Inspection on 11/12/07 for Poldhu

This inspection was carried out on 11th December 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Poldhu 23/11/06

Poldhu 28/11/05

Poldhu 27/07/05

Poldhu 01/02/05

Poldhu 02/09/04

Poldhu 13/05/04

Similar services:

Fairfields Country Rest Home

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

The Garden House

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

CARE HOMES FOR OLDER PEOPLE Poldhu Poldhu Cove Mullion Helston Cornwall TR12 7JG Lead Inspector Stephen Baber and Expert By Experience Sue Moss. Unannounced Inspection 11th December 2007 08:30 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 Poldhu DS0000008920.V352320.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. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Poldhu Address Poldhu Cove Mullion Helston Cornwall TR12 7JG 01326 240977 01326 240799 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) Swallowcourt Limited Tina Deborah Howard Care Home 63 Category(ies) of Old age, not falling within any other category registration, with number (63), Physical disability (15) of places Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home may accommodate up to 5 service users aged between 50 65 years for respite or permanent care 23rd November 2006 Date of last inspection Brief Description of the Service: Poldhu has a spectacular site on the Lizard Peninsular. It is registered under the Care Standards Act 2000 and Care Homes Regulations 2001 to provide accommodation and care with nursing to a maximum of 63 people. Poldhu also offers respite care to prospective residents. Poldhu provides free transport to the residents that live in the home. Residents bedrooms are spread out throughout the home and have been completely refurbished to a high standard. There are 54 rooms in total of which 40 have ensuite facilities. 6 are double. 13 single and one double room do not have ensuite facilities but toilets and bathrooms are located near to the bedrooms. Communal accommodation is spacious and a finished to a high standard. Rooms have been personalised and reflect the individuality of the occupants. To the front of the home is a very spacious, light and airy conservatory, which has been furnished and equipped to a very high standard. The dining room is light and airy and provides a high standard of furnishings and fittings. Residents and their visitors say how comfortable and satisfied they are with the accommodation. There is a 13person shaft lift, which travels to all three floors, aids, and equipment throughout to make life easier for the more dependent residents. There is excellent enhanced doctor back-up service. The management and nursing staff are very good at networking all community and health care professionals to provide a high standard of care in very comfortable surroundings. Mrs Howard is the registered manager with for the home. The aim of the service is to provide positive outcomes for residents. Weekly fees range from £450 to £900 per week. Free transport is provided for the residents for outings and trips to meet with appointments in the community. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection (CSCI) have made changes to the way we inspect services. Known as Inspecting for Better Lives (IBL). We are now more proportionate when reporting our findings, and more focused on the experience of people using services. This was the homes fourth inspection and noticeable improvements have been made since the last inspection. The purpose of the inspection was to ensure that resident’s needs are appropriately met, with good outcomes provided to them. The Commission have introduced Experts By Experience. This project was developed to improve social care services by involving people we can use in our inspections. Areas covered by the expert included talking with the residents and staff, observations of daily life and relationships between staff and people who use services and a look around the premises. The expert spent over 5 hours in the home and gave very comprehensive feedback to management at the end of her visit. This was a key inspection, which was unannounced. It took place on 11th and 13th December 2007 and lasted for approximately 16 hours. The purpose of the inspection was to ensure that residents’ needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus is on ensuring that residents’ placements in the home result in good outcomes for them. The inspection included interviews, some held privately in residents’ rooms and some in the communal area of the home, with residents and visiting relatives. Several members of staff were interviewed and there were opportunities to directly observe aspects of residents’ daily lives in the home and staff interaction with them. Other activities included an inspection of the premises, examination of care, safety and employment records and discussion with the manager and managing director who were present throughout the inspection. The managing director explained that the company are making major improvements throughout so that resident’s receive quality care in a comfortable environment. The principle method of inspection was “case tracking”. This involves interviews with a select number of residents; staff caring for them and/or their representatives, and examination of records relating to their care. This provides a useful impression of how the home is working overall. At this inspection three residents were case-tracked, with particular reference to their individual and diverse needs relating to their age, culture and ethnicity, religion, gender, sexual orientation and disabilities. