Inspection on 10/05/05 for Primley House

This inspection was carried out on 10th May 2005.

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 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 House 20/12/07

Primley House 21/09/06

Primley House 05/10/05

Primley House 23/08/04

Primley House 07/04/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Primley Housing Association Ltd Primley House Totnes Road Paignton Devon TQ3 3SB Lead Inspector Peter Wood Announced 10 and 11 May 2005 09:30 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 Housing Association Ltd D54-D07 S18413 Primley House V218393 100505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Primley Housing Association Ltd Address Primley House Totnes Road Paignton Devon TQ3 3SB 01803 558867 01803 558867 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) Primley Housing Association Limited Mrs Gail Collings (registered June 05) Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Primley Housing Association Ltd D54-D07 S18413 Primley House V218393 100505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23 August 2004 Brief Description of the Service: Primley House provides care for up to thirty-eight older people. It is a beautiful old house set in its own well-maintained grounds, which are frequented by peacocks, near Paignton Zoo. Indeed, the house was the original zoo, latterly the home of the original owner. Entrance to the house is by shallow steps or a disabled ramp to the side. The front door leads into a very large hall that has seating areas. The ground floor comprises a large library, large lounge that can be separated into two rooms, a long sun lounge, and a large dining room. There is also an office, treatment room, kitchen with numerous store rooms, staff room and toilet, separate men’s, women’s and disabled Service Users toilets and a shower room. There are 8 single en-suite bedrooms on the ground floor, 3 of which have en-suite baths. There are stairs with a shaft lift to the first floor which has a further twenty two single ensuite bedrooms, 7 of which have en-suite baths, there are 3 double bedrooms all with en-suite baths, and a flat which has a double bedroom, lounge and bathroom. There are a further 2 communal assisted bathrooms, both with toilets, and a further separate toilet. There is also a flat on the second floor where previous managers used to live Primley Housing Association Ltd D54-D07 S18413 Primley House V218393 100505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and took place over the two days of 10 and 11May 2005. A pre-inspection questionnaire had been completed by the new manager (about to become the registered manager) of the home. A complete tour of the home was undertaken during the inspection and a sample of relevant documentation including that relating to client assessment and care planning, staffing and health and safety was examined. Several members of the management committee assisted during the inspection, as did the manager and several staff. Virtually all residents were asked for their views of their experience of living at the home, and several residents, their relatives and visitors to the home completed comment cards. What the service does well: What has improved since the last inspection? What they could do better: The new manager has brought with her new documentation including various risk assessments. Whilst much of this may help staff in their assessment and care planning I recommend a period of consolidation and rationalisation of documentation so as to allow staff to devote more time to direct client contact rather than paperwork. Primley Housing Association Ltd D54-D07 S18413 Primley House V218393 100505 Stage 4.doc Version 1.20 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Primley Housing Association Ltd D54-D07 S18413 Primley House V218393 100505 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Primley Housing Association Ltd D54-D07 S18413 Primley House V218393 100505 Stage 4.doc Version 1.20 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 standard(s) 1, 2, 3, 4, 5 Thorough and comprehensive systems for admission allow service users and their relatives to be confident that their needs can be met. EVIDENCE: A statement of Purpose and Service User Guide were available for prospective service users and provided a clear description of the services offered. The Service User Guide was available in each bedroom as well as upon request. Assessments were undertaken to identify service users’ needs prior to admission. Service users said that they and their families had been able to visit the home before making a decision to move in. Indeed, this is the norm for this home. Primley Housing Association Ltd D54-D07 S18413 Primley House V218393 100505 Stage 4.doc Version 1.20 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, 10 Service users health, personal and social care needs are being met and service users are treated respectfully. The home’s practices relating to medication administration protect the service users from risk. EVIDENCE: Service users confirmed that they feel very well cared for and can ask at any time for assistance. Detailed assessments were recorded upon admission. Care staff described the service users’ care needs in detail and these were recorded in the individual care plans. Significant events were recorded in detail. Medication administration records were well maintained and medication was stored safely, including those in the rooms of residents who self-medicate. This home tries very hard indeed to involve all staff, relatives but especially residents in as many areas of running the home as possible, as well as allowing individual residents as much choice as possible. Residents confirmed this was the case. Staff in the Home were seen to respect Service Users’ privacy and dignity. Residents were seen to be undertaking whatever activity they wished to do, mostly in their own rooms. Primley Housing Association Ltd D54-D07 S18413 Primley House V218393 100505 Stage 4.doc Version 1.20 Page 10 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, 15 Social