Inspection on 24/11/05 for Philiphaugh

This inspection was carried out on 24th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 10/10/06

Philiphaugh 09/05/06

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 Unannounced Inspection 24th November 2005 08:45 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.V253967.R01.S.doc Version 5.0 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.V253967.R01.S.doc Version 5.0 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 Susan Laithwaite 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.V253967.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Total number of service users not to exceed a maximum of 32 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)) 11th May 2005 Date of last inspection 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.V253967.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 20th November 2005 over 6 hours. The inspection was carried out as an unannounced inspection. A tour of the premises took place and service users and staff were spoken to. Care records, staff files, policies and procedures and the medication system were inspected. Some of the service users who are able to give an opinion expressed positive comments on the standard of care that they are receiving at the home. The registered provider was present during the course of the inspection. The registered manager was at college undertaking her studies to achieve the registered managers award qualification. What the service does well: What has improved since the last inspection? The medication arrangements at the home have improved considerably since the inspection of the 11th and 12th May 2005. Recruitment procedures for the employment of new staff are now consistently satisfactory. Supervision of staff has been commenced by the registered manager. Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 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. Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 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.V253967.R01.S.doc Version 5.0 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): 1,2 and 3 The home’s statement of purpose and service user guide documentation as well as a brochure provide prospective service users with details of what the home provides helping an informed decision about admission to the home. A contract of care is provided to each service user/family which details the terms and conditions of their placement. EVIDENCE: As recommended in the inspection report of the 11th and 12th May 2005 the service user guide documentation and statement of purpose document have been brought up to date. Correct references are now in place for the details on The Commission for Social Care Inspection and The Care Standards Act (2000). Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 Page 9 Service users have now been issued with contracts of care that detail the terms and conditions of their placement. It is noted that reference is made to old legislation in the contract document which should be amended. The registered manager is involved in the assessment process prior to service users being admitted to the home. A pre admission assessment document is in place at the home. There have been no admissions to the home since the last inspection. Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 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 service user’s health, personal and social care needs are being met by the staff and multidisciplinary staff as required but staff are reminded that care plans should be reviewed monthly. Medication is being administered correctly to the service users and systems generally are noted to have improved since the last inspection. EVIDENCE: Each service user has in place a problem based plan of care which is supported by daily day and night recording. It was noted at the last inspection that the staff had worked very hard to organise and improve the care planning system. Unfortunately at this inspection it was noted that the system had “slipped” generally, for example monthly reviews were not consistently evidenced as having taken place for all the service users. It was also noted that some essential information was being held in back up files rather than the main working file. Risk assessment information is included in care planning documentation. The care plans evidence that the service users have access to specialist health care Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 Page 11 services to meet care needs as required, for example medical, nursing and dental services. All the service users are registered with a general practitioner and written evidence is in place of health care consultations. It was noted that the service users are not being weighed regularly which should be addressed. Information is included in care planning on dietary needs/requirements. All accidents in the home are being recorded as required by legislation. Considerable improvements are noted in the medication administration at the home since the inspection of the 11th and 12th May 2005. The medication policy and procedure is fully up to date to guide staff in safe administration. Medication administration records were found to be completed appropriately as were records on controlled medication being held at the home. All staff who have medication administration responsibilities have received recognised accredited medication training. The registered manager carries out a weekly audit of the medication system to ensure that medication standards continue to be safe. Service users who were able to express an opinion on the standard of care that they are receiving at the home did so with positive comments. It is noted that there is a policy and procedure in place to guide staff on the principles of caring for a service user who is dying. This standard will be assessed fully at a later inspection. Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 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): 14 and 15 Further work is required to ensure that each service user is living at Philiphaugh with a daily routine that is of their choice. Service users are receiving a wholesome appealing diet but at this time there is no flexibility in the times of the meals at the home. EVIDENCE: Prior to this inspection a complaint had been received at the CSCI on the unsuitable waking and rising times of the service users at the home. This complaint was upheld and the registered provider and registered manager have accepted that this took place. It is very important that service users are given a choice on their rising and retiring times. Where a service user cannot make this choice (as is the case with a number of service users at the home) decisions have to be made that are reasonable and in their best interests, rather than the best interests of the staff. It was noted on arrival at the home for the inspection that breakfast was finished at 8.45, having commenced at 8.00am. The staff then had their breakfast after this. Generally in a care home breakfast will take place over Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 Page 13 half the morning to suit the needs of the service users. The timings of this meal should be reviewed as a priority. Service users who were able expressed very positive comments on the standard of the meals that the home provides. The meal of the day is displayed on a board in the communal sitting/activity room. On the day of the inspection the main meal of the day was steak pie with fresh vegetables and mashed potatoes followed by rice pudding and jam. Staff in the afternoon ask the service users what they would like for their tea. A senior care staff member is presently taking responsibility for meal preparation in the home pending the appointment of a cook being employed. 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. A choice of meal is always available. Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 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): 16,17 and 18 The home has a complaints policy and procedure that must be updated to ensure that service users have the correct information should they or their representatives wish to complain. Amendments are required to the adult protection policy and procedure to ensure staff have knowledge and understanding of adult protection issues to protect service users from abuse. EVIDENCE: As identified in the inspection report of the 11th and 12th May 2005 amendments to the complaints policy and procedure were required. This has not been addressed. It is very important that service users have the correct information should they or their representatives wish to complain. This is included in this inspection report as a statutory requirement. As identified in the inspection report of the 11th and 12th May 2005 amendments to the adult protection policy and procedure were required. This has not been addressed. There appears to be a number of policies and procedures in the home on adult protection. These should be brought into one robust policy and procedure and the staff then given the opportunity to read this very important documentation. This recommendation was included in the inspection report of the 6th July 2004. Staff have received adult protection training from a member of the Cornwall County Council care management team. Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 Page 15 Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 Page 16 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): 19,20,21,23,24,25 and 26 Essential maintenance of a service users bedroom was noted to be required on the day of the inspection. Environmental standards are not satisfactory in the upstairs area of the home. 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. Essential maintenance of a service users bedroom was requested by the inspector on the day of the inspection. This was agreed by the registered provider. This bedroom was found to have very poor odour control and a very low standard of furniture quality. Generally the upstairs area of the home was found to be of an unsatisfactory standard. Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 Page 17 It is noted that wheel chair damage has not been attended to in the corridors of the annex of the home as identified in the inspection report of the 10th and 11th May 2005. Communal areas in the home are spacious and include a smoking lounge, television lounge, dining room and activity room/lounge. The laundry is provided with industrial machines for washing and drying of the service users clothes. Gloves and aprons are freely available for the staff for infection control reduction. Policies and procedures are in place to guide staff on safe working practices. Cleaning and laundry staff are employed by the home on every day of the week. Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 Page 18 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): 27,29 and 30 Staffing levels are appropriate to meet the needs of the service users. Recruitment procedures for the employment of staff are satisfactory. Staff employed must receive dementia training/mental disorder/learning disability training to ensure that they can meet the care needs of all the service users in the home. EVIDENCE: The home employs four care staff on duty in the morning and the afternoon in addition to the registered manager who is in the home throughout the week. In addition to the care staff, housekeeping, cleaning and maintenance staff are employed. Two waking night staff are also employed by the home. Prior to the recruitment of staff two written references are taken following a satisfactorily completed application form. Criminal records bureau checks are in place for all staff members employed at the home. Staff are issued with contracts of employment and a job description. Staff have recently received fire drill training and evidence is in place of regular testing of the fire alarm system. There is only one staff member employed in the home at this time who has received specialist training to include dementia/mental disorder training and learning disability training. This must be addressed to ensure all the care needs of the service users are being met at all times. This is included in this inspection report as a statutory requirement. Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 Page 19 Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 Page 20 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): 31,34,35,36,37 The registered manager runs and manages the home on a day to day basis to ensure that the service users receive consistent, quality care. The registered provider is present in the home during the week. The registered provider and registered manager must ensure that their staff are fully trained to meet the care needs of all the service users at Philiphaugh. EVIDENCE: The registered manager continues to demonstrate to the Commission for Social Care Inspection that she is a competent and capable manager. It is recognised that the medication arrangements have considerably improved at the home as have the recruitment procedures which is a credit to the manager. The lack of specialist training to the staff must now be addressed. The registered manager is presently undertaking her studies at college to obtain her registered managers award. On the day of the inspection the Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 Page 21 registered provider was present in the home. The registered manager was at college. A senior staff member was in charge on the floor as well as having the meal preparation responsibilities for the day. The registered provider has been asked to provide documented evidence of the financial viability of the home (from his accountant) to meet the requirements of standard 34. Records are in place to evidence the incoming and outgoing of the personal finances of the service users and an audit trail can be carried out. Social services are involved in legal procedures for the Court of Protection for two service users and appointeeship arrangements are in place for a number of service users. The registered manager has these responsibilities. It is recommended that written evidence is put in place for the names of the service users involved. Formal supervision documentation was not available on the day of the inspection but this has now been received (as requested) by the Commission for Social Care Inspection. To meet the requirements of standard 37 all the home’s policies and procedures should now be reviewed. Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 Page 22 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 N/A x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 2 18 1 1 3 1 x 1 1 1 1 STAFFING Standard No Score 27 3 28 x 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 2 2 x Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 Page 23 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 OP16 Regulation 22(5) Requirement The registered provider shall supply a written copy of the complaints procedure to every service user and to any person acting on behalf of a service user if that person so requests. The registered provider must make arrangements, by training staff to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. The registered provider shall ensure that the premises are kept in a good state of repair externally and internally. The registered provider shall ensure that the staff employed receive training appropriate to the work they are to perform. Timescale for action 31/12/05 2. OP18 13(6) 31/12/05 3. OP19 23(2) 31/03/06 4. OP30 18(1) 31/03/06 Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. 7. 8. Refer to Standard OP2 OP7 OP8 OP14 OP15 OP35 OP37 OP34 Good Practice Recommendations To add up to date information on relevant legislation in the contracts of care documents. For staff to consistently review each service users care plan monthly. For each service user to be weighed monthly. To establish that the home is being run with daily routines that are the choices of the service users. To review the time of breakfast (in particular) at the home to ensure that all service users are happy having this meal at 8.00am. To record the names of the service users who the manager is appointee for. To review all the policies and procedures at the home. To provide documented evidence of the financial viability of the home via the registered providers accountant. Philiphaugh DS0000009249.V253967.R01.S.doc Version 5.0 Page 25 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.V253967.R01.S.doc Version 5.0 Page 26 - 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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