Inspection on 09/03/06 for Plymouth House Nursing Home

This inspection was carried out on 9th March 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Plymouth House Nursing Home 20/10/06

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 9th March 2006 10:00 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.V282249.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. Plymouth House Nursing Home DS0000004134.V282249.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Plymouth House Nursing Home Address Alcester Road Tardebigge Bromsgrove Worcestershire B60 1NE 01527 873131 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 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.V282249.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th September 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 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 and 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. Plymouth House Nursing Home DS0000004134.V282249.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of half a day. On the day of the inspection there were 21 residents at the home. The main focus of this inspection was to undertake the statutory unannounced inspection, and to follow-up requirements from the previous inspection. A partial tour of the home took place and a selection of care, personnel and health and safety records were examined. Residents and staff were spoken to during the visit, in order to ascertain their views on living and working at Plymouth House. What the service does well: What has improved since the last inspection? What they could do better: A redecoration program, prioritising the most urgent areas first, would further enhance the homes appearance. The remaining radiators must be protected to reduce the potential risk of injury to the residents. A formal staff supervision program and staff training matrix should be introduced to further assist in monitoring staff development. Plymouth House Nursing Home DS0000004134.V282249.R01.S.doc Version 5.1 Page 6 Activities could be improved to assist other residents who may choose to participate. 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 Nursing Home DS0000004134.V282249.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 Plymouth House Nursing Home DS0000004134.V282249.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): 1,2,3 and 5 Residents’ individual needs are assessed prior to them moving into the home in order to establish the home’s ability to meet those needs, and to ensure appropriate care is to be provided. EVIDENCE: All residents are assessed prior to their admission to the home to establish their individual needs and to determine if those needs could be met by the home. The manager usually goes out to undertake a pre-admission assessment, and invites relatives to visit the home prior to them accepting the placement. The Statement of Purpose and Service User’s Guide are updated and under review to ensure they accurately reflect the service provided by the home. Plymouth House Nursing Home DS0000004134.V282249.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): 7,8,and 10 Care plans and risk assessments are reflective of the residents’ care needs helping to ensure that care staff are able to provide the appropriate level of support required. EVIDENCE: The care plans for three residents were reviewed at the time of the inspection. These showed that they had further developed since the last inspection. The care plans had appropriate risk assessments in place, and the plans of care were being reviewed and updated as required. The care plan included a detailed record of each resident’s social history. Residents spoken to confirmed that they were pleased with the care provision and were consulted by staff to ensure that the home was meeting their needs appropriately. Six staff were spoken to. They were all very complimentary about the care provided at Plymouth House. A new member of staff who had experience of working in other homes stated that the care practices within the home were “excellent”. Plymouth House Nursing Home DS0000004134.V282249.R01.S.doc Version 5.1 Page 10 Staff were observed caring for the residents in a dignified manner, and a friendly, warm atmosphere was evident. Plymouth House Nursing Home DS0000004134.V282249.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 and 15 Social activities are limited, meeting only some of the residents’ needs. The dietary needs of residents are appropriately catered for. Residents are encouraged to make choices about what they wish to eat and where they wish to eat it. EVIDENCE: The home does not employ specific staff to organise social activities. 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 possible to do so. During the inspection, some residents were observed reading the daily newspapers. Others were listening to music in the lounge. Some residents chose to remain in their bedrooms and watch television. 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 relative spoken to confirmed the staff were always most welcoming. Residents, who were asked, stated that the food and choices available were good. The catering staff confirmed that no expense was spared when Plymouth House Nursing Home DS0000004134.V282249.R01.S.doc Version 5.1 Page 12 purchasing food. All residents’ dietary likes and dislikes are catered for, and any request is accommodated by the home. Staff also confirmed that the food was good and they were provided with meals. Plymouth House Nursing Home DS0000004134.V282249.R01.S.doc Version 5.1 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 the following standard(s): 16 and 18 The home’s complaints policy is provided to residents on admission to the home. A vulnerable adults procedure is available to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The complaints records were examined during the visit. Since the last inspection neither the home nor the CSCI have received any complaint about the service the home provides. 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.V282249.R01.S.doc Version 5.1 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 the following standard(s): 19,20,21,22,23,24,25 and 26 The home provides a warm and comfortable environment for the residents. Further refurbishment and improvements are now necessary to ensure residents have a safe place to live in. EVIDENCE: Residents confirmed that the home was comfortable and they liked their bedrooms. The general appearance of some areas of the home is appearing tired and fatigued, and would benefit from a redecoration program. The home should prioritise on the areas in most need. The need to complete protecting the remaining uncovered radiators remains outstanding from the last inspection, and should be given urgent priority to further protect residents from accidental injury. Plymouth House Nursing Home DS0000004134.V282249.R01.S.doc Version 5.1 Page 15 All areas of the home were observed to be clean and tidy, and the management of odours was commended. Plymouth House Nursing Home DS0000004134.V282249.R01.S.doc Version 5.1 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 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): 27,28,29 and 30 Staffing levels are appropriate to meet the needs of the residents in the home. Procedures for the recruitment of staff are sufficiently robust to ensure the protection of residents. EVIDENCE: The duty rotas confirmed that the staffing levels were stable, and the home does not use agency staff. Staff training records were reviewed. Staff felt they were up to date with mandatory training. The records did not evidence this. The last fire drill stated all staff on duty attended, however no names were recorded. Training records should detail the course content, the length of time the course lasted and clearly evidence who attended the training session. Plymouth House Nursing Home DS0000004134.V282249.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): 31,32,33,36 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. The need to formalise a staff supervision program was discussed during the visit. Plymouth House Nursing Home DS0000004134.V282249.R01.S.doc Version 5.1 Page 18 All relevant records and registers requested were available and up to date at the time of the inspection. All records are appropriately secured in the home. Plymouth House Nursing Home DS0000004134.V282249.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 3 3 3 X 3 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 Standard No Score 16 3 17 X 18 3 2 3 3 3 3 3 1 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 2 X X Plymouth House Nursing Home DS0000004134.V282249.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP25 Regulation 13 Requirement All radiators must be guarded or have guaranteed low surface temperatures. REMAINS OUTSTANDING FROM LAST INSPECTION. Timescale for action 31/05/06 2. OP30 12, 18 3. 4. OP36 OP28 12, 18 12, 18 All staff must receive mandatory training updates, and a record of staff training must be available in the home to evidence this. Care staff must receive formal supervision at least six times per year. 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. 31/05/06 30/09/06 30/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Plymouth House Nursing Home DS0000004134.V282249.R01.S.doc Version 5.1 Page 21 1. 2 3 OP31 OP19 OP12 Arrangements should be made for the manager or deputy manager to undertake the Registered Managers Award. The registered person should supply the CSCI with a redecoration program prioritising urgent areas first. Further development with the planning of the activities should be undertaken, to assist more residents to participate. Plymouth House Nursing Home DS0000004134.V282249.R01.S.doc Version 5.1 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: 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 Plymouth House Nursing Home DS0000004134.V282249.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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