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 6 The CSCI pharmacist inspected the medication system and will be writing a report. He gave detailed feedback at the end of his visit to the manager and managing director. The Expert By Experience said in her report commented under specific headings, which have been dovetailed into the report. “The home stands on the edge of a headland with the most spectacular scenery, the home lives up to its surroundings with a light spacious and welcoming hall that is a real pleasure to enter. Flowers and plants can been seen around the home and the home is in the process of being beautifully decorated for Christmas.” What the service does well: Poldhu provides a warm and welcoming environment and management and staff clearly provide a caring and efficient service meeting the individual needs of residents. This was illustrated in a comment made to us “The staff here are very caring and friendly they do their best to make sure we are well cared for and there’s nothing I would change” Another resident commented that “this is my home”. Comments from relatives “I am lucky that my mother is in such a caring atmosphere where she feels safe and is well cared for in all respects”, “it feels like both residents and staff regard Poldhu as a real “home”, “make the residents feel “at home” and comfortable”. There is good retention of staff helping provide consistency in the care of residents and we are very impressed by the commitment of the company as the employer who makes every effort to provide a rewarding and supportive environment for employees. Care planning has improved and is of an excellent standard providing clear information about the individual health and social needs of residents. This alongside good reviewing practice that reflects the changing needs of residents. We including the expert by experience noted that the practices of staff and the approach of the manager ensure that residents are treated with dignity and respect. We noted the close and caring manner in which management and staff were interacting with the residents and their relatives. One relative came into the office and asked the manager about her father who may have to go into hospital. She asked the manager to keep her father in the home because he was very happy and did not wish to go. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 7 The residents said the catering arrangements at the home are to a very high standard and they able to exercise a great degree of choice. There was a candlelight supper for residents and their families with over 147 people attending. The residents said the next day that they were thrilled to have shared this occasion with their family and residents said the food was excellent. One elderly gentleman who is terminally ill said he made the effort to go with his daughters and he said it was marvellous. Formal systems to protect residents from abuse are in place and all staff working in the home are police checked and provided with training on what to do if they suspect abuse and making sure they read and understand the procedures on what to do, and follow them. Excellent systems to ensure good hygiene in the home are in place so that residents are protected from the risk of infection as far as is possible. This includes provision of suitable hand washing facilities in all the bathrooms, easily cleanable flooring in the laundry and training in infection control for all staff. The manager and managing director have created systems to consult with residents and their representatives on the quality of care provided in the home. The registered responsible individual sends monthly regulation 26 reports on the conduct of the home to the Commission every month. This is important to ensure that the home is run in the best interests of the residents. The Expert By Experience in her report said, “I had positive feedback from the residents I spoke to and for the number that live to over 100 (one is 102 and one 105) I would guess that life is very comfortable for them with the care and kindness that they receive to live a long and happy life. All in all the home is excellent and does exactly what it says on the label”. What has improved since the last inspection? The company are constantly thinking of new and creative ways to make sure that their service is able to do the things that matter to people. For example the manager gave us a lot of evidence that showed that people that use their service are fully involved in care planning and daily activities. This has meant that people who use services are well supported by staff that they like. The residents said to the expert by experience and I that they are very happy with the home, and that the quality of support has really improved in the last Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 8 year. One comment we got was ‘I am very happy with the manager and staff, I have a link nurse and key worker who give me special time on a one to one basis and they are very good. We are always told about important things that have happened in the home since we did our last key inspection. The home is managed in a way that shows it has the interests of the people using the home at the centre of what they do. The staff told us that they are happy working for the home. Several members of staff praised the increased level of relevant training and supervision that they have received. Four members of staff said that they were now better equipped to support the people living in the home. All staff have an individual training profile and we noted the comprehensive training they have completed. Those residents living at Poldhu can feel confident that staff knows their daily routines as these are kept under regular review. 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. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 9 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 Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 10 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): Standard 3 was assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The needs of prospective residents are comprehensively assessed so that residents and the representatives can be assured that the home can provide excellent care. EVIDENCE: The records for a three residents were case tracked. The manager had carried out a detailed admission assessment and involved the resident or their representative in the process. Once admitted very comprehensive assessments are carried out in the area of specialist assessments which include for example nutrition, daily living, Tullamore, Waterlow, manual handling, Barthel and Life Story. The manager and nursing staff had also drawn up a care plan with detailed directions and information for staff, so that the resident’s needs could be met. