Inspection on 27/11/06 for Philadelphia House

This inspection was carried out on 27th November 2006.

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 07/10/05

Philadelphia House 11/05/05

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 Mr Pearson Clarke Key Unannounced 27th November 2006 09:10 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 Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 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. Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Philadelphia House Address Penn Grove Norwich Norfolk NR3 3JL 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) 01603 419175 01603 409636 www.norfolk.gov.uk Norfolk County Council-Community Care Ms Elizabeth Helen Rayman Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Wheelchair users can only be admitted to bedrooms of at least 12sq metres i.e Rooms numbered 25 and 26 (as at 31 March 2002) Thirty five (35) Older People, not falling into any other category, may be accommodated. 7th October 2005 Date of last inspection 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. At the time of this inspection the services maximum fee was £368.72 with each service users fee individually assessed according to individual circumstance. Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out by using information from previous inspections, information from the providers ,the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home and this report gives a brief overview of the service and current judgements for each outcome. What the service does well: What has improved since the last inspection? Since the last inspection there has been a change of manager and of some of the management team. This potentially unsettling situation has been well managed with a period of consolidation before the introduction of change to the service. Since the last inspection of the service there has been a real improvement in the approach to medication, with a new delivery system and much improved storage. Work has also taken place to extend the range of entertainment offered, building on the services strength in this area. Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 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 Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 and 6 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit the inspector tracked a number of admissions to the service and discussed the admission process with the service manager. Based on this it is clear that a sound process is in place with the home carrying out needs led assessments to supplement social work assessments provided. The manager is clear about the needs the service can meet and gave examples of instances when she has rejected referrals, because they were inappropriate. Discussion with service users confirmed that people had received all necessary information to allow them to make an informed choice when considering the home. As such they had a copy of the service user guide, a statement of terms and conditions and knew how to complain. The service user guide and recent inspection reports are prominently displayed by the front door. The manager Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 Page 9 confirmed that she updates the service user guide when changes occur and that changes in fees are notified to service users by letter. The service does not offer intermediate care. Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Previous inspection of the service has found the home to have a sound system of care planning in place. During the site visit the inspector tracked a sample of six plans and found them to be well organised, informative and clear. As such plans, are based on assessment, contain appropriate risk assessment are subject to review and indicate that service users are part of the process. Service users spoken to were aware of their plans and felt that they received good care delivered in a way that they would wish. Staff on duty felt that plans were used to inform care. From inspecting care records and talking to service users and staff about access to health care the inspector formed the opinion that the service is meeting the needs of residents in this area. Information from the providers visiting reports showed that there has been a change in the medicine management arrangements at the home and that there was some Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 Page 11 concern regarding the storage of medicines. At the site visit the inspector was shown new storage arrangements which have subsequently been put in place and are much improved. Medicines were securely held and records seen were accurate and clear. The new medicine delivery system appears to be operating well and was felt by staff and management to be a success. Observation on the day indicated that care was being delivered in a way which respected the dignity and privacy of service users and those residents spoken to confirmed this to be the case. Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a good record of offering service users a range of stimulation and activity and it was apparent at the site visit that this is being maintained. Staff spoken to were motivated to do this and confirmed that time is made every afternoon for group, or individual activity. Service users spoken to on the day of the site visit were happy with the provision in this area and this view was supported by survey responses received. The service produces a regular newsletter which is clearly enjoyed and a schedule of planned activity was clearly displayed in the home. Residents told the inspector that the home was a relaxed and happy place to live and that they felt in control of their lifestyle and able to exercise choice. Visitors spoken to by the inspector were very positive in their praise for the home and felt that they were encouraged to maintain contact and that staff kept them fully informed as to their relatives day to day lives. Survey feedback showed people to be happy with the food served, feeling it was of a good quality and provided choice. This view was confirmed at the site visit, although it was noted by the inspector that minutes Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 Page 13 of recent meetings show some concern about meals. This was discussed with the manager who feels that problems raised had largely been resolved, however this should continue to be monitored. Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit the inspector looked at the services record of complaints, which was appropriately maintained and confirmed that issues are appropriately addressed. The provider has a sound system for complaints/concerns to be raised. Service users told the inspector that they had no reason to complain, however if they did they would know how and would feel confident in doing so. The provider has well established procedures for the protection of service users from abuse and these are supported by staff training. Staff spoken to were aware of the procedure in place and one person told the inspector how she had reported bad practice and had been supported in doing so. Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit the inspector toured the home looking at public space and a number of bedrooms. The building was clean, comfortable and warm. Although some unwanted odour was experienced, this would appear to be related to a specific situation and not a widespread issue. This was discussed with the service manager and it was clear that efforts are being made to resolve this issue. These efforts must be continued and all options should be considered. Although comfortable and homely it was the inspectors opinion that the décor in the home was looking tired and not in the best of condition. From discussions with management and staff on the day it would appear to be a considerable period of time since any decoration took place and in many Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 Page 16 corridors the paintwork was worn and with much evidence of wheelchair damage. Although the inspector did not see all bedrooms it would appear that many would benefit from redecoration. Given the above a requirement has been made to draw up and put into place a programme of general redecoration. See Requirement Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Recent inspection of the service has indicated that the home has had satisfactory staffing levels. Pre inspection survey responses painted a mixed picture with half of the relative survey forms received, indicating there are occasions when they feel that there are not enough staff on duty. As such this was an issue of focus for the site visit. Having spoken to service users and staff at the home, the inspector considered the current occupancy and dependency before reaching the judgement that the home is currently staffed to meet need. However this is an issue that the provider needs to keep under review and staffing should be increased in line with occupancy and dependency where necessary. It was also noted that the current staffing rota has periods when cover is not uniform, however it is understood that the provider is currently working to resolve such inequalities. The service manager confirmed that she would like to reduce reliance on agency staff and that this has begun with recent recruitment.Service users were united in the view that they receive excellent care from a kind and well motivated staff group and from observation and discussion on the day this was also the inspectors opinion. Staff spoken to felt able to do their jobs and able to give service users individual attention Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 Page 18 when needed. Staff are well trained and the service meets government targets for NVQ qualified carers. Records of recent staff employment were inspected and showed there to be a suitably robust process in place which offer protection to those living at the home. Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last visit to the service the home has had a change of manager and several other changes of personnel. As with any such change this promotes some uncertainty and a period of readjustment, however it is clear that this period has now passed and the service is now operating smoothly and is well managed. In reaching this view the inspector considered the views of staff, visitors and service users expressed on the day. These views were consolidated by the providers visiting reports and discussion with the service manager. The provider has a quality system in place based on an annual Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 Page 20 survey of views and at the time of this visit the results of this survey were being collated. The views of service users are also received through regular service user meetings. In support of the above the inspector would encourage the management to develop an annual improvement planning process. Service users finances are soundly managed and sample records relating to this were inspected and found to be in order. The providers approach to health and safety is sound and no issues were identified in this respect. It was noted that the staff supervision process whilst in place was not happening in line with the expectations of national standards and this should be addressed. See recommendation Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 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. 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 3 3 3 x 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 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 2 x 3 Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 Page 22 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 Standard OP19 Regulation 23 (2) b Requirement It is required that the provider devise and enact a general programme of redecoration for the service Timescale for action 28/02/07 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 OP36 Good Practice Recommendations That the service management develop a system to ensure that staff receive supervision in line with national standards. Philadelphia House DS0000035164.V321862.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000035164.V321862.R01.S.doc Version 5.2 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. 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