Inspection on 11/04/08 for Prince of Wales House

This inspection was carried out on 11th April 2008.

CSCI found this care home to be providing an Good service.

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

Prince of Wales House 23/04/07

Prince of Wales House 03/05/06

Prince of Wales House 04/01/06

Prince of Wales House 03/08/05

Prince of Wales House 07/10/04

Prince of Wales House 28/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Prince of Wales House 18 Prince of Wales Drive Ipswich Suffolk IP2 8PY Lead Inspector Tina Burns Unannounced Inspection 11th April 2008 09:45 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 DS0000029240.V362257.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. DS0000029240.V362257.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Prince of Wales House Address 18 Prince of Wales Drive Ipswich Suffolk IP2 8PY 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) 01473 687129 01473 604869 moya.blake@tpic.org.uk The Partnership in Care Limited Mrs Moya Elizabeth Blake Care Home 43 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (33), of places Physical disability (1) DS0000029240.V362257.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Prince of Wales House is registered to accommodate one named person in the PD category. 23rd April 2007 Date of last inspection Brief Description of the Service: The home is situated in a residential area of Ipswich about three miles from the town centre. There is a parade of local shops nearby and regular buses into the town. The accommodation is on two floors with passenger lift access for people unable to manage stairs. On the ground floor is a special needs unit for ten residents with a diagnosis of dementia. There is a large enclosed garden that is accessible by separate doors from the special needs unit and the main house. The bedrooms are single occupancy with bathrooms and toilets placed throughout the home within easy reach. There is a large lounge and dining room on the ground floor and smaller quiet lounges available if preferred. The special needs unit has a lounge, dining area and kitchen, with access to an enclosed part of the garden. DS0000029240.V362257.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced key inspection, which focused on the core standards relating to care homes for older people. The report has been written using accumulated evidence gathered prior to and during the inspection. The inspection process included a tour of the premises and examination of a wide range of documents and records including three residents care plans and three staff files. The inspector also spoke with four residents; three care workers and three ancillary staff. Information has also been gathered from the homes Annual Quality Assurance Assessment (AQQA) submitted to the commission in January 2008, and survey forms completed by 18 residents, 6 resident’s relatives, 4 staff and 2 health and social care professionals. The homes manager was on duty at the time of our visit and fully contributed to the inspection. What the service does well: Prince of Wales House provides a safe, warm and comfortable home. Residents tell us that their needs are met and they are well cared for. Comments received from residents and relatives included “my relative is looked after very well indeed”, “They are all sympathetic and kind. They do everything possible to assist me, nothings too much trouble”, “All staff members are very caring and patient with residents”, “All the staff at the home treat everyone with respect and nothing ever seems too much trouble” and “They treat residents as individuals”. The home is well managed and there is a strong commitment to self-evaluation and good standards of care. The management recognise the importance of creating an environment where residents can access a range of social activities. Two activity co-ordinators are employed and organise a good range of activities, there is also a dedicated craft room and the home has the use of a minibus. DS0000029240.V362257.R01.S.doc Version 5.2 Page 6 Residents are safeguarded by thorough and robust recruitment procedures and complaints and concerns are taken seriously and acted upon. 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. The summary of this inspection report can be made available in other formats on request. DS0000029240.V362257.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 DS0000029240.V362257.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service Prospective residents or their representatives are provided with information about the home and can expect to have an appropriate assessment so that they are assured the home can meet their needs. However, residents on “transition” cannot be sure that they will regain their independence as quickly as they could. EVIDENCE: Nine out of the eighteen residents that completed surveys told us that they had received enough information about the home before they moved in to make a decision about whether it was the right place for them. The remainder indicated that their relatives or the local authority had made the decision on their behalf following a hospital stay. Discussion with the manager and feedback from residents confirmed that the home provides accommodation and care to privately funded and local authority funded residents. Information available tells us that fees range between £341.00 and £495.00 per week. DS0000029240.V362257.R01.S.doc Version 5.2 Page 9 Feedback from surveys, records examined and discussion with the manager confirms that prospective residents have an assessment of their needs completed prior to moving into the home by the manager or other senior staff. A local authority assessment is also provided for residents that are funded by the local council. Assessments undertaken by the home covered areas such as general health, mobility, nutrition, breathing, hearing, vision, skin condition, elimination, mental state, hygiene, leisure and social needs. The home provides care for older people, people refered for intermediate or ‘transitional’ care following ill health or a stay in hospital and people with dementia. Residents with dementia were accomodated in the special needs unit and were provided with dediacted space, facilities and support. However, there was no evidence of any specialised facilities for people in ‘transition’. The five residents receiving transitional care at the time of our visit shared the main areas of accomodation with permenant residents. Further more, there was no evidence that staff received specific training in rehabilitation techniques. DS0000029240.V362257.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. 