CARE HOMES FOR OLDER PEOPLE
Petteril House Lightfoot Drive Harraby Carlisle, Cumbria CA1 3BN Lead Inspector
Paula Banham Unannounced 20 May 2005 8.20 am 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. Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Petteril House Address Lightfoot Drive Harraby Carlisle Cumbria CA1 3BN 01228 606393 01228 606402 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) Cumbria Care Helen Harrison Care Home 38 Category(ies) of OP - Old Age registration, with number DE(E) - Dementia over 65 of places Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 2. The home is registered for a maximum of 38 service users to include: up to 38 service users in the category of OP (older people not falling within any other category) up to 17 service users in the categroy of DE(E) (Dementia over 65 years of age 3. The staffing levels in the home must meet the Residential Forum Care Staffing Formula for Older Adults. 4. Two service users may share a bedroom of at least 16 sqm usable floor space only if they have made a positive choice to do so, when one of the shared spaces becomes vacant the remaining service user has the opportunity to choose not to share, by moving to a different room if necessary.) Date of last inspection 1 November 2004 Brief Description of the Service: Petteril House is a residential care home registered with the Commission for Social Care Inspection to provide care and accommodation for up to thirtyeight people over 65. The home is owned by Cumbria County Council and carried on by Cumbria Care which is a division of Cumbria Contract Services, a County Council business unit. The home is located on the outskirts of Carlisle and is close to local shops and public transport routes. The property is a two storey building and is equipped with a passenger lift to assist residents to access accommodation on the first floor. Accommodation is provided in four living units, each with its own sitting and dining area and small kitchen. There are toilet and bathing facilities close to all accommodation provided for residents. The home provides thirty-six single bedrooms and one double room which two people may choose to share. The home is set in its own grounds and has car parking available at the front of the property. Peteril House can only offer accommodation to people referred by a social worker. Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced carried out on 20th May 2005. The inspection focussed on how the home meets the needs of the people living there. This was assessed by speaking to residents and care staff, looking at the records held, looking around the premises and observing activity in the home. What the service does well: What has improved since the last inspection?
Areas of the home have been redecorated since the last inspection. Residents said the redecoration “keeps the home a nice place to live”. Handrails have been fitted in the passenger lift which make it suitable for people to use on their own and increases residents’ independence. Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.doc Version 1.30 Page 6 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. Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.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 Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.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) 3 and 4 Residents’ needs are thoroughly assessed and are met by the services provided in Petteril House. EVIDENCE: The home has an admissions procedure which includes residents’ needs being assessed before they are offered accommodation in Petteril House. Information from the needs assessments is used to produce an individual plan of care for each person which care staff use to provide the support they need. Residents receive the care they need in the way they prefer. Residents said, “The care couldn’t be better”. Petteril House does not provide intermediate care. Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.doc Version 1.30 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 standard(s) 7,8,9 and 10 Residents receive the personal and health care they need as detailed in their individual plan of care. Residents are treated with respect and their privacy is protected. EVIDENCE: A detailed plan of care has been produced for each person living in the home. The plans are used to inform care staff about the support each person needs and includes information about their preferences. Care staff are knowledgeable about residents’ needs and provide the support they require. Residents receive health care support from local GPs, district nurses, dentists and chiropodists. Residents are supported to attend health care appointments and their health and well-being are maintained. Medication is handled safely and residents receive the medicines they need. Residents are treated with respect and have developed positive relationships with the care staff who support them. Residents said this makes them comfortable receiving personal care from the staff and that this was important to receiving a good standard of care. Care staff know how to make sure that residents’ privacy is protected and take appropriate actions to respect peoples’ privacy and dignity. Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.doc Version 1.30 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 standard(s) 12, 14, and 15 Residents are supported to make choices about their lives and know that the decisions they make are respected. Routines in the home are flexible and responsive to the views and preferences of the people living there. Residents benefit from receiving a nutritious diet which offers choice and variety. EVIDENCE: Residents and care staff view Petteril House as the home of the people living there. Care staff support residents to make choices about their lives and respect the decisions people make. Residents are asked their views about the activities provided in Petteril House and know their views are listened to. New activities have been provided in response to requests from residents. Meals are planned using a menu which is changed regularly. Residents have a choice of meal and said “the meals are excellent”. Meals are attractively presented and residents who need help eating are assisted in a discreet and patient manner. Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.doc Version 1.30 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 standard(s) 16 and 18 Residents know that their complaints are listened to and appropriate action is taken to resolve them. Residents are protected from abuse by the home’s procedures and staff awareness. EVIDENCE: Cumbria Care has a complaints procedure which is used in Petteril House and is included in the information given to residents. The complaints procedure includes information about how long it should take before complaints are responded to and organisations outside of the home to which complaints may be made. Residents know how to complain and that their complaints will be handled properly. The home has regular residents’ meetings where people can raise any concerns in an informal way. All staff have received training in adult protection and are knowledgeable about the home’s procedures for protecting residents from harm. Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.doc Version 1.30 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 standard(s) 19, 20, 22 and 26. Residents are provided with clean, comfortable and safe accommodation which is well maintained and provides a pleasant and homely environment to live in. The home’s grounds are not secure and residents on three units do not have access to a safe outdoor area. EVIDENCE: The home is well maintained and has a maintenance plan which ensures that areas identified as needing repair are dealt with in a timely manner. The standard of decoration and furnishing in the home is high and provides a homely and comfortable environment for people to live in. Areas of the home had been redecorated since the last inspection and residents said this “keeps the home a nice place to be”. All areas of the home are clean and hygienic and residents are kept safe from the risk of infection. The home has a range of equipment and adaptations to assist people to maintain their independence. The passenger lift has been fitted with handrails and is suitable for people to be able to use on their own. The home’s grounds are not secure and residents on three units do not have an appropriate place to sit outside. Plans are in
Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.doc Version 1.30 Page 13 place to make the home’s ground safe and secure and to provide seating areas for residents. Residents said they “looked forward to being able to sit outside in the good weather”. Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.doc Version 1.30 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 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) 27 and 30 Residents benefit from being supported by trained and knowledgeable staff who are skilled and competent to provide the care they need. EVIDENCE: Care staff have received a range of training to enable them to carry out their duties safely and to provide the support residents need. Staff rotas are well managed and are arranged to make sure that there are enough staff on duty to ensure that residents’ receive assistance as they need. Residents said care staff “come straight away” when they used the call bell system. Care staff have developed good relationships with the residents in the home and know how each person likes to be assisted and spoken to. Residents said, “all the staff are lovely, you can have a laugh and a good crack with them”. Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.doc Version 1.30 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 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) 31, 32, 33, 36 and 38. Residents benefit from living in a well managed home where the focus is on meeting the needs of the people living there. Residents know their views are listened to and valued and that they can affect what happens in the home. Staff receive appropriate supervision and training to enable them to meet the needs of the residents and to carry out their duties safely. EVIDENCE: Petteril House is well managed and there is a clear management structure which supports staff and residents. Residents are comfortable approaching the manager and supervisors and know their views are listened to. The home has formal and informal procedures for asking residents about their views including regular residents’ meetings, unannounced visits to the home by a senior manager and supervisors and the manager asking people for their views as they carry out their duties in the home. Action is taken in response to what residents say and they are kept informed about proposed changes. Care staff
Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.doc Version 1.30 Page 16 receive regular formal and informal supervision which supports them to provide a high standard of care to the residents in the home. Care staff have received training to give them the skills to carry out their duties safely and to protect residents’ health and welfare. Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3
COMPLAINTS AND PROTECTION 3 2 x 3 x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 x 3 Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.doc Version 1.30 Page 18 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 20 Regulation 23 Requirement The homes grounds must be safe for residents to use. The grounds must be made secure and safe for residents. Timescale for action 31/8/05 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. Refer to Standard 20 Good Practice Recommendations Suitable furniture should be provided in the homes grounds to provide residents with appropriate outdoor facilities. Petteril House F58 F10 s36543 petteril house v218680 200505 ui stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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