This inspection was carried out on 28th June 2005.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.
CARE HOME ADULTS 18-65
Penwith Respite Care Limited 38 Polweath Road Treneere Penzance Cornwall TR18 3PN Lead Inspector
Paul Freeman Unannounced 28 June 2005 12.00 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Penwith Respite Care Limited Address 38 Polweath Road Treneere Penzance Cornwall TR18 3PN 01736 330638 01736 330638 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) Penwith Respite Care Limited Mrs Christine Doyle Care Home 10 Category(ies) of Learning Disability (10) registration, with number of places Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 28 February 2005 Brief Description of the Service: Penwith Respite Care Ltd is located at modern purpose-built premises situated on a residential estate that is run by Penwith Housing Association. The home is on the outskirts of Penzance and close to local shops, facilities and a bus route. The building is rented from Cornwall County Council. The establishment offers planned respite care to adults with a learning disability. The aim is to provide service users and their carers with planned pattern of stays of up to four nights. Stays at the home are arranged through Cornwall County Council Social Services Department. This is a popular service and up to ten people can be accomodated at any time. All the bedrooms are single. Nine are on the ground floor and seven have en suite facilities. The communal space is also on the ground floor and comprises a large L shaped lounge/dining room with a sensory area and a smaller lounge area in the new part of the building. The kitchen is located off the lounge and currently in the process of refurbishment. Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over five and a half hours. The Inspector looked over the building and at a number of records and documents. Seven of the people who use the service, three of the staff and the registered manager were spoken to. The Inspector found the requirements and recommendations set at the last inspections had been worked upon. What the service does well:
Prospective users of the service are assessed by the home to make sure they have a clear picture of the person’s needs and preferences. This follows on from an assessment that will have been completed by a social worker and also takes account of the views of any other professionals in contact with the person. This helps the home to plan the care and support required and to be satisfied they are able to meet the needs of the individual. Prospective users of the service are able to visit the home to help them decide if it is a suitable setting to stay at. The person’s parents or representatives are also invited to participate in the introductory visits and the assessment process. Users of the service commented they were able to choose the food they had and found the meals to be “nice” and “good”. A varied menu is provided that accommodates individual choices and preferences and dietary requirements. People at the home are able to participate in meal preparation when it is safe to do so. The care staff are responsible for cooking the food provided and have been suitably trained about this area. The home has satisfactory arrangements in place to protect users of the service from abuse and report any concerns they have to the Social Services Department. Any complaints or concerns are dealt with positively and users of the service or their families are encouraged to raise any issues they have. The people at the home commented they felt listened to and any worries were dealt with promptly and in a satisfactory manner. Sufficient numbers of staff are employed to meet the needs of the users of the service. The staff group are highly motivated, trained and well support in the work they undertake. Users of the service commented they find the staff to be approachable, helpful and flexible in the way they undertake their duties. Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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. Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 3. The admissions process is well managed and prospective users and their parents or representatives are fully consulted. The homes statement of purpose does not provide sufficient information to clearly detail the services provided. EVIDENCE: The home has a statement of purpose that is in the process of being reviewed. Currently there are some areas where the information does not clearly illustrate the services provided at the home. Prospective users of the services are able to visit the home to help them make a decision if it is a suitable setting for the person to stay. The visiting arrangements are flexible and parents and representatives are also invited to participate. Before staying at the home each prospective user of the service is assessed by the Social Services Department and the views of any other professional involved are also taken into account. The home also complete an assessment to make sure they are able to meet the needs of the person and this information also provides a clear picture of the care and support required. The views of the person’s parents or carers are also taken into account as part of the assessment arrangements. Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 9 Emergency admissions are also considered. In these circumstances every reasonable step is taken to help the person adjust to their new environment and to establish their needs and preferences at the earliest opportunity. Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 11. Users of the service are well looked after but further attention needs to be given to care plans and the management of risk. EVIDENCE: Each user of the service has a care plan that details their needs and where necessary the most appropriate means of meeting the needs. The home are in the process of improving and developing the information to make care plans more user friendly and provide clearer direction to the staff about meeting the persons choices, needs and preferences. The format for recording care plans has been improved but the information provided requires improvement. The person’s needs are considered during each stay and the home encouraged parents and other carers to advise them of any changes prior to each stay. The care is formally reviewed by the home every six months. At the point of admission to the home a senior staff member take action to monitor if there are any identifiable changes. Users of the service commented they felt consulted about their care plans and were able to decide how they spent their time at the home. They said they felt in control of the care and support provided and were able to direct the staff about the best way of providing the assistance they need. The Inspector observed a number of positive interactions between staff and the people at the home where staff positively responded to the users of the service wishes.
Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 11 Risks are taken account of but some of the current arrangements need to be improved. Reasonable steps are taken to minimise risks around the environment but individual risks that users of the service experience need attention. Each service user is assessed for risk but the records provide a summary of the finding and some direction to staff about the most suitable methods of minimising the identified risks. There are other occasions where any considerations about potential risk had not been recorded. This does not reflect attention given to the management of risk or provide staff with satisfactory direction about minimising potential risks a person may experience. Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 17 Satisfactory meals are provided that offer a nutritional balance and provide choice for users of the service. EVIDENCE: Users of the service commented they were very satisfied with the food provided. At each mealtime the individuals at the home make a choice about the meal they have. The food provided offers a nutritional balance and meets dietary needs as well as the preferences of the people concerned. The staff at the home prepares the food and have been suitably trained. Users of the service are also able to participate in preparing their meals when it is safe to do so. At the time of the inspection the kitchen was in the process of refurbishment and this includes new units and work surfaces as well as replacing some of the kitchen equipment. The kitchen presented as clean and hygienic. Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 The medication policy and procedure needs further attention about the administration of medicines and the use of invasive medication. EVIDENCE: Satisfactory arrangements are in place to store medication and the nominated staff responsible for medicines has been suitably trained. The home maintains good records that include all medicines that come to and leave the care home. The home needs to be mindful about disguising any medicines administered to make sure they meet the regulatory requirements. The home will also administer invasive medicines where this is necessary and the staff have completed specialised training. A policy and procedure for invasive medicines needs to be established. Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The home has an open approach to concerns or complaints that are dealt with positively and efficiently. The records of the complaints received are not satisfactory. The arrangements to protect users of the service from abuse are satisfactory. EVIDENCE: The home has an open approach to any concerns or complaints that are received. Users of the service commented they were confidant that any issues they raised would be dealt with positively and in a satisfactory manner. A record is maintained of all concerns that are raised, the action taken and the outcome. The current records need to be revised in order to comply with the DATA Protection Act and to make sure confidentiality is not compromised. Satisfactory arrangements are also in place to protect users of the service from abuse and all the staff has satisfactorily completed training about this area. Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 0 Not assessed. EVIDENCE: The Inspector noted no significant concerns. Users of the service commented they were very satisfied with the facilities provided. Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 16 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 and 36. Staff morale is high resulting in a positive work force that works positively with users of the service. Sufficient staff are employed to meet the needs of users of the service. Staff are well supported and trained in the work they undertake. EVIDENCE: Sufficient numbers of staff are on duty for waking hours and overnight. Each night a waking staff member is on duty and a second sleeps at the home to cover any emergencies. If the needs of an individual require close support additional staff are provided. During waking hours a senior staff member is on duty to coordinate the service provided. Users of the service commented that staff treated them with dignity and respect and were flexible in the manner they undertake their duties. Staff commented it was a “fantastic place to work” and described the staff team as “motivated about the users of the service”. Staff said they were well support and advice and guidance was readily available. The staff regularly meet as a group and staff commented there are no barriers to raising or discussing any issues or concerns. All the staff have opportunities to develop their knowledge and skills through training and formal supervision. Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 17 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 41 Apart from the records detailed in other parts of the report the record keeping arrangements are satisfactory. EVIDENCE: Generally the records kept at the home are satisfactory and any areas that require improvements have been detailed in other parts of the report. Daily records are kept on users of the service on each occasion they visit the home. The records summarise the events that occur, any issues of concern and the action taken. There are no barriers to users of the service accessing their records. Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 x x Standard No 22 23
ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 x 3 2 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x x x x x x 3 Standard No 31 32 33 34 35 36 Score x 3 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Penwith Respite Care Limited Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x x x 3 x x D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 19 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 1 Regulation 4 Requirement The statememt of purpose must provide clear information about the services and facilities at the home. Care plans must provide sufficent information and direction about the needs, preferences and choices of service users. When any situation arises that could potentially compromise the safety and well being of a service users a risk assessment and action plan must be established. Medicines must not be disguised without the agreement and direction of the service user or General Practitioner.. A policy and procedure for the administration of invasive medicines must be established. The records of complaints and concerns must comply with the DATA Protection Act. Timescale for action 30.10.05 2. 6 15 30.12.05 3. 9 13 30.9.05 4. 20 13 30.8.05 5. 6. 20 22 13 17 30.8.05 30.8.05 Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 20 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. Refer to Standard None Good Practice Recommendations Penwith Respite Care Limited D52-D04 S9127 Penwith Respite Care V224207 280605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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
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