Inspection on 30/09/08 for Porte Rouge

This inspection was carried out on 30th September 2008.

CSCI found this care home to be providing an Adequate service.

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

Porte Rouge 07/08/09

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Porte Rouge Vicarage Road Torpoint Cornwall PL11 2BW     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mandy Norton     Date: 3 0 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Porte Rouge Vicarage Road Torpoint Cornwall PL11 2BW 01752814469 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Ellen Patricia Knell Type of registration: Number of places registered: Torcare Limited care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 33. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old Age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Porte Rouge is sited in an Victorian style building and is currently undergoing modernisation and refurbishment. It sits in large mature gardens and is near the centre of Torpoint, Cornwall where local ammenities and public transport can be accessed. Accommodation is provided on 2 floors, with communal space, 2 lounges, a conservatory and a dining room, currently all on the ground floor. Access between both floors is via the stairs or the shaft lift. The home is being developed to provide accommodation for up to 18 older people and up to 12 poeple with learning disabilities, Care Homes for Older People Page 4 of 28 Over 65 33 0 Brief description of the care home who may also fit into the category of older people. The work to modernise and develop the home started when the curent providers, Torcare Ltd. took over the home early in 2008. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means that people that use this service experience adequate quality outcomes. This unannounced inspection took place from 12.55 pm to 4.25 pm on 30th September 2008. The inspection was conducted with the acting manager with the support of the training officer and the learning disability nurse. A tour of the home was carried out and people who live at the home were observed. Care staff were spoken to and observed during the insepction. (The current group of service Users include older people and a number of people with learning disabilities some of whom may also fall into the older people category). Care Homes for Older People Page 6 of 28 There were 14 people living at the home on the day of the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service currently have some information about the home in order to make an informed decision about whether the service is right for them. The personalised needs assessment means that peoples diverse needs are identified and planned for before they move to the home. Evidence: The home has recently been taken over by new providers who are in the process of registering to have people with learning disability and older people, some of whom might alos have a learning disability. The Statement of purpose and Service Users Guides are therefore being developed and were not available to view on the day of the inspection. They will be submitted as part of the re registration process. The acting manager said that people are always assessed prior to moving into the Care Homes for Older People Page 10 of 28 Evidence: home to ensure their needs can be met, although they are not taking on many new people, apart from for respite care, until part of the refurbishment is completed. If people are to be admitted they and their representatives are given as much up to date information about the service as possible, invited to look around and spend some time at the home and ask any questions they may have. The current fee level ranges from 500 pounds to 700 pounds per week (correct September 2008) Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The practice regarding the planning and delivery of care means that people can be sure that their health and personal care needs will always be fully met. Evidence: The acting manager said that all of the care plans have been updated since the new providers have taken over so that care staff can use them to refer to when caring for people and document ongoing progress. The care plans seen for both older people and people with a learning disability were up to date and contained a lot of relevant information about the person and their health, personal and social care needs. The care staff complete daily records about a persons welfare and detail what care has been provided. Information was included about visits made by or to health care professionals such as GPs, district nurses, opticians and dentists. The acting manager said that they try to keep relatives and representatives up to date about any changes to the resident either by telephone or in person and this has proved to be popular. The learning disability nurse who has recently joined the staff team showed an example of a specific care plan that he has developed for use with the residents who have a Care Homes for Older People Page 12 of 28 Evidence: learning disabilility. He said he will be transferring all the residents with a learning disability to this type of care plan in the near future. A tour of the home showed that equipment necessary for the promotion of tissue viability and prevention of pressure sores is available to meet peoples current needs. The acting manager said that they have enough equipment and most specialist equipment is provided by the community nursing services as required. The home uses a blister pack system for administration of medicines. They are kept in a locked trolley in a locked room. The drugs fridge has its temperature measured and recorded daily. Currently only 2 senior care staff administer medicines and they have had training in medicines administration. The medication administration records (MAR) sheets seen were completed as required. The procedure for receipt, storage and disposal of unwanted medicines was explained and is in accordance with laid down legislation. Staff were heard and observed interacting with people appropriately and providing care and support in a discreet manner. Staff were knocking on doors before entering and doors remained closed whilst personal care was taking place. Care Homes for Older People Page 13 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of activities within the home and the local community mean that people have opportunities to participate in stimulating and motivating activities. Meals