Inspection on 28/06/05 for Primrose House

This inspection was carried out on 28th June 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Primrose House 18/06/08

Primrose House 03/07/07

Primrose House 27/06/06

Primrose House 09/02/06

Primrose House 25/11/04

Primrose House 20/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Primrose House 2 Moor View Western Road Ivybridge PL21 9AW Lead Inspector Margaret Crowley Announced 28 June 2005 th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Primrose House Address 2 Moor View, Western Road, Ivybridge, Devon, PL21 9AW 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) 01752 894222 NONE Mrs C A Nurse Mrs C A Nurse Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25/11/04 Brief Description of the Service: Primrose House is a small care home registered for five younger adults with a learning disability. The home provides a service primarily for people with autism and Aspergers syndrome. The present service users are all under the age of forty years old. The emphasis is on a homely atmosphere where service users can be as independent as possible while being supported within a safe and caring environment. Service users are included in the daily domestic routine of the home and are encouraged and supported to voice and express their views and concerns.Primrose House is a large terraced house in the centre of Ivybridge village, which is located ten miles to the east of central Plymouth. Service users accommodation is spread over two floors. The home does not have appropriate facilities for potential service users with significant physical disabilities. The house has a large garden to the rear. The location of the home allows service users to walk to local shops and amenities and enjoy a lifestyle that minimises restrictions but provides support and guidance as necessary. The registered provider, Mrs Cheryl Nurse, has owned and managed the home for the past seven years. Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and took place on 28th June 2005 over a period of one day. A tour of the premises took place, and records were inspected. All five of the service users were spoken with. Discussions took place with Mrs Nurse the proprietor who manages the Home. 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,5 Prospective service users now have written information to assist them in choosing to live at Primrose House. EVIDENCE: The statement of purpose and the service users guide have been combined into one document. This will now be available for new and existing service users. The statement of purpose should state the age range of service users catered for. There have been no new service users admitted since the last inspection. When new service users are admitted their needs are assessed prior to admission. The statements of terms and conditions inspected had not been signed by the service user or their representative. No additional charge is made for transport. Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 All service users have care plans, but there is a lack of a systematic process to review risk assessments and care plans to ensure that service users needs are met. EVIDENCE: All service users have care plans, and daily records are maintained. Reviews of care plans and risk assessments should take place a minimum of six monthly and should be recorded. Discussions with service users and observations during the inspection demonstrated that they are enabled to take as much control as is feasible over their daily lives. However, any restrictions of choice agreed with service users should be fully documented in their care plans. The proprietor is the appointee for one service user. One service user manages his own financial affairs. Service users have individual cash boxes and a thorough record of money received and money spent is kept with receipts. All service users have bank accounts. Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,14,17 Service users are supported in developing their skills and independence. Service users enjoy stimulating activities within the local community and beyond. EVIDENCE: Primrose House is located with easy access to the shops and facilities in Ivybridge. During the inspection service users were seen to enjoy organising their own daily activities. Some attend work placements locally and college. All service users use the local shops independently. Support and assistance is provided flexibly from staff as required. Service users enjoy using local amenities such as the sports centre, swimming pool and horse riding. They participate in activities individually, but at weekends group outings are organised in the Home’s minibus to venues of their choice. Service users do not have an annual holiday provided as part of the contract price because the proprietor says that this is not feasible within the fees received. Service users are encouraged to develop their daily living and social skills. They use the kitchen facilities within their assessed capabilities and provide snacks and drinks for themselves. Main meals are provided by staff with Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 10 flexibility in the times and choice of meals. Service users help to take care of their own room and the communal areas. Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 Service users are provided with personal and healthcare support appropriate to their needs. EVIDENCE: Service users are independent in their personal care, although they may need prompts regarding personal hygiene. Service users choose their own daily routine. They shop for their own clothing and make their own decisions regarding their appearance. Staff will give advice and assistance when asked. The proprietor ensures that service users receive health checks. Health needs are documented in service user plans. There has been some difficulty in obtaining appropriate psychological support for one service user with complex needs. The proprietor was particularly concerned by the delays in obtaining the service of the community nurse from the learning disabilities team. There are systems in place for the receipt, storage and administration of medicines. The proprietor must ensure that these comply with the guidance provided by the Royal Pharmaceutical Society. Where service users manage their own medication, this is not currently subject to risk assessment and review. Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Satisfactory procedures are in place to enable service users to complain and to protect them from abuse EVIDENCE: There is a complaints procedure which is accessible to service users. No complaints have been received since the last inspection. There is an adult protection procedure. It is recommended that the proprietor and care staff attend the multi agency adult protection training. Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,27,28,30 Service users are provided with accommodation that is homely, comfortable, and clean EVIDENCE: The house is bright and spacious, and room sizes are adequate for the number of service users accommodated. There is an attractive garden and patio area at the rear, which is used during the summer for barbeques. Service users rooms are personalised to their individual taste. The premises were clean and free from odours. Although the toilets and bathrooms are fitted with locks and therefore privacy is assured, the locks are of a type that cannot be overridden from the outside in the event of an emergency. Staff use the lounge area for ‘sleeping in’ duty, which could restrict service users use of this room during at night. The proprietor said that she has applied for planning permission to extend the kitchen and create an office/sleeping- in room for staff. Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35 Primrose House has a small staff team who provide continuity of care for the service users. Service users would benefit from a more co-ordinated approach to staff training and development. EVIDENCE: The staff team consists of the proprietor and 5 support workers. There is usually one member of staff on duty at any time, with 2 on duty on Saturdays when service users go out on outings or are at home. The proprietor said that there is sufficient staff on duty at any time to meet the needs of the service users. She lives locally and is on call at all times. No new staff have commenced work at the Home since the last inspection to demonstrate the use of an induction programme in line with the Sector Skills Council specification and the Learning Disability Award Framework. Two support staff are qualified to NVQ level 2. Only one member of staff holds a current first aid certificate. The home does not have a written training and development plan for the staff team. The registered provider monitors staff practice on a day-to-day basis. Staff have a handover between shifts when any issues arising are discussed. There is no formal, recorded individual supervision between the registered provider and individual staff members. Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,42 Service users have open access to the proprietor who provides an informal system of management. Service users live in an environment where most health and safety standards are satisfactory, but safe working practices must be maintained by risk assessments and staff training. EVIDENCE: Primrose House is a small care home, which is owned and managed by Mrs Nurse. Service userssay that they like the informal, homely atmosphere. Mrs Nurse is a registered nurse and has many years of experience in working with people with a learning disability. She does not yet hold the registered managers award or an equivalent management qualification. Records available for inspection were maintained up to date and accurate. Staff records were not inspected as these are not held on the premises, but the proprietor informed the inspector that staff now receive training in fire safety twice per year; and one staff member has received training in health and safety since the last inspection. Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 16 As staff are lone workers, it is essential that all staff receive training in first aid. There must be a staff member qualified in first aid on the premises at all times There are no covers on radiators, no restrictors on hot water outlets or restriction of first floor window openings. The proprietor said that the client group could manage these general risks appropriately within the building. However, these should be included in the service users individual risk assessment. A risk assessment to prevent the risk of legionella is not in place. The electrical wiring and small appliances should be tested. SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x x x 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 Primrose House Score 3 2 Standard No 24 25 26 27 28 29 Score 3 x x 2 2 x Version 1.20 Page 17 D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc 8 9 10 LIFESTYLES x 2 x Score 30 STAFFING 3 Standard No 11 12 13 14 15 16 17 x x 3 2 x x 3 Standard No 31 32 33 34 35 36 Score x x 3 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 2 x Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 18 yes 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 YA9 Regulation 13 Requirement All risk issues must be thoroughly assessed and documented and reviewed. These risk assessments must include general risks apparent in the home, e.g. uncovered radiators and hot pipes and un adapted hot water outlets. Previous timescale of 31/04/05 not met Service user statements of terms and conditions inspected must be signed by the service user or their representative. The proprietor must ensure that procedures for the administration of medicines comply with the guidance provided by the Royal Pharmaceutical Society. Where service users manage their own medication, this must be subject to risk assessment and review. The home must have a written training and development plan for the staff team All staff must receive training in first aid The proprietor must ascertain from the environmental health officer that windows above first D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Timescale for action 28/09/05 2. YA3 5 28/09/05 3. YA20 13 28/09/05 4. 5. 6. YA35 YA42 YA42 18 13 13 28/10/05 28/10/05 28/09/05 Primrose House Version 1.20 Page 19 7. 8. YA23 13 floor windows not fitted with restrictors comply with the Health and Safety Act 1974 The proprietor and care staff should attend the multi agency adult protection training 28/11/05 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. 2. Refer to Standard YA1 YA 42 Good Practice Recommendations The statement of purpose should contain state the age range of service users catered for. A legionella risk assessment should be carried out. All electrical wiring and domestic appliances should be checked for electrical safety. The infection control policy should be reviewed to reflect the needs of the homes client group. Each service users bedroom should contain all the items listed under standard 26 or if the availability of any of these items is assessed as either unsuitable, or not in the service users best interests, then the reasons for this decision should be clearly documented in the service users plan Toilets and bathrooms should be fitted with locks that can be overridden from the outside to allow access in the event of an emergency. The home should explore options to provide sleeping in staff with a sleeping facility that is separate from the service users communal spaces A system of regular, recorded, one to one, staff supervision meetings should be developed and implemented. The proprietor should obtain the registered managers award 3. YA26 4. 5. 6. 7. 8. YA27 YA28 YA36 YA37 Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 20 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. Extracts may not be used or reproduced without the express permission of CSCI Primrose House D54-D07 S3780 Primrose House V221428 280605 Stage 4.doc Version 1.20 Page 21 - 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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