CARE HOMES FOR OLDER PEOPLE
Portelet House Residential Care Home 22 Grand Avenue Southbourne Bournemouth Dorset BH6 3SY Lead Inspector
Carole Payne Key Unannounced Inspection 26th January 2007 09:10 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 Portelet House Residential Care Home DS0000003973.V328371.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. Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Portelet House Residential Care Home Address 22 Grand Avenue Southbourne Bournemouth Dorset BH6 3SY 01202 422005 01202 433362 portelethouse@aol.com 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) Portelet Care Limited Mr Jean Alain Henri Moocarme Care Home 14 Category(ies) of Dementia - over 65 years of age (14), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (14) Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. In addition to registered places a day care service of up to 7 hours per day may be provided for one person in the categories MD(E) DE(E). 9th January 2006 Date of last inspection Brief Description of the Service: Portelet House is a care home for up to 14 older people with dementia or mental disorders over sixty five years of age who also have need of personal care. The home also offers respite care and day care. Portelet House is part of Portelet Care Ltd. The Proprietors are Jean Alain Henri Moocarme and David Lallana. Mr Moocarme takes an active role in the running of Portelet House and is registered as the manager. Portelet House is located in the centre of the Southbourne area of Bournemouth. It is a short walk to the cliff top, sea views and also to the shops and local community facilities. Portelet House is a double fronted detached converted property. There is a paved area to the front of the house and off street parking is available. At the rear of the home there is an enclosed courtyard / garden. Service user accommodation is over 3 floors with a 2-person passenger lift that enables easy access around the home. There are 10 single rooms and 2 double rooms available. Eight of the single rooms and both double rooms have en suite facilities. The home has a comfortable lounge, adjoining dining area and conservatory, overlooking the rear garden. Current fees are £485 to £550. See the following website for further guidance on fees and contracts: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_peop le_choos.aspx Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out on the 26th January 2007 and took a total of 8.5 hours, including time spent in planning the visit. The inspector was made to feel welcome in the home during the visit. This was a statutory inspection and was carried out to ensure that the fourteen residents who are living at Portelet House are safe and properly cared for. Requirements and recommendations made as a result of the last inspection visit and key standards met at the last inspection on 9th January 2006 were also reviewed. The premises were inspected, records examined and the daily routine observed. Time was spent in discussion with seven residents living in the home and three staff members on duty. Nine resident survey forms were received by the Commission for Social Care Inspection prior to the visit; two comment cards from health and social care professionals who visit the home; ten relative / visitors’ comment cards and two comment cards from General Practitioners. Family members completed some resident survey forms on behalf of the residents. The home also returned a detailed pre-inspection questionnaire prior to the visit. Throughout the inspection and following the visit the management and staff team have demonstrated a positive and proactive commitment to addressing any issues raised and to continuously improving the quality of life for people living at Portelet House Residential Care Home. What the service does well:
Thorough assessments ensure that people do not move into the home without having their needs assessed and being assured that they can be met. Comments in survey forms returned by people involved with the life of the service included: A care manager / placement officer said ‘Portelet House is an excellent home.’ ’Person centred approach.’ A health and social care professional said a ‘high standard of care.’ Relative / visitors said ‘An excellent home.’ ‘Satisfied with the standard of care.’ Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 6 Thorough assessments ensure that people do not move into the home without having their needs assessed and being assured that they can be met. The home’s welcoming environment helps to assure residents and their relatives that the home is able to fully meet their needs. Detailed personal and social care plans support staff members to deliver an empathetic standard of care and support to people living at Portelet House Residential Care Home. Staff members treat residents with great care and respect, upholding the privacy and dignity of residents living at the home. People who live at Portelet House Residential Care Home receive care and support to experience a varied quality of life, which reflects their interests and preferences. Relatives and friends are made very welcome at the home, enabling residents to continue to enjoy relationships that are meaningful to them. Residents are supported to live their lives in the way that they choose. People living at Portelet Care Home enjoy a varied and nutritional diet, with sensitive support that enables residents who need help to enjoy their meals. Residents and their relatives and friends can feel confident that they are protected by the home’s policies and procedures with regard to complaints. Effective training, policies and procedures protect people living at Portelet House Residential Care Home from abuse. Residents enjoy living in a very homely environment. Portelet House Residential Care Home is well managed in the best interests of people living in the home. Residents’ monies are not handled by the home, supporting the safeguarding of people’s financial interests. What has improved since the last inspection?
