Inspection on 20/10/06 for Plymouth House Nursing Home

This inspection was carried out on 20th 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 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

Plymouth House Nursing Home 09/03/06

Plymouth House Nursing Home 08/09/05

Plymouth House Nursing Home 10/02/05

Plymouth House Nursing Home 23/08/04

Plymouth House Nursing Home 26/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Plymouth House Nursing Home Alcester Road Tardebigge Bromsgrove Worcestershire B60 1NE Lead Inspector Chris Potter Unannounced Inspection 10:00 20 October 2006 th 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 Plymouth House Nursing Home DS0000004134.V309040.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. Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Plymouth House Nursing Home Address Alcester Road Tardebigge Bromsgrove Worcestershire B60 1NE 01527 873131 F/P 01527 873131 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) Mr Francis Edward Ursell and Mrs Margaret Irene Ursell Mrs Margaret Irene Ursell Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (25), of places Physical disability over 65 years of age (25), Terminally ill (25) Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th March 2006 Brief Description of the Service: Plymouth House is a care home providing 24 hour nursing care and accommodation for 25 elderly residents. The home is privately owned by Mr and Mrs Ursell and has been operating since 1983. Mrs Ursell is the registered manager and a first level registered nurse. She is responsible for the day-to-day management of the home. The home is a traditional detached residence that has been converted to accommodate 25 residents. The home has maintained its traditional features both internal and external. Accommodation is provided on the ground, first and second floor with a passenger lift to enable residents to access all areas of the home. Residents are accommodated in either single or shared bedrooms, some rooms benefiting from en-suite facilities. Other areas used by residents include two lounges / dining areas. The home has extensive gardens that are well maintained and easily accessible. The home is located in Tardebigge with wonderful views over the open countryside. A local bus service stops directly outside the home. The home the fees range between £525.00 to £575.00 Hairdressing, newspapers, and chiropody are not included in the fees. Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes key unannounced inspection and took place on the 20th of October 2006 over a period of 5 hours. Both the registered manager and registered provider were present for the inspection. The inspection focused on the requirements from the last inspection, care records, staff recruitment and the training. No comment cards were received from residents or relatives prior to the inspection. The pre – inspection documentation had been completed and a copy was provided for the CSCI. Six residents and four members of staff were spoken to during the inspection to ascertain their views about the home. Both the residents and staff expressed their satisfaction with the care provided at the home. What the service does well: What has improved since the last inspection? Since the last inspection the home has guarded the radiators in the residents bedrooms. Some redecoration has been completed to assist in enhancing the homes appearance. Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 6 The home has implemented a staff supervision program, and is reviewing all staff training needs. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Plymouth House Nursing Home DS0000004134.V309040.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 Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3, standard 6 does not apply Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Family members and advocates are provided with adequate information about the home, and the services it offers. Residents are assessed prior to admission to the home. EVIDENCE: Since the last inspection the home has updated their Statement of purpose and Service User’s Guide, a copy of each document was available for the inspector. The home provides prospective residents with a copy of the Service User’s guide and encourages them to visit the home to assist them in making their choice. A new resident was spoken with during the inspection and confirmed that they had been provided with the relevant information. Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 9 The manager goes out to assess all potential residents prior to their admission this helps to ensure that the home can fully meet their assessed needs. Other information is reviewed from professionals, family and friends to assist the manager in completing the pre-admission assessment. The pre – admission assessment forms the basis of the residents care documentation. Three care records were reviewed these had copies of the pre-admission assessment included. Residents also confirmed that they were more than happy with the size of their bedrooms and the homely environment. Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans gave the necessary detail regarding residents’ care needs to ensure that care staff are able to provide the level of assistance required. EVIDENCE: Three Residents care records were reviewed at the time of the inspection. The care documentation provided appropriate information to assist staff in understanding the residents care needs. Risk assessments had been completed and a plan of care developed to minimise the risk. Both risk assessments and care plans had been regularly up dated. The care plan Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 11 included a detailed record of each resident’s social history, which assists staff in understanding the resident’s needs. It was recommended that staff include a record of any social activities that the residents participate in for example aromatherapy. All staff were able to demonstrate the residents’ care needs when asked to do so. A physiotherapist is employed by the home, and assists staff in meeting the residents moving and handling assessments. Residents spoken with during the inspection were most complimentary about the homes facilities, the staff and the high level of care provided. All commented that they had no complaints. Staff spoken to also confirmed that they enjoyed working at the home and advised the inspector that in their opinion the care practice was excellent. Staff were observed caring for the residents in a dignified manner, and a friendly, warm atmosphere was evident. Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Flexible routines of daily living give residents a choice in how they spend their day. Visitors are actively welcomed into the home. The home needs to formalise a program of meaningful activities for the residents. EVIDENCE: It was evident during the day that residents are encouraged to exercise their own personal choice. Some residents chose to sit in the small quiet lounge; some residents were in the main lounge whilst others preferred to stay in their own bedrooms. The care records include a detailed summary of the residents life history this assists staff in understanding their needs further. The home provides limited activities for those wishing to participate. All care staff assist and encourage residents to maintain their preferred interests, if that is Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 13 possible. The home has some very dependent residents who are reluctant to participate in any activities. The home has pet cats and a dog, and residents were obviously fond of them. Staff assist residents to go out and maintain family links. Relatives are able to visit at anytime. A resident spoken to confirmed this at the time of the inspection. Residents and staff, who were asked, stated that the food and choices available were good. All residents who are able eat at the tables for meals, and assistance is provided where necessary. Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is satisfactory. Staff demonstrate a good awareness of adult protection issues. EVIDENCE: The home receives minimal complaints, the last one recorded in 2004. Records examined demonstrated that the home follows their complaints policy, and outcomes are recorded. A copy of the complaints procedure had been given to all residents, and was available for relatives and visitors. The manager confirmed that this is because she is at the home daily, and spends time talking to the residents and their families. A procedure for responding to allegations of abuse is available. The home’s manager was aware of the Protection of Vulnerable Adults register, and the procedures necessary to adopt in the instance when reporting is necessary. Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a warm and comfortable environment for the residents. The standard of housekeeping is commendable. EVIDENCE: The home provides accommodation for residents in both single and shared bedrooms. The home is a large traditional building, which has been converted to accommodate residents. The home’s décor is in keeping with the homes external appearance. It was recommended that the home review the bathing/shower facilities, given the dependency of some of the residents it must be difficult to offer the residents a choice of bath or shower with the Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 16 present facilities. Staff commented that a ramp would assist them when transporting residents upstairs. Residents who commented stated that they were pleased with their bedroom and the homes facilities. The main lounge/dining room is quite cramped when the home is full. Since the last inspection the home has upgraded the small lounge, and some bedrooms. The registered provider confirmed that bedrooms are decorated as they become vacant. Since the last inspection the home has provided covers to all radiators in the residents bedrooms. The registered provider confirmed that the high-risk radiators in the rest of the home are covered. The grounds around the home are well maintained providing a pleasant outlook from the home. Residents are able to sit outside when the weather permits. A small courtyard is used by the small number of residents who smoke. All areas of the home observed were commendably clean and tidy with no offensive odour noted. Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures for the recruitment of staff are sufficiently robust to ensure the protection of residents. Staff receive induction and further training to equip them in meeting the residents needs. EVIDENCE: Three recently employed staff’s files were reviewed during the inspection. These evidenced that the home had adhered to their recruitment procedure. All appropriate checks had been completed including protection of vulnerable adults first checks prior to them commencing work. This further assists in protecting the residents. Staff training records were examined it was recommended that the home further develop a training matrix to assist in recognising who has received training. Staff spoken to confirmed that they had attended training sessions and were up-to-date with their mandatory training. Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area of good. This judgement has been made using available evidence including a visit to this service. The manager is fit and competent to run the home, and adopts an open and approachable manner to management in the home. Records kept in the home were well maintained, up to date and available for inspection. EVIDENCE: Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 19 The manager is Mrs Ursell who is a first level registered nurse, and has managed the home since it opened. The residents and staff confirmed that the manager is approachable and always available to offer advice and support. The deputy manager is looking to undertake the registered managers award in the near future. Since the last inspection the deputy manager has formalised a staff supervision programme and the records were available at the time of the inspection. A review of the fire log maintained in the home showed that all checks were being carried out in line with current guidelines. All records required to show appropriate health and safety measures have been carried out were available and up-to-date. The home undertakes its own quality audit and the results of this audit were available at the inspection. Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 20 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 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 2 X X 2 3 STAFFING Standard No Score 27 X 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 X 3 Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP28 Regulation 12, 18 Requirement Arrangements must be made for staff to receive training that will enable a minimum of 50 of care staff to attain a qualification at NVQ 2 or equivalent. Timescale for action 30/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP31 OP25 OP12 Good Practice Recommendations Arrangements should be made for the manager or deputy manager to undertake the Registered Managers Award. The home should continue to review the risk of unguarded radiators to further protect the residents. Further development with the planning of the activities should be undertaken, to assist more residents to participate. The home should develop a staff-training matrix to assist with monitoring the staff’s development. 4 OP30 Plymouth House Nursing Home DS0000004134.V309040.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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