Inspection on 07/09/05 for Pennsylvania House

This inspection was carried out on 7th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 16/01/06

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 Announced Inspection 7th September 2005 10:00 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.V256098.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. Pennsylvania House DS0000022007.V256098.R01.S.doc Version 5.0 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.V256098.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th March 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.V256098.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over six hours in early September 2005. The home had been notified that an inspection would take place within three months and had returned a pre-inspection questionnaire, information from which was used to write this report. The focus of this inspection was staffing and four members of staff were spoken with and staff records were inspected. Three residents were spoken with in private with a further two at the lunch table. What the service does well: What has improved since the last inspection? What they could do better: There were areas of the home where there was an unpleasant odour, and there were some chairs that were dirty. The dignity of residents could be better promoted by ensuring personal care is more closely monitored, as one resident had particularly long fingernails. Pennsylvania House DS0000022007.V256098.R01.S.doc Version 5.0 Page 6 Window restrictors, radiator guards and thermostatic mixer valves should be fitted where necessary and a visitors book should be maintained. Staff should receive more specialist training in dementia care and adult protection issues. 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.V256098.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 Pennsylvania House DS0000022007.V256098.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): None of these standards were inspected on this occasion EVIDENCE: Pennsylvania House DS0000022007.V256098.R01.S.doc Version 5.0 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): 10 Residents’ dignity is not always promoted EVIDENCE: One service user was sat in a chair that had food stains on it and another was in a wheelchair that was also quite dirty. One resident had very long fingernails. These matters were discussed with the manager who told the inspector that there was a regular cleaning programme for the home, that night staff were responsible for cleaning wheelchairs, and the chiropodist was to cut the long fingernails at their next visit. Though staff were seen to treat residents with respect, the home must ensure that these matters are monitored closely to ensure the dignity of the residents in promoted at all times. Pennsylvania House DS0000022007.V256098.R01.S.doc Version 5.0 Page 10 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 and 15 Residents are offered good choices in many aspects of daily living EVIDENCE: Lunch was taken with residents and it was wholesome and nutritious. There was a choice of main and sweet course on offer. All residents that were spoken with said that they always enjoyed their food and that there was plenty of it. Pottery was seen that had been decorated by residents for presents for their relatives. A local pottery had visited the home and provided the plain mugs and bowls and it was waiting to be taken to be ‘fired’. Staff said that did quite a lot of other activities with residents in the afternoons. Pennsylvania House DS0000022007.V256098.R01.S.doc Version 5.0 Page 11 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): 18 Staff training in adult protection issues is not satisfactory and has the potential to place residents at risk of harm or abuse EVIDENCE: Staff who were spoken with had had varying amounts of training in relation to recognising and dealing with abuse. Though they all gave reasonable responses as to what they would do if they thought abuse was occurring, it is recommended that all staff receive some formal training in adult protection issues. Pennsylvania House DS0000022007.V256098.R01.S.doc Version 5.0 Page 12 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): 25 and 26 The overall quality of furnishings and fittings is satisfactory, though the cleanliness of the home should be improved in order to provide residents with a more comfortable place in which to live EVIDENCE: While the inspector was walking around the building she noticed that there were two spots that had unpleasant odours. One may have been due to soiled incontinence pads having recently been carried through that area, but the other was due to the carpet in a resident’s bedroom. The owner said that this carpet was due for replacement. Two carpets have recently been replaced and the top lounge is due for redecoration. It was also noted that one resident’s arm chair was very dirty as was a wheelchair. Pennsylvania House DS0000022007.V256098.R01.S.doc Version 5.0 Page 13 Though the inspector was told that there is a regular cleaning programme for wheelchairs and carpets it would appear these need to be more closely monitored. See also Standard 38 in relation to the safety of the home. Pennsylvania House DS0000022007.V256098.R01.S.doc Version 5.0 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): 27, 28, 29 and 30 The procedures for the recruitment of staff are robust and offer protection to residents. Training in specific areas such as dementia should be improved in order to better meet the needs of such residents EVIDENCE: The inspector spoke in depth with four care staff who had received varying amounts of training. Two staff have had NVQ training, one has recently started but another does not wish to start. Staff confirmed that they have received training in First Aid, Food Hygiene and fire precautions. The home has residents who have varying degrees of dementia but staff have not received any training in this area. It is recommended that staff receive such training. Staff said that they did not feel rushed to do their jobs and had time to sit and chat to residents. When asked what they felt the home does well, responses included, ‘ make residents feel at home and safe’, ‘get a lot of training’, ‘good attitude towards residents’, ‘ family atmosphere’ and ‘treat residents as their own person, let them come and go as they like’. When asked what the home could do better, responses included ‘ a visitors book, to let us know who is here’ (see also Standard 37), ‘more staff’ (though staffing levels are in line with those set by the previous regulatory authority) and ‘nothing at all. Pennsylvania House DS0000022007.V256098.R01.S.doc Version 5.0 Page 15 The files of the two most recently appointed staff were inspected, both contained all the required information and satisfactory CRB (Criminal Records Bureau) checks. Files for two other prospective staff were seen and contained applications for CRB checks. Pennsylvania House DS0000022007.V256098.R01.S.doc Version 5.0 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 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): 32, 36 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 EVIDENCE: Staff confirmed that they receive regular supervision, though this is not always recorded. Staff and residents said that they felt they could discuss anything with the manager and she would deal with it straight away. Radiators are not all covered, though there is a programme in lace to ensure they will all be covered. There was a discussion relating to window restrictors and it is recommended that restrictors be fitted to any windows that are above Pennsylvania House DS0000022007.V256098.R01.S.doc Version 5.0 Page 17 ground floor level. It is further recommended that thermostatic mixer valves are fitted to sinks which resident have access to. No visitors book is maintained at the home and therefore there is no way of knowing who is in the building. In line with Regulation 17 a visitors book must be maintained. Pennsylvania House DS0000022007.V256098.R01.S.doc Version 5.0 Page 18 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 X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 X X X X X X 2 1 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X X X 2 1 2 Pennsylvania House DS0000022007.V256098.R01.S.doc Version 5.0 Page 19 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. 1 Standard OP10 Regulation 12(4)(a) Requirement You are required to conduct the care home in a manner which respects the dignity of service users You are required to keep the care home free from offensive odours You are required to ensure all parts of the care home are kept clean You are required to keep a record of all visitors to the care home, including the names of visitors Timescale for action 10/11/05 2 3 4 OP26 OP26 OP37 16(2)(k) 23(2)(d) 17(2) Sch 4(17) 10/11/05 10/11/05 10/11/05 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 OP30OP18 OP38OP25 Good Practice Recommendations You are recommended to ensure all staff receive training in adult protection issues You are recommended to ensure all radiators are guarded DS0000022007.V256098.R01.S.doc Version 5.0 Page 20 Pennsylvania House 3 4 5 6 OP30 OP36 OP38 OP38 You are recommended to ensure all staff receive training in caring for people with dementia You are recommended to record all staff supervision sessions You are recommended to ensure that all windows above ground floor level are fitted with restrictors You are recommended to fit thermostatic mixer valves to all sinks that residents have access to Pennsylvania House DS0000022007.V256098.R01.S.doc Version 5.0 Page 21 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. 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