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 11 The manager is very aware of the need to complete thorough assessments of prospective residents to ensure that the home is able to meet their needs and preferences. The home’s assessment format complies with the standard and permits flexibility in recording the complexity and detail of the assessment. The residents who had been admitted reported that the home was comfortable, clean and tidy, and the staff had been very kind in helping them to feel at home. They also confirmed that they are consulted on issues that affect their care and if they choose not to be involved then their representative is consulted. The Company have said in their AQAA that their plans for improvement in the next twelve months are: To be constantly investing in the structure and refurbishment of the home. To constantly invest in staff training and development. To look for new innovations and equipment so that our care homes are at the forefront using modern equipment and up-to-date methods. To address any areas of concern that arise quickly and efficiently. To address any areas arising from inspections or visits from CSCI. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 12 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): Standards 7,8,9 and 10 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Written care plans direct and inform staff in detail about the residents’ health and personal care needs so that these can be met. The manager and staff are very attentive in monitoring the changing healthcare needs of residents and ensuring that these are addressed. The arrangements for the management of medicines require improvement to protect residents EVIDENCE: We case tracked three residents’ records. These records all had written care plans. The manager and nursing staff draws up a separate care plan record for each care need, activity and risk. The plans cover the residents’ personal; health, special needs and social care needs. Each plan sets out a stated objective, the action to be taken and regular dated evaluations. The care plans provide detailed and specific directions for staff to meet the residents’ care needs. Residents sign a proforma sheet to give their agreement to the care to be offered. A number of care plans were looked at and showed good Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 13 information about individuals. Included was Life Story, Assessment of daily living, (routines, waking, meals, personal hygiene and diet) Risk assessment had been completed specifically where the individual was at risk of falls. Manual handling risk assessments had also been completed and these had been reviewed as part of the care plan review. Monthly reviews take place and appropriate action taken as a result of the reviews is recorded. The manager and nursing team are upgrading the care plans at present. The manager and staff are excellent at accessing the full range of community based health services that visit the home on request. If residents have appointments outside the home staff support residents to meet with these appointments. The residents I spoke with said that “they always” received the medical support they needed and the nursing and care staff are very kind and caring. There is further evidence of their participation in care planning in the ‘Resident’s Preferences’ record and agreement for frequency of checks at night. Nursing staff record daily notes consistently; these are legible and signed. However the daily notes do not always detail how care has been given Comments such as all “self Care” “ no problems” are recorded. These comments are meaningless and should detail in more depth what has happened throughout the day and night. The care plans contained regular reviews and evaluations. They documented the actions that had been taken to meet the changing needs of residents. Residents reported that staff were ‘kind and caring ’, knew what they were doing in the delivery of care, and respected their privacy and dignity. Residents were very satisfied with the quality of the care they receive. Residents see GPs at the weekly surgery held at the home if they wish and community professionals as and when they visit. Residents can see them in their own rooms or in the nurse’s clinic room, which is also used by the activities coordinator. Most residents have a telephone installed in their rooms. The C.S.C.I.’s pharmacist inspected the medication system and his report is as follows: “On arrival we observed that the medicines were being administered and this was carried out safely and the people administering the medicines explained what they were for to the individuals. The medicines were kept secure during the administration process. However it was not always possible to determine who had applied creams and ointments to people in the home. We found that although medicines are stored within a locked room the method of locking was not secure; the temperature of this room was also felt to be high although no regular monitoring of the room temperature was taking place. This can affect how the medicines work if stored outside the temperature range as specified by the manufacturer. We also found that the medicines fridge was recorded as having a temperature above 8C on several occasions. It was agreed during the inspection that a new medicines fridge would be obtained and also that the medicines storage area would be moved to a cooler room in a different part of the building. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 14 We also found that some people were given medicines from other people’s bottles although individual supplies were available. This is not good practice as it is not possible to audit individual’s medicines. We also found that although the home were making good records of medicines being disposed of and this was happening regularly, there were several boxes in the room that had had the dispensing labels either partially or completely removed from them”. The Expert By Experience in her report said” All the rooms I visited, the member of staff knocked before entering. The residents have an option of having locks on their doors. The rooms I visited had either or both. I spoke with one man who drives his car and is able to choose when and where he goes so would be able to go to his choice of church. Mostly religious services are held in the home with residents having the choice to attend. I was impressed with the thought and consideration taken to keep the residents active both physically and mentally. A bus is available to take residents on trips and I was told of the latest shopping trip to Marks and Spencer which the ladies really enjoyed”. The Company have said in their AQAA that their plans for improvement in the next twelve months are: To maintain the high standard of care provided at the home. To improve the facilities further with more specialist equipment. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 15 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): Standards 12,13, 14 and 15 were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported in a lifestyle, which accords as far as possible with their own expectations and preferences. There are regular activities and the activities coordinator keeps this under review so that they meet residents’ needs and preferences. The excellent diet provided is varied and nutritious with attention to individual preferences with residents having wide choice at mealtimes. EVIDENCE: Poldhu has a friendly, warm and an inviting environment and the resident’s we spoke with said their visitors were always “made to feel welcome and given hospitality”. The activities coordinator develops and reviews the range of indoor activities provided by the home. She provides regular sessions of activities for residents, which is recorded in their personal profile. During good weather the staff support residents to go out in the mini bus. We were told that this is very popular at present, with the vehicle being regularly full. The coordinator had introduced sessions with musical entertainers, which was very Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 16 successful. The company have a clear intention to continue to review and improve the activities provided so that residents receive a qualitative experience. The manager and staff welcome family and friends visiting at any time as long as this accords with the wishes of the residents. Visitors were coming to the home throughout the inspection. Residents can receive visitors in their own rooms or the communal rooms. The front conservatory provides a quiet area for receiving visitors. The resident’s I spoke with said that they were able to follow their preferred routines. Residents discussed their interests and were observed engaged in sitting their rooms, reading, entertaining visitors, watching television and enjoying listening to the radio and conversation. In talking with residents about the routines of the home they spoke of how they were able to choose “how I spend my day” “its up to me” Several residents when asked about getting up and going to bed said how “they can choose its up to me”. The previous night the home organised a candlelight supper for residents and their families. Over 147 people attended and the overall opinion of the residents I spoke with next day was that it was a great success. Poldhu is the only home in Cornwall that has a designated waiter service. The first class service to the residents was noted and wine and cold drinks of all sorts were available with their meals. The residents made consistently positive comments about the quality and content of the food and the standard of catering. The menu records a varied and wholesome diet. Overall the standards are very high making for a very enjoyable dining experience. A range of choices is provided for breakfast, which is taken at the residents preferred time. The main meal is served at midday. We sat with the residents in the dining room to have lunch. The dining room is spacious and furnished to a high standard with small tables that seat up to four and tables have clean linen tablecloths and napkins. The variety of meals was well presented and appetising, and was enjoyed by the residents. The residents were unrushed and waiting staff provided appropriate individual attention with the care assistants offering help to residents who required more assistance. Meals can be taken in the dining room; other residents prefer to eat in their own rooms. The Expert By Experience in her report said “ I was able to talk with five (approx) of the residents, one offered to show me her room and talked to me of the time she moved there to be with her sister and the time she has spent there since her sister died. She was very happy and positive and wouldn’t want to be anywhere else. As she had moved from the East end of London, it was quite a change of surroundings for her but she spoke highly of the staff and the home. I was very impressed at the menu and choice of food available. I was told that several residents have special dietary needs, which are all catered for. At short notice the chef prepared a delicious Vegan lunch for me. The head chef has been at the home for 21 years and runs a clean, airy and well organised kitchen with a team of happy helpers”. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 17 The Expert By Experience in her report said “All the residents I visited felt very much at home and would not want to live anywhere else. A visiting Library visits the home on a regular basis and papers and magazines are available. Computers are available and computer skills can be taught if requested”. The Company have said in their AQAA that their plans for improvement in the next twelve months are: The combination of internal audits, quality assurance audits will continue to enable us to meet and surpass our residents’ needs. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 18 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): Standards 16 and 18 were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a comprehensive complaints procedure that would ensure that complaints are listened to and acted upon. The company has established excellent arrangements to protect residents from abuse. EVIDENCE: The complaints procedure complies with the standard. The manager and staff actively consult residents individually and obtain their views about the services provided. The residents we spoke with were very satisfied with the service and none had felt the need to make a complaint. They stated that they found the manager and staff approachable and helpful. A relative reported over the telephone that the care her mother receives was excellent and the manager and staff knew the residents very well. We went to see the training manager for the company. She explained that the company have created training officers in each of their homes who specialise in specialist training. Adult protection being one of that specialism. The home’s policy and procedure on the prevention of abuse complies with the standard. The training manager has a copy of the recently issued multi agency Cornwall Adult Protection Policy. As evidenced staff receive training in the protection of vulnerable adults during induction. Records of training are recorded in individual staff training profiles. Staff were aware of their responsibilities in Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 19 relation to adult protection. The training manager keeps comprehensive records and reviews the provision of regular refresher training for staff in this area. The Company have said in their AQAA that their plans for improvement in the next twelve months are: To carry out research into the topic of restraint which affects some residents who have poor cognitive ability. To monitor each area of restraint such as medication, cot sides and reclining chairs. To train staff to be aware of the freedom of liberty, at which point we need to be considering the Bournewood principles for which there is a draft code of practice available, formally due for implementation in Autumn 2008. To continue to have consent from G.P, relatives and friends for residents who are suffering from low capacity. To always evidence this in our care plan. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 20 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): Standards 19 and 26 were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well maintained and safe and provides a high standard of accommodation. The premises are clean and hygienic providing a pleasant environment and reducing risks to residents. EVIDENCE: Information about the accommodation is provided in the statement of purpose. In walking around the room it was very evident that there is a high standard of cleanliness and residents confirmed how the home is always clean and free from unpleasant odours as on the days of the inspection. It was also very evident that the company have made a real effort to provide a homely environment with well-furnished communal areas and fully equipped rooms. There are a number of seating areas providing a choice of areas for Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 21 residents as to where they can sit. The main lounge/dining room is a bright and inviting space overlooking spectacular views of the sea and hills beyond. The grounds are well maintained and can be enjoyed by the residents in the better weather. A number of residents commented how much they enjoyed the spectacular views. The Expert By Experience in her report said “I looked at several of the rooms and talked to the occupants who all agreed that they felt warm and comfortable”. The Company have said in their AQAA that their plans for improvement in the next twelve months are: We run a continuous programme of refurbishment. When bedrooms become vacant they are redecorated and new carpets provided as required. Evidenced throughout is the commitment to providing high standards of accommodation which matches individual preferences and needs. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 22 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): Standards 27,28,29 and 30 were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The staffing and training arrangements ensure that the needs of residents are met. There is a high level of qualified staff. Recruitment procedures and practice support and safeguard the residents. EVIDENCE: Staffing rotas were examined and showed a good level of staffing in the home and taken against the identified needs of residents provide sufficient staff to meet those needs. We spoke with the residents and observed the call bell going throughout the two-day. The residents said that staff ‘always’ available when you need them but acknowledged that there are times when several call bells are going off together and staff have to prioritise. Some resident’s spoke of how the staff were all very good and how “you get all the help you need” Recruitment records for recently appointed staff were inspected. This is an area of management responsibility that has improved since the last inspection. These contained the required information and documents, including application forms, references, Criminal Records Bureau disclosures and POVA first checks. All staff receive statements of terms and conditions of employment. Staff receive copies of the General Social Care Council Code of Conduct. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 23 The home has a structured programme for induction training based on the industry standard Skills For Care Induction. The induction training is tailored to the level of qualification and previous experience of new staff. Staff reported that they received a thorough introduction to their job and sound support and supervision through a lengthy induction period. Records of induction training were on file, appropriately signed and dated. The training manager delivers or arranges training in required areas. Also she keeps under constant review the arrangements for the delivery of refresher training in food hygiene, manual handling, first aid, health and safety and fire for staff. Staff have individual training records and files detail regular supervision. The manager should review how often she meets with senior staff. There has been an incident where communication between the staff had not been followed through. Poldhu is a very large home with over fifty members of staff. There are times when situations go wrong and immediate action has to be taken. The manager should look at different ways to make sure individual meetings with staff happen regularly. Staff members may then feel that they have the opportunities to discuss their work and matters that are important to them. The Expert By Experience in her report said “ Whilst being shown around the home by a member of staff we encountered two residents in need of attention, apologies were made and the member of