Inspection on 22/11/05 for Poulton House

This inspection was carried out on 22nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 20/03/06

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 Vivienne Morris Unannounced Inspection 22nd November 2005 3.00pm 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.V268876.R01.S.doc Version 5.0 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.V268876.R01.S.doc Version 5.0 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.V268876.R01.S.doc Version 5.0 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) 7th February 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.V268876.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over half a day during November 2005. Two Regulatory Inspectors from the Commission for Social Care Inspection conducted this visit, which focused on the outcomes for people living at the home. During the course of the inspection service users and staff were spoken to, relevant records and documentation were examined and a tour of the premises took place, when a random selection of private accommodation was viewed and all communal areas were seen. The Commission for Social Care Inspection had received no complaints about this service since the previous inspection. What the service does well: Relevant information had been obtained prior to admission, except in the case of one emergency admission, to determine if the home could adequately meet individual needs. The needs of each person living at the home had been reviewed at frequent intervals using a multidisciplinary approach and plans of care reflected changing needs to ensure that appropriate care was being delivered to meet current needs. The plans of care were well-written in relation to supporting people who lived in the home with their independence and it was evident that a variety of external professionals were involved in the care of those living at the home to promote a multidisciplinary approach to the care and treatment being provided. A variety of risk assessments had been conducted and action required to minimise or eliminate the risk had been recorded. Opportunities were given for physical exercise to aid in mobility and activities of daily living. Appropriate equipment was provided for those requiring rehabilitation care to ensure that they were supported to return to the community. The procedures and management processes in place to assess and address health care needs good and individual needs were met in a supportive and caring environment. The staff team worked well together and showed a good understanding of the needs of the people living at the home. The staff team received appropriate training and guidance that provided them with the knowledge and experience needed to care for this client group. Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 Page 6 People living at the home benefited from the happy relaxed atmosphere and good relationships have been established between residents and staff. What has improved since the last inspection? 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.V268876.R01.S.doc Version 5.0 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.V268876.R01.S.doc Version 5.0 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 and 6 The needs of those wishing to move into the home had been adequately assessed prior to admission, except in the case of an emergency admission to the home, in which case relevant information had been obtained as soon as practicable. The plans of care had not been consistently generated from the pre-admission information. Those referred for intermediate care had been appropriately assessed and it was evident that they were fully supported to maintain their independence. Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 Page 9 EVIDENCE: The care records of three people living at the home were examined at the time of the inspection. Full pre-admission information had been obtained for two of the people whose files were examined, to demonstrate that the home had assessed individual needs prior to admission, in order to ensure that these needs could be appropriately met by the staff team. Brief telephone details had been obtained for one resident, admitted as an emergency admission. However, a multidisciplinary case review had been conducted shortly after admission in relation to this individual’s needs and a review of needs had taken place one week later, which demonstrated that the home had determined this residents needs as soon as practicable. Plans of care had been developed for each person whose records were examined, although assessed needs had not been consistently recorded to demonstrate that all needs were being met, particularly in relation to health care needs. A multi disciplinary team was available, which included a variety of external professionals, to ensure that appropriate advice was being sought and that residents’ needs were being regularly reviewed. Staff received relevant training in relation to rehabilitation and they were supported by other professionals, based on site to ensure that staff were aware of how to meet individual needs. Specialist facilities and equipment were provided including a fully fitted rehabilitation kitchen to promote mobility and activities of daily living. Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 Page 10 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 and 8 The plans of care were not consistently generated from the information obtained prior to admission to ensure that all assessed needs were being adequately met, particularly in relation to health care needs. EVIDENCE: Plans of care were in place for those living at the home, which identified a variety of needs. However, not all assessed needs for one resident were recorded, particularly in relation to health care in order to demonstrate that these specific needs were being adequately met. The plans of care needed to be more specific and individualised in order to provide clear guidance for the staff team as to how the needs of people living at the home were going to be appropriately met. A variety of risk assessments had been conducted, which outlined action to be taken in order to minimise or eliminate the risks identified. The plans of care demonstrated that the needs of those living in the home had been reviewed at frequent intervals, usually on a weekly basis to reflect changing needs and to ensure appropriate care was being delivered to meet current needs. Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 Page 11 The plans of care seen did not demonstrate that those living at the home had been given the opportunity to be involved in the care planning process to ensure that they were in agreement with the content of their care plan. The care records examined for two people living at the home demonstrated that they were both independent and required little intervention. The plan of care was detailed in relation to staff supporting these people to retain their independence. As Poulton House provided rehabilitation care there was set criteria for those admitted to the home, which indicated that some level of independence was necessary and therefore a high level of health care intervention was not required for those living at the home. Where required the District Nursing team conducted pressure risk assessments to identify those at risk of developing pressure wounds and appropriate equipment was provided in accordance with risks identified. Opportunities were given for appropriate exercise and physical activity with the involvement of occupational therapists and physiotherapist, who were based on site and ensured that appropriate rehabilitation care was being given. Assessments had been conducted for those at risk of falling to ensure any potential risks were minimised or eliminated. Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 Page 12 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): 12 and 13 The daily routines were flexible so that service users were able to exercise choice, have some control over their lifestyle and maintain contact with family and friends. The range of social activities available met the expectation of people living at the home. EVIDENCE: Records and discussion with service users showed that appropriate attention was paid to helping residents to take part in valued and fulfilling activities that were already established or developed in and outside the home so that the lifestyle experienced by residents met their expectations and preferences as much as possible. Service users had a range of needs and ability; some were able to go out independently, whilst others were reliant on support from staff. Service users spoken to were generally satisfied with the activities available. One said, “I join in the activities sometimes or stay in my room if I’m not interested or can’t be bothered”. Another said, “There is something to do if you want but we are all working towards going home so we practise walking and things like that so we can manage when we get home”. One service user had attended a specialist centre where she had been helped to come to terms with her Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 Page 13 reduced abilities, she said, “I have been helped to accept my limitations and focus on what I can do instead of what I can’t”. Service users spoken to said that they were able to exercise choice about what time they got up and went to bed and what clothes they wore, giving them some control over their lifestyle. When asked how they helped residents to exercise choice staff said, “we ask if they want to get up and what they want to wear every day”. The statement of purpose outlined the home’s visiting policy and included a statement about residents being able to exercise choice in relation to visitors. These documents were available to residents and visitors so they could refer to them if they wanted information about the facilities and services available to them. This meant that residents and relatives knew what the home’s approach to visiting was and could comply with any policies operated by the home. Residents spoken to confirmed that they were able to see visitors in their own room or in one of the communal areas of the home so the meetings could be private if they wished. Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 Page 14 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 The home had a clear and accessible complaints procedure that ensured service users and their representatives knew how and who to complain to. EVIDENCE: The home had not received any complaints since the last inspection. A complaints procedure was in place and residents spoken to know how and who to complain to one resident said, “I’d go to the boss if I had a complaint, not that I’ve needed to so far”. The complaints procedure should be amended to reflect contact details for the local Commission for Social Care Inspection office so that the management of any complaints is not delayed by having to reroute the complaint from the Commission’s head office in Newcastle. A comments/suggestion book was kept in the foyer, providing service users, relatives and any other visitors to the home an opportunity to make their views known. Resident’s spoken to felt that they were encouraged to raise any concerns they might have about the home, that they would be listened to and action would be taken on any issues raised. Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 Page 15 Staff were able to discuss how they would respond if a resident complained to them and realised how important it was to make sure residents felt able to raise concerns and be sure they were listened to. Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 Page 16 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): EVIDENCE: The environmental standards were not fully assessed at this inspection. However, the requirement to take adequate action in relation to external windowsills that needed repainting had not been addressed. Action had been taken to address the requirement made in relation to concerns from service users about the bedrooms being stuffy at night. Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 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): 27 and 29 The skill mix of and number of staff on duty was sufficient to ensure the needs of service users were met. The recruitment process was thorough enough to ensure the continued protection of service users. EVIDENCE: Staff rotas showed the number and skill mix of staff on duty at any time and that enough staff were on duty to ensure the needs of service users could be met. Comments from service users indicated that there was always sufficient numbers of staff on duty and they felt that they were looked after and attended to properly. Comments included, “The staff are good, they do what they can and I have no grumbles”. Staff spoken to felt that there was enough staff on duty so that they were able to provide a good standard of care to residents. The organisation’s staffing department managed the recruitment of new staff. However, copies of CRB checks, references and application forms were kept at the home for information purposes. Records showed that appropriate checks were made on staff before they started work at the home to ensure that staff appointed were suitable to work with vulnerable adults. Staff talked about how they had been recruited and confirmed that they had received a statement of terms and conditions of employment and a job Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 Page 18 description so that they knew what their responsibilities were and what was expected of them. Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 Page 19 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): 38 The management of health and safety matters needs to be improved to ensure the continued health, safety and welfare of service users and staff. EVIDENCE: Most of the certificates to confirm that equipment and systems used by the home were up to date. However, servicing of the nurse call system was out of date, the deputy manager agreed to send a copy of the servicing report to the Commission when it had been completed. Staff were unable to find the home’s fire risk assessment although they were sure one had been developed and contacted the registered manager to confirm this. A copy of the fire risk assessment must be sent to the Commission as soon as possible. Records showed that fire drills were held, usually every six months. It is recommended that the drills be held more frequently so that all staff, including night staff can be involved. Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 Page 20 Records relating to fire safety training were not up to date so the inspector was not able to confirm that all staff had received appropriate instruction about fire prevention and the procedures to be followed in case of fire, including the procedure for saving life. Discussion with staff indicated that they had received moving and handling training and first aid training so that they had been provided with the theoretical knowledge to make sure they were up to date with current good practice. Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 Page 21 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 2 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X X X X X 3 X STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 2 Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 Page 22 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 OP3OP7OP 8 Regulation 15(1) Timescale for action Unless it is impracticable to carry 31/12/05 out such consultation, the registered person shall, after consultation with the service user or their representative, prepare a written plan (“the service user’s plan) as to how the service user’s assessed needs in respect of their health care needs are to be met. The registered person must 28/02/06 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 not met) The registered person must ensure that the nurse call system be regularly serviced by an appropriately qualified person. Confirmation that the servicing has been undertaken should be forwarded to the Commission. Requirement 2 OP19 23(2)(b) 3 OP38 23(2)(c) 31/01/06 Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 Page 23 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 Refer to Standard 16 Good Practice Recommendations It is recommended that the complaints procedure be amended to reflect contact details for the local Commission for Social Care Inspection office. Poulton House DS0000035570.V268876.R01.S.doc Version 5.0 Page 24 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. 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