Inspection on 31/01/06 for Penmount Grange

This inspection was carried out on 31st January 2006.

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

Penmount Grange 24/07/07

Penmount Grange 20/06/06

Penmount Grange 03/05/05

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 Inspection 31st January 2006 08:20 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 Penmount Grange DS0000061897.V268520.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. Penmount Grange DS0000061897.V268520.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Penmount Grange Address Lanivet Bodmin Cornwall PL30 5JE 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) 01208 831220 Mr Leander Joseph Difford Mrs Pauline Janet Difford Mrs Alice Margaret Taylor Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Penmount Grange DS0000061897.V268520.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One named person with a learning disability (LD) under the agreed age range. Because of limitations to communal spatial requirements resident service users and day care must not exceed 24 together at any given time. 3rd May 2005 Date of last inspection 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 DS0000061897.V268520.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over five hours and forty minutes and was carried out as an unannounced inspection. A tour of the premises took place and staff files, care records and associated documentation were inspected. Service users were spoken to during the course of the inspection in the lounge or the privacy of their bedroom. All of the service users expressed very positive comments on the standard of the care that they are receiving. 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? On the inspection of the 3rd May 2005 some of the service users had expressed negative comments on the standard of the meals provided in the home. This situation appears to have been addressed. The meals are once again cooked in the kitchen at the home, a new cook has been employed and the service users spoken to during the course of the inspection expressed positive comments in regard to the standard of the meals. Penmount Grange DS0000061897.V268520.R01.S.doc Version 5.0 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 DS0000061897.V268520.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 Penmount Grange DS0000061897.V268520.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): 2,3,4 and 5 Documentation is required to ensure that each service user is provided with a contract of care. 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. Documentation still requires development to evidence this assessment process. EVIDENCE: Service users who have been admitted to the home via social services have a contract of care in place that details the terms and conditions of their placement. The contract of care has been written and issued by social services. Service users who have been admitted to the home privately are without this documentation and this must be addressed to meet the standard. Penmount Grange DS0000061897.V268520.R01.S.doc Version 5.0 Page 9 New service users are admitted to the home following a full assessment undertaken by the registered manager. Documentation still requires completion to evidence the pre admission assessment process. A number of clients attend the home for a day care service and a permanent respite bed facility are available which allows service users the opportunity of experiencing the home prior to a long term stay. Penmount Grange DS0000061897.V268520.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 The service user’s health, personal and social care needs are being met by the staff and multidisciplinary staff as required. Medication is being administered correctly to the service users but one good practice recommendation is made as a result of this inspection. EVIDENCE: All the 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. Evidence is in place that the monthly reviews of the care plans are happening. It is recommended that the service users are regularly weighed and this information is documented. 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 Penmount Grange DS0000061897.V268520.R01.S.doc Version 5.0 Page 11 problems and tissue viability concerns. Dietary needs are identified in care planning. The home has a medication policy and procedure in place that should be updated to change names and addresses where appropriate. Some of the staff who administer medication have received accredited medication training with the rest of the staff due to undertake this soon. Medication administration records were found to be completed appropriately on the day of the inspection. 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. An inspection of the medication system was undertaken on the 4th January 2006 by the pharmacy who supplies the medication to the home. This inspection was found to be satisfactory. Service users spoke positively about the care delivery in the home which ensures that their privacy and dignity is respected at all times. Penmount Grange DS0000061897.V268520.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): 14 and 15 Service users at Penmount are encouraged to make choices about their daily routines. Service users spoken to during the course of the inspection expressed positive comments on the standard of the meals in the home. EVIDENCE: The service user guide document at Penmount states that service users are encouraged to express choice and control over their lives by for example their rising and going to bed times. All the service users spoken to during the course of the inspection expressed very positive comments on Penmount being very much their home. The home has employed a new cook and the meals for the home are once again being cooked in the kitchen at Penmount. Service users spoken to during the course of the inspection expressed positive comments on the standard of the meals being provided. Penmount Grange DS0000061897.V268520.R01.S.doc Version 5.0 Page 13 On the day of the inspection the main meal of the day was braising steak, potatoes, carrots and broccoli and peas. Records of meals being provided at the home are in place as required by legislation. It is noted that an inspection of the kitchen on the 20th July 2005 by the district council environmental health officer found the conditions below standard. It is understood that there has been no follow up inspection since this date. Penmount Grange DS0000061897.V268520.R01.S.doc Version 5.0 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 the following standard(s): 16 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. There are plans for staff to attend training in this area to expand their knowledge of these issues. 