Inspection on 13/09/06 for Primley View Nursing Home

This inspection was carried out on 13th September 2006.

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

The inspector 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 View Nursing Home 22/05/07

Primley View Nursing Home 21/03/06

Primley View Nursing Home 07/10/05

Primley View Nursing Home 26/11/04

Primley View Nursing Home 20/04/04

Primley View Nursing Home 12/11/03

Primley View Nursing Home 06/06/03

Primley View Nursing Home 28/05/02

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

CARE HOMES FOR OLDER PEOPLE Primley View Nursing Home Primley View 25 Primley Park Paignton Devon TQ3 3JW Lead Inspector Mandy Norton Key Unannounced Inspection 10:40 13 September 2006 th 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 Primley View Nursing Home DS0000028756.V303121.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. Primley View Nursing Home DS0000028756.V303121.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Primley View Nursing Home Address Primley View 25 Primley Park Paignton Devon TQ3 3JW 01803 559229 01803 559229 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) Optima Care Partnership Mrs Susan Mary Wiltshire Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (3), Physical disability (30), Physical disability of places over 65 years of age (30) Primley View Nursing Home DS0000028756.V303121.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Registered for max PD 30 Registered for max PD(E) 30 service users over the age of 65 Registered for max OP 3 Date of last inspection 21st March 2006 Brief Description of the Service: Primley View Nursing Home is built in an elevated position overlooking the seaside town of Paignton. It offers panoramic views of Torbay from Thatcher Rock to Berry Head. It caters for elderly people who have a physical illness or disability that need respite or full time nursing care. There is a trained nurse on duty 24 hours a day. There are three lounges and 27 bedrooms, two of which are double bedrooms and seven that have en suite facilities. Several of the bedrooms enjoy sea views. A shaft lift goes to each floor that the Service Users are accommodated on. This recently extended home is comfortably furnished throughout creating a warm, friendly and relaxed environment. The majority of the bedrooms are single occupancy and all contain a nurse call bell system and television point, some have their own telephone sockets. There is a small garden to the rear of the building that is accessible to wheelchair users. Relatives and friends may visit at any reasonable time. Primley View Nursing Home DS0000028756.V303121.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place with the deputy matron. It included a tour of the home, examination of documentation and speaking with a number of service users. The results of the 5 completed care workers surveys and the 1 completed relatives /visitors comment card are reflected in the following report. A completed pre inspection questionnaire (July 2005) was also used when completing the report. The home had 22 patients on the day of the inspection. The pre inspection questionnaire states that the maximum fee is £525. What the service does well: What has improved since the last inspection? What they could do better: The care plans must contain risk assessments when bed rails are in use and an thorough wound assessment should be implemented when there is a wound to care for. The carpet in the corridors and stairs of original house is worn and therefore looks dirty and needs replacing. The domestic staff need to be reminded not to leave hazardous chemicals in bathrooms or any other areas once they have finished using them and they must ensure the cleaning store is always locked. Primley View Nursing Home DS0000028756.V303121.R01.S.doc Version 5.2 Page 6 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 View Nursing Home DS0000028756.V303121.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 Primley View Nursing Home DS0000028756.V303121.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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments are made prior to any admissions ensuring that the home offers a service that meets their needs. EVIDENCE: The deputy matron said that the matron visits prospective clients in their current setting where possible to assess whether the home can meet their assessed needs. She said and records confirmed that information, when patients are publicly funded, about their needs is received by the home prior to admission. The home also works closely with the local multi disciplinary team (CARRIE) who have some dedicated beds within the home that they can use for admissions. There is a good exchange of information prior to these admissions. This has been discussed in detail during previous inspections and the deputy matron said that its success continues. Information is given or sent to people to help decide if the home will meet their needs, they can also look around the home at anytime reasonable time. Primley View Nursing Home DS0000028756.V303121.R01.S.doc Version 5.2 Page 9 The home does not offer intermediate care Primley View Nursing Home DS0000028756.V303121.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 outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care, which a client receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Each patient has a care plan, the plans examined (3) included information necessary to plan the individuals care and included some risk assessments The plans were generally reviewed and updated. There was no evidence of risk assessments being carried out on the use of bed rails and there was not sufficient information about wound management in one of the plans examined. The plans examined showed that patient’s health is monitored (regular weight, urine tests for example) and appropriate action taken. The home seeks professional advice on health care issues (e.g. GP, tissue viability nurse, dietician) and acts upon it. Contact information and a record of such visits was detailed in the care plans. Primley View Nursing Home DS0000028756.V303121.R01.S.doc Version 5.2 Page 11 The home has a medication policy which is accessible to staff. The deputy matron explained the medication systems in place in the home and records seen were up to date including recording of medicines received, administered and disposed of. The current system in use, that consists of medication boxes, is soon to be updated to the use of a ‘drugs trolley’. Staff were seen and heard knocking on doors before entering rooms and were carrying out personal tasks in private. Staff were observed interacting appropriately with clients being courteous but also enjoying lively conversation. Completed relatives surveys indicated that they are ‘satisfied with the overall care provided’. Primley View Nursing Home DS0000028756.V303121.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 outcome area is good. This judgement has been made using available evidence including a visit to this service. Social and recreational activities provided help to meet patients expectations. Patients are offered a healthy, varied diet according to their assessed requirements and choice. EVIDENCE: The pre inspection questionnaire states that activities such as musical entertainment are ongoing. Patient care plans examined had a completed social care assessment. Many relatives were seen coming and going during the inspection and all were well know to and chatting with the staff. Relatives survey indicated that they ‘ are welcome in the home at any time’. Patients were seen in their rooms or in one of the 2 lounges. Patients spoken to said they had the choice about where to spend their time. During a tour of the home some patients were seen reading the daily newspaper and/or magazines, others were watching the television. Patients spoken to said the food was nice and there was plenty of choice another was not so happy with the meals but accepts that for health purposes what is offered is suitable. Primley View Nursing Home DS0000028756.V303121.R01.S.doc Version 5.2 Page 13 The menus provided with the pre inspection questionnaire have a variety of home made traditional meals on a 2 week rolling programme. Special diets are catered for as necessary on an individual basis. Primley View Nursing Home DS0000028756.V303121.