Inspection on 20/03/06 for Poulton House

This inspection was carried out on 20th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Poulton House 15/07/08

Poulton House 13/10/06

Poulton House 22/11/05

Poulton House 07/02/05

Poulton House 25/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Poulton House Winterhey Avenue Wallasey Wirral CH44 4DX Lead Inspector Anne Taylor Announced Inspection 20th March 2006 09:45 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 Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 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. Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Poulton House Address Winterhey Avenue Wallasey Wirral CH44 4DX 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) 0151 639 8844 Metropolitan Borough of Wirral Mrs Barbara Jean Norris Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Two (2) beds to accommodate persons under 65 years of age in an overall total of 38 (OP) 22nd November 2005 Date of last inspection Brief Description of the Service: Poulton House is a large, two storey establishment set in well-maintained gardens. The home is registered with the CSCI to provide care and accommodation for 38 service users within the category of old age. Service users’ bedroom accommodation is single occupancy with bathroom facilities being shared. The large dining room is bright and pleasant in appearance; there are six lounges of a smaller size and all are comfortably furnished and well decorated. An area of the foyer is used as an additional communal sitting area. A separate room for visitors is also provided. Service users are currently admitted to the home on a short-term respite basis or for rehabilitation and assessment from hospital. There was one long stay service user although it is envisaged that the home will not admit further service users for long term care. In relation to the rehabilitation beds these are joint funded by Social Services and the local Primary Care Trust. A multi-professional team, including a physiotherapist, dietician, occupational therapist and social workers, work closely with members of the care team to assist in the assessment of service users and in providing support during their stay in the home. Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over half a day during March 2006. Two Regulatory Inspectors from the Commission for Social Care Inspection conducted this visit, which focused on outcomes for people living at the home. The inspection involved discussion with people who lived and worked at the home and visitors, examination of records, policies and procedures and a tour of the premises. An excellent response was received from residents, relatives and other professionals in relation to the comment cards circulated, which provided some very positive feedback. Some of the comments are included within the body of this report. The Commission for Social Care Inspection had received no complaints about this service since the previous inspection. What the service does well: What has improved since the last inspection? The admission process had improved so that individual needs were clearly identified and a plan of care produced that showed how the home would meet those needs. Information about how to contact the local Commission for Social Care Inspection had been updated so that complainants knew how to contact the Commission directly if they so wished. Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 6 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. Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 7 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 Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The preadmission process was thorough enough to ensure that all needs were properly and consistently identified. EVIDENCE: Standard 3 was not fully assessed at this inspection. However, progress in meeting the requirement made at the last inspection was monitored. There had been some improvement in the pre-admission process and the compilation of information. Sufficient detail had been obtained about any person who was coming to live at the home to ensure that individual assessed needs could be met by the staff team. Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The care planning process was thorough enough to ensure the needs of service users were properly identified. The management of medications was thorough enough to protect the people living at the home. Staff were sensitive to the needs of residents and made sure that residents’ rights to privacy and dignity were upheld. EVIDENCE: There had been some improvement in the standard of care planning since the last inspection. Care records of the residents chosen for case tracking showed that a detailed plan of health, personal care and social needs had been formulated, which gave a clear picture of the individual needs of those living at the home and how those needs would be met. Comments received from residents included “The care I received was exceptional and very satisfactory. Everything was perfect”, “The care and Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 10 support is excellent” and “Poulton House is a haven. I feel very safe with the manager and staff”. Policies were in place in relation to the management of medications so that staff were aware of the correct procedures to follow. People living at the home were encouraged to administer and retain their own medications, within a risk management framework, so that independence was promoted. Care staff administering medications to service users had received appropriate training and assessment to ensure that they were aware of correct procedures to be followed and able to demonstrate competence in the administration of medicines. The Medication Administration Records (MAR) were signed to demonstrate that medications had been given and controlled drugs were being appropriately managed. However, a list of specimen signatures was not in place so that care staff authorised to administer medication could be easily identified. It is recommended that a new MAR chart is introduced at the beginning of each month to ensure that clear records are maintained and so that the potential for errors is minimised. Staff were observed knocking on bedroom doors before entering. They were seen to be providing care in a sensitive manner, which promoted residents’ dignity. People living at the home said that staff maintained their dignity and treated them respectfully. All new staff received council corporate training and induction training, which included instruction on privacy, dignity and respect so that staff had knowledge and understanding of this before they started to give care to residents. Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14,15 Residents were helped to exercise choice about the activities of daily living so that they had some control over their lives. The importance of providing a well balanced diet was recognised by the home so that residents were able to eat healthily and given a choice about what they ate. EVIDENCE: During conversations with residents and staff it was evident that residents were able to make choices about the way they lived within the home and were helped to make decisions about their future welfare. Policies and procedures were in place covering the rights of residents to access their personal records, handle their own finances and exercise personal autonomy and choice. Records were kept of individual likes and dislikes and staff were aware of residents’ dietary needs and personal preferences, which ensured that those living at the home received a nutritional diet in accordance with their needs. Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 12 The lunchtime meal was relaxed and unhurried with staff available to provide supervision or assistance if needed. Residents spoken to were generally satisfied with the range and quantity of food available to them. When asked one resident said, “I have no complaints about the food. I get a choice, whatever I want really”. Hot and cold drinks and snacks were available through out the day and staff had access to food stores during the night if any resident needed something to eat or drink. Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The arrangements in place for managing complaints made sure residents knew how and who to complain to. Management processes in relation to abuse were thorough enough to make sure people living at the home were protected. EVIDENCE: Standard 16 was not fully assessed at this inspection. However, progress in meeting the recommendation made at the last inspection was monitored. The complaints procedure provided people with the correct contact details of the local Commission for Social Care Inspection office so that they were able to refer a complaint to the Commission if they so wished. The home had a very detailed and thorough adult abuse policy in addition to a copy of guidance issued by the department of health. Discussion with staff showed that they were aware of the above documentation and were quite clear about what they would do if an allegation or suspicion of abuse came to their attention. The manager was aware of her responsibilities in relation to protecting people living at the home and making sure staff were appropriately trained to recognise and act upon any signs of possible abuse. Induction training records for new staff included information and guidance about abuse so that all new Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 14 staff were familiar with the subject and how to respond to any allegation or suspicion of abuse. Staff confirmed that they received regular updates so that they continued to be made aware of the need to protect the people they care for. Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25, 26 The home was clean, comfortable, and homely. And provided an environment that was suitable for it’s stated purpose. EVIDENCE: The home was accessible to all residents. Ramps allowed easy access to the outside. Outside the grounds were tidy and well maintained, providing a pleasant area for residents to enjoy if they wished. However the outside windowsills needed repairing and repainting. This issue has been raised at the last two inspections and the requirement made previously remains outstanding. The building in general was in need of some updating and exposed pipe work in bathrooms and toilets had not been covered so there was a health and safety risk to residents. Inspectors were told about possible medium term plans for the building. The Commission should be kept informed of any developments in relation to this. Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 16 Residents spoken to were happy with their private accommodation and some had personalised their rooms so that they felt more at home. One said, “I like my room, everything is alright and I have enough space for the things I wanted to bring in with me”. The home was clean and free from offensive odours. One resident said, “ My room is always clean and tidy”. One visitor said, “ it’s always clean and tidy, it never smells or anything”. Policies and procedures were in place that identified infection control measures in place at the home. Staff were able to discuss infection control procedures so the risk of cross infection between residents was minimised. Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28,30 Training was provided for new and existing staff that helped make sure they were competent do their jobs and able to practice safely. EVIDENCE: Training records showed that new staff received induction and ongoing training that provided them with the basic skills needed to carry out tasks allocated to them. Staff spoken to said that training opportunities were good and that regular training courses were held for fire safety, moving and handling and other health and safety topics so that they were kept up to date about safe working practices. National vocational training (NVQ) was available to care staff and some carers had already achieved level two or three. The manager was aware of the need to have fifty per cent of staff trained to NVQ level two or above. Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 Residents lived in a home, managed by a responsible person who was able to make sure the home was managed and organised in a way that helped make sure the service was run in the best interests of residents. The arrangements for handling money on behalf of residents were thorough enough to ensure their financial interests were safeguarded. EVIDENCE: The registered manager has extensive experience of running and managing a care home for this client group and was appropriately qualified. Records showed that she had completed lot of training whilst managing the care home in order to keep up to date with changes in legislation and current good practice. Discussion with staff showed that the manager provided leadership and direction so that every one knew what their role was and what was Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 19 expected of them. Staff spoken to say the manager was approachable and very supportive. Systems were in place to monitor the quality of service delivered so that the home could be made aware of its strengths, weaknesses and whether residents were satisfied with the service they received or not. Discussion with the manager showed that feedback from the consultation was used as a means of improving and developing the service. An annual development plan was produced as part of the home’s annual review that reflected the wider strategic aims of the local authority and plans for the future development of the home. The home did not routinely handle personal allowances for residents. The majority of residents received intermediate care and were being supported to manage their own affairs ready for when they returned home. For the one person who was staying at Poulton House on a long term basis arrangements had been made to make sure they received their personal allowance each week. Any money brought in by residents or relatives was stored in the home’s safe. Records were kept of any money handed in for safekeeping and receipts kept for any purchases made on behalf of residents so there was a clear audit trail of income and expenditure. When asked about access to their money residents said, “I have my own money and somewhere safe to keep it. My family help if I need it”. Standard 38 was not fully assessed at this inspection. However, progress in meeting the requirement made at the last inspection was monitored. The nurse call system had been serviced by an appropriately qualified person. Confirmation that the servicing had been undertaken had been forwarded to the Commission for Social Care Inspection. Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 20 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 X X X 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 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X 2 3 STAFFING Standard No Score 27 X 28 2 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP19 Regulation 23(2)(b) Requirement Timescale for action The registered person must 31/05/06 ensure that adequate action is taken in relation to the following: A significant number of external windowsills were found to have peeling paint. (Timescale of 07/04/05 and 28/02/06 not met) 2 OP25 13(4) The exposed pipe work in the toilets and bathrooms must be guarded. 30/06/06 Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP9 OP9 OP28 Good Practice Recommendations A specimen list of signatures of those staff responsible for the administration of medications should be compiled. It is recommended that new MAR charts be introduced at the beginning of each month. The home should continue to work towards achieving a minimum ratio of 50 of care staff with a National Vocational Qualification. Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Poulton House DS0000035570.V284389.R01.S.doc Version 5.1 Page 24 - 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!