Inspection on 11/05/05 for Philadelphia House

This inspection was carried out on 11th May 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.

Other inspections for this house

Philadelphia House 27/11/06

Philadelphia House 07/10/05

Philadelphia House 17/01/05

Philadelphia House 29/07/04

Philadelphia House 13/01/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Philadelphia House Penn Grove Norwich Norfolk NR3 3JL Lead Inspector Dot Binns Announced 11 May 2005 9.30am 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. Philadelphia House Version 1.10 Page 3 SERVICE INFORMATION Name of service Philadelphia House Address Penn Grove, Norwich, NR3 3JL 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) 01603 419175 01603 409636 Norfolk County Council - Community Care Mrs Jean Reynolds Care Home 35 Category(ies) of Old Age (35) registration, with number of places Philadelphia House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. Wheelchair users can only be admitted to bedrooms of at least 12sq metres i.e rooms numbers 25 and 26 (as at 31 March 2002). 2. Thirty-five (35) Older People, not falling into any other category, may be accommodated. Date of last inspection 17th January 2005 Brief Description of the Service: Philadelphia House is a registered care home and can provide accommodation and care to 35 older people. The home is owned and managed by Norfolk County Council and has a registered manager. The accommodation consists of 35 single bedrooms situated on the ground and first floor. A number of the rooms have a view of a nearby park that is in walking distance. There are two rooms on the first floor that are the appropriate size to accommodate wheelchair users. Access to the first floor is by a shaft lift or stairs if the service users are able to negotiate them safely. There are a number of communal areas that service users can choose to access according to their preference and need. The home is situated in a residential area of Norwich and is a short bus ride to the city centre. Philadelphia House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine announced inspection of the Home lasting 7.5 hours. During the inspection, there were discussions with the manager about the progress of the Home and whether requirements made in a previous inspection had been met. Records and policies were examined. Five service users were seen privately in their rooms, one accompanied by a relative. Three staff were also seen in private. In addition surveys were also sent out by the Commission to all service users in the Home and their relatives. The GPs and community nurses were also asked to comment. Responses to those surveys have been incorporated into the report. What the service does well: This Home provides an excellent service making the residents feel comfortable and well looked after. They speak highly of how the home is run, how the staff listen to them and how they feel free to be themselves. The food is good and varied with choices at each meal and plenty of drinks offered. The Home is well managed by an experienced and committed manager who has high standards of care. Staff are well supported and trained with clear ideas of how residents should be treated based on sound principles of care. Records are well maintained and are properly used as a help to staff in looking after the residents. Policies and procedures for keeping residents safe and for ensuring the staff work well are in place. Communication between staff and residents and manager and staff is very good. Philadelphia House Version 1.10 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Philadelphia House Version 1.10 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 Philadelphia House Version 1.10 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) 2,3,4, All service users have their needs assessed before coming into the Home and the Home is careful to ensure that they can cater for each person. All service users receive a contract outlining the conditions and terms of the Home. EVIDENCE: Contracts were seen on the three care files chosen at random. There were full details on the care records of each service user’s needs and abilities showing that the home gathered as much information as possible to make sure they knew how to cater for them. The information included transfer notes from hospital and information from the social worker as well as completion of the home’s own assessment document. Philadelphia House Version 1.10 Page 9 There was no evidence that the Home was trying to cater for people outside its competence and the manager was able to discuss situations where extra assistance has been sought to ensure proper provision was made for the service user. The service users themselves all felt they were very well catered for and had no complaints about the home. Philadelphia House Version 1.10 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 and 10 The service users’ health, personal and social care needs are outlined in their care plans and are responsibly monitored by staff. Policies, procedures and records are in place for ensuring that medication is safely managed. Service users are very clear that staff treat them with respect. EVIDENCE: Three care plans were chosen to examine. They each had full details of the care required by the service user and what assistance they needed from staff. The care plans also contained information about routines and interests and were signed by the service user. The care is reviewed monthly and daily reports are made by the care staff on the health and welfare of each service user. Philadelphia House Version 1.10 Page 11 There was ample evidence in the care records that the health of service users was monitored. The records showed GP visits, contact with community nurses, monitoring of weight and mobility and contact with chiropodists, dentists and opticians. There were specific care plans about continence and moving and handling assessments where service users needed help to move around. Good daily reports by staff ensured that service users were monitored if they were not well and that community professionals were brought in if required eg physiotherapists. One service user said that because the staff encouraged her to be mobile she is more independent now. A survey sent out by the Commission to the GPs and community nurses covering the Home (4 replies) produced a positive response. The medication systems were inspected. Medication was kept safely in locked facilities and the administration record was properly