Inspection on 10/10/06 for Philiphaugh

This inspection was carried out on 10th October 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Philiphaugh 06/07/09

Philiphaugh 29/08/07

Philiphaugh 09/05/06

Philiphaugh 24/11/05

Philiphaugh 11/05/05

Philiphaugh 10/11/04

Philiphaugh 06/07/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

St George`s

5 Seafield Road

Credence House

Poldhu

Queensmount

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

CARE HOMES FOR OLDER PEOPLE Philiphaugh Station Road St Columb Major Cornwall TR9 6BX Lead Inspector Elaine Bruce Key Unannounced Inspection 10th October 2006 09:00 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 Philiphaugh DS0000009249.V308608.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. Philiphaugh DS0000009249.V308608.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Philiphaugh Address Station Road St Columb Major Cornwall TR9 6BX 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) 01637 880520 01637 880520 Mr Stephen Michael Hendy Mrs Alice Margaret Taylor Care Home 32 Category(ies) of Dementia - over 65 years of age (19), Learning registration, with number disability over 65 years of age (6), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (19), Old age, not falling within any other category (12) Philiphaugh DS0000009249.V308608.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Service users to include up to 12 adults of old age (OP) Service users to include up to 6 adults aged over 65 with a learning disability (LD(E)) Service users to include up to 19 adults aged over 65 with a mental illness (MD(E)) Service users to include up to 19 adults aged over 65 with dementia (DE(E)) Total number of service users not to exceed a maximum of 32 Date of last inspection 9th May 2006 Brief Description of the Service: Philiphaugh provides care for up to thirty two service users in need of care by reason of old age, dementia, mental disorder and a learning disability. Respite care is available at the home in addition to long stay care (when a bed is available). The home also provides a day care service. The home is situated close to the town of St Columb Major enabling the more mobile service user to visit the shops and facilities independently. The home is set in attractive grounds and is a listed building. Car parking is available in the grounds of the home. The building has been extended with two wings. There are several communal rooms including an activities room and a smoking lounge. Access to the first floor in the main house is by a staircase, which is provided with a stair lift. Bedrooms are available on the ground and first floor of the home. Many of the bedrooms have en suite facilities. Philiphaugh DS0000009249.V308608.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection took place on the 10th October 2006 as an unannounced inspection. Case tracking of particular service users took place as did conversations with them and other service users. Staff files were inspected and staff members on duty were spoken to. Policies and procedures were inspected as were the standards of the meals and medication. A full tour of the premises took place with all the environmental standards assessed. Some of the service uses who were able to give an opinion expressed positive comments on the standard of the care that they are receiving at the home. They expressed very positive comments that the proposal to cancel registration notice has been removed by the CSCI. The registered provider was present during the course of the inspection as was the registered manager and her deputy manager. The legal proceedings in relation to cancellation of registration have been removed following improvements at the home. In addition staff training has taken place which removes the agreement that was in place between the CSCI and Philiphaugh not to admit any service users into the home other than in the category of old age (OP). The home is now able to admit service users (over 65) in the category of dementia (DE) and mental illness (MD). The range of fees for the home are between £330 to £350 per week. What the service does well: The registered manager has worked very hard to move the home forward. Staff are now trained in dementia and mental health and will be able once again to admit service users in these categories to Philiphaugh. It was noted during the course of the inspection that the deputy manager is working very hard to involve the service users in this years festive activities. All the service users who were having a Christmas concert rehearsal stated Philiphaugh DS0000009249.V308608.R01.S.doc Version 5.2 Page 6 that it is with credit to the deputy and all her hard work that the concert will take place. 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Philiphaugh DS0000009249.V308608.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 Philiphaugh DS0000009249.V308608.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4 and 5 The quality outcome in this area is adequate. The home’s statement of purpose and service user guide are now in place ready to be issued to service users and prospective service users. The documentation provides details of the services the home provides enabling an informed decision about admission to the home. The manager assesses all service users prior to admission to the home to ensure that their care needs can be met. Prospective service users and their family, always have the opportunity to visit and spend time in the home prior to admission. EVIDENCE: Philiphaugh has developed a combined statement of purpose and service user guide, which sets out the aims and objectives of the home and provides information about the service. The guide is made available to service users in Philiphaugh DS0000009249.V308608.R01.S.doc Version 5.2 Page 9 a standard format. Reference is made to meeting the diverse needs of the service users. Some additional information to be included was suggested at the time of the inspection. Admissions to the home are not made until a full needs assessment has been undertaken. This job is undertaken by the registered manager and in her absence the deputy manager. Where the assessment has been undertaken through the care management arrangements the registered manager accesses a summary of the assessment and a copy of the plan. It was recommended at the time of the inspection that an admission policy and procedure is developed to guide staff in best practice in the absence of the manager. Documentation is now in place to record information in regard to the pre admission assessment process. The home is keen to admit service users in the category of old age who have a dementia and or a mental disorder. All staff employed at the home have recently attended training in these areas. The staff therefore have the necessary skills and ability to care for service users in these categories. Prospective service users and their family, always have the opportunity to visit and spend time in the home prior to agreeing admission. Philiphaugh DS0000009249.V308608.