activities are managed well and provide daily interest for the service users. Meals are nutritious and varied. EVIDENCE: The home engages the services of an Activity Co-ordinator who arranges some sort of activity every day. Most of these are planned in advance with the service users. Service users commented that they can chose which activities they wish to participate in and how much they enjoy these and that their relatives and friends are invited as well. A record is kept of the trips out of the home to local places of interest. A notice board provides information about the activities offered and other matters of interest to service users. Service users said that the food was plentiful and very good. Most residents choose to take their meals in the very comfortable dining room, though they can have meals in their own room if they prefer, as some do at least sometimes. Drinks and snacks were available at all times to residents and their visitors: water fountains provide excellent cool water whilst a coffee percolator in the front hall is well used. Staff were seen to respect residents’ privacy and dignity. Primley Housing Association Ltd D54-D07 S18413 Primley House V218393 100505 Stage 4.doc Version 1.20 Page 11 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) 16, 17, 18 Complaints and suggestions from service users, relatives or other visitors to the home, are treated seriously. Service users are listened to and issues resolved promptly. EVIDENCE: Service users said that the manager and committee members were very approachable and they were confident that any issues of concern would be listened to and dealt with. Photographs of the committee displayed on a board in the entrance hall assist residents recognise members of the committee who visit regularly while the chair visits several times each week. The home has received no complaints since the last inspection. The complaints register details the action taken to resolve issues promptly. A copy of the complaints procedure is available to all service users and visitors to the home and detailed in the home’s Service User Guide. Staff have received training in issues relating to abuse and the protection of vulnerable adults and described the actions they would take should an issue of abuse be suspected. Primley Housing Association Ltd D54-D07 S18413 Primley House V218393 100505 Stage 4.doc Version 1.20 Page 12 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, 20, 21, 22, 23, 24, 25, 26 The service users live in a pleasant, well-maintained comfortable home that provides sufficient facilities to meet their needs. EVIDENCE: Service users said that they found the home spacious and comfortable, warm in the winter and as cool as possible in today’s heat, helped by many large fans strategically placed throughout the house. The home is a superior property in extensive gardens, is clean and well maintained. Since the last announced inspection about £75k has been spent on improvements, most notably the complete renewal of the space-age kitchen. The home has sufficient toilet, washing and bathing facilities to meet the needs of residents. Plans are in hand for virtually all rooms to have ensuites (most already do), together with a new shower downstairs to enable those residents who live downstairs to have bathing facility without having to go upstairs. Primley Housing Association Ltd D54-D07 S18413 Primley House V218393 100505 Stage 4.doc Version 1.20 Page 13 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) Service users are cared for by well-trained and motivated staff in sufficient numbers to meet the needs of those currently living in the home. Recruitment processes protect vulnerable service users. EVIDENCE: Numbers and competence of staff, by reason of experience and particularly training, has always been good at this home. A new staffing structure has recently been implemented to improve this. The home uses a proper application form with reference to the Rehabilitation of Offenders Act, a declaration of no convictions, undertakes CRB checks (which now include a check of the POVA list) and undertakes proper references. Primley Housing Association Ltd D54-D07 S18413 Primley House V218393 100505 Stage 4.doc Version 1.20 Page 14 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) This is a good, well-managed home for older people, some with additional disabilities associated with age. The committee, manager and staff team strive to provide a stimulating, safe environment that respects and protects residents’ rights and best interests. EVIDENCE: The manager is well qualified and is well supported by the deputy and the chair of the management committee. Considerable work has been undertaken since the last inspection to enhance the fabric of the building and enhance the safety of residents. Primley Housing Association Ltd D54-D07 S18413 Primley House V218393 100505 Stage 4.doc Version 1.20 Page 15 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 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 Standard No 16 17 18 Score x x x 3 3 3 3 3 3 3 3 Primley Housing Association Ltd D54-D07 S18413 Primley House V218393 100505 Stage 4.doc Version 1.20 Page 16 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 3, 4, 7 Good Practice Recommendations The new manager has brought with her new documentation including various risk assessments. Whilst much of this may help staff in their assessment and care planning I recommend a period of consolidation and rationalisation of documentation so as to allow staff to devote more time to direct client contact rather than paperwork. Primley Housing Association Ltd D54-D07 S18413 Primley House V218393 100505 Stage 4.doc Version 1.20 Page 17 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton Devon 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. Extracts may not be used or reproduced without the express permission of CSCI Primley Housing Association Ltd D54-D07 S18413 Primley House V218393 100505 Stage 4.doc Version 1.20 Page 18 - 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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