maintained. The home uses the Nomad system where the medication is pre packed by the pharmacist in weekly boxes. Stock control was monitored and a returns book was seen enabling an audit to be carried out if required. A requirement had been made at the last inspection regarding medication and this has been attended to. Overall health and medication issues are well managed in this Home. Service users seen at the inspection all confirmed that they were treated with respect and were cared for privately in their bedroom. The GP sees them privately in their rooms as well. They could also stay in their bedroom if they wished to be alone and could have privacy to make a phone call or speak to their relatives. The Homes policies on confidentiality and on Data Protection gave guidance to staff about the need for discretion with information. Philadelphia House Version 1.10 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 and 15 Service users are very happy with the lifestyle experienced in the Home. They can remain in contact with family and friends and know the home will make them welcome. Service users feel in charge and well listened to. Service users receive a good diet and enjoy their food. EVIDENCE: Five service users were spoken to privately in their rooms. One person had a relative with them. They were unanimous in praising the home and felt they were very comfortable. Their comments such “you can go round Norwich and not find a better home”, “it’s like living in a hotel – they do anything for you”, “everyone takes me as I am”, “I’ve got on marvellously since I came here” and “There are no faults at all” showed a wholehearted contentment with the home which is exceptional. Philadelphia House Version 1.10 Page 13 They talked about the choices they had in their routines, the activities provided and the excellent attitudes of staff which was the basis of making them feel at home. They also joined in the residents meetings where they could give their views about the Home. They felt consulted and listened to. More tellingly, one service user described the atmosphere as “people talking and laughing – one big happy family”. A survey of the service users for the inspection also produced a very positive general response about the home (10 returned). Out of those 2 thought there were not enough suitable activities it has been suggested to the manager that she looks into this. Staff may need to keep asking service users more about what they would like. The Home keeps a record of the activities offered and there seemed to be a variety. There are bingo sessions, regular entertainers, church services, newspapers and library books, and outings in the minibus. One staff on the day of the inspection was doing an exercise class. There is also a much improved garden which in the good weather will be an attractive resource. Fifteen relatives also replied to the survey and again were extremely positive. Comments such as “a good and friendly home”, “staff are always cheery, welcoming and ready to look after the residents” “I cannot praise the Home enough – the level of care, attentiveness and efficiency is remarkable” and “ my mother is very happy there” are a wonderful endorsement of the Home and the staff should be praised for their hard work and commitment. Service users seen at the inspection also confirmed they saw their relatives when they like and in private in their room and there is also a small lounge with coffee making facilities available. As far as the meals go service users were very happy with it describing it as “lovely food”, “very good food” “food is good with a lovely choice” and “the main meal is lovely”. One person who has to have liquidised food also said the food was good. Service users confirmed they had plenty of drinks and could have their meals in their room or in the dining room. The menus seen showed a good variety with choices at each meal. Meals are made on the premises with a dedicated cook. Philadelphia House Version 1.10 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) 16 and 18 Service users feel listened to and have been given the complaints procedure in the service users guide. Service users are protected from abuse through policies and training of staff. EVIDENCE: The complaints procedure with the address of the Commission is contained in the service users guide which has been given to all service users. A complaint record was seen of those complaints which have been dealt with by the Home. These were seen to be dealt with at an early stage when still a grumble rather than a full blown written complaint and the actions taken by the home were recorded. Full abuse policies including whistle blowing policies were seen to be in place and staff interviewed as part of the inspection confirmed that they had had training on the prevention and identification of abuse. To protect service users from financial abuse, staff sign a form (held on their staff record) to say they will protect service users property and money and not accept gifts or be involved in the making of wills. This is good practice. Philadelphia House Version 1.10 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) 19,20,21,22,23, The Home is bright and attractive for the service users and their rooms are comfortable and individual. Specialist equipment and adapted bathrooms make it easier for the service users though the call bell and the hot water system could be improved. EVIDENCE: There has been a lot of redecoration in the home since the last inspection. The main lounge is looking light and attractive with a new large screen television, and there is new carpeting and décor in the small lounge with new French windows installed to allow access to a much improved enclosed garden now equipped with seats and tables and more pot plants. In the small lounge there are facilities for relatives to make a drink. The reception area and dining room have also been brightened up. Philadelphia House Version 1.10 Page 16 Service users rooms are also cosy and personal with locked facilities and room for personal possessions. Only two of the rooms are big enough to accommodate wheelchair users and this is a condition of the registration that new admissions who use wheelchairs can only be admitted to those rooms. Currently one of these rooms is being so used but another person who became a wheelchair user after admission is currently in a smaller room. It has been agreed that they will move to a larger room when there is a vacancy. Where necessary hoists and adaptations have been