Inspection on 23/10/08 for Portland House

This inspection was carried out on 23rd October 2008.

CSCI found this care home to be providing an Good 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

Portland House 01/11/07

Portland House 04/12/06

Portland House 15/08/06

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Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Portland House 25 Belvidere Road Shrewsbury Shropshire SY2 5LS     The quality rating for this care home is:   two star good 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: Pat Scott     Date: 2 3 1 0 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 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 23 Information about the care home Name of care home: Address: Portland House 25 Belvidere Road Shrewsbury Shropshire SY2 5LS 01743235215 01743353856 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Kelly Residential Limited care home 43 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The home can accommodate a maximum of 43 (forty-three) service users requiring nursing care which includes a maximum of 3 service users with PD (Physi cal Disability). The home must provide the following minimum staffing levels for 30-33 service users: 8am - 2 pm 2pm - 8pm 8pm - 8am 2 RN`s 1 RN 1 RN 6 care assistants 5 care assistants 3 care assistants These are minimum levels required throughout the 24hr day, including weekends, for service users who have low to medium dependancy nursing needs. Additional staff must be on duty when high dependancy service users are accomodated. These minimum levels are for direct nursing and personal care only. They do not inlcude ancilliary staff. They are exclusive of the Manager`s time. The home must provide the following minimum staffing levels for 43 service users: 8am - 2 pm 2pm - 8pm 8pm - 8am 2 RN`s 1 RN 1 RN 6 care assistants 5 care assistants 3 care assistants These are minimum levels required throughout the 24hr day, including weekends, for service users who have low to medium dependancy nursing needs. Additional staff must be on duty when high dependancy service users are accomodated. These minimum levels are for direct nursing and personal care only. They do not include ancilliary staff. They are exclusive of the manager`s time. Care Homes for Older People Page 4 of 23 Over 65 43 0 0 3 Date of last inspection Brief description of the care home Portland House is situated in a residential area of Shrewsbury. Kelly residential Ltd were registered as the provider in May 2006 with Mrs M Rai as the responsible individual. The home comprises of an older building with a modern extension situated within large grounds. Kelly Residential Ltd make their services known to prospective service users in: The Statement of Purpose and service user guide which has been updated for October 2008. Portland Houses rates are reviewed annually on 1st April each year and service users are notified one month in advance. The additional charges to service users are detailed in the service user guide. This is clearly laid out in the terms and conditions. Fees for Portland House are £650-£800 per week. Care Homes for Older People Page 5 of 23 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: two star good 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 *TWO star good service. This means the people who use this service experience good quality outcomes. We, the commission, used a range of evidence to make judgements about this service. This includes: information from the manager in the annual quality assurance assessment (AQAA), staff records kept in the home, medication audits, survey results from people who use the service, discussion with the manager, tour of the premises, previous inspection reports, quality assurance processes, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. Care Homes for Older People Page 6 of 23 Care Homes for Older People Page 7 of 23 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 23 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 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has produced an improved assessment process so that people wishing to be admitted to the home can be confident that their needs will be addressed. The manager is pursuing staff training so that the service has the capacity to meet individual needs. Evidence: Information is available about the home in a document called the statement of purpose. It is in large print format and is up to date for October 2008. The information reads with clarity so people who may wish to use the service can understand the facilities and care the home can provide. Another document called the service users guide is also available and provides clear information regarding the accommodation, staffing and how to make a complaint to the service. The manager has developed the assessment format they use which asks comprehensive questions about the persons Care Homes for Older People Page 10 of 23 Evidence: needs. The manager is reviewing staff training so that the home can be confident that the staff have updated skills, abilities and qualifications to meet the assessed needs of new people. Two people spoken with told us that when admitted, staff gave them information, good attention and enabled them to ask questions about life in the home. The written information provided reinforces this personal approach. Care Homes for Older People Page 11 of 23 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. Peoples care needs and risk assessments are set out in their individual plans of care which ensures that all care needs have been addressed and will be fully met. The manager understands the need to comply with safe medication systems and staff practice ensures that the homes procedures are complied with and that residents health matters are safely addressed. The actions of staff and their approach to care ensures that people are treated with respect and their right to privacy is upheld. Evidence: Each resident at the home has a care plan. The practice of involving residents in the development and review of the plan has improved. The staff demonstrate this clearly in the documentation seen. The plans have improved in that they are more person centred and now reflect the actual care being delivered as they are updated on a Care Homes for Older People Page 12 of 23 Evidence: monthly basis. The manager conducts a care plan audit on a regular basis. The record of this task show that action plans are in place to address omissions with the individual staff concerned through supervision. Care staff have had a limited role in contributing to the care plan. The manager has reviewed the keyworker system and is aiming to improve recording input care staff have in the plans. Staff spoken with state that the care plan provides them with a clear picture of the persons needs and progress. Keyworkers also spoke of how they involve people with their care planning. Risk assessments have been completed for the use of bed rails for individual people. These again are more person centred by ascertaining agreement from all parties concerned in the decision making process to use them. The manager has consulted with the Primary Care Trust for a full review of medicine management in the