CARE HOMES FOR OLDER PEOPLE
Penns Mount Vicarage Hill Kingsteignton Newton Abbot TQ12 3BA Lead Inspector
Sharon Goldsworthy Unannounced 03 August 2005 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. Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Penns Mount Address Vicarage Hill, Kingsteignton, Newton Abbot, Devon, TQ12 3BA 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) 01626 360274 01626 363104 Penns Mount Limited Mrs Elizabeth Aldridge Care Home 22 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (22), of places Physical disability (22), Physical disability over 65 years of age (22) Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. PD over 50 years of age Date of last inspection 7th December 2004 Brief Description of the Service: Penns Mount is a registered residential care Home for people over the age of 50 with physical disabilities, frail elderly and people with dementia.The Home is a large detached House set back off the road and surrounded by attractive grounds. The accommodation is set over two floors with lift access to all levels. Most of the bedrooms are ensuite and there are several communal bathrooms with assisted bathing facilities. The Home is close to local amenities and is on a bus route to the local town. Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place at 10.30am on Tuesday 2nd August 2005. The Inspector met with twelve residents and the three members of staff on duty. Time was spent observing care practice and an activity, having a meal with the residents and time with the Manager looking at and discussing a sample of records. No visitors were seen on the day of this visit. What the service does well: What has improved since the last inspection?
The home’s Proprietor and Manager are constantly looking at ways in which to improve the level of care and services offered in the home. They are open and accepting of suggestions and good practice guidance and actively seek this information.
Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 Page 6 The home has obtained an Occupational Therapist report on the premises and have addressed the three minor recommendations made in this report. The Proprietors have recently built and registered two rooms to these premises. The two rooms are adjoining in a separate building adjacent to the home. This accommodation offers two furnished rooms with ensuite facilities and a kitchenette. There is a shared patio area that overlooks some fields and the Teign Estuary. Both are furnished and decorated to a high standard. 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. Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 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 Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 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) 3 Residents can be assured of a full assessment of their needs for suitability before being offered a place at Penns Mount. EVIDENCE: Records were seen for a resident who moved into the home three days prior to this inspection visit. A care plan and needs assessment was present from the referring local authority. The Manager had visited the lady at home and had completed a needs assessment. Upon admission to the home a further initial assessment was completed, and from this a care plan, manual handling assessment and pressure area assessment were completed. There were detailed care records in place covering all aspects of the resident’s life from the time of her admission to the home. The Manager confirmed that the care plan will be reviewed and updated from these records following a monthly and thereafter monthly, as all others. Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 Page 9 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, 10 The care planning system provides staff with the information needed to meet the needs of the residents. There is good multidisciplinary input and working with this home to ensure residents health care needs are being met. EVIDENCE: Three sets of care records chosen at random were seen on the day of this visit. All were found to be comprehensive and up to date and from meeting with these three residents, they appeared to accurately reflect the current needs of these residents. Care records consist of initial assessments, manual handling, pressure care and general risk assessments. There are “at a glance” care plans that are used by care staff daily, and evidence was seen of these being updated regularly. There are additional night care plans and daily care records, all of which were found to be up to date and again accurately reflect the residents needs. All residents spoken with on the day of this visit confirmed that they were aware of their care plans and had been involved in the writing of the initial document. Some confirmed that they have been involved in the reviewing of
Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 Page 10 this document. This is not to say however, that the others have not, but simply stated they could not remember. Care staff spoken to and observed were aware of the residents needs. Care records demonstrate that health care professionals are involved in the care of some residents on a regular basis, and for others health care has been sought when required. Residents confirmed that they were afforded privacy, should they wish to remain in their bedrooms. They confirmed that staff always knock on bedroom doors before entering. Staff were observed talking to and interacting with residents in a way in which maintains their dignity and with an appropriate level of respect. Staff were discreet at times when offering assistance with personal care tasks and at the table for the main meal. Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 Page 11 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, 14, 15 Activities are well organised, creative and provide stimulation and interest to residents. Residents are encouraged to exercise choice and control over their lives, although this could be further improved upon, to maintain skills and independence. Dietary needs are well catered for, with a balanced and varied selection of food. EVIDENCE: There is a good activity programme offered in the home, which includes discussions, newspaper readings, quizzes, art and crafts, whist, music, relaxation, exercises, movie afternoons and regular entertainment and celebration parties. Residents confirmed that something was offered each day. The inspector joined a quiz group in the main lounge. A large percentage of residents who were sat in the room participated in this quiz. The member of staff was motivating and introduced a good level of humour to this activity, which the residents thoroughly enjoyed. The home has produced a monthly newsletter informing all residents of forthcoming activities and celebrations. The residents invited the Inspector to lunch with them. This was a pleasant experience. The dining room was clean, tables well presented with table clothes, place mats, napkins, glasses, cutlery and condiments. The atmosphere throughout was jovial, chatty and relaxed. The meal was served ready plated to individuals and was at a pace appropriate to individuals. The
Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 Page 12 food was home cooked, with fresh vegetables and was well presented. Alternative meals and puddings were offered to individuals with special dietary requirements or who simply did not like the main meal offered and had requested something else. A discussion was held with the Proprietor and Manager on the day of the inspection about encouraging and supporting residents in maintaining skills of independence. Some examples of this would be that residents are offered tea pots, sugar bowls and milk jugs, from which to make their own drinks, serve their own vegetables from dishes on the table, or sauces and gravy’s and cold drinks and waters from jugs. This would of course need to be done in a way, which supports and enables, but also ensures the residents safety. Both the Manager and Proprietor stated their intention to discuss this with the staff team and residents and had plans to implement some of this in the next few weeks. Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 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 standard(s) 16 Complaints and concerns are listened to and complaints are dealt with satisfactorily. EVIDENCE: The home has a complaints procedure that is displayed in the main entrance area to the home and is in the Statement of Purpose and Service User Guide. The Manager was able to evidence records in relation to a previous formal complaint received. These records demonstrate that the home takes complaints seriously and was able to evidence the investigation and outcome to the complaint. The home does not however, have a complaints logbook in place, where both formal and informal complaints and comments can be recorded. This record would further demonstrate that the home takes all complaints seriously however small or informal. The Manager agreed with this and confirmed her intention to introduce such a log. Residents spoken with confirmed that they were aware of the complaints procedure and of how they would go about making a complaint should they need to. Three residents stated that they feel comfortable in raising concerns or issues with staff on duty, and have on occasions spoken with the Manager or Proprietor. They confirmed that on these occasions action has been taken immediately. Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 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 standard(s) 19, 26 The overall quality of décor and furnishings is of a high quality and the home is clean and hygienic. EVIDENCE: The home has a continual programme of maintenance. The homes décor and furnishings are of a very high quality. Communal rooms and bedrooms are tastefully decorated, are bright and most rooms have views of either surrounding countryside of the Teign Estuary – a very positive point made by several residents on the day of this visit. The garden is large and landscaped and provides plenty of different of places in which to sit. The home is clean and hygienic. The laundry was found to be clean, tidy and well organised. Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 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 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) EVIDENCE: None of these standards were considered in depth at this visit. Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 Page 16 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) EVIDENCE: None of these standards were considered in depth at this visit. Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 Page 17 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 x x 4 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 x 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 x x x x x x x x x x Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 Page 18 no 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 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. Refer to Standard 14 16 Good Practice Recommendations Support residents in maintaining skills of independence where this can be accommodated and where it is felt an acceptable risk to do so. Implement a Complaints/Comments log book Penns Mount D54-D07 S3772 Penns Mount V223407 030805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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