CARE HOMES FOR OLDER PEOPLE
Perran Bay Home For The Elderly St Pirans Road Perranporth Truro Cornwall TR6 0BH Lead Inspector
Diana Penrose Announced Inspection 8th December 2005 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 Perran Bay Home For The Elderly DS0000009126.V258851.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. Perran Bay Home For The Elderly DS0000009126.V258851.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Perran Bay Home For The Elderly Address St Pirans Road Perranporth Truro Cornwall TR6 0BH 01872 572275 01872 572275 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) Cornwall Old Peoples Housing Society Mrs Linda Joyce Whitford Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Perran Bay Home For The Elderly DS0000009126.V258851.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 30th June 2005 Brief Description of the Service: Perran Bay Care Home is situated in the heart of Perranporth adjacent to the main street with level access to a variety of shops. On the other side of the home there are uninterrupted views of Perranporth beach. The home has two pleasant gardens, and there is adequate parking for visitors. The registered provider is Cornwall Old Peoples Housing Society which is a registered charity. The home provides spacious accommodation and provides personal care for up to 34 elderly residents. The home also provides daycare for up to 5 people. The premises consists of a three storey building with a modern single storey extension. There is a lift to access the first floor. All rooms are single occupancy but one room is used as a double if a married couple require respite care. The home provides ample shared space and has two lounges overlooking the beach. Meals are prepared in the kitchen on the ground floor and served in the spacious dining room, or individual bedroom if preferred. Suitably experienced care staff provide personal care within a relaxed, friendly, welcoming atmosphere. Perran Bay Home For The Elderly DS0000009126.V258851.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspector visited Perran Bay Care Home on the 08 December 2005 and spent five hours at the home. This was an announced visit. The purpose of the inspection was to gain an update on the progress of compliance to requirements identified in the last inspection report dated 30.06.05. In addition the inspector focused on the following key areas of care: assessment and care planning, medication, complaints, some of the environment, recruitment and Health and Safety On the day of inspection 31 residents were living in the home. The methods used to undertake the inspection were to meet with residents, staff, the registered manager and one of the directors to gain their views on the services offered by Perran Bay. Records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. What the service does well: What has improved since the last inspection?
The recently appointed manager has reviewed many aspects of the service and has implemented beneficial changes where required. A lot of refurbishment has been taking place. New carpet has been fitted in the sun lounge, hall, front staircase, top staircase and two bedrooms. One of the
Perran Bay Home For The Elderly DS0000009126.V258851.R01.S.doc Version 5.0 Page 6 assisted bathrooms has been decorated in a Beryl Cook style, according to resident’s wishes and they are all very happy with it. All of the corridors have been decorated. The small kitchen has been painted with washable paint. A ramp has been fitted to replace the steps inside the front door. All of the windows have been oiled and repaired and the fire escapes are being refurbished. A gate has been installed at the entrance to the home to discourage unauthorised parking. A washer disinfector has been installed in the sluice. An administrator has been appointed and has proved invaluable. 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. Perran Bay Home For The Elderly DS0000009126.V258851.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 Perran Bay Home For The Elderly DS0000009126.V258851.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): 3 Residents are only admitted to the home following an assessment of their needs to ensure the home can provide adequate care. EVIDENCE: The registered manager said she visits prospective residents prior to admission. She undertakes a thorough needs assessment with the resident and often their family; this is documented and forms the basis of the care plan. She said she makes sure she has a Social Services assessment for prospective residents if appropriate and gets information from other health professionals as necessary prior to deciding to accommodate anyone. It should be documented who is involved in the initial assessment and signatures obtained when possible. Perran Bay Home For The Elderly DS0000009126.V258851.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): 7 and 9 Individual care plans are generated for each resident that inform and direct the staff in their care provision. There are suitable systems and policies in place for dealing with resident’s medicines; some extra vigilance in record keeping will help to ensure residents safety. EVIDENCE: Each resident has an individual care plan that is reviewed monthly or more frequently if necessary. The care plans are signed as agreed by the resident or representative. Relevant risk assessments are undertaken including falls, nutrition, and moving and handling. Daily records are maintained and are informative. The Registered Manager said she is working on improving the care plans. Perran Bay Home For The Elderly DS0000009126.V258851.R01.S.doc Version 5.0 Page 10 The home has an appropriate medication policy used in conjunction with The Royal Pharmaceutical Guidelines for the Administration of Medicines in Care Homes. A monitored dosage system (MDS) is used. There are gaps on the medication administration records were medicines have not been signed as given; this must be addressed. Other records are satisfactory, for example, Lactulose syrup. Staff have received training with Penwith College. Perran Bay Home For