Inspection on 01/08/05 for Pilton House

This inspection was carried out on 1st August 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

Pilton House 22/05/08

Pilton House 14/06/06

Pilton House 08/02/06

Pilton House 10/01/05

Pilton House 12/07/04

Pilton House 13/02/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Pilton House Pilton Street Pilton Barnstaple EX31 1PQ Lead Inspector Victoria Stewart Unannounced 1 August 2005 st 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. Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Pilton House Address Pilton Street, Pilton, Barnstaple, Devon, EX31 1PQ 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) 01271 342188 0870 1219766 Barnstaple Old Peoples Housing Association Limited Mrs Gina Helen Rogers Care Home 27 Category(ies) of OP - Old Age (27) registration, with number MD(E) - Mental Disorder over 65 (27) of places DE(E) - Dementia over 65 (27) Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10/01/2005 Brief Description of the Service: Pilton House is an extremely spacious and attractive listed Georgian manor house. It is situated in the Pilton area of Barnstaple. Barnstaple Old People’s Association (BOPA) is the registered provider and a Committee play a regular and active part in the running of the home. It is registered to provide are for 27 service users in the categories of old age (OP), Mental Disorder – over 65years of age (MD, E) and Dementia – over 65 years of age (DE, E). The home is situated in large, attractive grounds in a residential area and is close to the local facilities, amenities and services of both Pilton and the centre of Barnstaple. It has an extensive parking area. Bedrooms are mainly en-suite, of varying sizes and are situated on two floors. There are a variety of communal areas in the building which includes a large sitting room, dining room, ‘quiet’ lounge and a small library. Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was carried out as part of the normal programme of inspection for the current year. The inspection took place over 5 hours and the registered manager and staff took part in the process. During the inspection positive discussions took place and some issues of concern talked over. The inspector saw all the residents in the home and spoke at length with 14 of them. The registered manager was off duty when the inspector arrived, but chose to come in and assist during the inspection. The home has an informal, welcoming and open atmosphere. The home was full on the day of inspection with 2 of those residents admitted in the local hospital. What the service does well: The home is well run in an efficient but personal manner. Residents and staff are regularly included in the decision-making process and are actively involved with each other in various activities. The home has recently gained the ‘Investors in People Award’ and undertook a great amount of work to achieve this and in doing so the home has improved for both staff and residents. A common theme running through the comments from residents was that the management and staff are excellent with comments such as “both carers and management are good’ and “staff are very good and tolerant”. The home invests in staff training and therefore provides well-trained, skilled and experienced staff to meet resident’s needs. Residents of the home were very complimentary of the food received. The home provides a spacious environment and extensive grounds which residents take advantage of. Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,6 A pre-admission procedure is in place, which ensures that resident’s needs and wishes are fully understood and that they are helped to make the right choice of home. EVIDENCE: The manager visits each prospective resident either at home, hospital or elsewhere to ensure that all their needs can be met by the staff at Pilton House. The manager is very experienced in the correct assessment procedure. She was able to demonstrate on two occasions when an assessment had been undertaken which had led to one resident requiring nursing care and one resident being re-assessed by Social Services. One recent resident admitted confirmed that her needs were assessed in another care home prior to her move to Pilton House. Intermediate care facilities are not provided. Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 9,10 The staff have a very good understanding of the residents support needs, which is evident from the positive relationships that have been formed between staff and residents. The medication at this home is well managed promoting good health. EVIDENCE: The pharmacist inspector visited on the last inspection of 10 August, 2005 and gave some suggestions and advice to improve the medication practice. All of his requirements and recommendations have been put into practice. The home has two designated members of senior staff who have responsibilities for maintaining stock supplies and supervising practice. The home carries out its own self-audit once a month and ensures that any deficits in recording, handling and disposing of medicines are brought to the attention of the staff and improved upon. The supplying Boots pharmacist also visited in June and found procedures satisfactory. The Medication Administration Record was checked and found to be generally satisfactory with some minor omissions in signatures. Controlled drugs were checked and found to be satisfactory. Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 10 Residents confirmed that they are always treated with privacy and dignity and one resident said, “I’m most satisfied with the efficient and compassionate approach of staff”. Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 11 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) 12,13,14,15 Dietary needs of residents are very well catered for with a balanced and varied selection of food available that meets resident’s tastes and choices. Activities are well planned and staff play an active part in ensuring that residents enjoy them. EVIDENCE: Residents confirmed that they have choice over their daily lives and that they have the freedom in the home to do as they wish, with the exception of set meal times. Food in the home is well appreciated and liked, with the main meal served at lunchtimes. Residents have a very good choice of food available to them. This follows a menu plan, which is regularly looked at and changed when necessary by the manager, cook and resident input. The staff at Pilton are very accommodating to meeting individual resident’s likes, to the extent of storing, cooking and serving food bought by one resident who has a special dietary needs. The inspector enjoyed a lunch with two of the residents. Food was well served, nutritious and appetising. Residents described the food as “excellent”, “very nice” and “lovely”. Residents confirmed that visitors are “very welcome” at any time and that drinks were always available to them. Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 12 Following recent feedback from residents, the home now ensures that all planned activities are displayed on the notice board. The home had many activities on offer with one member of staff responsible for planning these. Activities include the usual in-house ones such as bingo, quizzes, exercises, hand massage, fingernail painting, arts/crafts and entertainers. Other inventive activities include strawberry picking, a sunflower growing competition and a visiting performing dog. Outside activities recently included the Pilton festival, a trip to the North Devon show, theatre and shopping trips. The home provides taxis or buses to outside activities. Residents and staff take part in the weekly Pilton lottery/bonus ball. Staff also take part in fund raising for the home and one recent event included a “Ladies Race Day” (complete with hobby horses) when staff and residents dressed up for the day. A car boot in the grounds, abseiling in the local area, a bike rides and a BBQ/disco are also planned for the future. The staff are currently raising funds to put towards a new call bell alarm call system. Residents enjoyed the activities on offer and particularly liked the events where staff also take part and make it a “family event” with their children invited also. There are plans for a separate designated activities area. Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 13 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) Not inspected on this occasion. EVIDENCE: Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 14 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) 19,21,23,24,25,26 The home creates a comfortable and safe environment for those living there and visiting, although some areas would benefit from redecoration. EVIDENCE: The home is pleasant, homely and generally decorated to a reasonable standard, although some areas of the home require attention. A full-time maintenance person is employed but as the home is a listed building, it continually needs attention. Following work on the hot water system six months ago, some hot water piping remains uncovered which looks unsightly and could pose a health and safety problem. Some areas of the home are looking tired. All rooms are of individual sizes and decorated with personalised items of sentimental value. When residents are admitted into a smaller room, they are given the choice of having a larger one when available. One resident showed me her new room after her recent move. Televisions and telephones are installed in each private room. Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 15 One main bathroom has recently been updated with modern assisted equipment. Further work is planned on the upstairs old sluice room. All rooms have en suite facilities. The home is kept very clean. Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 16 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) 27,30,32 The home has an enthusiastic workforce that works positively with residents to improve their quality of life. Resident’s benefit from an organisation that invests in the training and development of staff. EVIDENCE: The home takes staff training very seriously and invests in this area. Staff have recently received training on death and dying and incontinence. The home has several members of staff undertaking either NVQ level 2 or level 3 in care with the deputy manager undertaking the NVQ 4 and Registered Manager’s Award. 3 members of staff are trained as assessors at A1 level. The manager will be undertaking the NVQ Level 5 in training and development. The home was staffed well on the day of inspection and many of the staff members have worked at the home for many years. Some members of staff appear to be resistant to change but recognise this is for the benefit of the residents. Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 17 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) 31,33,38 The manager is supported well by senior staff and provides clear leadership throughout the home. The home provides a safe place for residents to live. EVIDENCE: The manager is a qualified nurse and manages the home in a positive and inclusive way. A deputy manager, administrator and senior care staff have designated responsibilities. Residents and staff are valued for their opinions and regular meetings are held to take their views into account. The home recently sent out questionnaires to relatives/residents, which showed a very positive and appreciative feedback, with any negative comments actionned upon. Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 18 The home operates efficiently with specific staff designated certain responsibilities. The home has an effective organisational structure of management, administrator and support staff. The manager ensures that the health, safety and welfare needs of residents are maintained. Devon Fire and Rescue visited on 27 July, 2005 with a satisfactory inspection, although some recommendations were made. As a result the fire plan is being updated. Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A 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 4 COMPLAINTS AND PROTECTION 3 x 3 x 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 4 3 x x x x 3 Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 20 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations Pilton House D54-D06 22096 Pilton House 231536 010805 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Exeter Office, Suites 1 & 7 Renslade House Bonhay Road EXETER, EX4 3AY 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. 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