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. Residents can expect the home to meet their health and personal care needs and the principles of respect, dignity and privacy are put into practice. EVIDENCE: The home has a computer recording system and all residents care plans and monitoring records are held in this way. Each resident has a copy of their care plan in their room for their own information and easy reference by the care staff providing their personal care. Information provided in the homes AQAA and discussion with the manager indicated that since the last inspection the home had developed residents care plans so that they were more detailed and focused specifically on each individual’s needs and preferences. This was reflected in the three care plans that were examined on the day of inspection. Each care plan included clear information about how to meet resident’s key needs and records confirmed DS0000029240.V362257.R01.S.doc Version 5.2 Page 11 that residents or their relatives had been involved in the development and review of plans. Records seen during the inspection confirmed that the home works in partnership with a range of health care providers so that residents health care needs are met, for example GP’S, district nurses, chiropodists and specialist nurses. Feedback from surveys indicates that resident’s personal and health care needs are met. Comments included “my relative is looked after very well indeed”, “They tend to their every need” and “They look after my relative and all the other residents very well”. Information provided in the AQQA, records seen and discussion with the manager confirmed that the home had addressed previous requirements about the handling and administration of medication so residents were better protected from mistakes with medication. Medication was appropriately stored and audits were undertaken regularly. The application of prescribed creams and lotions and PRN medications were being appropriately recorded on Medication Administration Records. Some discussion took place about whether the information held about PRN medications was adequate enough to enable staff to make a judgement about whether it should be given, consequently the manager decided to review the care plans of all those residents on PRN medication. Observations were that staff interacted positively with residents and were polite and respectful at all times. All personal care was given in the privacy of resident’s rooms. Comments received included “They are all sympathetic and kind. They do everything possible to assist me, nothings too much trouble”, “All staff members are very caring and patient with residents”, “All the staff at the home treat everyone with respect and nothing ever seems too much trouble” and “They treat residents as individuals”. Out of eighteen residents surveyed fifteen confirmed that they felt staff always listened to them and acted on what they had to say. DS0000029240.V362257.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. 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. People who use this service can expect to maintain contact with their families and friends, participate in recreational activities of their choice and enjoy healthy and appetising meals. EVIDENCE: Residents spoken with during the inspection and comments made in relatives surveys confirmed that the home supports residents to maintain contact with their friends and family and indicated that visitors are made welcome at the home. People were also encouraged to participate in a range of activities organised by the homes activity co-ordinators, either on a one to one basis or in small groups. On the day of inspection more than thirty residents enjoyed a coach trip to Felixstowe for a fish and chip lunch with the assistance of the activities co-ordinators and additional care staff and volunteers. Residents at the home can enjoy the facilities of a dedicated activities and craft room and a programme of activities that includes church services, quizzes, bingo, carpet bowls, crafts, board games and outings. The home also has use of a minibus that it shares with a number of other homes owned by the same DS0000029240.V362257.R01.S.doc Version 5.2 Page 13 company. The activities co-ordinator spoken with was also very pleased with the new interactive gaming system that the home had purchased and the enthusiastic reaction from residents. Surveys completed by residents, relatives and health professionals confirmed that the home meets resident’s different needs. Comments included “The Prince of Wales treats their residents as individuals”. Residents were able to bring their own possessions and personal effects with them when they moved into the home and lockable drawers were provided. On the day of inspection dining tables were attractively set with tablecloths, napkins and flowers and the lunch provided looked wholesome and appetising. Residents confirmed that there is always a choice of meals but most were having fish, potatoes and vegetables. Residents could eat in one of the dining areas or in the privacy of their own room. Of the eighteen residents that completed surveys eight said that they always liked the meals provided, six said that they usually liked them and four said that they sometimes liked them. Comments included “I should say that they are pretty good as a whole”, “The sweets are very good, they make a nice custard”, “Would like a bit more variety but I do enjoy the meals”, “They are very nice but I don’t have much of an appetite” and “I am very satisfied”. DS0000029240.V362257.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. 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. Residents can expect their complaints to be listened to, taken seriously and acted upon. Further more they can expect to be safeguarded from abuse. EVIDENCE: The home has a complaints procedure in place, which is provided to residents on admission. The commission has received one complaint about the home since the last inspection this was passed to the registered person to investigate and has been appropriately addressed. The homes record of complaints and compliments was examined on the day of inspection and evidenced that complaints are documented and thoroughly investigated. There had been nine complaints received by the home since the last inspection and thirteen recorded compliments. Residents spoken with and surveys returned confirmed that most residents knew how to make a complaint and felt that any concerns they raised would be listened to and taken seriously. Records examined and staff spoken with confirmed that staff are given training and guidance on how to recognise and respond to abuse and neglect. Since the last inspection the home had referred two concerns to the local authority safeguarding team and have demonstrated a good understanding of the local safeguarding protocols. DS0000029240.V362257.