Where a service user is admitted to the home on an emergency basis, it is now ensured that there is documented evidence from the referring agent regarding the persons immediate care needs. Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 7 When completing a pre-admission assessment, the source of information obtained is now recorded and all assessment records are signed and dated. Where a service user is in receipt of wound care from a district nurse, the home establishes a care plan identifying the action necessary should the dressing become damaged between the nurses’ visits. The home’s menu now offers a choice of meals in a written format that is available to, and suits the capacities of service users. All staff members now receive training by a competent trainer in issues relating to abuse and protection of vulnerable adults. The home is making progress in ensuring that staff members are suitably trained and achieve National Vocational Qualifications (NVQ’s) in care. Safe procedures for the administration of medicines have been reviewed. For care staff to give a medicine it is now labelled with the service user’s full name, the name, form, strength, dose and frequency of the medicine. A quality assurance system has been established. This must now be maintained to ensure that a system for reviewing and improving the quality of care in the home is in place and that a report of any such review is available to service users. Residents care files are now complete and all information including preadmission assessments and contracts are held securely and are available for reference. Recorded evidence is now available demonstrating that regular, monthly checks are made of the emergency lighting in the home. What they could do better:
Individual daily records must be kept in order to ensure that residents’ needs are kept confidentially and appropriately monitored, so that changing needs are monitored and identified. A formal nutritional and manual handling risk assessment needs to be carried out for all residents, so that the home ensures that it has assessed and identified any presenting risks and how to minimise them. Where necessary there must be regular monitoring of weights and individual recording of food and fluid intake. A system for auditing the safe administration of medicines must be implemented, in order to ensure that residents are fully protected by the home’s safe practices.
Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 8 The home’s medicine trolley must be stored in a hygienic environment. It is recommended that Portelet House premises are assessed by suitably qualified persons including an occupational therapist to establish the extent of any disability equipment and environmental adaptations required. Radiators and pipe work, which presents a risk of scalding, must be suitably guarded, protecting residents living in the home. A door must be fitted to the laundry and the room must be made clean and maintained in a hygienic condition. Consideration must also be given to providing hand washing facilities in the laundry to minimise the risk of infection. A POVAFirst check must be obtained prior to new members of staff starting work in the home. Once this check has been received the member of staff may work under supervision, as set out in the Department of Health Protection of Vulnerable Adult’s guidelines until a Criminal Records Bureau check is received. Proof of identity and a photograph must be obtained and kept on individual staff member’s files prior to commencement of employment. It is recommended that Portelet House premises are assessed by suitably qualified persons including an occupational therapist to establish the extent of any disability equipment and environmental adaptations required. 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. Portelet House Residential Care Home DS0000003973.V328371.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 Portelet House Residential Care Home DS0000003973.V328371.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): 3&4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Thorough assessments ensure that people do not move into the home without having their needs assessed and being assured that they can be met. The home’s welcoming environment helps to assure residents and their relatives that the home is able to fully meet their needs. EVIDENCE: Pre-admission assessments were viewed for two residents who have moved into the home since the last inspection. The assessments were very detailed and included details of who had provided the information. A representative of the service had visited one of the residents. Details recorded included information in relation to individual needs and preferences. Discharge sheets had also been obtained from external health and social care professionals. Although one of the residents had been an emergency admission to the home,
Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 11 information had been obtained, which enabled the service to ensure that it could meet the person’s needs. All the resident survey forms returned prior to the inspection stated that people felt that they had received enough information about the home prior to moving in. One resident said that they had received a ‘warm welcome’. A relative responding on behalf of a resident said that ‘the individual time’ spent with their family member had helped them to settle very quickly. A relative spoken with at the time of the visit said that the home had made her feel ‘confident’ to entrust her family member to the ‘special’ care of the home. Portelet House Residential Care Home DS0000003973.V328371.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): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Detailed personal and social care plans support staff members to deliver an empathetic standard of care and support to people living at Portelet House Residential Care Home. Care records do not currently reflect the informal assessment, tracking, and monitoring of the healthcare needs of residents. Effective liaison with healthcare professionals ensures that people’s needs are responded to. Generally adequate procedures are in place for the administration of medicines. The fitness of storage procedures for purpose will ensure that residents’ needs are fully protected. Staff members treat residents with great care and respect, upholding the privacy and dignity of residents living at the home. Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 13 EVIDENCE: Three care plans were viewed for residents living in the home. Detailed plans support care staff to carry out personal and social support with respect for residents’ wishes and preferences regarding daily routine. Care plans seen had been regularly reviewed and updated according to changing needs. Records demonstrated that people had needs in terms of support with getting around the home and nutrition. At present there no formal risk assessments carried out in relation to residents’ manual handling and nutritional needs. People with specific manual handling needs, such as the use of a hoist had been referred to an occupational therapist and very thorough details were on file as to how the person was to be moved safely. Another resident had been referred for an assessment, but the home had not carried out its own formal risk assessment for manual handling. Eight residents returning survey forms said that they always receive the care and support that they need; one person said that this was usually the case. Daily records are kept but are not completed each day. Recordings are made in a daily report book, which is used to handover individual needs of residents to staff members coming on duty. Residents’ records are kept collectively and there is no clear audit trail to enable specific needs to be easily tracked. For example one resident was identified as requiring monitoring of fluid intake. No records of daily intake had been made. There had been no daily record entries from 5/12/06 to 15/01/07. Although there had been entries in the daily report book with general comments, there was no tracking of the person’s fluid intake and ongoing needs. The deputy manager reported that the resident was now drinking well; this needed to be reflected in the records. Another daily record for a resident with a poor appetite had no daily record entries between 3/01/07 and 21/01/07. Although it was identified in the records seen that there was regular appropriate referral to external health and social care professionals when needed, regular individual monitoring needs to be carried out as necessary, or it must be stated if a problem has resolved. A formal risk assessment needs to be carried out for all residents, so that the home ensures that it has assessed and identified any presenting risks and how to minimise them. Where necessary there must be regular monitoring of weights and individual recording of food and fluid intake. It was required in the last report that there are clear instructions to protect wounds, should the integrity of a dressing be compromised in-between the district nurses visits. Full details were recorded on one file seen of action to be taken should this situation occur. Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 14 One resident returning a survey form said ‘as far as I am aware the medical support is good.’ The home has a medicine’s trolley, which is suitably locked. At present the trolley is located in a toilet. Although the trolley is not opened in the toilet, this is not a hygienic environment in which to store medicines. The home has clear procedures for the receiving and disposal of medicines. Medicines checked corresponded with amounts detailed on the Medication Administration Records (MAR) charts. Allergies, or none known are clearly recorded on each MAR chart. At present the home does not have a system for auditing the process of the safe administration of medicines. There was a recommendation in the last report that the temperature of the fridge, which is used to store medicines, is routinely monitored. The home’s thermometer had broken at the time of the visit. The freezer compartment door was missing and the ice box full of ice. The deputy manager has confirmed since the inspection that a suitable thermometer has been acquired and the temperature of the fridge is now monitored and recorded daily. (See Management and Administration.) Throughout the visit staff members were seen providing the utmost care and respect to residents living in the home. Staff members sat with residents in the lounge. Small stools ensure that staff can sit close to residents at a respectful level and chat with them. Should any resident need any help staff were immediately responsive and sensitively understanding of the residents’ needs. Care records seen reflected respect for the individual privacy and dignity of residents. One relative / visitor returning a comment card said that they are ‘in awe of the care provided.’ Portelet House Residential Care Home DS0000003973.V328371.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): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at Portelet House Residential Care Home receive care and support to experience a varied quality of life, which reflects their interests and preferences. Relatives and friends are made very welcome at the home, enabling residents to continue to enjoy relationships that are meaningful to them. Residents are supported to live their lives in the way that they choose. People living at Portelet Care Home enjoy a varied and nutritional diet, with sensitive support that enables residents who need help to enjoy their meals. EVIDENCE: During the visit staff members spent time with residents individually. One staff member spoke about one of the resident’s hobbies and how they had been supported to continue to engage in previous interests since moving into the home. One resident was busy doing a crossword. The manager said that most
Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 16 residents very much enjoy singing and this is included as part of the activities programme. Four people returning resident survey forms said that there are usually activities that they like to take part in, two said sometimes and three people said that there are always appropriate activities. One person said that they like the karaoke. Relatives / visitors to the home returning comment cards said that they are satisfied with the overall care provided and feel welcome in the home at any time. ‘Portelet House is an open house we can go at any hour.’ One relative spoken with during the visit described how they work with staff to provide care to their relative. ‘It is like coming from home, to home.’ They spoke of how much they feel included in the life of the service and feel totally confident in the staff team to provide the very best for their family member. Care records seen included details of next of kin and important relationships to the resident. Care records seen included details of people’s preferences, particularly about the daily routine and meals and mealtimes. When a resident is unable to express their own views, family members had been consulted to ensure that as much as possible people’s lives at the home reflect their wishes and preferences about lifestyle. A list is kept of what people like for breakfasts and important things such as choices of drinks. Five people retuning resident survey forms said that they usually like the meals provided. Four people said that they always like the meals. ‘The meals are varied and thought is also given to nutrition, even offering fruit between meals to residents.’ At lunchtime some residents sat at the dining time, others received individual and sensitive support with eating when required. Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 17 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives and friends can feel confident that they are protected by the home’s policies and procedures with regard to complaints. Effective training, policies and procedures protect people living at Portelet House Residential Care Home from abuse. EVIDENCE: The manager confirmed that the home has received no complaints since the last inspection; this is also detailed in the pre-inspection submitted by the home. The complaints procedure is provided to people moving into the home. Seven people returning survey forms said that they know how to make a complaint. ‘I have never needed to.’ Staff members have received training in adult protection from Bournemouth Borough Council. Copies of training undertaken are kept on individual files. (See standard 30.) The home has an adult protection procedure in place. This was amended at the time of the inspection to reflect that any allegations of abuse will be referred to the local Social Services department. The home also has a copy for reference of the Dorset No Secrets guidance. Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 18 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 25 & 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents enjoy living in a very homely environment. The guarding of radiators and pipe work will protect people living in the home from the risk of scalding. The home is kept generally clean. However, the laundry must provide a clean and hygienic environment in which to launder residents’ clothing and bedding. EVIDENCE: Although some areas of the home are showing signs of wear and tear, the home has a comfortable and traditional environment. A relative said that they were impressed with their family member’s room, which had been personalised, with personal possessions and objects that were precious to the person. The assisted bathroom on the first floor is showing signs of wear. For
Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 19 example the grouting around the bath is discoloured. It was confirmed by the manager that the carpeting in the communal areas is to be replaced shortly. A recommendation was issued in the last report that Portelet House premises are assessed by suitably qualified persons including an occupational therapist to establish the extent of any disability equipment and environmental adaptations required. This recommendation is repeated in this report. An immediate requirement was issued at the time of the inspection, as there were radiators that were not covered and presented a risk of scalding. Some were in areas where some residents walk around the home; the risk of burning urgently needed to be addressed. The home has indicated that they will take immediate and responsive action to this issue. Staff members were seen during the visit carrying out their duties with respect to infection control in using gloves. It was advised that liquid soap rather than bars of soap are used and paper towels for staff to dry their hands, rather than a cloth towel, to minimise the risk of cross infection. The deputy manager confirmed that these would be put in place. The home’s laundry is located by going outside the building. The deputy manager confirmed that laundry is not carried through the kitchen. There is no door on the laundry and the room is dirty and the ceiling is covered in cobwebs. There is also no hand washing facilities in the room to enable staff members to wash their hands before going back into the home. Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 20 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): 27, 28, 29 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Satisfactory staffing levels ensure that residents’ needs are met in an unhurried and supportive manner. The seeking of a POVAFirst prior to the recruitment of staff members will ensure that the home’s generally efficient recruitment procedures are supported by good practice. The maintenance of a summary record of training will allow training needs to be identified, monitored and addressed, so that staff members receive the ongoing training that they need to meet residents’ needs and keep them safe. EVIDENCE: Staffing levels at the time of the visit adequately met the needs of residents, with time to spend qualitatively with people living in the home, engaging in individual activities and chatter. From rosters seen staffing levels meet the needs of residents living in the home. It was advised that the roster show the times that individuals have worked, rather than stating am and pm, reflecting a morning or afternoon shift worked. Resident survey forms returned commented favourably on the skills of staff members. ‘The care staff are excellent.’ ‘Staff are always attentive.’
Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 21 At the time of the visit one of the providers confirmed that eight members of the eighteen care staff working at the home possess a National Vocational Qualification (NVQ) in care. In addition to this members of staff are both starting or expressing an interest in undertaking the programme. Recruitment files were seen for two staff members working in the home. The home had copies of references on one file, a completed job interview assessment form, a curriculum vitae and a health declaration. There was also a copy of a passport with photograph, as proof of identity, a job description and a contract. However the seeking of a Criminal Records Bureau check or POVAFirst prior to employment did not support these thorough recruitment checks. If a POVAFirst had been obtained the member of staff may have worked under supervision until the Criminal Records Bureau check had been received. A copy of a Criminal Records Bureau check was on file from a previous employer. However, these checks are not portable from one employer to another. There was also no proof of identity for a second member of staff working in the home. An induction checklist and a training record was seen on one of the files. Copies of certificates were also on file. It was not possible without going through all staff members’ records to ascertain if all staff have had mandatory and specialist training. It was advised that a summary list is compiled so that the management are able to monitor and see at a glance individual training needs. The management team have taken prompt action since the visit and have produced a summary record, which the deputy manager has confirmed will be maintained to ensure that ongoing training needs are met. Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 22 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Portelet House Residential Care Home is well managed in the best interests of people living in the home. Residents’ monies are not handled by the home, supporting the safeguarding of people’s financial interests. Attention to aspects of health and safety highlighted within this report will support the home’s commitment to keep people safe. Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 23 EVIDENCE: The home is well managed. The manager liaises with the deputy to ensure that the day-to-day management of the home is organised in the best interests of residents. From the day of the visit both residents and relatives know the provider, who is also the manager, well and there is a sense of caring and family in the way that the home is conscientiously managed. People came up and spoke with the manager and deputy manager if they had any concerns and felt confident to do so. Regular staff meetings and supervision are used as a medium to improve the service. The home has started to ask people about aspects of the service and has designed a format for recording responses and detailing action to be taken to continuously improve the service. The deputy manager confirmed that the home does not hold any monies on behalf of residents. A fire log is maintained detailing regular checking of equipment. It was confirmed on the home’s pre-inspection questionnaire submitted that regular servicing of equipment and facilities takes place. The home’s laundry does not currently provide a hygienic environment to launder clothes. (See Environment.) At the time of the visit the home did not have a summary record of training to identify and ensure that all staff members have received required training in all aspects of health and safety. (See staffing.) However the deputy manager has confirmed since the inspection that this has been completed and from this staff members will receive updated training in Health and Safety. From records seen of staff attendance training lists, regular fire training and drill practice takes place in the home. It was advised that both fire training and drill practice are included in the home’s summary list of training so that training needs can be monitored and suitable updating of practice maintained. Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 2 X X 1 1 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 25 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 OP7 Regulation 12 and 15 Requirement The registered person shall ensure that the care home is conducted in a manner, which protects the privacy of residents and promotes their health and welfare. Individual daily records must be kept in order to ensure that residents’ needs are kept confidentially and appropriately monitored, so that changing needs are monitored and identified. The registered person shall ensure that residents’ health and welfare is promoted and any risks to the health of residents are identified and as far as possible are either eliminated or minimised. A formal nutritional and manual handling risk assessment needs to be carried out for all residents, so that the home ensures that it has assessed and identified any presenting risks and how to minimise them. Where necessary there must be regular monitoring of weights and individual recording of food and fluid intake.
Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 26 Timescale for action 30/04/07 2. OP8 13 and 15 31/05/07 3. OP9 13 The registered person shall make 30/04/07 arrangements for the recording, handling, safekeeping and safe administration and disposal of medicines of medicines received into the care home. A system for auditing the safe administration of medicines must be implemented, in order to ensure that residents are fully protected by the home’s safe practices. The home’s medicine trolley must be stored in a hygienic environment. The registered person shall ensure that any risks to the health or safety of residents are identified and as far as possible are either eliminated or minimised. Radiators and pipe work, which presents a risk of scalding, must be suitably guarded, protecting residents living in the home. An immediate requirement regarding this issue was made at the time of the inspection. The registered person shall make 30/04/07 suitable arrangements to prevent infection, toxic conditions and the spread of infection in the care home. A door must be fitted to the laundry and the room must be made clean and maintained in a hygienic condition. Consideration must also be given to providing hand washing facilities in the laundry to minimise the risk of infection. 4. OP25 13 28/02/07 5. OP26 13 Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 27 6. OP29 19 The registered person shall not employ a person to work at the care home unless: A POVAFirst check must be obtained prior to new members of staff starting work in the home. Once this check has been received the member of staff may work under supervision, as set out in the Department of Health Protection of Vulnerable Adult’s guidelines until a Criminal Records Bureau check is received. Proof of identity and a photograph must be obtained and kept on individual staff member’s files prior to commencement of employment. An immediate requirement regarding recruitment practice was issued at the time of the inspection. 31/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 5. Refer to Standard OP22 Good Practice Recommendations It is recommended that Portelet House premises are assessed by suitably qualified persons including an occupational therapist to establish the extent of any disability equipment and environmental adaptations required. This recommendation was issued in the inspection report dated 9th January 2006. Portelet House Residential Care Home DS0000003973.V328371.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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
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