Inspection on 05/08/05 for Primley Court Nursing Home

This inspection was carried out on 5th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Primley Court Nursing Home 17/01/07

Primley Court Nursing Home 25/11/05

Primley Court Nursing Home 16/02/05

Primley Court Nursing Home 14/09/04

Primley Court Nursing Home 08/05/03

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Primley Court Nursing Home Optima Care Partnership 13 Primley Park Paignton TQ3 3JP Lead Inspector Doug Endean Unannounced 05 August 2005 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 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. Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Primley Court Nursing Home Address Optima Care Partnership, 13 Primley Park, Paignton, Devon, TQ3 3JP Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01803 555988 01803 555988 Optima Care Partnership Mrs Monica Anne Gumus Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (24), Old age, not falling within any other category (6), Physical disability over 65 years of age (6) Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. 65 years and over 2. Registered for maximum 6 OP 3. Registered for maximum 6 PD(E) service users 65 years and over 4. Registered for maximum 24 DE(E) service users 65 years and over 5. Registered for maximum 24 MD(E) service users 65 years and over Date of last inspection 16/02/2005 Brief Description of the Service: Primley Court is a 24-bedded care home providing personal and Nursing care to older people primarily with mental health problems who may also have physical frailties. The home is one of a group owned by Optima Care Partnership that are spread over the South West of England. The accommodation is arranged over four floors with a large lounge/dining area on ground floor and a large lounge on the first floor. The basement accommodates the Registered Manager’s office, kitchen and staff room and provides level entry to Service Users and their visitors who can then use the shaft lift to access the rest of the home. Being located on a high elevation and close to Paignton town centre there are some excellent views from some rooms over the town and the bay. The bedrooms are mainly single and a small number have en-suite facilities. As the home provides nursing care it always has a registered nurse in charge of each shift. The Registered Manager is a very experienced Registered Nurse with management skills and has achieved Register Managers Award at National Vocational Qualification level 4. The home has also been awarded the “Investors in People Award” in February 2004. There is work going on at present to extend the home to provide further beds and communal spaces that will meet the present National Minimum Standards. Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the afternoon of the 5th August 2005. The inspector spent approximately two hours and forty-five minutes at the home. In that time he toured the home, spoke to three staff and several residents. The personal records of four clients were read, and two staff files were read. The “Investors in People Award” was seen displayed in a prominent place. The inspector also looked at maintenance and other quality assurance records. What the service does well: 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. Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 Page 7 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 standard(s) 3. Standard 6 is not applicable. The pre-admission assessments are well constructed and provide a good deal of appropriate information that supports the decision to admit individuals to the home. EVIDENCE: The files of clients were reviewed and 4 pre-admission assessments were read. Each one provided a good deal of appropriate information about the clients that enabled the registered manager to make an appropriate admission. The information held in these assessments included comments on behaviour, memory problems, nutrition and mobility. This information was supported by Care Manager and nursing/hospital discharge referrals. The information was collectively used to draw up an initial care plan for each client. A registered nurse employed by the National Health Service, assesses the clients for the National Health Service determination funding. Details about these assessments are not readily available to the home. Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 Page 8 Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 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 standard(s) 7, 8 & 9. The home provides a good standard of care, aided by a satisfactory level of up to date equipment, which is directed by very good care planning. EVIDENCE: The inspector saw 4 detailed care plans that were initially drawn up from the pre-admission assessment and supporting information. The information in the care plans is updated by the named nurse for each client following a 20 point assessment that is completed each month. The inspector saw evidence of this in the 4 client files that were reviewed. The assessments included information on nutrition, mental state and risk assessments for physical problems that may occur such as pressure sores. The home operates a Key Worker system with an individual being identified for each client and this is recorded in the staff room on a white board. There is clear evidence that the care plans are reviewed every month. The home is staffed by experienced nurses 24 hours a day who are supported by well trained care staff. There is little turnover of staff at this home. The home has open communications with the external multidisciplinary team including the General Practitioner and Community Mental Health Team for the Elderly. Records were seen in the client’s notes of visits to the home by these people to review individuals. Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 Page 10 The home has many aids to meet the needs of the client’s such as hoists built into the baths, mobile hoist’s, stand aid, wheel in shower room and a nurse call system throughout the establishment. The inspector saw all these pieces of equipment during the tour of the home. The registered nurses are responsible for all the medication related activities at the home. There is a multi dose system in use and the inspector saw that the storage and administration records for these medications was satisfactory. This view was supported by the visiting pharmacists report dated 03/08/05. The inspector saw the staff speak to the clients and provide them with care, such as helping them with a meal or toileting them, in a manner that was dignified and respectful. The records hold a level of information on the clients that identifies them as individuals. A history is taken where possible that provided the inspector with an insight into the past of each of the clients he read about. Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 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 standard(s) 12, 13 & 14. The home has more than adequate measures in place to meet the social needs of the clients they care for. The Relatives Group is a good tool for the home to allow the relatives and advocates of clients to express their views and wishes on a regular basis that is recorded. EVIDENCE: The client’s records provided the inspector with evidence of individual and group activities that are planned from the homes knowledge of the client’s likes and dislikes as seen in the sample of files that were read. The general activities are carried out by the staff who work at the home. The home employs, on a twice-weekly basis, an Occupational Therapist who carries out a verity of activities such as craft and reminiscence sessions for groups and individuals. She records information in the Service Users files as to the level of interaction that was achieved. Outings are arranged for individuals as well as groups where possible. The hairdresser comes to the home each week to aid the staff in meeting the emotional needs of the clients by improving their personal appearance. Visitors are welcomed to the home at any reasonable time and to take part in the routine of the home with the Service Users. The home has established a “Relatives Group” that meet every six weeks and is organised by an external facilitator. Minutes of these meeting were available to the inspector. Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 Page 12 The client’s rooms are provided with lockable doors and each client is risk assessed for their suitability to hold a key. The inspector saw the locks and the keys that will open them during the tour of the home. The client’s bedrooms are personalised where this has been their wish or that of their advocate. The client’s choose whether they will eat at the routine time or later in the day, which area of the home they wish to be in, what cloths they will wear (with guidance) and who will care for them where this is possible. The client’s advocate’s wishes are also listened to with regard to who will provide intimate care to their relative, partner or friend. The home will provide advice and guidance to the client’s advocates about managing their financial affairs but will not accept responsibility for managing the affairs of the client’s. Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 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 standard(s) 18 The home has provided adequate abuse training to its care staff team. EVIDENCE: Evidence was provided to show that there has been in house vulnerable adults training and that the home has also asked the local authority for places on their “Protection of Vulnerable Adults Training”. The manager is aware of the need to report the names of staff who are found to be unsuitable to work in the care home sector to the Protection of Vulnerable Adults register. The homes policies and procedures are robust in the area of protection and reporting of abuse and there is a policy regarding the acceptance of gifts by care staff from clients. Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19 & 26 The arrangements for keeping the home in a good state of repair, and in a condition that meets legislative requirements, are satisfactory. EVIDENCE: The layout of the home and facilities provided within it make it a suitable environment for the clients who are resident there. The inspector saw that the premises were clean and reasonably decorated during his tour of the home. There is a maintenance man who is employed by the company, who carries out property risk assessments to a very high standard and follows this up with an appropriate level of maintenance. There were a variety of hoists for clients that met with individual’s manual handling assessments. The bathrooms have baths with built in hoists as part of their design. The shaft lift stops at all floors. Windows are restricted to prevent opening beyond the Health & Safety Executive requirement of 100 centimetres. The home is designed to provide level access from the car park to the home with a shaft lift to all floors. There is also access via the front door that is at the top of several steps. A signing in book is provided at each entrance for Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 Page 15 visitors and the inspector saw them during this inspection. This is a good practice recommendation by the Health & Safety Executive and the Fire Department and a requirement under the Care Homes Regulations. The building complies with present Fire and Environmental Health legislation and the home manager has provided evidence of this through visit reports. The home is presently being extended but parking is still available and access is generally not restricted. The laundry meets the requirements of having impermeable floor covering and washable walls. It is equipped with machinery that is adequate for the task. The laundry is in a building separate to the home and dirty laundry does not have to pass through any food preparation areas. The inspector saw mechanical sluicing facilities in strategic areas around the home. There are presently 45 dedicated hours of cleaning and 36 dedicated hours of laundry time provided each week and this information is recorded on the ancillary staff duty sheets. Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29. The recruitment arrangements are satisfactory, and retention of staff plus their deployment provides a continuity of care that is beneficial to the clients. EVIDENCE: On the day of the inspection there were twenty-one clients resident at the home. There were four care staff and one registered nurse on duty between the hours of 08.00 and 20.00 hours and it was planned that two care staff and one registered nurse be on duty between 20.00 hours and 08.00hours. This was verified by the duty rota’s seen during the inspection. The skill mix is set at an appropriate level to fulfil the needs of the clients. The care staff are supported by the ancillary staff team who were made up of the kitchen staff, cleaning staff and laundry staff. Further time is provided by external staff who provide regular activities for the clients in addition to that provided by the care team. The inspector saw records that provided evidence of the time and care service that they provide. The observation made by the inspector was that the staffing levels met the needs of the clients and the ancillary tasks. The home experiences a low turnover of staff and there have been no changes since the last inspection that took place on the 16th February 2005. Two staff files were inspected and these were found to hold the level of information required of them as stated in the Regulations and Schedule 2. The records included evidence of Criminal Records Bureau checks, two references, items of identification, contracts of employment and a record of appraisals and supervision. Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 Page 17 Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 & 38 The quality assurance measures, including risk assessments of the premises, show that the manager and registered person do understand their responsibilities fully and act appropriately to meet them. EVIDENCE: The home has good methods, which they regularly use, to evaluate the service they provide. The Registered Provider attends the home monthly and carries out his Regulation 26 visit sending a copy of his report to the Commission for Social Care Inspection. There is a quarterly anonymous questionnaire sent out to advocates of the clients, with stamped addressed return envelopes, to enquire about the level of satisfaction. The home also has an active relatives group that is managed by an external facilitator where views can also be expressed and acted upon in the overall planning of care. The premises is continually assessed to maintain it in good, safe order and the records were available to show the extent of the work undertaken such as Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 Page 19 measures to store and deliver hot water safely and maintenance of the shaft lift and hoists in the home. There is a record of all accidents that includes details of where and when an accident occurred, the name of any witness, the level of injury and the action taken by the staff on duty. Fire risk assessment and fire training records provided evidence that the home is up to date in managing this issue. All the records relating to Health & Safety risk assessments that are carried out by the maintenance man are of a high standard. The home achieved the “Investors in People Award” in February 2004, another measure of quality assurance by an external source. Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 3 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 Standard No 16 17 18 Score x x x x x 4 x x x x 4 Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 Page 21 NO 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. 1. 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 Good Practice Recommendations Primley Court Nursing Home D54-D07 S28755 Primley Court V238132 050805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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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