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to live in a safe, clean, comfortable and well-maintained environment. EVIDENCE: At the time of inspection all areas seen were tidy, safe and clean and the home smelled fresh and pleasant. Out of eighteen residents surveys returned fourteen said that the home was always clean, three said usually and one said sometimes. The furniture, décor and facilities provided were comfortable and pleasant and created a homely and relaxing environment. Observations made, information provided in the AQAA and discussion with the manager confirmed that the home has an ongoing and effective maintenance and refurbishment plan. DS0000029240.V362257.R01.S.doc Version 5.2 Page 16 Discussion with the house keeping staff, observations made and a tour of the premises confirmed that appropriate procedures and facilities were in place to safeguard residents from infection, further more care staff and house keeping staff were provided with suitable protective clothing and had undertaken training in infection control. DS0000029240.V362257.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. 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. Residents can expect to be safeguarded by the homes recruitment procedures. Further more, they can expect to be supported by adequate numbers of staff that have been appropriately trained to do their job. EVIDENCE: On the day of inspection the home had made arrangements for additional staffing so that both residents remaining at the home and residents on a day trip to Felixstowe could be appropriately supported. The manager advised that usual staffing levels were one senior and seven care assistants on morning shifts and one senior and six care assistants on afternoon shifts. Residents spoken with and feedback from surveys indicated that there were generally enough staff on duty but sometimes there were problems when staff went off sick. The manager confirmed that their biggest challenge was keeping the home adequately staffed. However, they had managed to recruit two relief staff and also used a bank of agency staff to provide cover when necessary. Further more people spoken with and feedback from surveys indicated that residents received the care and support they needed. Three staff recruitment records were examined and included all documentation required including photographs, evidence of ID, CRB checks, application forms, references and health checks. DS0000029240.V362257.R01.S.doc Version 5.2 Page 18 Feedback from residents, staff spoken with and records seen confirmed that the home provides appropriate training in core areas such as safeguarding adults, health and safety, fire safety, infection control and manual handling. Although there had been an issue for some staff with respect to a delay in manual handling training the manager advised that this had been a temporary problem that had been resolved. The home has since had a member of staff trained as a manual handling trainer, further more the manager confirmed that they were clear that untrained staff must not undertake moving and handling tasks. Staff training also included dementia care and understanding the mental capacity act. Senior care workers also undertook First Aid training and training in the Administration of Medicines. Following discussion with the manager about the special needs of one resident they agreed to ensure that staff are provided with more guidance about how to provide their personal care. The manager advised us that over fifty percent of care workers employed hold or are working towards NVQ level two in care or above. DS0000029240.V362257.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the residents and their health, safety and welfare is promoted and protected. EVIDENCE: The manager is an experienced registered manager who is familiar with the conditions associated with old age. Feedback from staff, residents and relatives indicate that the manager is accessible and approachable. The manager advised that they are currently ‘over seeing’ a second registered home within the same company consequently the deputy manager regularly takes responsibility in the managers absence. Feedback from staff and residents indicate that this does not have a negative impact on the service provided to residents. DS0000029240.V362257.R01.S.doc Version 5.2 Page 20 Records seen and feedback from staff evidenced that staff are appropriately supervised. They attend regular staff meetings and individual supervision sessions. There was also a resident’s and relatives meeting planned for the 22nd April 2008. Discussion with the manager and information provided in the homes AQAA confirms that the home is committed to ensuring that good quality assurance processes are in place. Processes used included annual residents satisfaction surveys, residents and relatives meetings, regulation 26 monitoring visits, inhouse and company audits. The manager had a good understanding of areas where the home performed well and areas where it needed to improve. The manager confirmed that she did not act as agent or appointee for any of the residents. Records relating to residents finances were not examined on this occasion however the manager confirmed that the company audited them regularly. Residents were provided with lockable drawers in their rooms. Discussion with the manager, observations made during a tour of the premises and records seen confirmed that routine maintenance and health and safety tests are carried out, for example fire alarm and fire equipment tests, water temperature checks, manual handling equipment checks and portable appliance tests. Further more training records indicated that staff undertake appropriate health and safety training such as infection control, food safety, manual handling, fire safety, first aid and control of substances hazardous to health (COSHH). Procedures for reporting accidents and incidents were in place and notifications required by the Commission have been made. DS0000029240.V362257.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 3 3 3 X X 2 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 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 3 X 3 DS0000029240.V362257.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 OP4 Good Practice Recommendations Where residents are admitted only for intermediate care, dedicated accommodation should be provided, together with specialist facilities and equipment and a dedicated team of staff. DS0000029240.V362257.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000029240.V362257.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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