Inspection on 08/02/06 for Pilton House

This inspection was carried out on 8th February 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

Pilton House 22/05/08

Pilton House 14/06/06

Pilton House 01/08/05

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 Devon EX31 1PQ Lead Inspector Victoria Stewart Announced Inspection 8th February 2006 10:30 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 Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 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. Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Pilton House Address Pilton Street Pilton Barnstaple Devon EX31 1PQ 01271 342188 0870 1219766 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) Barnstaple Old People`s Housing Association Limited Mrs Gina Helen Rogers Care Home 27 Category(ies) of Dementia - over 65 years of age (27), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (27), Old age, not falling within any other category (27) Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st August 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 Peoples Association (BOPA) is the registered provider and a Committee play a regular and active part in the running of the home. The home 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 ensuite, 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 DS0000022096.V276057.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out as part of the normal regulatory inspection process. The inspection took place over 5 hours and the registered manager, deputy manager, officer in charge, administration assistant, staff and residents took part in the process. The home was full on the day of inspection and the inspector spoke or saw all of the residents in the home, either in the communal areas or in their private rooms. The inspector also spoke with two relatives. This report is written with information gained from talking with residents, staff, visitors and management, looking at a selection of records (including resident files, staff files, financial records, staff training records and quality assurance surveys) and undertaking a full tour of the home. Prior to the inspection, the manager had completed an excellent pre-inspection questionnaire. In order to gain a full picture of Pilton House, this report should be read together with the earlier inspection report of 1 August, 2005. The home is always welcoming to the inspection process and on the day of inspection, lots of activity was going on in the home. One member of staff was organising activities for residents and one member of staff was formally supervising a selection of staff. Staff openly called in to the office during the inspection to ask questions and visitors and relatives came and went throughout the visit. Positive discussion took place throughout the day and any queries were raised by the manager to the inspector and dealt with. What the service does well: The home provides high quality care to residents living at the home by ensuring that all staff are trained, supervised and managed in their care practice. Residents were very complimentary of the staff at the home and staff have a good understanding of residents’ needs, which is evident from the positive relationships that have been formed between staff and residents. Some comments received by the inspector by residents or relatives included: ‘The care and attention given has eased our worries’, ‘We are impressed on our visits of how well the staff treat residents’ and ‘We were told what residents could expect and found everything to be satisfactory’. One relatively newly admitted resident said: ‘I was happy at my other home, but I am so glad I came here, it’s lovely’. Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 Page 6 The manager is well supported by her senior staff and ensures the home runs smoothly and efficiently. The home is well maintained, decorated and furnished to a high standard, despite the constant struggle due to the age and listing of the building. The atmosphere is warm, homely and open at the home and visitors are welcomed into the home at all times. Residents are actively involved in the running of the home and their views listened to and acted upon. The home has a committed and dedicated staff group who regularly take part in fundraising events, some quite innovative, to buy items of equipment for the people living at the home. 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 DS0000022096.V276057.R01.S.doc Version 5.1 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 Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 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): 3 fully met the standard at the last inspection. 6 The home does not provide intermediate care services. EVIDENCE: Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 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 the following standard(s): 9,10 fully met the standard at the inspection. 7,8 The health and care needs of residents are met with evidence of effective training and good multi-disciplinary working taking place. There is a clear and accurate care planning system in place to provide staff with the information they need to satisfactorily meet residents’ needs. EVIDENCE: All residents have an individual plan of care and the inspector selected three of these plans to look at the care given. All three files contained excellent information with regard to the health, personal and social care needs identified and planned for. For example staff have received specialised training in how to assess resident’s risk of falling – each resident has this assessment carried out which is regularly reviewed and audited. Plans show evidence of multidisciplinary involvement, for example the district nurse, chiropodist and General Practitioners. Significant events and useful information had been recorded and details of any care or action given was followed-up, for example one file contained important information, risk assessment and action required following a resident who wished to continue to smoke at Pilton House and one contained information about how a resident likes to go shopping with staff and Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 Page 10 spend their monies. All three files showed evidence of regular review. The three residents confirmed that their individual care needs were being met by staff and were very appreciative of the care given. Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 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 the following standard(s): 12,13,14,15 fully met the standard at the last inspection. EVIDENCE: Since the last inspection the menu planning has been reviewed with the kitchen staff and manager. One of the resident’s has specific nutritional needs and the menus were planned with her involvement to ensure the meals were satisfactory to her taste. Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 Page 12 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 18 The home has a good complaints system with evidence that residents feel that their views are listened to and acted upon. EVIDENCE: There have been no complaints since 28 July, 2005. The inspector looked at this last complaint which had been made at the home. A very thorough and comprehensive investigation had been carried out by the home. However, the outcome of the complaint was not recorded and any actions taken as a result not clear. This was discussed on the day of inspection and suggestions given as to how this could be improved upon. No complaints were made on the day of inspection and residents confirmed they felt comfortable to tell the manager if they had any concerns. Staff regularly attend the formal training on the Protection of Vulnerable Adults offered by Devon County Council Social Services. The training records, staff and the list showing the next four people attending shortly confirmed this. This training ensures that staff are trained to recognise adult abuse. Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 Page 13 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): 19,21,23,24,25,26 fully met the standard at the last inspection. Residents’ benefit from living in a home which is well looked after and provides an attractive and safe place to live. EVIDENCE: An on-going programme of maintenance continues and any area that is needed to be redecorated is included in the plan. The front entrance hall and office have recently been decorated. Plans for the near future include a new carpet for the staircase. This will benefit residents greatly as the colour and type has been specially chosen by staff to lessen the risk of falls to residents. The shape, design and furnishings of the dining room are shortly to be updated which will enable all residents to be able to sit together and provide a bigger space for those residents with walking aids. There are plans to update an uncovered garden area in the home, which residents, relatives and staff are planning and undertaking together. This will enable residents to enjoy a different sort of recreational area in the home. Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 Page 14 The home employs a maintenance person full-time who ensures that the home is continually maintained and made safe for residents. Any room which needs decorating is undertaken when it becomes vacant to prevent any unnecessary disruption to the individual resident. A new, modern alarm call system has recently been installed to replace the old one. This system is portable and pendants have been purchased for those residents who can remain mobile but are able to feel secure by being able to all for assistance if required, wherever they are in the home. Staff and residents in the home raised a large proportion of the money needed to purchase this by fundraising events. Further fundraising events are planned for this year to enable the home to purchase a minibus which will enable the home to have its own transport for residents outings. Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 Page 15 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): 27,30 fully met the standard at the last inspection and was not assessed. 29,28,30 Residents’ benefit from care staff who are well trained and supported. The home has an enthusiastic workforce that works positively with residents to improve their quality of life. The home has a good recruitment procedure in place, but it is essential that this be followed for every new member of staff employed at the home. EVIDENCE: The manager is very committed to training and is currently undertaking NVQ level 5 in this subject. Staff benefit from her knowledge and skills by having their training needs identified and planned into their development. Residents’ benefit from well-trained staff looking after them. Staff numbers were in excess of that required on the day of inspection and residents’ needs were all being met. Several members of staff have left since the last inspection with valid reasons. New staff have been employed and have settled in to the home. One of these members of staff was spoken with during the inspection and she confirmed she had had a thorough induction. This member of staff felt well supported of the other staff and said that it was ‘fantastic’ to work at Pilton House. Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 Page 16 There is a high proportion of staff undertaking formal NVQ qualifications at levels 2, 3 and 4. Several members of staff are qualified to assess NVQ work and this enables staff to progress quickly through their NVQ training. The home provides dedicated domestic and kitchen staff for the large part of the day, which allows care staff to concentrate of meeting resident care needs. Three staff files were looked at. Two of these files were satisfactory and held all the information required. The third file concerned a member of staff who had been employed, left the home and has since been re-employed. Whilst the residents and staff at the home know this member of staff very well, it is essential that all the necessary pre-employment checks be carried out as a break in service has occurred for several months and this person must be treated as a new employee. Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 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 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): 31,32,33,38 fully met the standard at the last inspection. 31,33,34,35 Residents are safeguarded from any risk by accurate financial and account keeping. The systems for resident consultation in this home are satisfactory with evidence that residents feel that their views are listened to and acted upon. EVIDENCE: Any resident admitted to Pilton House is encouraged to maintain their own finances. If not possible, relatives or solicitors are approached. The home has an administration assistant (previously the home manager) who looks after the monies and accounts of all the residents in the home. The home does not hold valuables for residents, but secure facilities are available in resident’s bedrooms for this use if they wish. Financial records were looked at and found to be satisfactory, with one suggestion made by the inspector to improve the recording methods. Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 Page 18 Any resident admitted since the last inspection are encouraged to complete a questionnaire shortly after their admission to find out if they are happy and all their needs are being met at Pilton. The inspector looked at some of these surveys and saw that any comments made to improve the service by residents or relatives had been acted upon by the home, for example one wished that fresh fruit could be supplied and this is now readily available at all times. Regular resident meetings are held and any issues brought up are acted upon and resolved. Residents confirmed that they are listened to and feel involved in the running of the home. The management committee of the home meet regularly and discuss relevant issues to the running of the home. One member of the committee tours the home each month and speaks with staff, relatives and residents which ensures that care standards are being maintained. The home has a good organisational structure and the manager is well supported by senior staff who have been delegated specific responsibilities within the home. The manager has recently set up a ‘care focus meeting’ with managers of other care homes in the area which provides a valuable support and networking group to share ideas and information. Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 3 X X X Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 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 OP29 Regulation Requirement Timescale for action 19(1)b The registered person shall not Sch. 2 1-7 employ a person to work at the care home unless all the information and documents specified in paragraph 1 to 6 of Schedule 2, except where paragraph (7) applies, paragraph 7 of that Schedule. With regard to: • 28/03/06 Ensuring that all persons employed at the home have the necessary preemployment checks carried out and copies held on file at the home 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 OP35 Good Practice Recommendations It is recommended that any monies handed over to staff when a senior member of staff is not on duty is receipted, signed for and recorded in the financial record folder. Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Exeter 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. Extracts may not be used or reproduced without the express permission of CSCI Pilton House DS0000022096.V276057.R01.S.doc Version 5.1 Page 22 - 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!