CARE HOMES FOR OLDER PEOPLE
Porthgwara Nursing Home LLP Porthgwara Nursing Home North Corner Coverack Helston TR12 6TG Lead Inspector
Diana Penrose Key Unannounced Inspection 15th May 2007 09:30 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 Porthgwara Nursing Home LLP DS0000056600.V336557.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. Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Porthgwara Nursing Home LLP Address Porthgwara Nursing Home North Corner Coverack Helston TR12 6TG 01326 280307 01326 281137 pnhenquiries@porthgwaranursinghome.co.uk porthgwaranursinghome.co.uk Porthgwara LLP 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) Mrs Marian Ann Ozard Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (38), Physical disability (12) of places Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. To accommodate 6 service users aged between 50 and 64 years. Date of last inspection 6th December 2005 Brief Description of the Service: Porthgwara is a detached well maintained care home set in landscaped grounds in the village of Coverack, near the town of Helston. The home boasts a wonderful panoramic view of the sea from the front of the property, which is appreciated by residents, staff and visitors to the home. Porthgwara provides nursing and personal care for up to thirty-two elderly people. The registration also allows for people with a physical disability. Accommodation is provided on four floors and consists of the original house with modern day extensions. The most recent extension provides six rooms with en-suite facilities. There are six double rooms, four of which had single occupancy on the day of inspection, as that was the resident’s preference. There are spacious communal areas and adequate toilet and assisted bathing facilities. There are two shaft lifts to access the upper floors. The extensive gardens, lawn and very large patio are extremely well maintained. There are large plant tubs on the patio. Access for residents is restricted in certain parts of the grounds for safety reasons. A quiet area of the garden has been set-aside for visitors and staff to utilise. There is limited car parking space at the front of the home. Qualified nurses and care staff provide care in a relaxed friendly atmosphere. There is a flexible visiting policy and visitors are actively encouraged. Suitable activities take place each day organised by an activities co-ordinator and these are very much appreciated by the residents. Information about the home is available in the form of a statement of purpose, residents’ guide, and colour brochure, which can be supplied to enquirers on request. A copy of the most recent inspection report is available in the home. Fees range from £546.83 to £666.00 per week; this information was supplied to the Commission on the day of inspection. Additional charges are made in respect of private healthcare provision, hairdressing and personal items such as newspapers, confectionary and toiletries. Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. An inspector visited Porthgwara Nursing Home on the 15 May 2007 and spent seven and a quarter hours at the home. This was a key inspection and an unannounced visit. 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 was on ensuring that residents’ placements in the home result in good outcomes for them. On the day of inspection 27 residents were living in the home. The methods used to undertake the inspection were to meet with a number of residents, relatives, staff and the Registered Manager to gain their views on the services offered by the Home. Records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. There were two requirements and one recommendation set following the last inspection, all of which have been met. There are no requirements or recommendations set following this inspection. Residents and relatives expressed extreme satisfaction with the care and services provided at the home. Overall the home is providing an excellent service and a very high standard of care to the residents placed there. What the service does well:
The home provides nursing and personal care to a very high standard; the implementation of the Liverpool Care Pathway helps to ensure that a high standard is maintained through to the end of life. Efforts are made throughout the home to continually improve the service for both residents and staff. There is a very open style of management and this along with residents meetings, staff meetings and an excellent quality assurance system allow everyone to have a say. Staff and residents have great respect for the Registered Manager, Head of Care and owners of the home. The home is well managed and the owners visit regularly. The Company Secretary has worked at the home for many years and ensures that the administration systems are in order and regularly audited. The home has a suitable statement of purpose, resident’s guide and colour brochure that are issued to residents and also available in the entrance hall of the home. Resident’s needs are assessed prior to admission to the home and prospective residents are encouraged to visit with their family and friends. Each resident has an individual care plan, compiled from their assessment. The plans include
Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 6 health, personal and social care needs. Relevant risk assessments are undertaken, for example, to prevent pressure sores, to prevent the risk of falls and to ensure appropriate moving and handling. The plans are agreed with the resident or their representative and signed when possible, they are reviewed every month and changes made as necessary. Daily records are kept for each resident that are informative. Residents spoken with said their health needs are met very well and they have access to a doctor, nurses and other health professionals when required. Staff have the equipment they need for moving and handling and pressure relief. There is a suitable system for the storage, administration and disposal of medicines and relevant guidelines are available for the staff. The records inspected were fully completed and the GP signs changes in medicines prescribed. Staff were observed to respect residents privacy during the inspection and residents said this is always the case. Suitable screening is provided in shared rooms and residents are addressed by their preferred name, which is recorded in their care plan. The home has an experienced activities co-ordinator who has undertaken several courses in the subject. She ensures that activities are available each day and that residents have the opportunity to go out on trips and have regular entertainment in the home. Residents said there is always plenty to do in the home, they talked about the new ‘Art for Health’ programme and their artwork is on display. Some residents were making things for their garden fete in July and were keen to show these to the inspector. The owners have purchased a car to enable residents to get out and to ensure they can get to hospital appointments on time. Visitors are welcomed in the home and residents said they could receive their visitors in private if they wish. Residents also go out with their friends and family when they wish. Residents said they have plenty of choice and can live the life they choose. The daily routines are flexible, there are choices on the menu and residents wear clothes of their own choice. All of the residents spoken with said they enjoy living in the home and that they can do whatever they want. Some residents choose to stay in their room and this is respected. The menu is updated with the residents, it is a nutritious menu with good choices available. Cakes are homemade and fresh fruit and vegetables are on the menu each day. Residents said the cook makes cakes for special occasions and they enjoy celebrations in the home. One resident said she celebrated her one hundredth birthday recently and had a wonderful party. Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 7 There are systems in place for complaints and the protection of vulnerable adults and staff receive appropriate training in this area. There have been no complaints or abuse issues in the home. Residents live in a safe well-maintained home that is well decorated. It is very clean, homely and comfortable with no unpleasant odours. The home is situated in a beautiful setting, which is appreciated by residents, staff and visitors. The grounds are lovely and kept very tidy, the large patio overlooking the sea is a peaceful place to sit and is utilised for the annual fete and for visiting bands and singers. A quiet area of the garden is set aside for staff or relatives use. Laundry is efficiently dealt with in the home and suitable equipment is provided. There is a suitable team of staff with the relevant skills to care for the residents. There is a training co-ordinator employed to ensure that training needs are met and that the staff’s knowledge and skills are kept up to date. She maintains excellent records to evidence that training takes place. 80 of care staff are qualified to at least NVQ level 2 in care and others are doing the course. Recruitment procedures are robust and the checks required by law are undertaken. What has improved since the last inspection?
A new call system has been installed that logs the call response times so that they can be audited and issues addressed. The statement of purpose has been updated to include the new CSCI contact details. The home has purchased a car for taking residents out on trips and to hospital appointments and so on. The home has joined ‘Art for health’ and a local artist has implemented the package. Care staff and nurses have received appropriate palliative care training and the Liverpool Care Pathway has been implemented. This documentation helps to evidence that residents receive appropriate end of life care and that their wishes are respected. There is a new medicines policy. All staff have received basic food hygiene training. Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 8 The menu has been improved following discussion at the resident association meetings. 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. Porthgwara Nursing Home LLP DS0000056600.V336557.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 Porthgwara Nursing Home LLP DS0000056600.V336557.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): 1 and 3 (6 is N/A) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Very good information is given to prospective residents enabling them to make an informed choice as to where to live. Residents are only admitted to the home following an assessment of their needs to ensure the home can provide suitable care. EVIDENCE: Evidence was provided in the form of documentation, talking with the Registered Manager and the Company Secretary. The home has a suitable statement of purpose and resident’s guide. There is also a colour brochure with photographs of the home and grounds. The Registered Manager said these documents are given to prospective residents or their representatives they are also available in each resident’s room and in the entrance hall of the home. The statement of purpose has recently been updated with the new local CSCI contact details.
Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 11 The Registered Manager said that prospective residents and their relatives are encouraged to visit the home before deciding it is the right one. The Registered Manager or the Head of Care visits prospective residents to undertake an assessment of their care needs. The information is recorded on a specific form and those seen were completed appropriately. The form includes a section that details who is involved in the assessment and where the information is gathered. Information from social workers or hospital nurses is included where appropriate. This home does not provide intermediate care. Porthgwara Nursing Home LLP DS0000056600.V336557.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, and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual care plans are generated for each resident, they are reviewed and updated to inform and direct staff in the care provision. There are appropriate risk assessments and records that accompany the care plans. Residents have access to health care services as necessary to ensure their assessed needs are met. There are systems and policies in place for dealing with resident’s medicines that assure residents safety; the policy has recently been updated. The homes policies and culture ensure that residents are respected and their privacy is upheld at all times. EVIDENCE: Evidence was provided in the form of documentation, talking with residents, staff, Registered Manager and the Company Secretary. Each resident has a detailed written care plan and a concise care plan that lists personal care needs; this is kept in the resident’s room. The Registered Manager said she goes through the plans with the resident or their representative and they are signed when possible. Some of the care plans
Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 13 inspected had been signed and residents spoken with were aware of their care plan. There is a lot of useful information in the resident’s files and relevant risk assessments are included. There is a specific risk assessment and consent for the use of cot-sides, the risk assessment needs to be more detailed and this was discussed with the Registered Manager. She said she would update this using the guidelines on the use of bedrails in care homes. Care plans and risk assessments are reviewed monthly. Daily records are maintained and informative. Residents spoken with said their health needs are met very well and they have access to a doctor, nurses and other health professionals when required. The Registered Manager said that links with specialist healthcare professionals is very good. She talked about the tissue viability nurse, the speech and language therapist and physiotherapists. Appropriate equipment for moving and handling is provided including four hoists and a stand-aid. There are also appropriate mattresses and cushions provided for pressure relief. Care practice was observed to be appropriate during the inspection and carried out in a calm, efficient manner. Residents said they are well cared for by all of the staff and their personal care is carried out as they wish it to be. The home has an appropriate policy for the administration of medicines that has been updated and a copy of ‘The Royal Pharmaceutical guidelines for the administration of medicines in care homes’ is available to staff. Patient Information Leaflets (PIL) are also maintained. Current reference books are available to staff. Medicines records are all satisfactory; a GP signs the charts when medicines are changed. A system of separate pots and boxes is used. Storage is appropriate; the medical room is due to be revamped to improve the storage arrangements generally. New care staff receive informal basic training in respect of medicines, the Registered Manager agreed to formalise this as part of the induction programme. Nurses said the pharmacist would give training if required and there are external courses on offer. The arrangements for ensuring privacy and dignity are specified in the statement of purpose. Staff were observed to respect residents privacy during the inspection and residents said this is always the case. Suitable screening is provided in shared rooms and residents are addressed by their preferred name, which is recorded in their care plan. Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 14 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 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides activities each day and staff spend time with residents, aiming to offer a lifestyle that meets their needs. Links with family and friends are excellent and allow residents the opportunity to socialise. Residents said they are helped to maintain control over their lives and staff respect their individual preferences and choice. Dietary needs of residents are well catered for with a varied selection of food that aims to meet their taste and preference. EVIDENCE: Evidence was provided in the form of documentation, talking with residents, staff, Registered Manager and the Company Secretary. The home has an experienced activities co-ordinator who has undertaken several courses in the subject. Activities or entertainment are offered daily, there are posters showing what is happening and records are kept. Residents said they have their say as to what activities are included. Activities include singers, games, films, art and crafts, nail painting, Holy Communion, planting flower seeds and bingo. Trips out are organised, the owners have purchased a car for this and for taking residents to hospital appointments and so on, a trip
Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 15 to Stithians show is planned in July. A pantomime took place at Christmas and a summer fete will take place in July. Residents were busy making things to sell at the fete and were keen to show the inspector what they had done; they were very enthusiastic about their lives in the home. Two residents said ‘there is no time to sit around, we are very busy, there is always plenty to do here’. ‘Art for health’ has been introduced and an artist comes to the home each week to implement the package. A corner of the large lounge downstairs has been set aside to display the artwork done by the residents and residents said they are enjoying themselves. There are scrapbooks full of photographs showing events that have taken place in the home. There is a record of visitors to the home and there were visitors in the home during the inspection. Residents said they could receive visitors in private and at any time. Visitors spoken with said they are always made welcome in the home and can call in when they like. Residents said the telephone arrangements in the home are very good. Residents can go out in the community, for example, for walks or to local coffee mornings. Some residents went out walking during the inspection, they sign a board by the Registered Manager’s office when they go out and rub this off when they return, and this ensures the manager knows where they are for fire purposes. Residents said they go out with their friends and family when they like. Staff said residents choose what they do each day. Residents said they choose when they get up and go to bed, whether to stay in their room or go to the lounge. One resident said ‘I choose to stay in my room, I can do as I please but I don’t feel isolated at all’. Residents said they choose what clothes to wear and how they spend their day, one said ‘I love my home, I have such fun here and I can do what I want when I want’. All residents were suitably dressed in clean clothes and their rooms were personalised with their own belongings and furniture. There is a four-week menu with choices available at each meal. Nutritional needs are assessed and special diets are catered for. Everyone spoken with said the food is very good, residents said they can voice their views on the food with staff or raise it at the resident association meetings. There is evidence that the menu has been discussed, and issues have been raised and dealt with, in the resident association minutes. Homemade cakes are provided and the cook bakes a special cake for birthdays or other special occasions. Fresh vegetables and fruit are included each day and snacks and drinks are available between meals; water or juice is provided for residents at all times. Meals are cooked in a well-furbished kitchen and served in the dining areas, residents can eat at their armchair or in their bedroom if they prefer. The lunchtime meal was observed to be unhurried and appropriate assistance was given. Both cooks have achieved the Intermediate Food Hygiene certificate and all staff in the home have received basic food hygiene training. Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 16 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 and 18 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 complaints procedure that ensures complaints are listened to and acted upon. There is a resident’s association run by the residents allowing them to air their views and voice their opinions openly, records show they are listened to and necessary action is taken. Arrangements are in place for the protection of residents safeguarding them from harm or abuse. EVIDENCE: Evidence was provided in the form of documentation, talking with residents, staff, Registered Manager and the Company Secretary. There is a suitable up to date complaints policy available in the home that has been issued to residents. Residents said they could approach the staff, Head of Care or the Manager if there was a problem. Residents also said they could raise issues at the resident association meetings. Thank you letters and cards are kept in a file. The Registered Manager and several staff have attended the local ‘No Secrets’ course provided by the department for adult social care. In house training also takes place regularly. Staff said the training is very useful. There is a copy of the local inter-agency procedures in the home and the home has a suitable up to date policy. There have been no abuse issues at the home.
Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 17 Porthgwara Nursing Home LLP DS0000056600.V336557.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 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home and grounds are extremely well maintained providing a very safe environment for residents, staff and visitors. The home is clean and free from offensive odours making it a very pleasant place to live in. EVIDENCE: Evidence was provided in the form of documentation, talking with staff and residents, observation and a tour of the building. Residents live in a safe well-maintained environment, which is well decorated, clean, homely and comfortable. The home has an ongoing maintenance and refurbishment programme. There are some areas where the paintwork is chipped and some decorating is needed, the maintenance man was aware of this and said he has it in hand. The Registered Manager said that eleven beds and two armchairs are being replaced and the upstairs bathroom is back in
Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 19 use. The home operates a no smoking policy, there are air fresheners in use and there were no unpleasant odours on the day of the inspection. All laundry is dealt with in house and the laundry person has a good system in place, she tries to get the resident’s clothes washed, dried and returned within two hours. Residents said there are no problems with the laundry system. There are two washers and one drier. COSHH data sheets are available to staff. Porthgwara Nursing Home LLP DS0000056600.V336557.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 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staffing levels meet the needs of residents and staff morale is good. Resident’s benefit from the 80 of care staff that are trained to at least NVQ level 2 in care. Recruitment procedures are robust and offer protection to the residents. The home provides and supports staff with suitable training to help them be more competent and skilled in their roles. EVIDENCE: Evidence was provided in the form of documentation, talking with residents, staff, Registered Manager and Company Secretary. The Registered Manager said the home incorporates a skill mix that meets the resident’s needs. On average there are six care staff on duty in the mornings, four in the afternoons and evenings and two at night. A qualified nurse is also on duty at all times. There are three kitchen staff each day, three cleaners and a maintenance man. Staff said they feel there are enough staff and the team works well together. Residents said there are enough staff and that they are kind and caring. 80 of care staff are qualified to at least NVQ level 2 in care. All care staff are encouraged to gain this qualification.
Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 21 There is a robust recruitment procedure and staff files inspected contained all of the relevant documents. The Company Secretary has a database of staff photographs on her computer. It was noted that interview records are not maintained. There should be evidence that interviews are fair and equal and that any gaps in employment have been discussed; the Registered Manager said she would keep records in future. An equal opportunities policy is in place. All staff are issued with a job description. There is a training co-ordinator who organises all training in the home and arranges external training when required. There is a training matrix for each area and excellent records of training are maintained. There is a list of training available on the staff notice board along with details of external courses. Staff said they are paid if they come in for training during their off duty time. There is a training plan for fire and moving and handling training. All care staff are involved in the Liverpool Care Pathway training and all staff have had basic food hygiene training. An in house first aid training package has been purchased and will soon be implemented. Training needs are identified during appraisals and supervision and the co-ordinator also spends time talking to staff. There is a six-week induction programme in line with the skills for care standards. Porthgwara Nursing Home LLP DS0000056600.V336557.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 and 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Registered Providers, Registered Manager and Head of Care are people of good character and fit to run the home. The home is run in the best interest of the residents and they benefit from the excellent Quality Assurance systems in place. Resident’s money is managed well safeguarding their financial interests. Appropriate training and safety checks are undertaken to ensure the health safety and welfare of service users and staff. EVIDENCE: Evidence was provided in the form of documentation, talking with residents, staff, Registered Manager and the Company Secretary. Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 23 The Registered Manager is a Registered General Nurse who has achieved the Registered Managers Award. She is very competent in running the home and said she strives for best practice in all areas. She said she attends all statutory training updates and reads the nursing press and uses the internet to keep up to date on current issues relevant to her client group. She is an NVQ assessor and has completed the fire warden’s course. She is going on a course about employment law soon. The Head of Care is a Registered General Nurse who said she keeps herself up to date with current issues. The owners of the home visit regularly. Staff and residents spoke highly of the whole management team. The home is audited annually as part of the ISO 9001:2000 quality assessment audit and excellent administration systems have been in place for some time. The company secretary undertakes her own audit of records four times a year; these include accidents, medicines and care plans. A newsletter is produced to aid communication in the home. Residents and their relatives complete a Quality Assurance survey annually; the results are included in the statement of purpose. The Registered Providers visit the home very regularly and s a report is compiled every month and kept in the home, in accordance with Regulation 26. The Registered Manager also undertakes audits, for example, suppliers, environment and kitchen cleaning. The new call system logs the calls and if any take over three minutes to be answered they show up in red. This enables the manager to audit the response time, discuss and resolve issues with staff. Staff meetings take place regularly and changes have been made following these meetings. There is an independant residents association that meet regularly, minutes are kept and the meetings are very well attended. The meetings are chaired by a resident and members of staff are invited at the resident’s request. Residents said they can air their views and things have improved as a result of their meetings. The Registered Manager said that residents could control their money for as long as possible, seven currently control their own money. Appropriate records and receipts are kept. The records are checked and signed by two people. Money is held for residents in individual bags, securely in the safe. There is a policy in place for the control of money and personal possessions. Residents agree to the home dealing with their money, it is included in their contract. The management endeavour to ensure that working practices are safe. Relevant service checks take place as required. Staff receive statutory training regularly and records are kept. The Manager said there is a person trained in first aid on duty at all times, a new training package is being introduced for first aid. All staff have received food hygiene training and the cooks are trained to intermediate level. Accident reporting complies with data protection and the few accidents in the home are audited. Health and safety and fire risk assessments have been undertaken. Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 24 Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 26 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Porthgwara Nursing Home LLP DS0000056600.V336557.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Devon Office Unit D1 Linhay Business Park Ashburton Devon 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
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