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Inspection on 08/09/05 for Plymouth House Nursing Home

Also see our care home review for Plymouth House Nursing Home for more information

This inspection was carried out on 8th September 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a comfortable homely environment for the residents. It is conveniently located near Redditch town centre and stands in well maintained gardens providing a pleasant outlook from the home. The manager visits potential residents to ensure the home can meet their care needs. Appropriate information is provided to potential residents and their families to assist them in making their choice. The home is well organised and maintains appropriate records and registers which they are required to maintain. Residents spoken to at the time of the inspection were complimentary about the home and the care provision.

What has improved since the last inspection?

Care plans have further developed since the last inspection. Some refurbishment has been undertaken since the last inspection. The manager is committed to the home, residents, families of residents and staff.

What the care home could do better:

The home should formalise a staff supervision and training program for all the care staff employed.

CARE HOMES FOR OLDER PEOPLE Plymouth House Alcester Road Tardibigge Bromsgrove B60 1NE Lead Inspector Christine Potter Unannounced 8 September 2005 - 14:00 . 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. Plymouth House E52 S4134 Plymouth House V244137 080905.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Plymouth House Address Alcester Road Tardebigge Bromsgrove Worcestershire B60 1NE 01527 873131 0121 445 1860 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) Mr Francis Edward Ursell and Mrs Margaret Irene Ursell Mrs Margaret Irene Ursell CRH 25 Dementia - over 65 Old age Physical disability - over 65 Terminally ill 25 25 25 25l Category(ies) of DE(E) registration, with number OP of places PD(E) TI Plymouth House E52 S4134 Plymouth House V244137 080905.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10 February 2005 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 was established in 1983. Mrs Ursell is a first level registered nurse and 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 benefitting from en-suite facilities. Other areas used by residents include two lounges and dining areas. The home has extensive gardens that are well maintained and easily accessible. The home is located in Tardebigge with wonderful veiws over the open countryside. A local bus service stops directly outside the home. Plymouth House E52 S4134 Plymouth House V244137 080905.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection took place over three hours on the afternoon of the 8th of September 2005. The inspection was unannounced and part of the planned program of inspections. A tour of the home was completed and residents spoken with at this time. Care plans and other records were reviewed during the inspection process. There have been no complaints made to the CSCI or the home since the last inspection. What the service does well: What has improved since the last inspection? Care plans have further developed since the last inspection. Some refurbishment has been undertaken since the last inspection. The manager is committed to the home, residents, families of residents and staff. Plymouth House E52 S4134 Plymouth House V244137 080905.doc Version 1.40 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. Plymouth House E52 S4134 Plymouth House V244137 080905.doc Version 1.40 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 Plymouth House E52 S4134 Plymouth House V244137 080905.doc Version 1.40 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 Residents’ are appropriately assessed prior to being admitted to the home. EVIDENCE: Three residents’ care plans were examined at the time of the inspection these included a pre-admission assessment. The assessment was completed by a first level registered nurse, and included the information appropriate to meet the standard. Plymouth House E52 S4134 Plymouth House V244137 080905.doc Version 1.40 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) 7, 8 and 10. Care plans and risk assessments had improved since the last inspection. EVIDENCE: Since the last inspection the deputy manager has revised the care documentation and risk assessments for the residents. Those inspected included personal and social histories, and information about the activities of daily living. Appropriate risk assessments had been carried out and recorded. The documentation had been regularly reviewed and updated by the nursing staff. The residents are able to retain their own general practitioner (GP) on admission to the home, or register with the GP who covers the majority of the residents. The GP reportedly provides a good service, and residents have access to physiotherapy and other community services as required. Staff were observed talking to the residents in a respectful manner. Residents able to comment were most complimentary about the manager and the staff, and stated that “nothing was too much trouble” for the staff. The home had assisted a resident in celebrating her 90th Birthday, with family, friends and fellow residents from the home. The resident was appreciative of this and complimented everyone concerned. Plymouth House E52 S4134 Plymouth House V244137 080905.doc Version 1.40 Page 10 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 and 15. The meals provided are well balanced and provide a varied selection of food. Social activities are suitable for those residents who chose to participate. EVIDENCE: Residents and staff were complimentary about the quality and choice of food available at the home. The lunch was