staff immediately gave her attention to them in a kind and sympathetic way. I was very impressed at the way she handled each resident and quickly dealt with the problem. I met several members of staff, all seemed very kind and caring in the way they were talking and dealing with residents. Several members of staff have been at the home for more than 20 years, they were very happy in their work which came across during my chat with them. All members od staff that I saw came across as attentive to the needs of the residents and very caring”.i The Company have said in their AQAA that their plans for improvement in the next twelve months are: It has been identified that some staff are working long shifts which are tiring and not necessarily productive. The Poldhu will be recruiting sufficient staff and have the ability to draw from the Swallowcourt bank to enable this practise to be eradicated. The company value its staff and the contributions they make. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 24 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): Standards 31,33,35,36 and 38 were assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager is very experienced and highly qualified, and fit to run a care home. The manager uses a range of methods to obtain the views of residents and their representatives. The manager operates a system for safeguarding residents’ spending money. The health and safety of residents and staff are promoted and protected. EVIDENCE: Mrs Howard is the registered manager and has managed the home since 2005. Mrs Howard has a degree and nursing qualification with extensive experience in working in nursing homes. She is clearly seen by residents and staff as Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 25 approachable and open in her approach and in discussing residents clearly had a real understanding and knowledge of individuals in the home. Staff described her as supportive and very in touch with the day-to-day life of the home. Mrs Howard places great importance on making sure there are opportunities for residents to express their views about the quality of care provided in the home. Regular daily contact with the residents ensures that the views and opinions of the residents are heard and acted upon. The residents we spoke said that she was a good and very caring manager who leads by example. Supervision records were maintained in the office with the nurse having responsibility for named carers. The company ‘Health and Safety Policy’ sets out the responsibilities of the employer and employees, and the arrangements for managing health and safety. There are hazard analyses and risk assessments for a range of activities and equipment. The manager works closely with the head of maintenance in the area of health and safety with all records for the seven homes maintained in his office. Records relating to health and safety practice in the home were examined and showed that the necessary fire drills, alarm tests (weekly) are undertaken, emergency lighting tests on monthly basis are completed. Fire system plan is kept up to date and inspected by the fire authority when they carryout their inspections. Maintenance of equipment such as lifts are carried out at regular intervals. The home’s information pack sets out the arrangements for quality monitoring and includes a summary of the actions taken following the last service review. The company employ a number of quality assurance systems. These include: - a three-monthly internal quality audit which covers the care, recruitment, premises safety and maintenance audit; - a regular recorded individual monthly review with each resident of their views on the care and services provided; - An assessment form for visitors and relatives; - monthly inspection by the Responsible Individual for the company on the conduct to the home. Yearly quality audits with action identified and acted upon within time limits. Personal money held in safekeeping for residents was inspected. The records have been completely reviewed and the current system offers security and safety for personal money held by the home. Staff felt that the company was attentive to health and safety matters, and that, for example, moving and handling was well managed. Accidents records were appropriately completed. The Company have said in their AQAA that their plans for improvement in the next twelve months are: - Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 26 To continuously update the company policies and procedures introducing legislative training. To work closely with the Health and Safety company that advises Swallowcourt and The Poldhu and provides the policies in this important area. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 27 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 4 X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 2 10 N/A 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 3 X 4 3 3 4 Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 28 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 OP9 Regulation 13(2) Requirement Arrangements must be made for the safe storage of medicines in the home. This must include both the safe custody and the storage within the temperature ranges as specified by the manufacturers. Timescale for action 29/02/08 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 OP7 Good Practice Recommendations The registered person should encourage all staff to write daily records that reflect how care has been given and should be in more depth to say what has happened throughout the day and night. It is recommended that there is a record of delegation for the application of creams and ointments and that the person carrying out the task would be the person making the entry on the record chart. The registered person should arrange or look at different ways to make sure individual meetings with senior staff happen regularly. Staff members may then feel that they DS0000008920.V352320.R01.S.doc Version 5.2 Page 29 2 OP9 3 OP36 Poldhu have the opportunities to discuss their work and matters that are important to them. Poldhu DS0000008920.V352320.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP 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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