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Patients have access to an effective complaints procedure and the systems in place in the home help protect them from abuse. EVIDENCE: The complaints procedure is displayed within the home. Patients spoken to said they knew who to approach if they wanted to complain. The completed relatives survey indicated that they are ‘aware of the homes complaints procedure’. The complaints log was not available during the inspection as the matron keeps it locked in her office. The pre inspection questionnaire stated that there has been 1 complaint since the last inspection which was not substantiated and no adult protection investigations. The policies and procedures regarding protection of residents are satisfactory and available to staff at all times in the main office. All of the completed care workers surveys indicated that they are ‘aware of adult protection procedures’. Primley View Nursing Home DS0000028756.V303121.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, 24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The design and layout of the home enables residents to live in a safe, generally well-maintained and comfortable environment. EVIDENCE: A tour of the home confirmed it is homely, comfortable and well maintained. The original part of the house needs to have the carpets renewed in the corridors and stairs as it is worn and therefore also appears dirty in some areas. Aids and equipment to meet the care needs of the patients was seen distributed around the home. The home was clean and tidy and hygienic. (The infection control policies were not discussed at this inspection although all policies and procedures are available to staff at all times). Patients rooms seen were individualised with personal belongings and small items of furniture. Some rooms have the benefit of en-suite facilities. Primley View Nursing Home DS0000028756.V303121.R01.S.doc Version 5.2 Page 16 The shared areas consist of a lounge on each floor and one in the ‘extension’. Several patients were using the lounge, some were chatting to each other, some had visitors. There is a choice of bathing facilities, both assisted and unassisted, and there are a number of toilets strategically placed around the home. The laundry is on the lower ground floor and meets the needs of the home and sluice facilities provide a sluicing disinfector. Primley View Nursing Home DS0000028756.V303121.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. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to meet the assessed needs of the clients. EVIDENCE: Duty rotas, provided with pre inspection questionnaire , show that sufficient numbers of staff are working in the home with more staff at peak times of activity. There are trained nurses on duty 24 hours a day. The completed relatives comment card indicates that there are ‘always sufficient numbers of staff on duty. Staff files and training records were not seen as the matron has access to these and she was not available. The pre inspection questionnaire states that statutory training in moving and handling, fire safety and health and safety takes place and that ‘training sheets’ are held in the home. One (1) of the five (5) completed care workers surveys indicated that more training opportunities would be welcome. Recruitment was not discussed at this inspection as the Matron was not available. Completed care workers surveys all indicated that their recruitment was carried out properly and included a CRB check and provision of names of 2 referees. Primley View Nursing Home DS0000028756.V303121.R01.S.doc Version 5.2 Page 18 The pre inspection questionnaire states that there have been 180 hours of agency staff used at the home over the last 8 weeks. The home uses the same staff to provide some consistency. Primley View Nursing Home DS0000028756.V303121.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, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect. The systems in place in the home generally ensure the health, safety and welfare of the patients and staff is maintained. EVIDENCE: The matron has the required qualifications and experience and is competent to run the home. She has been in post for several years and is well respected by the staff group. She includes the staff in decisions about the home and meets with them regularly. The deputy matron said she works well with the matron and feels supported in her role. Primley View Nursing Home DS0000028756.V303121.R01.S.doc Version 5.2 Page 20 The home has policies and procedures in place, which are kept in the main office and available to staff at all times. The home has a clear health and safety policy but the manager needs to ensure that risk assessments are in place when bed rails are in use. During the tour of the home some hazardous chemicals had been left in a bathroom and the cleaning store cupboard containing hazardous chemicals was unlocked. There is formal quality assurance system in place the results of which have been sent to the Commission with a regulation 26 visit report. The completed care workers surveys indicate that staff feel well supported and part of a team. Records examined were of a good standard and stored in the main office. Equipment seen around the home was in a good condition. The home has all the necessary insurance cover in place and the up to date certificate is displayed in the home. The pre inspection questionnaire states that 3 patients handle their own financial affairs and 15 patients are subject to power of attorney. The home has secure facilities for storing small amounts of money and valuables. Primley View Nursing Home DS0000028756.V303121.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 X 3 X X N/A 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 X X 3 X 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 X 3 X 3 X X 3 Primley View Nursing Home DS0000028756.V303121.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP7 Good Practice Recommendations When bed rails are in use the care plan should have a robust risk assessment which is kept under review. When a wound is being managed the care plan should include a comprehensive wound assessment which is kept under review. Carpets in the corridors and stairs of the ‘original’ house should be renewed as they are worn in places and therefore look dirty. Domestic staff should ensure that hazardous chemicals are removed from bathrooms following their use and that the cleaning store cupboard is kept locked at all times. 2 3 OP19 OP38 Primley View Nursing Home DS0000028756.V303121.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Ashburton Office 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. Extracts may not be used or reproduced without the express permission of CSCI Primley View Nursing Home DS0000028756.V303121.R01.S.doc Version 5.2 Page 24 Primley View Nursing Home DS0000028756.V303121.R01.S.doc Version 5.2 Page 25 - 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. 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