and mealtimes are not rushed and staff are available to help make them an enjoyable and social occasion for people. Evidence: The acting manager said that the older people and the residents with learning disabilities often mix with each other and generally get on well. People are encouraged to exercise choice in how they spend their time and activites are offered individually or in groups and are facilitated by the activity co-ordinator who works between the 2 homes (Torpoint Nursing Centre next door now owned by the same company - Torcare Ltd.). She said they have trips out in the minibus on Mondays and Thursdays and have entertainers bought in to the home. She said that they have bingo sessions, quizzes and are encouraging baking and gardening sessions. Outside links are encouraged and some peopele attend day centres or local churches. MENCAP provide befrienders for some of the residents and independant advocacy is available for those who need it. Care Homes for Older People Page 14 of 28 Evidence: The care plans are designed so that information about peoples interests and hobbies is recorded and can be used when trying to develop person centred care. Visitors are welcomed at anytime and some people regularly go out with friends or relatives. There are large mature gardens around the home which once given some care and attention will be used for barbeques, fetes where the local commnity will be invited and for people just to enjoy and sit out in. There is access to the gardens via steps and ramps, the acting manager said there are plans to improve the curent access for people so everybody can use the facilities. Most people have their meals in the dining room, which although in need of decorating, is a large space where the older people and the people with learning disabilites are both encouraged to meet.The acting manager said that this arrangement currently works well. People are asked what they would like for their meal and there is always a choice. Fresh fruit is available and drinks and snacks are available 24 hours a day. Records are kept of what people eat to ensure they are receiving a balanced diet. The acting manager said that staff are available at mealtimes to give people any help or support they may need. Care Homes for Older People Page 15 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Formal complaints and safeguarding policies and procedures are in place and are available to staff, resdients and their representatives at all times. All staff undertake safeguarding training which means that people who live at the home are adequately safeguarded. Evidence: The complaints procedure was seen displayed in the home and is included in the new Statement of Purpose. It is comprehensive and gives options about who to contact and timescales for respomnses to be made. There have been no complaints made to the Commission or the home since the new providers took over. The acting manager said that people are seen by senior staff daily and hopes that any issues or concerns would be bought up at then. Some of the residents have advocates or visit day centres so are able to raise concerns to people outside the home if necessary. The training officer has attended the County Council safeguarding training and trains all the staff in the home on safeguarding, they also have information about safeguarding when doing National Vocational Qualification (NVQ) training and during induction training. Care Homes for Older People Page 16 of 28 Care Homes for Older People Page 17 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Despite ongoing building work, refurbishment and redecoration people have a generally comforatable, homely and safe environment in which to live. Evidence: Porte Rouge is currently registered to take up to 33 people. On the day of the insepction 14 people were resident at the home. It has recently been taken over by Torcare Ltd. who are eventually hoping to register the home to take up to 18 older people who require personal care and up to 12 people who are assessed as having learning disabilities making a maximum of 30 people. Building, refurbishmet and redecoration work is currently ongoing to achieve this. Areas of the home where building work is ongoing are empty and key pads are in place ensure no current service users are able to access the areas. A tour of the home showed that peoples rooms are personalised with furniture and momentos they bought in with them. People spoken to said they were happy with their current accommodation. Care Homes for Older People Page 18 of 28 Evidence: Communal space consists of one lounge with no natural light (although the plans in place are set to address this), one lounge leading to a conservatory from where there is access to the extensive gardens, althougth the access needs to be improved so everybody can access the outdoor space. The large dining room is in need of redecoration (included in the ongoing refurbishment plan) but is used by most people who live at the home for at least their main meal of the day. Once the refurbishement is completed a ratio of 1:8 bath/shower rooms will be achieved, although there are currently enough bathrooms and toilets for the people who currently live at the home. Future plans inclue improving the entrance foyer and the office to make it lighter and more inviting. Consideration should be given to a mechanical sluice facility and a wheelchair/equipment storage area in the future. Correct water temperatures, heating and lighting should be assessed as an ongoing process during the building work and refurbishment to ensure they are always reliable. The kitchen and laundry are not involved in the current refurbishment and are large enough to manage when the home has 30 people living in it. On the day of the insepction the home was clean, tidy and hygeinic, despite the ongoing building work. Policies and procedures around infection control are up t date and available to staff at all times. In house training on the importance of infection control is routinely offered to staff. Care Homes for Older People Page 19 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing levels and skill mix are satisfactory meaning peoples needs are being met at all times. The robust recruitment procedure means that people who live at the home are being looked after by appropriate staff and their welfare is not at risk. Evidence: The manager and care staff are supported by administrative staff, a training officer, an activity