The Elderly DS0000009126.V258851.R01.S.doc Version 5.0 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): 14 Residents are helped to maintain control over their lives and staff respect their individual preferences and choice. EVIDENCE: All residents spoken with said their individual preferences are respected and they are supported to maintain their independence. They said they could go out if they wish and the daily routines are flexible. All residents control their own money and they all have their own belongings in their rooms. The menu has choices available. Perran Bay Home For The Elderly DS0000009126.V258851.R01.S.doc Version 5.0 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 The home has a satisfactory complaints procedure that ensures complaints are listened to and acted upon. EVIDENCE: The home has an appropriate complaints policy and a copy is displayed in the hall. A comments book is also available in the hall. There is a method for recording complaints; there have been no complaints since the last inspection. Thank you cards and complimentary letters are kept. Perran Bay Home For The Elderly DS0000009126.V258851.R01.S.doc Version 5.0 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 home and grounds are well maintained providing a safe environment for residents, staff and visitors. The home is clean and from offensive odours making it a pleasant place to live in. EVIDENCE: The home is well maintained, decorated and furnished to a good standard. It is very clean, homely and comfortable. A great deal of maintenance work and refurbishment has been going on in recent months. The grounds are tidy and accessible. Residents said they are very happy in their home and surroundings. The home is non-smoking and this is stated in the statement of purpose. The laundry facilities are small but suitable with two washers and one drier. All linen and towels are contracted out. Residents have no complaints about the laundry service. There are appropriate hand-washing facilities for staff with alcohol hand cleansing gel used. Protective clothing is provided. The home has a sluice with a washer disinfector. Perran Bay Home For The Elderly DS0000009126.V258851.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 and 29 Staffing levels meet the needs of residents and staff morale is good. Recruitment procedures are robust and offer protection to the residents. EVIDENCE: The working duty rota is displayed. There are suitable numbers of staff on duty in all areas. The Registered Manager said the staffing is calculated according to the dependency of the residents. Prospective employees complete an application form and are interviewed prior to selection for employment. Personnel files inspected contained the records required by legislation. Job descriptions are supplied to staff. An employee handbook, various policies and induction handbook are given to new employees. All staff are issued with terms and conditions of employment. Perran Bay Home For The Elderly DS0000009126.V258851.R01.S.doc Version 5.0 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): 35 and 38 There is a system in the home for dealing with residents’ money; further safeguard need to be in place to more fully protect the residents’ financial interests. Appropriate training and safety checks are undertaken to ensure the health safety and welfare of residents and staff. EVIDENCE: There is a policy for the safe keeping of resident’s money; this requires reviewing and should include the amount of money to be held on behalf of the residents (in line with the insurance limit for the safe). It is recommended that the residents sign a form agreeing to the home looking after their money. All residents control their own money but the Registered Manager holds pocket money for some residents. This is stored safely in individual plastic envelopes in the safe. Appropriate records are maintained of all transactions and are signed. Two people sign spot checks. Receipts are kept for purchases and for money received on behalf of residents. It is recommended that the Registered Manager keep a copy of any power of attorney certificates.
Perran Bay Home For The Elderly DS0000009126.V258851.R01.S.doc Version 5.0 Page 16 The management endeavour to ensure that working practices are safe. Relevant service checks take place regularly. Staff receive statutory training as required and records are kept. There is a person trained in first aid on duty at all times. The kitchen staff have all received food hygiene training. Health and safety and fire risk assessments have been undertaken. Perran Bay Home For The Elderly DS0000009126.V258851.R01.S.doc Version 5.0 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 3 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 3 Perran Bay Home For The Elderly DS0000009126.V258851.R01.S.doc Version 5.0 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. 1 2 Standard OP9 OP9 13 (2) Regulation 13 (2) Requirement Medicines administered must be signed for on the MAR or a reason given if ommitted. Medicines prescribed for an individual resident must not be given to anyone else. Timescale for action 08/12/05 08/12/05 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 3 4 5 7 Refer to Standard OP3 OP26 OP22 OP35 OP35 OP35 Good Practice Recommendations It should be documented who is involved in the assessment of prospective residents and signatures obtained when possible. The Registered Provider should provide an ensuite toilet in room 31 The assessment of the premises undertaken by an Occupational Therapist should be addressed. Residents should sign a form agreeing to the home looking after their money The policy for the safekeeping of residents money should be reviewed The Registered Manager should keep a copy of any power
DS0000009126.V258851.R01.S.doc Version 5.0 Page 19 Perran Bay Home For The Elderly of attorney certificates Perran Bay Home For The Elderly DS0000009126.V258851.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection St Austell Office 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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