr R Putterill has completed his NVQ level 3. Recruitment records for two recently appointed staff were inspected. These contained most of the required information and documents. The Criminal Records Bureau Disclosures had been obtained after the staff had started, without the ‘POVA first’ check required by the regulations. A requirement has been made in respect of this. The application form also needs to ask applicants to detail their complete employment history. These requirements Penlee DS0000008917.V258872.R01.S.doc Version 5.0 Page 16 were introduced in amendments to the regulations in July 2004. Staff confirmed that they had received copies of the General Social Care Council Code of Conduct and discussed its contents. The home has a structured induction which complies with the Skills For Care specification. Records of partially completed induction training were on file, with completed sections appropriately signed and dated. We discussed the new specification for induction training, which comes into effect from September 2006 and is available on www.skillsforcare.org.uk. The provider is planning to use a new provider for distance learning for infection control and safe handling of medicines, and possibly, food hygiene. Staff have individual training records which include ‘Performance and Development Reviews”. There is a summary training plan, which details the training that staff have received and are up to date in. The provider is planning to complete this summary with the details of staff individual training requirements. Mrs Putterill is an assessor for NVQ awards. Penlee DS0000008917.V258872.R01.S.doc Version 5.0 Page 17 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): 38 The health and safety of residents and staff are promoted and protected. EVIDENCE: The provider’s ‘Health and Safety Policy’ sets out the responsibilities of the employer and employees, and the arrangements for managing health and safety. There are hazard analyses and risk assessments for a range of activities and equipment. The most recent Penwith District Council environmental health officer visit health and safety report is dated 16.02.04 and identified a high standard. The most recent Fire Service report dated 30.03.05 details “a satisfactory standard of fire safety”. Staff felt that the provider paid satisfactory attention to health and safety matters. The pre-inspection questionnaire detailed required maintenance and safety checks. A sample of these were checked against the original documents and Penlee DS0000008917.V258872.R01.S.doc Version 5.0 Page 18 found to be accurate. There is a policy and guidance note on Legionella. Records evidence regular required checks of the fire alarm systems, emergency lighting and equipment. The provider records individual risk assessments as apart of the care plan for service users in relation to moving and handling, risk of falls, and other risks. The premises are audited regularly in relation to maintenance and health and safety. Accidents records were appropriately completed and comply with the Data Protection Act. Penlee DS0000008917.V258872.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 3 3 X X X 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 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 3 Penlee DS0000008917.V258872.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. 1 2 Standard OP27 OP29 Regulation 17(2) and sched 4.7 19 and schedule 2 Requirement The roster must detail the hours worked by the registered providers. The registered person must not employ a person to work at the home unless he has obtained a Criminal Records Bureau Disclosure or a ‘POVA first’ check. The registered person must not employ a person to work at the home unless he has obtained a full employment history. Timescale for action 31/03/06 01/12/05 3 OP29 19 and schedule 2 01/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations The registered person should review and rewrite where necessary the objectives and the directions and information for staff on care plans which have changed over time. Appropriate codes should be entered in medication DS0000008917.V258872.R01.S.doc Version 5.0 Page 21 2 Penlee OP9 3 OP18 administration records when medicines are not administered. The registered person should amend the adult protection procedure to refer to the revised Local Multi-agency Code of Practice for the Protection of Vulnerable Adults. The registered person should obtain a copy of the code of practice. Penlee DS0000008917.V258872.R01.S.doc Version 5.0 Page 22 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 © 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 Penlee DS0000008917.V258872.R01.S.doc Version 5.0 Page 23 - 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. 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