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11 The quality outcome in this area is adequate. Documentation is in place to evidence that the staff have information on the care needs of the service users and how their needs can be met. The medication at the home is well managed promoting good health. Personal support in the home is offered in such a way as to promote and protect service users’ privacy, dignity and independence. The wishes of the service users re terminal care and arrangements after death are recorded in care planning. EVIDENCE: Each service user has a care plan in place which is supported by daily day and night recording. The system at the home is presently being reviewed and updated to improve care planning documentation. Evidence of updating information and changing actions appears on care plans. The service users are encouraged to be involved in care planning, evidence of monthly reviews are in place. Philiphaugh DS0000009249.V308608.R01.S.doc Version 5.2 Page 11 The service users have access to health care services that meet their assessed needs both within the home and in the local community. All the service users are registered with a general practitioner of their choice and all have access to dentists, opticians and other community services. Separate documentation/records are held on visits to the service users by health care professionals. There is evidence in the care plan of health care treatment and intervention, and a record of general health care information including weight monitoring. The home has a medication policy which is accessible to staff. Medication records are up to date for each service user and medicines received, administered and disposed of are recorded. All staff who have responsibility for medication administration have received training for these duties. Staff are aware of the need to treat the service users with respect and to consider dignity when delivering personal care. The home has policies and procedures, which inform staff how they should handle dying and death. All staff are aware of these and try to work to them. The wishes of service users about terminal care and arrangements after death are recorded in care planning. Good practice information is included in the policy and procedure on religious/spiritual needs. Philiphaugh DS0000009249.V308608.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 The quality outcome in this area is good. Consideration has been given to meeting the social care needs of the service users at Philiphaugh. The meals at Philiphaugh are good offering both choice and variety and catering for special dietary needs. EVIDENCE: The service users are able to enjoy a full and stimulating life style with a variety of options to choose from. The home has sought the views of the service users and considered their varied interests and abilities when planning the routines of daily living and arranging activities. The daily records held at the home evidence that the service users are involved in a number of activities to include for example weekly bingo, skittles, board games, music and regular trips out. The home has it’s own transport. The home has developed a system for displaying information and bringing attention to community events and activities. The notice board on the day of the inspection displayed information on activities for Halloween and Christmas. Sufficient staff resources are provided to allow time for activities and Philiphaugh DS0000009249.V308608.R01.S.doc Version 5.2 Page 13 stimulation. On the day of the inspection a number of service users were rehearsing (with a staff member) for a Christmas concert. The service users are encouraged to keep in contact with family and friends living in the community. Visitors are welcome at any time. Daily records evidence when a service user has received a visitor. Some of the service users in the home chose and are able to be independent and exercise this choice by going to the shops to collect a paper for example. An experienced cook is responsible for providing quality nutritional meals. She regularly meets with the service users to listen to their choices and suggestions for the menu. The cook is familiar with the dietary requirements recorded in the service users care plan and provides a diet that meets their individual needs. The meals for the day are displayed in the dining room of the home. The menu rotates over a four week period and is mainly traditional to include two roasts in the week and fish and chips on a Friday. The main meal of the day on the day of the inspection was lamb casserole and dumplings with mashed potatoes and fresh vegetables. This was to be followed by fruit pie and custard and for tea scrambled egg on toast. Consideration has been given to changing the times of the meals which are presently fixed. For example breakfast is at 8.00am, the main meal of the day at 12 midday and tea and 4.00pm. Discussion with the manager, registered provider and service users confirms that these times suit the service users. Philiphaugh DS0000009249.V308608.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The quality outcome in this area is adequate. The home has a satisfactory complaints policy and procedure to guide the service users should they or their representative wish to complain. Policies and procedures on adult protection have recently been updated by the registered manager. Staff have received adult protection training to ensure the safety of the service users at all times. EVIDENCE: The home has a complaints procedure that meets the national minimum standards and regulations. The complaints procedure is available within the home. The home has received no complaints. The policies and procedures regarding the protection of the service users have recently been updated by the registered manager. The documentation guides staff on immediate action to take and when and who to refer any incident on to. Staff have received adult protection training from a member of the Cornwall County Council care management team. Philiphaugh DS0000009249.V308608.