home. Medication audits are conducted monthly. Staff training is being reviewed by the manager so that the service can demonstrate that competency is being maintained in delivering all health care needs. Staff discuss issues on each shift during the daily debrief. A member of staff is a link nurse for palliative care training. Care Homes for Older People Page 13 of 23 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. Staff support people to keep in touch with family, friends and representatives so that they have appropriate relationships. The food in the home is of good quality so that the dietary needs of people are met. Evidence: The activity service has a commitment to enabling the residents to develop or maintain their leisure hobbies. Histories of people are to be taken. Residents spoken with said they enjoyed their leisure time and were looking forward to trips out and christmas. Visitors are welcomed in the home. The menus have been reviewed with an emphasis on more choice. Care staff were seen to be sensitive to the needs of those residents who find it difficult to eat and to give assistance with this. The lunch time is comfortable and unhurried. Care Homes for Older People Page 14 of 23 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. The service has a complaint procedure which is accessible so that people who use the service have information of how to make complaints about the home. Training is planned so that residents are protected from abuse and have their legal rights protected. Evidence: A recent adult protection referral identified a problem in how the service initially dealt with an incident. The new manager has made changes as a result and has revised its approach to ensure that staff know when to deal with situations promptly. Adult protection is covered after recruitment and discussed at supervision. A new member of staff on induction confirmed that adult protection had been addressed and her record of induction verified this. Residents spoken with stated they would be happy to approach the new manager as they felt she would listen to them and act on their worries. The manager is addressing the shortfall in adult protection training. She also has plans to ensure staff understanding about this topic through supervision. This was seen in records viewed. There have not been any complaints made to the service since the random inspection 17.7.08. Care Homes for Older People Page 15 of 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Personalisation of the home has improved, through service user choice, so that people feel they live in a comfortable, clean home with modern furnishings and facilities which suit their individual needs and preferences Evidence: A tour of the premises showed that areas which need attention such as sluice floor, laundry are in hand. Rooms are to be redecorated as they becomes vacant. Some rooms have been improved to become single en suite. The manager conducts room checks on a daily basis. Staff inform the maintenance person through a communication book of anything which comes to their attention and the manager holds weekly maintenance meetings. People personalise their room according to their wishes. Care Homes for Older People Page 16 of 23 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. Staff get access to training, supervision and support they need from the manager so that people receive planned care. Staff in the home are trained and recognise the importance of care planning so that peoples changing needs are identified and acted upon. Evidence: Residents spoken with stated they are happy with the way staff care for them. Staff rotas show the manager ensures there are enough staff rostered to care for the current residents needs. The manager recognises the importance of training and is trying to motivate the team to participate in a programme of training which will refresh, enhance and ensure competency of the staff group to care for vulnerable people. The manager spoke of the gaps in training and has plans in place to deal with this. The Regulation 26 reports into the conduct of the home details interviews with staff and discussion about attendance at training. From staff files seen, the services recruitment process meets the statutory requirements. The induction process is very thorough as seen in an example reviewed with the Senior Carer on duty. The manager audits this process to ensure there have been no omissions. Care Homes for Older People Page 17 of 23 Evidence: A new member of staff spoke of her recruitment process and her induction into the home. Care Homes for Older People Page 18 of 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The new management of the home is based on openness and respect. The service has quality assurance surveys in place so that people are assured that the overall conduct of the home is taking into account their views. Peoples opinions are more central to how the home develops and reviews its practice, and the service is developing appropriate ways of making sure they get things right. So, people have confidence in the care home because it is run and managed well. Evidence: The new managers practice is resident focused and customer satisfaction is high on the agenda. This is evidenced by the commitment to conducting surveys, resident meetings that are minuted, staff surveys and meetings and provision of a monthly newsletter. The manager and her staff are attending training events and updates to complement Care Homes for Older People Page 19 of 23 Evidence: their roles within the home. Staff files seen record all training activity. Through discussions with the manager, she demonstrates that she is confident in her ability to lead a staff team whilst being fully aware of the individual needs of the people living at Portland House. The home actively encourages people, where able, to manage their own money. Accurate records are kept and audited. Equality and diversity for service users is promoted throughout the home within the assessments, care plans and activities. Equality for staff is promoted through the opportunities for training at all levels. Quality assurance takes place throughout the service in both a formal and informal manner. Meetings, surveys, audits, day to day contact all provide records to show that resident satisfaction is at the heart of the service. The manager is committed to implementing plans for improvement The new general manager produces a monthly report to the manager to demonstrate that the overall conduct of the service is being managed well. It covers areas such as; interviewing residents, relatives, staff, catering, complaints, health and safety. The home keeps records to show that the health and safety of service users is promoted and protected. The service conducts fire drills, has regular alarm tests and has reviewed its fire risk assessment. Care Homes for Older People Page 20 of 23 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 21 of 23 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 Care Homes for Older People Page 22 of 23 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 © (2009) 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 23 of 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!