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 home has in place a policy and procedure for the protection of the service users from abuse. Whistle blowing information is included in the policy and procedure. Two staff members have attended adult protection training that the local social services department is providing with more staff due to attend. Penmount Grange DS0000061897.V268520.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26 The registered providers are constantly improving the premises internally and externally at Penmount Grange. EVIDENCE: The original part of Penmount Grange is an older property with more recent extensions added to include a recently added new area with en suite bedrooms and a communal bathroom with assisted bathing facilities. These bedrooms are spacious and have been built to a high standard. Not all of the bedrooms have been registered as the communal space presently does not meet the requirements of the standards. The registered providers plan to add a conservatory to the home which will address this. Communal space at the home includes a spacious lounge with a dining room off the lounge and in turn a quiet lounge off that. Penmount Grange DS0000061897.V268520.R01.S.doc Version 5.0 Page 16 Improvements to some of the bedrooms in the older part of the home are presently taking place. A maintenance staff member is employed. Bedrooms have been personalised and service users are encouraged to bring their furniture into the home. Some of the bedrooms have en suite facilities but where bedrooms do not have this facility they can access communal bathrooms. Assisted bathing is provided at the home if required. 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. Unfortunately the pre set valves have caused a problem with the flow of the water which has resulted in carers topping up baths with water from jugs. This was discussed with the registered provider who has advised that he is fully aware of this unsatisfactory situation and is to address it with planned work. The home was found to be clean on the day of the inspection. Penmount Grange DS0000061897.V268520.R01.S.doc Version 5.0 Page 17 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 Staffing levels are appropriate to meet the needs of the service users. Statutory and good practice training for staff is ongoing. Recruitment procedures could be improved. 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 and additional staff at peak times. It is understood that the staffing levels will increase when all the new beds are registered. There are two waking night staff members employed. Approximately 50 of the care staff are trained to level NVQ 2 in care. Staff training presently taking place includes medication training, basic food hygiene certificate training and moving and handling training. It was noted during the course of the inspection that a staff member was employed in the home (and had been since September 2005) without an enhanced criminal records bureau check. Staff must not be employed without at least a check on the vulnerable adults register as a minimum. Penmount Grange DS0000061897.V268520.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 and 37 During the course of the inspection the service users gave very positive comments on the registered manager who they obviously highly regard. More evidence is required to ensure that some of the standards in this section are met. EVIDENCE: The registered manager has an NVQ 4 qualification as well as the registered managers award and is also an NVQ assessor. She is now due to commence an accredited medication training course. During the course of the inspection it was apparent that the registered manger is highly regarded by the service users and she knows them all very well. The registered manager is supported in her duties by the registered providers and a recently appointed assistant Penmount Grange DS0000061897.V268520.R01.S.doc Version 5.0 Page 19 manager. The registered providers 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. There have been some staff meetings taking place but there are plans for this to happen more frequently. 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 held. These records were found to be completed appropriately on the day of the inspection. There is no evidence in place at this time that staff supervision is taking place. There is no evidence of any quality assurance/monitoring has taken place at Penmount Grange. Improvements to policies and procedures are required to include up to date information on correct names and addresses. Penmount Grange DS0000061897.V268520.R01.S.doc Version 5.0 Page 20 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 2 2 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 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 3 2 2 x Penmount Grange DS0000061897.V268520.R01.S.doc Version 5.0 Page 21 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. 1. 2. 3. 4. 5. 6. 7. 8. 9. Refer to Standard OP2 OP3 OP7 OP9 OP18 OP30 OP36 OP33 OP37 Good Practice Recommendations To provide each service user with a contract of care that details the terms and conditions of their placement. To develop a pre admission assessment document that is a separate document to care planning documentation. To weigh the service users regularly and add this information to care planning documentation. To update the medication policy and procedure. For staff to attend the social services department adult protection training. For all staff to have (at a minimum) a protection of vulnerable adults register check prior to employment. For evidence to be provided of regular supervision to the staff. To carry out a quality assurance/monitoring on the running of the home that involves the service users. For all policies and procedures to be updated and personalised to Penmount Grange. DS0000061897.V268520.R01.S.doc Version 5.0 Page 22 Penmount Grange Penmount Grange DS0000061897.V268520.R01.S.doc Version 5.0 Page 23 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. 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