being served at the time of the inspection, and the meal was well presented. Staff were helping residents who required assistance. Relatives and friends of the residents are welcome to visit at any time, and the manager and staff have developed good communication systems with them. Care documentation records relevant details about the residents’ families and friends. The residents care documentation records details their social needs and likes and dislikes. The manager confirmed that the residents are assisted to go shopping, and pursue their hobbies, which include reading, knitting, watching television, and listening to music. Plymouth House E52 S4134 Plymouth House V244137 080905.doc Version 1.40 Page 11 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) 16 and 18 Complaints are handled objectively and residents are confident that their concerns will be listened to and taken seriously and acted upon. A vulnerable adults procedure has been developed to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a simple and clear complaints procedure. The home receives very few complaints and none have been received by the home or the CSCI in the last 12 months. The manager attributes this to always being available for the residents and their relatives, and having good (open) communication systems. A system for responding to allegations of abuse is available, and all staff receive training and information about protecting vulnerable adults. Plymouth House E52 S4134 Plymouth House V244137 080905.doc Version 1.40 Page 12 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 and 26 Residents are provided with a warm and comfortable home, which is well maintained and meets the assessed needs of the residents. EVIDENCE: The home provides a safe, comfortable and well-maintained environment, which also has a homely atmosphere. The bedrooms are personalised by the residents, which further adds to the homely appearance. The home has two lounges that double as a dining area for the residents. The home has an on-going program for routine maintenance, and a system for checking safety aspects. Since the last inspection the home has started to guard unprotected radiators, to protect residents from sustaining accidental injury from hot surface contact burns. The manager confirmed that this work is planned for completion within the next three months. The home was clean and tidy, and the management of odours was commended given the dependency needs of the residents. Plymouth House E52 S4134 Plymouth House V244137 080905.doc Version 1.40 Page 13 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, 28 and 30 Staffing levels are suitable to ensure that residents’ needs are identified and met. EVIDENCE: There were suitable nursing and care staff on duty to provide care and support for the 24 residents within the home. In addition to nursing and care staff, there was also administration and ancillary staff on duty to support service provision. Residents complimented the staff, and stated that all staff were hardworking and most helpful. The majority of staff have worked at the home for many years and are able to demonstrate a good knowledge and understanding of the residents and their assessed needs. Whilst this is appreciated, the need to ensure all staff receive training updates within areas of mandatory training is considered necessary. This should include, infection control, first aid, health and safety, food hygiene and moving and handling. Plymouth House E52 S4134 Plymouth House V244137 080905.doc Version 1.40 Page 14 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, 32, 36 and 37 There is clear leadership, guidance and direction to staff to ensure residents receive consistent care, resulting in practices that promote and safeguard the health, safety and welfare of the residents using the service. EVIDENCE: The registered manager is a first level registered nurse with many years experience working in the care field. Staff and residents confirmed that the manager was most approachable, and always available for staff and residents. The manager has yet to commence the registered manager’s award, and is currently reviewing this. The home operates an informal staff appraisal system, the need to formalise this was discussed at the time of the inspection. Records inspected indicated that regular health and safety checks are carried out. Risk assessments are in place to ensure the safety of the residents and staff at all times. Plymouth House E52 S4134 Plymouth House V244137 080905.doc Version 1.40 Page 15 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 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x 2 3 3 Plymouth House E52 S4134 Plymouth House V244137 080905.doc Version 1.40 Page 16 yes 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 25 Regulation 13 Requirement All radiators must be guarded or have guaranteed low surface temperatures. REMAINS OUTSTANDING FROM LAST INSPECTION. All staff must receive mandatory training updates Care staff must receive formal supervision at least six times per year. Arrangements must be made for staff to receive training which will enable a minimum of 50 of care staff to attain a qualification at NVQ 2 or equivalent by 2005. Timescale for action 31st December 2005 31st December 2005 31st December 2005 31st December 2005 2. 3. 4. 30 36 28 12, 18 12, 18 12, 18 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 31 Good Practice Recommendations Arrangements should be made for the manager or deputy to undertake the Registered Managers Award. Plymouth House E52 S4134 Plymouth House V244137 080905.doc Version 1.40 Page 17 Commission for Social Care Inspection The Coach House John Comyn Drive Droitwich Road Worcester WR3 7NW 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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