Inspection on 09/08/06 for Powbeck House

This inspection was carried out on 9th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 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

Powbeck House 25/09/07

Powbeck House 23/02/06

Powbeck House 31/08/05

Powbeck House 23/02/05

Powbeck House 08/07/04

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 Powbeck House Meadow Road Mirehouse Whitehaven Cumbria CA28 8HL Lead Inspector Mrs Margaret Drury Unannounced Inspection 9th August 2006 10:00 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 Powbeck House DS0000035545.V300708.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. Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Powbeck House Address Meadow Road Mirehouse Whitehaven Cumbria CA28 8HL 01946 852563 01946 696574 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) www.cumbriacare.org.uk Cumbria Care Care Home 38 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (38), of places Physical disability (1) Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 38 service users to include: up to 38 service users in the category of OP (Old age, not falling within any other category) up to 10 service users in the category DE(E) (Dementia over 65 years of age) 1 service user in the category PD (Physical disabliities) When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. 23rd February 2006 3. Date of last inspection Brief Description of the Service: Powbeck House is a care home owned by Cumbria Care, an internal business unit of Cumbria County Council and registered to provide accommodation and care for up to 38 older people, some of whom may have varying forms of dementia. The home currently has no registered manager but is being run on a day-to-day basis by Debbie Sandwith who was recently appointed as the home manager and is awaiting registration with the Commission for Social Care Inspection. The home is situated in a large housing estate on the outskirts of Whitehaven, where there are two churches, a library, shops and a sheltered housing complex in close proximity. The accommodation is situated over two floors with a day care centre and offices forming part of the ground floor. Also on the ground floor are two specialist units. One 10-bedded unit is devoted to people with varying forms of dementia and the other is designated as an intermediate care unit that is staffed and equipped to deliver packages of care to enable people to regain their independence and return home. There are two units on the first floor each providing communal and personal space for the residents together with bathing and toilet facilities. There is a secure garden to the rear of the property that includes a patio area for sitting out during the summer months. Limited car parking is available at the front of the home. The day care unit operates every day and although residents from Powbeck House are welcome to use the facilities, the unit is not currently subject to inspection. Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit, which forms part of the key inspection, took place over one day in August. As the manager was on annual leave, the inspector was assisted by two of the supervisors who were able to provide all the documentation required. Time was spent speaking with the residents, family members who were visiting the home, the intermediate care nursing sister and members of the staff team. Care plans and documentation concerning the care of the residents and running of the home were examined. This documentation was found to be up to date and gave the care staff the necessary information to provide a high level of care. Part of the lunchtime medication round was observed, with medication given in a relaxed manner. Medication records were examined and found to be neatly and correctly completed. Some parts of the building were looked at including the intermediate care unit. Staff and residents from this unit were interviewed. The fees in this service range from £317.00 - £422.00 per week as at April 2006. There are extra charges for Chiropody, hairdressing, newspapers, toiletries and holidays. What the service does well: The home has a comprehensive admission procedure that includes a full assessment of needs and capabilities. Residents who spoke with the inspector said they liked the staff and they received a high level of care. They were also very appreciative of the manager’s help and support and said “you can go to any of the staff at any time” and “they very approachable”. Care plans are comprehensive and were up to date, with monthly reviews being completed. The home ensures the safe handling of medication by means of a member of staff acting as a “checker”. One resident is responsible for her own medication and, at the request of the family, this will continue as long as possible. The home provides warm, comfortable and safe surroundings for the residents. Healthcare needs are met with the help of visiting healthcare professionals. Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 Page 6 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. Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 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 Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 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): 2, 3, 4, 5 & 6 The quality in this outcome area is good. Admissions to the home only take place if the manager is confident staff have the skills, ability and qualifications to meet the assessed needs. Each resident is provided with a contract and terms/ conditions of residency that sets out in detail the facilities the home provides. This judgement was made using the available evidence including a visit to the service. EVIDENCE: Admissions to the home do not take place until a full assessment of needs has been completed. This assessment is carried out in addition to social services management plans received by the home. The dependency levels of those already living in the home are also taken into consideration when assessing prospective residents. Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 Page 9 All prospective residents and their families are invited and encouraged to visit the home prior to their admission. This gives opportunity for them to meet the staff and talk to other people living in the home. Some residents have had respite care and are already familiar with Pow Beck House and the facilities on offer. All residents are given a contract and terms and conditions of residency and there is also a copy held on each resident’s file. The home provides intermediate care in a small 6-bed unit and the inspector was able to spend time speaking with staff and the residents who were staying the unit. The staff interviewed agreed that the type of care given to the residents was different in that they were “enablers” rather than “carers” as this ensured that residents, at the end of their stay, were usually sufficiently confident to return home. Discussions with members of the multi-disciplinary team that visit the home every week confirmed that the unit is extremely successful in rehabilitating people to the level required for them to return to their own homes. Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 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, 8, 9 & 10 Quality in this area is good. . All residents have a plan of care that is reviewed regularly involving residents and/or their families wherever possible. The reviews ensure the necessary action is taken to respond to any changes deemed necessary. Healthcare needs are met by healthcare professional services that are available when required. The home works to an efficient medication policy with staff following the corporate procedures to ensure the records are kept up to date. The home considers treating the residents with dignity and respect to be important. This judgement has been made using the available evidence including a site visit to this service EVIDENCE: Care plans and daily records were checked to ensure the care plan reviews agreed with the daily care records. In all cases they did, showing that the information contained in the daily records was reflected in the care plan monthly reviews.The daily record evidenced that healthcare needs were met by Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 Page 11 imput from the local healthcare professionals. This was confirmed by discussions with the residents who all agreed that their doctors visited on request and the services of the district nurses were available when required. The inspector observed some of the lunch time medication being given to residents. This was completed in an appropriate and relaxed manner. Medication records were examined and found to be up to date and correctly completed. The corporate medication policy allows for a second member of staff to act as a “checker” in an effort to ensure errors do not occur or are kept to a minimum. Discussions with the residents and visitors evidenced that they felt all care needs were met in such a way that privacy and dignity were respected at all times. They all spoke highly of the staff and told the inspector that they were a good lot of girls who could not do enough for you. One of the visitors said “it is like visiting my sister in a private room at the hospital”. The inspector noted that all personal care was given in the privacy of the residents bedrooms with the door closed. Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 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, 13, 14 & 15 Quality in this area is good. The home tries to be flexible and every effort is made to provide an individual service within the staffing levels available. The home works to open visiting arrangements and visitors are made welcome. The food in the home is of good quality and enjoyed by all the residents. This judgement has been made using the available evidence including a site visit to this service EVIDENCE: All residents are allocated a key worker and the inspector was able to speak with those on duty during the inspection. Interviews with residents indicated that the residents were happy with their daily routines and the choices given about how they wished to spend their day. One resident did, however, tell the inspector that he enjoyed a chat but the staff were not often able to spare the time to talk. Staff agreed that sometimes the only available time to chat to residents was during the afternoon when the unit was generally quiet. The home provides some group activities organised by the support worker/ activities co-ordinator. These include, a weekly bingo group with prizes, Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 Page 13 quizzes and games on each of the units, reminiscence sessions and sing-alongs. A weekly shop has recently introduced,from which the residents can purchase personal items and a home’s news letter that is available for residents and family members. Residents said they could join in the activities if they wished although some of the them who spoke with the inspector said thay also ejoyed the privacy of their own room. They all agreed that they enjoyed buying personal items from the shop even those who preferred to remain in their rooms. The inspector was able to observe the lunch being taken on the dementia care unit where the residents all agreed that they enjoyed their food. The care staff on each of the units serve the meals and, from observation, these are relaxed and sociable times. Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 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 & 18 The quality in this area is good. The home has a suitable complaints procedure that is kept up to date. Residents are confident that their views and concerns are listened to. Adult protection training is organised and the staff showed an awareness of adult protection issues. This judgement was made using the available evidence including a site visit to the service. EVIDENCE: The home has a complaints procedure in place with a copy on display in the hall. The record of complaints was checked and the inspector discussed the recent internal complaint with the supervisors. This was investigated and has now been settled with appropriate action taken to ensure this kind of incident does not happen again. Residents spoken with were confident that any complaints or concerns expressed would be taken seriously and dealt with as soon as possible. The training matrix indicated that training in elder abuse forms part of the training programme and interviews with the staff indicated that they were aware of adult protection issues. This subject is also covered in one of the NVQ units. Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 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, 20, 22, 23, 24, 25 & 26 Quality in this area is good. The management and staff encourage the residents to see Pow Beck House as their own home. It provides a safe, clean, comfortable and homely environment that is able to meet all assessed needs. The units within the home provide communal space and all bedrooms are suitable for their stated use. This judgement was made using available evidence including a visit to the service EVIDENCE: There is a programme of maintenance for the home, planned and agreed annually, within the organisation. The home is reasonably well maintained with 9 of the residents rooms recently redecorated. There is a maintenance programme that is overseen by the organisation’s head office, working within the constraints of the annual budget. Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 Page 16 The Inspector looked around most parts of the home and judged that there was sufficient communal space to meet the needs of residents. This included a lounge/dining room with kitchen area on each of the four units, as well as a small quiet lounge on the unit for people with dementia, and a lounge on the first floor that can be used by people who wished to smoke. The main lounge/diner on the dementia unit is a little small but the residents are a little reluctant to use the separate lounge that forms part of the unit. The internal decoration throughout the home, on the whole, was good with 9 bedrooms and some communal areas redecorated since the last inspection. There is a range of equipment available in the home to assist people in their day-to-day life. This includes a passenger lift, hand and grab rails, assisted baths and toilets and hoists. There are sufficient bathrooms and toilets for the residents, all of which are suitable for people with a disability. The bedrooms that were inspected during the visit were all personal to the individual, with ornaments, pictures and photographs from the residents’ own homes. The inspector was able to spend some time with a member of the domestic staff discussing the cleaning schedules. The home was extremely clean, which minimises the risk of cross infection. The member of staff confirmed that there was never a shortage of cleaning materials, protective clothing and gloves. Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 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, 28, 29 & 30 Quality in this outcome area is good. Staffing arrangements are good ensuring the needs of the residents are met. Staff are well trained (having completed the required training) and provide a skilled and experienced workforce. This judgement was made using the evidence available including a visit to the service. EVIDENCE: The manager uses her allocation of staff hours well, the result being a staff team that work together for the benefit of the residents. There is sufficient care staff on duty during the day to meet the assessed needs of the residents and provide a high level of care. However, there are only 2 members of waking staff on duty through the night to care for up to 38 older people, including a unit for people with varying forms of dementia. It would be beneficial for there to be at least one extra member of waking night staff on a permanent basis although the manager does bring in extra night staff should this ever be necessary. Extra, allocated, staff hours are utilised for a member of staff to work with the seniors as a “checker” when giving out the medication. The home uses the organisation’s recruitment policy and procedure, which means all the required checks are completed prior to employment starting. Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 Page 18 There is a good training programme with each member of staff being responsible for keeping their own continuous professional development files up to date. Over half of the care staff are qualified to NVQ level 2 and a further 3 are working towards the award. Training recently completed includes, moving and handling updates, emergency action, infection control and dementia awareness. The manger is keen on ensuring all staff training is up to date and is constantly looking for as much external training as possible. Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 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): 31, 32, 33, 35, 36, 37 & 38 Quality in this outcome area is good. . The manager has the required experience and is competent to run the home although awaiting registration with the Commission for Social Care Inspection. She works continuously to ensure a high quality of life for the residents. She is resident focused and leads and supports a strong staff team. The home has sound policies and procedures that are reviewed and updated on a regular basis. This judgement was made using available evidence including a visit to the service EVIDENCE: A new manager was appointed to the home in April this year and has yet to complete the process for registration and fitness as a manager with the Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection. Although the necessary documentation was sent to the area office this was not received and another set of forms will be sent as soon as possible. She was present during the last inspection but was on annual leave at the time of this visit. Discussions with the supervisors on duty confirmed that the home has always been run in the best interests of the residents. Staff interviewed commented, “After a period of instability the environment and atmosphere of the home has greatly improved during the past 5 months”. Senior team meetings now take place to discuss the running of the home and the provision of care. Tasks and duties have been delegated on a workflow pattern to ensure the smooth running of the home. Any personal allowance kept at the home for items such as newspapers or hairdressing is recorded with the details of any monies spent signed out by 2 members of staff. Members of the senior team undertake staff supervision and this is up to date with the annual appraisals just completed. Part of the supervision includes reading of set policies and discussions about the contents of those read. The home has a corporate health and safety policy and manual in place. The organisation’s health and safety officer completes annual audits after which a report is prepared and given to the manager with an action plan if required. All risk assessments are in place and equipment is maintained via annual maintenance contracts. Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 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 3 3 3 3 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? 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. 1. Refer to Standard OP27 Good Practice Recommendations It is recommended that consideration be given to increasing the number of waking night staff. Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Powbeck House DS0000035545.V300708.R01.S.doc Version 5.2 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. 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