CARE HOMES FOR OLDER PEOPLE
Penns Mount Vicarage Hill Kingsteignton Newton Abbot Devon TQ12 3BA Lead Inspector
Sharon Goldsworthy Announced Inspection 5th January 2006 09:30 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 Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Penns Mount Address Vicarage Hill Kingsteignton Newton Abbot Devon TQ12 3BA 01626 360274 01626 363104 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) 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 DS0000003772.V275285.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. PD over 50 years of age Date of last inspection 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 DS0000003772.V275285.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection is the second of this year. This visit was announced and took place on a Thursday for six hours. The Inspector spent some time with the Proprietors, staff on duty and residents. Eight pre inspection questionnaires were received from residents and their relatives prior to this inspection visit. A tour of the premises was conducted and a sample of documents were viewed at this visit also. No relatives were present 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 DS0000003772.V275285.R01.S.doc Version 5.1 Page 6 The home has introduced a comments and complaints record, where all comments and complaints, however trivial, are recorded along with any action taken by the manager or proprietor. The Proprietors and Manager are continuing to look at maintaining existing skills for residents and improving their skills of independence where possible. They are currently exploring the use of vegetable dishes, drinks, coffee/tea pots, milk jugs etc to the dining tables, for those residents who can manage this. They plan to continue to look at areas where these ideas can be expanded. 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.
Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 Page 8 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 Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 Page 9 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): None of these standards were considered in depth at this inspection visit. EVIDENCE: Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 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): 9 The medication system is well managed, promoting good health and the safety of residents. EVIDENCE: The medication records are accurate and detailed. They include staff signature samples, full resident details, GP details and details in relation to all medications the individual is taking. The medication administration charts are complete and clear. A highlighter pen is used to alert staff to specific instructions. Controlled drugs records were seen to be accurate and up to date. A medication policy is in place that is clear and understood by staff on duty. All staff responsible for the administration of medications have completed training from Boots pharmacy. The home’s pharmacist completes an annual audit and it is reported that the relationship with the pharmacist is good. The medication storage was found to be tidy and well organised. The medication given out at lunchtime was done so safely and accurately.
Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 14 Activities are well organised, creative and provide stimulation and interest to residents. Residents are encouraged and supported in maintaining contact with relatives and friends. Residents are encouraged to exercise choice and control over their lives, although this could be further improved upon, to maintain skills and independence. 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 home has produced a monthly newsletter informing all residents of forthcoming activities and celebrations. No relatives or other visitors were seen on the day of this inspection visit. However, residents confirmed that their visitors can visit at any time of the day, and that they are supported in maintaining contact with relatives, if they were to need assistance with telephone calls and writing etc. Some residents stated that they often visit relatives at their own homes or are often taken out by relatives and friends. A number of residents have their own private
Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 Page 12 telephone lines in their rooms, which allow them free access to contact with friends and relatives. A discussion was held with the Proprietor and Manager on the day of the last inspection in August 2005, 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. Some discussions have taken place with residents and staff and some introduction of these new ideas have been started. It is hoped that in the next couple of months, this work will continue. Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 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, 18 Complaints and concerns are listened to and complaints are dealt with satisfactory. The homes policies and procedures and level of staff training protects the residents from the possible risk of harm or abuse. 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. Complaint records have been introduced, and demonstrate that the home takes complaints seriously and was able to evidence the investigation and outcome to the complaint. 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. They confirmed that on occasions when they have raised concerns, action has been taken immediately. The home has policies in place in relation to the Protection of Vulnerable Adults from Abuse, Whistle blowing, Dealing with Aggression, Physical Interventions and Bullying in the Workplace. Nearly all staff have now completed or are in the process of completing NVQ training. This training covers compulsory training in relation to the protection of vulnerable adults from abuse. Those staff who have not enrolled on NVQ training, have completed basic induction training in this topic, but would benefit also from some external certificated training. The Proprietor stated their intention to look into this. Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 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): 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 and kitchen areas were found to be clean, tidy and well organised. Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 Page 15 Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 Page 16 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, 29, 30 Residents’ needs are met with adequate numbers of staff who are competent and trained. Staff recruitment practices and policies protect the residents from being placed at harm or abuse. EVIDENCE: The home is currently fully staffed. A number of the staff team have worked in the home for some years now – and the staff team as a whole is dedicated and committed to providing a good service to the residents. The numbers of staff on duty are adequate to meet the needs of the current resident group. The staff were seen to be attentive to residents, having time to spend with residents not only for personal care tasks, but to sit and talk with them or to run an activity. Residents confirmed that staff are always around to assist or to talk to them and that staff respond to calls for assistance promptly. The Proprietor and the Manager are currently undertaking NVQ training at Level 4. Three staff have completed NVQ’s to level 3 and two at level 2. One member of staff has just registered to complete NVQ training to level 2. Three members of staff are trained nurses in their countries of origin (Phillipines and Czechoslovakia). The staff’s induction package is comprehensive and was found to be completed for a sample of the staff team chosen on this inspection day.
Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 Page 17 The home has an ongoing training programme. Records indicate that staff have attended the following training; Care of the Dying, Dementia Care, Medication administration, Infection Control, Manual Handling, Fire Safety, Laundry practices, Health and Safety and MRSA. The home is currently undertaking some in house training in the prevention and monitoring of falls. Training is booked to be completed in the next month for Health and Safety, Manual Handling and First Aid. All staff will attend this. Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 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): 33, 35, 38 Residents are fully consulted and informed about the running of this home. Their financial interests are safeguarded. Residents and staff’s health and safety are protected. EVIDENCE: The home has a good quality assurance system in place. Questionnaires have been given to all residents and their relatives. The questionnaires have been analysed and a plan has been drawn up to address the areas where residents are not fully satisfied with the service. There are regular reviews of the facilities and property as a whole, which includes all health and safety aspects. Routines have been developed for staff to follow (but not strictly). There is evidence that this routine is regularly reviewed with the staff team. There are regular staff and resident meetings and there is a newsletter in place, which is distributed to all residents and relatives monthly. Additional quality assurance checks include meals and meal times; care plans and medication, which are completed by both the Proprietor and Manager. There are plans to implement
Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 Page 19 falls monitoring records in the next few weeks. A discussion was held with the Proprietor as to how to further develop the current quality assurance system with the introduction of questionnaires for other visitors to the home such as district nurses, GP’s, hairdresser, opticians, dentists etc. There is a policy in place in relation to dealing with and managing residents monies. All residents upon admission are asked how they would like to continue to manage their monies – giving them the options of managing it themselves, for the home holding monies for them, or that the home purchases items when required and invoice them monthly. Appropriate records were found to be in place where resident’s monies are held by the home. The Proprietors keep extremely detailed and comprehensive health and safety records. There is a comprehensive policy and procedure manual covering all aspects of health and safety. A sample of records were seen and found to be very well organised and up to date. Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 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 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 Page 21 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. 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 Refer to Standard OP14 OP18 OP33 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. Staff who are not currently undertaking NVQ training should attend external certificated training in the Protection of Vulnerable Adults from Abuse. Further extend the homes quality assurance programme to seek the views of all external visitors to the home. Penns Mount DS0000003772.V275285.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Ashburton Office 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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