co-ordinator, catering, domestic, laundry and maintenance staff, all of whom work for Torcare Ltd. and may be based at more than one home. The manager and the duty rota seen confirmed that there are 3 care staff, one of whom is a senior, plus the manager , who is supernumery, on duty during the day and overnight there are 2 waking care staff. This is seen as sufficient for the number of people who currently live at the home (14) and is based on their dependancy levels. The training officer said that new staff have a 2 day induction that covers health and safety, fire safety, safeguarding and person centred care followed by a further day working under supervision after which they are offered a job if they are suitable. She said that after 3 months new staff are enrolled on an NVQ course and will continue to have training relevant to their role with either older people or people with learning Care Homes for Older People Page 20 of 28 Evidence: disabilities. This may be in house or by use of outside training establishemts as required. Training opportunities were seen displayed in the office and the training room during the inspection. Torcare Ltd. have a robust recruitment procedure that includes 2 written references and a CRB check. The manager said that the staff files in place when they took over have been checked and references have been sent for if necessary to make sure they have the required information in them. The manager interviews prospective staff and the administative part of the process is carried out by the Torcare Ltd. administrative team. Staff files were not examined during this inspection. Care Homes for Older People Page 21 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The systems and procedures now in place are designed to meet the needs of the service as they strive to improve the service the home offers to the people that live there. The attitude to health and safety shown by the providers, care and anciliary staffmeans that people generally live in a safe and well maintained environment. Evidence: When the home was taken over an in house management team were asked to look at areas that required improvement and begin work in those areas. A staff member who has been with Torcare for a number of years working in one of their other homes has been working at Porte Rouge for a short time and is being put forward to become the registered manager. She is experienced in managing teams of staff and has worked as a nurse with older people for many years. She is to be supported by a learning disability nurse who is to already in post and implementing appropriate care plans for Care Homes for Older People Page 22 of 28 Evidence: people. (Although the manager and the learning disability nurse are nurses the home is registered to provide personal care only. Any nursing needs will be met by the community nursing services). Administrative support is provided by Torcare Ltd. based at the home next door to Porte Rouge. A formal quality assurance assessment has not been carried out since Torcare Ltd. took over whilst they tried to establish a stable staff group and get to know the current residents and their relatives and representatives. A system to suit both older people and people with learning disabilities will be developed and put into practice in the future. In the meantime the providers and the manager have an open door policy and are happy to hear any concerns or issues as they arise and are then able to act on them immediately. The acting manager said that money held on behalf of the current residents is kept securely at the administrative offices based in Torpoint Nursing Centre, next to Porte Rouge, records are kept of income and outgoings and receipts are kept as evidence of the transactions. Residents have access to their money at all times. A petty cash float is kept at Porte Rouge in case people need access to their money very quickly. Records were not examined during this insepction. The training officer said that all staff have statutory training that includes health and safety, first aid, lifting and handling and food hygeine. She has a database that helps her keep up to date with who is due to have what training. A number of routine servicing and maintenance documents and the fire log book were examined and found to be up to date. An unexpected fire alarm went off during the inspection staff were seen to act appropriately and in a timely fashion. The current fire risk assessment has been carried out by the homes insurance company. This will need to kept under review during ongoing building work and refurbishment. The Environmental Health Office carrried out a routine assessment of the kitchen in May 2008. Some recommendations were made which have since been carried out. A member of the maintenance team checks the defect book daily and carries out repairs as requested. They also carry out ongoing in house and outdoor routine maintenance tasks. The current residents cannot access areas of the home where building work is ongoing due to security key pads being place. Areas of the home where refurbishment is ongoing and residents are living are continually subject to risk assessments to ensure the ongoing health, safety and welfare of them. Once the building work is completed an outside organisation will be asked to carry out a full health and safety assessment. Care Homes for Older People Page 23 of 28 Evidence: Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 Once the Statement of Purpose and Service Users Guide have been properly developed they should be available within the home and given to everybody that subsequently moves in. Planned building and refurbishment work should continue to ensure the premises is fit for its stated purpose. Plans to ensure the one lounge without natural light receives some should continue. Access to the outdoor space should be improved as part of the ongoing refurbishment. 2 3 19 20 4 25 Assessment of the water temperatures, heating and lighting should be ongoing during the building work and refurbishment to ensure they are all satisfactory at all times. The acting manager should apply to The Commission for Social Care Inspection to become registered in the near future. The acting manager should undertake a management qualification in the near future. 5 31 6 33 The provider should carry out a formal quality assurance assessment as soon as is practical. Page 26 of 28 Care Homes for Older People Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!