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Inspection on 05/07/05 for Perrins House Nursing Home

Also see our care home review for Perrins House Nursing Home for more information

This inspection was carried out on 5th July 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is set in beautiful grounds and the premises are well appointed and maintained. Standards of housekeeping are very good. The people who live in the home appreciate the lovely surroundings, spacious rooms and individual care they receive. The staff are described as kind and attentive, respectful and helpful. Independence and choice is encouraged and supported. Personal and health care is provided to a high standard. A range of in-house and community activities are arranged and people are welcomed to choose whether they participate or not. Decisions are respected.

What has improved since the last inspection?

Since the last inspection minor omissions in the records have been corrected. A training programme has been developed and implemented for the first six months of all new staff`s employment.

CARE HOMES FOR OLDER PEOPLE Perrins House Nursing Home Moorlands Road Malvern Worcestershire WR14 2TZ Lead Inspector Yvonne South Unannounced 5 July 2005 11:00am th 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 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. Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Perrins House Nursing Home Address Moorlands Road Malvern Worcestershire WR14 2TZ 01684 562701 01905 821544 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) Friends of the Elderly Catherine Henrietta Kenward Care Home with Nursing 43 Category(ies) of OP Old Age - 43 registration, with number PD(E) Physical Disabilities (over 65) - 43 of places Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registrations to those recorded on the previous page. Date of last inspection 12 October 2004 Brief Description of the Service: Perrins House is located in extensive grounds on the outskirts of Malvern overlooking the common. It was constructed in 1972. The family home (Davenham) and grounds were bequeathed to The ‘Friends of the Elderly’ by Mrs Perrins in memory of her late husband, Mr Dyson Perrins. The ‘Friends of the Elderly’ are a registered charity. Perrins House has well appointed communal rooms that have views across the mature gardens. The home is registered to accommodate 43 service users of either sex. All rooms can be used for nursing care with the exception of those on the lower ground floor. These do not currently have lift access. All bedrooms are for single occupancy and have en-suite facilities. The home is fitted with two shaft lifts to facilitate movement between floors. These lifts do not descend to the three bedrooms on the lower floor therefore the occupants of these rooms need to be able to negotiate stairs. Mrs Lorna Long is the responsible individual for the registered provider Friends of the Elderly and she is also the Director of Care. Mrs Catherine Thurlow is the Area Manager and Mrs Catherine Kenward is the registered manager of the home. Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection took place over 3.45 hours commencing at 11am. The manager and deputy manager assisted the inspector. She spoke to two service users and assessed the records of three people and walked around parts of the home. What the service does well: What has improved since the last inspection? What they could do better: This nursing home shares the laundry that is in its sister home Davenham. This causes health and safety issues relating to infection control and the loads that need to be carried between the buildings. Serious consideration should be given as to how this lack of facility can be addressed. More information should be available to enable staff to support people with their interests and activities without being intrusive. Please contact the provider for advice of actions taken in response to this Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 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 standard(s) 1,2,3,4,5, Information is available to inform and help service users decide if they wish to live in the home. Each person who lives in the home has documentary information regarding the terms and conditions of their residence. The service is only offered to people who have been appropriately assessed as having needs that can be met by the service and this is confirmed during an initial trial/respite stay. EVIDENCE: The statement of purpose and service users’ guide were acceptable. Service users confirmed that they had received all the information they required prior to making a decision to move into the home. There was some discussion on how the documents could be kept up to date to reflect changes in staffing levels, training and qualifications and service users views. Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 Page 9 During the initial respite/trial period temporary contracts were drawn up. These were replaced with permanent contracts if the person decided to stay and the home was able to meet their needs. Assessments of needs were carried out prior to a trial stay and were expanded on during the stay. The random sample of records assessed did not reflect this as two people had been in the home before the current acceptable assessment document was in use and the third person had been assessed under stressful conditions in hospital. None the less the home was able to meet the needs of all three people and care plans were in place. Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 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 standard(s) 7,8,9,10,11 Service users’ plans provide detailed information to guide and advise staff in the provision of individual care. Health care is closely monitored and provided. Medication is managed to promote independence and safety in the service users’ best interests. Service users can be confident that they will be respected and cared for throughout their time in the home and when they die. EVIDENCE: Three service users’ plans were assessed. They contained details of care needs and delivery plans. It was advised that more information be provided regarding the interests and activities preferred by individuals. Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 Page 11 Detailed health care records were maintained indicating that the primary health care team visited the home when needed and their advice and instructions were complied with. Health care matters such as pressure area and nutritional assessments were undertaken, plans drawn up and implemented. These were then monitored and reviewed. The service users said that they continued to manage their medication independently. Appropriate storage was available. The records identified people who self medicated and the manager confirmed that ability was monitored and independence encouraged. Assessments had been documented and reviewed. Only trained staff administered medication. Records were appropriately maintained. Service users confirmed that their personal and health care needs were being met. The staff were described as kind, and respectful. Gender preferences were respected. They had access to the keys to their bedroom doors and could lock them when they chose. All en-suite facilities were also fitted with locks. All aspects of privacy and dignity were respected. It was observed that the service users’ wishes relating to their terminal care and death had been recorded and was available. Intensive care was provided with sensitivity and respect. Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 Page 12 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 standard(s) 12,13,14,15 A range of activities is available to provide entertainment and stimulation for those who chose to participate. Individual choice and ability is respected. Contacts are maintained with family, friends and community according to personal preferences. A choice of acceptable meals are provided with due regard for individual health needs and wishes. EVIDENCE: The service users in this home have access to an activities programme that provides events in the home and in the community. Everyone if free to participate or not as they wish and are able. Two service users said that they preferred to stay in their rooms and rarely joined the other service users in social functions. However they were aware of what was provided and knew they could join in if they wished. They said that they were content with their music, television and story tapes. They received visitors and maintained telephone contact with family and friends. Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 Page 13 It was recommended that the service users preferences were recorded in their care plans and staff were advised how to support them without becoming intrusive. Community links and activities were maintained. Some service users attended community churches. Others chose to attend the chapel in Davenham. Service users were articulate and able to make decisions and choices regarding their lives and care. One person said that the food was ‘variable’ and that it had been ‘good’ that day. The other person said that the food was ‘ok’ and the choice was ‘good’. The care plans indicated where assistance was needed and identified specific likes, dislikes and requirements. Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 Page 14 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 standard(s) These standards were not assessed during this inspection. EVIDENCE: No complaints have been brought to the attention of the Commission for Social Care Inspection since the previous inspection. Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 Page 15 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 standard(s) These standards were not assessed during this inspection. EVIDENCE: The premises were not inspected in detail however it was observed that the home was well maintained, decorated and furnished. Service users’ bedrooms were spacious attractive and arranged with private furniture and personal property. Everywhere was clean and pleasant. It was a credit to the staff concerned. A requirement was made following the previous inspection that inventories of the service users private furniture should be drawn up. These were available in the files assessed during this inspection. Therefore the requirement had been met. Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 Page 16 The home shares the laundry facilities in the adjacent home. It has long been recommended that this nursing home should have its own facilities. Concerns have been expressed in the past regarding risks relating to infection control and the moving and handling of loads. These concerns continue. There has been no move by the providers to address them. Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed during this inspection. EVIDENCE: A requirement was made following the last inspection that a foundationtraining programme to meet the NTO specifications be developed and implemented. This had now been done. The requirement has been met. Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed during this inspection. EVIDENCE: Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x x x x x x x x 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 Standard No 16 17 18 Score x x x x x x x x x x x Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 Page 20 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 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. Refer to Standard 12 26 Good Practice Recommendations The information regarding service users interests and activities should be developed in their care plans and advice be available as to how individuals can be supported. An improvement in the laundry facilities should be considered. Ideally each home, especially those providing a nursing service, should have independent facilities. Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 Page 21 Commission for Social Care Inspection The Coach House. John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Perrins House Nursing Home E52 S4132 Perrins House NH V228736 050705.doc Version 1.30 Page 22 - 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. 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