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26 The quality outcome in this area is poor. The environment at Philiphaugh could be improved by some day to day maintenance with specific attention required to odour control. EVIDENCE: Philiphaugh is well placed for service users to access St Columb Major and all it’s facilities. Grounds are spacious and seating is provided for the service users. Car parking is available in the grounds of the home. Painting has commenced in the dining room at the home which will considerably improve the appearance of this room. The lounge that is available for service users to smoke in is presenting as very shabby at this time. Paint work is discoloured and the furniture is very shabby. The rear lounge of the home also requires painting where the chairs have rubbed against the walls. The home employs a maintenance person for all internal and external maintenance. Philiphaugh DS0000009249.V308608.R01.S.doc Version 5.2 Page 16 The majority of the bedrooms are en suite with toilets being well placed near to communal areas. Some of the bedrooms require attention in the older part of the home, again to include specifically odour control. Corridors in the extension of the home are badly in need of decoration following damage from wheel chairs. Limited assisted bathing equipment is available at the home but facilities could be improved. The laundry is provided with industrial machines and equipment such as gloves are readily available. The home employs cleaning staff who undertake cleaning duties on every day of the week. There were a number of areas of unsatisfactory odour control on the day of the inspection. Philiphaugh DS0000009249.V308608.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 The quality outcome in this area is good. Staffing levels at the home are satisfactory to meet the care needs of the service users. A large amount of staff training has recently taken place at the home to include mental health awareness and dementia training to ensure that the staff have the knowledge and skills to care for the service users at all times. Recruitment procedures are satisfactory. EVIDENCE: The service users spoken to during the course of the day expressed positive comments about the staff that care for them. It was noted that good staff and service user relationships have been formed. Staffing rotas were found to be satisfactory, with particular attention given to busy times of the day. Some of the staff are moving on to undertake nursing training or moving out of the county. A number of the service users expressed concerns about the staff who are leaving. Two waking night staff are employed by the home. In addition to the care staff, housekeeping, cleaning and maintenance staff are employed. The service recognises the importance of training and has recently undertaken a large amount of staff training as requested by the CSCI. This has included Philiphaugh DS0000009249.V308608.R01.S.doc Version 5.2 Page 18 mental health awareness training to all staff and dementia training, again to all staff. Plans are in hand for the staff to start advanced dementia training in November at a local college. A large number of the care staff have undertaken their NVQ training. (14 out of 17 staff have this qualification). It is recommended that induction training be improved along with the good practice guidance in The National Minimum Standards. The service has satisfactory recruitment procedures. It is recommended that the equal opportunities policy and procedure is updated and reviewed. Philiphaugh DS0000009249.V308608.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37 and 38 The quality outcome in this area is adequate. The registered manager is competent to run the home and has worked hard to meet the requirements of legislation. She has a good understanding of the areas in which the home needs to improve. EVIDENCE: The registered manager has the required qualification and experience, is competent to run the home and meet it’s stated aims and objectives. She is fully aware of the shortfalls in the service and works to continuously improve services and provide an increased quality of life for the service users. Staff and service users spoken to during the course of the inspection expressed very positive comments on the manager. Philiphaugh DS0000009249.V308608.R01.S.doc Version 5.2 Page 20 The manager is fully aware that all the policies and procedures in the home require updating and some important documentation has already been reviewed and updated. The manager regularly undertakes training herself and this has recently included dementia training and fire training for example. The registered provider attends the home daily in the week from a Monday to Friday. He has recently undertaken a quality assurance/monitoring of the home to involve the service users and other stakeholders with the aim of meeting standard 33 of The National Minimum Standards. A number of service users are unable to manage their finances and are therefore helped with their finances where there are no relatives/advocates to undertake this. The home provides facilities to keep their valuables and money safe. An audit of the records found this process to be satisfactory. To meet the requirements of standard 37 and 38 all the home’s policies and procedures should now be reviewed. Philiphaugh DS0000009249.V308608.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 x 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 Standard No Score 16 3 17 x 18 3 1 2 2 2 2 2 2 1 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 x 2 2 Philiphaugh DS0000009249.V308608.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES 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 The registered provider shall ensure that the premises are kept in a good state of repair externally and internally. (An extended date has been given for compliance). Timescale for action 31/12/06 2. OP26 23(2)(d) The registered provider shall 31/12/06 having regard to the number and needs of the service users ensure that all parts of the care home are kept clean and reasonably decorated. 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 OP3 Good Practice Recommendations To develop an admission policy and procedure to guide staff on best practice. DS0000009249.V308608.R01.S.doc Version 5.2 Page 23 Philiphaugh 2. 3. OP29 OP37 To update the equal opportunities policy and procedure for staff recruitment. To review all the policies and procedures at the home. Philiphaugh DS0000009249.V308608.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Philiphaugh DS0000009249.V308608.R01.S.doc Version 5.2 Page 25 - 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!