installed. The main problem with the rooms is that there are no controls on the hot water system and the Home has had to put up signs warning service users to be careful. Risk assessments have been carried out on those most vulnerable. Bath water is controlled by special valves. All four bathrooms are adapted to allow easy access for those who are frail and there are handrails in corridors and round toilets. The Home is on the level on both floors with a shaft lift between the floors. There are no other changes of level to negotiate. The callbell system was heard to work effectively ringing from two callboards (one on each floor) which are loud and could be disturbing at night. Philadelphia House Version 1.10 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) 27,28,29 and 30 There are enough staff on duty to safeguard the service users. Training is excellent with induction and foundation courses and NVQ qualifications being completed by staff. Recruitment procedures are rigorous except for the completion of criminal records checks which was found to be faulty. EVIDENCE: The rota for the week of the inspection was examined and showed that 345 care hours were available when 385 are required. However there are 120 management hours in this home and it is assumed that the 40 hours required for care are supplied by the management team. Domestic hours on the rota were short by 15 hours though catering hours are more than required. The shifts of staff are consistent with four care staff on duty with a manager throughout the day and three on duty with a manager in the evening. At the weekends there has been an improvement from the last inspection with four care staff on duty with a manager in the mornings and three care staff on duty with a manager in the afternoons and evenings. The Home has steamed ahead with training opportunities for staff. A full training profile for each staff member was presented for the inspection outlining recent and earlier courses attended by staff. Training is offered regularly from the evidence of these profiles, which is excellent practice. Philadelphia House Version 1.10 Page 18 One new staff confirmed she had undergone an induction training with 20 hours of shadowing an experienced colleague and the completion of a workbook. Five care staff have completed their NVQ2 training and another seven are currently studying for it. If these staff complete this year this will mean the Home will have more than 50 of staff trained to NVQ2 level which meets the standard. An assistant manager has completed her NVQ3 and another is studying for her NVQ4. This shows a very good emphasis on training. Recruitment procedures were rigorous with references, medical declarations identity checks and completion of application forms. (seen in staff files). Criminal records checks were also carried out except that one person had a standard instead of an enhanced check and another had nothing on file to show the check was carried out though the manager said there would be a copy at County Hall. These procedures need to be tightened. Philadelphia House Version 1.10 Page 19 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) 31,32,33,35,36,37 and 38 Service users live in a well managed home where the manager is committed to high standards of care. Service users benefit from this leadership with staff well trained and supported to look after the service users well and make them feel important. Procedures for protecting service users and for keeping the Home safe are in place. EVIDENCE: The manager is very experienced and is very competent. This is a home which has been running successfully for many years and does not give concerns to the Commission. The manager has the support of a management structure within the social services department as well as supplementary support from County Hall. Philadelphia House Version 1.10 Page 20 The manager communicates a clear sense of direction and leadership with staff understanding the standards expected. There is a clear sense of how service users should be treated underpinning the care. All the service users felt the Home was run well with their interests at heart. They felt they had a say (residents meetings) and were kept informed. There is a newsletter every month edited by one of the staff. The manager also supports and trains her staff and has an open dialogue with them – staff meetings, supervision, handover meetings. There is a quality assurance system with care reviews, supervision of staff and complaints addressed. There is also an annual survey of service users’ views and the results of this is printed in the service users guide. This is excellent practice. Where they can, service users handle their own personal money or have the help of relatives. However the Home handles 21 of the service users money. Appropriate records are maintained and these were checked against the cash held and found to be correct. Because this is a local authority home, it is the county council who becomes involved in those service users who cannot draw their own benefits. Seven people have their accounts managed at county hall and hold their bank accounts. However evidence of these was produced for the inspection and cross referenced with the Home’s records. Records are well maintained and policies are in place. Health and safety procedures, policies and training were all in place. Certificates for equipment were seen and fire drills were up to date. The accident record was kept appropriately. Philadelphia House Version 1.10 Page 21 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 2 3 3 x x x STAFFING Standard No Score 27 3 28 3 29 2 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 4 4 3 x 3 3 3 3 Philadelphia House Version 1.10 Page 22 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 29 Regulation 19(1)(b) Requirement The process for the verification of criminal record checks needs to be tightened up to ensure all staff have an enhanced check. Timescale for action 31.5.05 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 22 Good Practice Recommendations Although notices have been put up and risk assessments carried out, it continues to be recommended that the temperature of the hot water supply is controlled by the installation of valves. Philadelphia House Version 1.10 Page 23 Commission for Social Care Inspection 3rd Floor Cavell House St Crispins Road Norwich NR3 1YF 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 Philadelphia House Version 1.10 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!