Inspection on 16/01/06 for Pennsylvania House

This inspection was carried out on 16th 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

Pennsylvania House 18/07/07

Pennsylvania House 13/09/06

Pennsylvania House 07/09/05

Pennsylvania House 09/03/05

Pennsylvania House 27/07/04

Pennsylvania House 30/03/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

St George`s

5 Seafield Road

Credence House

Poldhu

Queensmount

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Pennsylvania House 7-9 Powderham Crescent Exeter Devon EX4 6DA Lead Inspector Sue Dewis Unannounced Inspection 1 March 2006 1pm 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 Pennsylvania House DS0000022007.V278022.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. Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Pennsylvania House Address 7-9 Powderham Crescent Exeter Devon EX4 6DA 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) 01392 256346 01392 433224 henry-morgan@tiscali.co.uk Mr Henry Arnold Morgan Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Learning registration, with number disability over 65 years of age (25), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (25), Old age, not falling within any other category (25) Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th September 2005 Brief Description of the Service: Pennsylvania House, a privately owned home is situated in a residential area of Exeter, is within a short walk of the city centre. It comprises three adjoining terraced houses with accommodation on he ground first and second floors. A passenger lift provides access to the upper floors. To the front is a small garden and there is car parking to the rear. The home provides care and accommodation for a maximum of twenty-five older people with dementia, mental health needs and learning disabilities. Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place one morning at the beginning of March 2006. The inspector spoke with a total of seven residents. Two were spoken with in private and the others in various groups. The owner and care manager were available throughout the inspection. Four resident’s care plans were inspected and a full tour of the building was made. What the service does well: What has improved since the last inspection? What they could do better: No requirements were made at this inspection, though several small recommendations were identified. Risk assessments for nutrition and pressure areas should be completed, and the risk assessments for the building should be reviewed. Records of the tests on emergency lighting should be correctly maintained and copies of equipment servicing should be forwarded to CSCI. Covers should be fitted to all radiators and thermostatic valves should be fitted to all taps to which residents have access. Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 Page 6 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. Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 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 Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 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): 3 Prospective residents are assured that their care needs can be met EVIDENCE: Four residents’ files were inspected. The file of the most recent admission contained a completed assessment form and the resident confirmed that their needs were being met. Another resident remembered the care manager visiting her before she moved into the home. Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 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 the following standard(s): 7, 8 and 9 Care plans are well formulated and give clear information to enable staff to meet resident’s health and social care needs. In order to ensure there is good nutritional and pressure area care, risk assessments should be completed. Systems for the storage and administration of medicines ensure residents are appropriately protected. EVIDENCE: Four residents’ files were inspected. All contained a photograph of the resident and had been reviewed monthly. There were good instructions to staff on how to meet the day-to-day needs of residents and also good daily recordings. There were risk assessments for individual residents for their daily living activities and moving and handling. However, there were no risk assessments for nutritional needs or pressure areas. Health care needs were identified and it was possible to see where a resident had been unwell and the doctor had visited. Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 Page 10 Medications were stored appropriately, including controlled drugs. All records, including those for controlled drugs, were appropriately maintained. However, there were no sample signatures and initials to identify which staff member had signed as having administered the medicines. Pennsylvania House DS0000022007.V278022.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): 13 and 14 Residents are offered good choices in many aspects of daily living. The home provides a good range of activities and entertainments to suit individual interests. EVIDENCE: Residents said that they generally spend their time as they please, reading, knitting or watching TV. Various activities are organised throughout the week, and include reminiscence and gentle exercise sessions. One resident told the inspector a pottery mug that she had decorated, and was very proud of her lovely fingernails that staff regularly varnish for her. Another resident told the inspector that staff are always asking her what she wants to do and what she wants for lunch and tea. Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 Page 12 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 Complaints are handled correctly and provide residents with confidence that their concerns will be listened to and acted upon. Staff training ensures residents are protected from abuse. EVIDENCE: There is a simple complaints procedure displayed in the main hall and the communal lounges. Details of any complaints made are kept in a separate log, where it is possible to see the outcome of the complaint. One resident told the inspector how their concerns had been appropriately dealt with. Two members of staff have completed the POVA (Protection Of Vulnerable Adults) training for trainers, and are able to ensure all staff are kept up to date with these issues. Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 Page 13 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 and 26 The overall quality of furnishings and fittings is satisfactory, enabling residents to live in comfortable, clean and safe surroundings. EVIDENCE: There has been some redecoration of communal areas mainly the corridors. Some bedrooms have also been redecorated and have had a new carpet fitted. The home was generally clean and tidy and there were no offensive smells around the home. Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 Page 14 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): None of these standards were inspected on this occasion. For more information please see the report of the inspection carried out on 7 September 2006. EVIDENCE: Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 Page 15 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, 33, 35 and 38 The home is generally well managed though some aspects of Health and Safety could be improved in order to promote and safeguard the welfare of the residents. The home has a range of methods in place to check the quality of the services and facilities provided. EVIDENCE: Mr Morgan has owned the home for many years, he is supported by a care manager who is on the last unit of their RMA (Registered Managers Award). It is proposed that they will then apply to become registered as manager of the home. Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 Page 16 The home has a variety of quality assurance systems in place, including regular residents’ meetings, care plan reviews and checks on the quality of food provided. The home manages monies for several residents and uses the ‘Microsoft Money’ system to manage the TSB Residents’ Account. Four residents’ accounts were checked and all were appropriately maintained and had the correct money held in separate wallets. Risk assessments for the building had not been reviewed since February 2002. Though fire records were generally well maintained, and the inspector was assured that all tests are carried out at the required intervals, there were some gaps in the records relating to the testing of emergency lighting. The inspector saw a five year electrical certificate that had been issued in 2004. However, no other service certificates were available for inspection. Covers are being fitted to radiators in a rolling programme, but there is, as yet, no date when thermostatic valves will be fitted to all taps. Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 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 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 Page 18 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. Refer to Standard OP7 OP38 OP38 OP38 OP38 OP38 Good Practice Recommendations You are recommended to complete risk assessments for You are recommended to ensure all radiators are guarded You are recommended to ensure risk assessments for the building are reviewed You are recommended to ensure emergency lighting tests are appropriately recorded You are recommended to fit thermostatic mixer valves to all sinks that residents have access to You are recommended to send copies of equipment service reports to CSCI Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Pennsylvania House DS0000022007.V278022.R01.S.doc Version 5.1 Page 20 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!