Inspection on 03/05/05 for Penmount Grange

This inspection was carried out on 3rd May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Penmount Grange 24/07/07

Penmount Grange 20/06/06

Penmount Grange 31/01/06

Penmount Grange 21/12/04

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 Penmount Grange Lanivet Bodmin Cornwall PL30 5JE Lead Inspector Elaine Bruce Unannounced 03 May 2005 09:00 am 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 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. Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Penmount Grange Address Lanivet Bodmin Cornwall PL30 5JE 01208 831220 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Leander Joseph Difford Mrs Pauline Janet Difford Mrs Alice Margaret Taylor Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: One named person with a learning disability (LD) under the agreed age range. Date of last inspection 21/12/04 Brief Description of the Service: Penmount Grange is a care home registered to provide accommodation and personal care for up to twenty one older people. Building work is presently taking place to increase the beds from twenty one to twenty seven. The home is situated on a hill, overlooking the A30 approximately half a mile from the village of Lanivet. The home consists of the main house and two added extensions. Bedroom accommodation is provided for service users on the ground and first floors through nineteen single and one double room. The home offers a respite bed facility all year. A number of clients attend the home for day care. There are two lounges (the smaller of the two being a `quiet area) a dining room and various communal bathrooms and toilets provided for service users. The detached house stands in grounds with seating areas. There is car parking available in the grounds of the home. Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 hours and was carried out as an unannounced inspection. A tour of the premises took place and staff files, care records and policies and procedures were inspected. Service users were spoken to during the course of the inspection over the main meal of the day and in the privacy of their bedrooms. Staff on duty were also spoken to during the course of the inspection. The registered manager was on duty during the inspection and one of the registered providers visited the home during the course of the day. What the service does well: What has improved since the last inspection? Formal documentation as requested in the inspection report of the 21st December 2005 has now been provided in the form of the electrical hard wiring testing. Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 6 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. Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 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 standard(s) 1 and 3 The home’s statement of purpose and service user guide documentation provide prospective service users with details of what the home provides helping an informed decision about admission to the home. The registered manager assesses all potential service users prior to admission to the home to ensure that the home will be able to meet their care needs. EVIDENCE: The home has produced a detailed statement of purpose and service user guide. The service user guide is very informative to include having a lot of useful information for moving into the home. New service users are admitted to the home following a full assessment undertaken by the registered manager. Documentation is being completed by the manager before and during the assessment process but to meet the requirements of the standard a separate document must be developed from care planning, which at this time it is not. Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 9 A number of clients attend the home for a day care service and a permanent respite bed facility are available which allow service users the opportunity of experiencing the home prior to a long term stay. Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10 and 11 The service users health and personal care needs are being met by the staff team and multidisciplinary staff as required. Care needs are met in such a way as to promote and protect the service users’ privacy and dignity. EVIDENCE: All service users have a plan of care in place which details their care needs and how these needs can be met by the care staff. Care plans are supported by day and night records. The service users are involved in the care planning process. There are gaps in the monthly reviews of the care plans which must be addressed to ensure that all the care plans are regularly up to date. Service users are registered with their own general practitioner. The home keeps detailed records to evidence that all health care needs are being met. Community nurses and community psychiatric nurses visit the service users as requested. Risk assessments are in place for those service users with mobility problems and tissue viability. Dietary needs are identified in care planning. The home has a medication policy and procedure that should be updated to change names and addresses where appropriate. Staff who have medication Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 11 administration responsibilities are presently undertaking training which is accredited. The home has a medication trolley and a medicine cabinet on the first floor of the home for the ease and safety of medicine administration. Medication administration records were found to be completed appropriately. It was though noted that the medication charts were not dated correctly from the pharmacy and the manager dealt with this on the day of the inspection. Service users spoke positively about the care delivery in the home which ensures that their privacy and dignity is respected at all times. The service user’s wishes for their death are recorded in care planning. The registered manager has undertaken training in this sensitive area and policies and procedures are in place to guide staff. Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 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 standard(s) 12,13 and 15 The social care needs of the service users have been identified in care planning but daily records must be improved to evidence how these care needs are being met. Service users spoken to during the course of the inspection expressed negative comments on the standard of the meals in the home. EVIDENCE: The social care needs of the service users have been clearly identified in care planning but at this time the daily records do not indicate how these needs are being met. Activities do take place in the home for example bingo and this information must be recorded. Trips out had been planned but at this time the transport that the home has is off the road. This should only be a short term disadvantage. Visitors are welcomed to the home, they are asked to sign in the visitors book and daily records evidence when a service user has seen their visitor. On the day of the inspection negative comments were received from the service users on the standard of the meals provided at Penmount. The menu displayed indicated that lamb steaks and herbie potatoes with broccoli, carrots Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 13 and peas would be provided as the main meal of the day. This was not the case with a beef casserole served and different vegetables to those on the menu. The meat was tender which according to the service users had not been the case. One of the vegetables was frozen which is not what the service users have been used to. The meals are presently being cooked in another home and delivered to Penmount. Some problems around this process have been sorted out but more requires to be done to satisfy the service users and the CSCI. The dessert on the day of the inspection consisted of tinned fruit with no custard or ice cream or cream. This is not satisfactory. The service users also made it very clear that they are given no choice which again is not satisfactory. Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 14 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 standard(s) 16,17 and 18 The home has a satisfactory complaints procedure provided to the service users in the service users guide. The home has in place adult protection policies and procedures. This documentation is discussed in supervision to provide staff with the knowledge and understanding of adult protection issues to protect service users from abuse. EVIDENCE: The home has a complaints policy and procedure that also forms part of the service user guide. Each service user in the home has this information. In addition the complaints policy and procedure is displayed in the entrance of the home. The CSCI has recently investigated a complaint related to the meals provided in the home. Service users wishing to participate in the political process are supported to do so by the postal voting system. The statement of purpose document and the service user guide reference to the service user that their legal rights will be respected at the home and for example that the service user has a right to see their care notes should they so wish. Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 15 The home has in place a policy and procedure for the protection of the service user from abuse. Whistle blowing information is included in the policy and procedure. This important documentation is presently being discussed in staff supervision. It is recommended that staff attend the adult protection training that the local social services department is providing. Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 16 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 standard(s) 25 and 26 Some service users at this time are unable to use their en suite facilities due to poor water temperature control and flow. This does not provide service users with a comfortable environment which must be addressed. EVIDENCE: The home is presently being extended by the registered providers and some internal refurbishment work is also taking place. The registered provider is reminded of the entry in the inspection report of the 21st December 2004 reference standard 20 which states: “It is recommended that full consideration be given to the amount of communal space per service user in relation to the extension of the home and the numbers of service users at the home for day care”. Further information is awaited on this point from the registered provider pending the registration of the new bedrooms in the home. Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 17 Central heating is provided throughout the home by radiators that are guarded. Pre set valves have been installed in all rooms allowing bathing/washing to be provided close to a safe 43c. During the course of the inspection some service users expressed concerns on the lack of a bath for the last two weeks. When investigated further it transpires that there have been problems with water temperature control and a boiler has had to be replaced. Although this has addressed the situation in one area of the home it has not in another where water is not even warm or has a poor flow resulting in carers having to carry water which is unacceptable. It is recognised the building work taking place at the home does cause extra cleaning. It is though recommended that the twenty cleaning hours (per week) be reviewed. Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 Staffing levels are appropriate to meet the needs of the service users. The staff team are a stable group with no staff changes since the last inspection. EVIDENCE: The staffing rota demonstrates satisfactory numbers of skill mix to meet the needs of the service users. There is a minimum of three staff on duty in the mornings with three staff in the afternoon with additional staff at peak times. It is understood that the staffing levels will increase when the new beds are registered. There are two waking night staff members employed. There have been no changes to the staff team since the last inspection. Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32,35 and 38 During the course of the inspection the service users gave very positive comments on the registered manager who they obviously highly regard. EVIDENCE: The registered manager has an NVQ 4 qualification as well as the registered managers award and is also an NVQ assessor. She is to now due to commence an accredited medication training course. During the course of the inspection it was apparent that the registered manager is highly regarded by the service users and she knows them all very well. The manger is supported in her duties by the registered providers. They visit the home regularly and one of the registered providers spoke with the inspector during the course of the day. The registered manager adopts an “open door” management approach to the running of the home. She is supported in her duties by a senior staff member. Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 20 She involves the staff in the running of the home to include staff meetings. She is presently in the process of organising a staff meeting for the night staff. Service users control their own money except where they are unable or do not wish to do so. Written records are maintained where service user money is retained. The home employs a staff member for health and safety responsibilities/duties. Competency evidence was asked for in regard to this staff member and this was dealt with on the day of the inspection by the manager. The electrical hard wiring for the building has now been tested as requested in the inspection report of the 21st December 2004. Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 1 COMPLAINTS AND PROTECTION x x x x x x 1 2 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 4 3 x x 3 x x 3 Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 22 YES Are there any outstanding requirements from the last inspection? 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. Standard 7 Regulation 15 Requirement The registered person must keep the service users plan under review at least once a month to reflect changing needs. The registered person must provide in adequate quantities, suitable, wholesome and nutritious food which is varied and properly prepared and available at such times as may reasonably be required by service users. The regsitered person must ensure that wash hand basins and baths are fitted with a satisfactory hot and cold water supply. Timescale for action Immediate 2. 15 16 Immediate 3. 25 23 To be discussed and agreed 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. 2. 3. Refer to Standard 3 9 18 Good Practice Recommendations To develop a pre admission assessment document that is a separate document to care planning documentation. To update the medication policy and procedure For staff to attend the social services department adult D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 23 Penmount Grange 4. 29 protection training. to review the cleaning hours in the home to establish if they are satisfactory. Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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 Penmount Grange D52-D04 S61897 Penmount Grange V224764 030505 Stage 4.doc Version 1.30 Page 25 - 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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