Inspection on 18/12/08 for Princess House

This inspection was carried out on 18th December 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

Princess House 13/12/06

Princess House 13/12/05

Princess House 30/06/05

Princess House 25/01/05

Princess House 26/07/04

Princess House 20/02/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

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Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Princess House 19 Cliffe Park Seaburn Sunderland SR6 9NS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Allan Helmrich     Date: 1 8 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Princess House 19 Cliffe Park Seaburn Sunderland SR6 9NS 01915483723 01915484198 danick@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs J Young,Mr J Young Name of registered manager (if applicable) Lynne Harbottle Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Princess House is a detached house standing in its own grounds and overlooking the seafront at Seaburn. Some people have described it as a landmark as it stands adjacent to the area, which is used to host the yearly Sunderland Air show. Though it is a three-storey building, only the ground and first floor are used for residential accommodation. The top floor is used for administrative purposes and can also be utilised for staff training. Most of the bedrooms are single occupancy and many of the rooms have a sea-view. It is only a short walk from a busy shopping parade in Fulwell as well as being close to facilities in Seaburn. In addition to this, a local bus service offers easy access to Sunderland City centre. The home as its own garden which offers disabled access and Care Homes for Older People Page 4 of 25 care home 19 Over 65 5 19 0 0 Brief description of the care home also a patio area to the side of the building as well as a conservatory, which offers sweeping views of the coastline. The home provides a service to older people and is registered to provide personal care for a maximum of 19 people that includes four people who may have needs related to dementia. It is not registered for people who have a physical disability. The home does not provide nursing care but individual service users can access services provided by the Community Health team and their own GP. The weekly fees are 385:00 pounds. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The Visit: Care Homes for Older People Page 6 of 25 The inspection was unannounced and started at 10:15am and lasted 5.5hrs. During the visit we: Talked with people who use the service. Talked with the home manager and staff on duty. Looked at information about the people who use the service and how well their needs are met. Looked at case records for three residents and other records that must be kept, including medication. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to assess if it was clean, safe and comfortable. Checked what improvements had been made since the last visit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Comprehensive pre admission assessments are recorded and clear information for residents is provided so people can make an informed choice and know their care needs will be met before moving into the home. Evidence: There is an assessment process that is carried out before anyone is admitted into the home. This helps to ensure that peoples individual care needs can be met. Records seen demonstrated that the initial assessment is carried out by the care manager. A copy of the assessment and care plan is given to the home and a date is agreed for the service user to visit the home. In some cases a number of visits will take place before an admission date is decided upon. The assessment process is continued with the homes own assessment record completed following a home visit by the Manager to the prospective service user. Care Homes for Older People Page 10 of 25 Evidence: Following admission, each service user has a care plan developed from the assessment information so that, when followed by staff it helps the care needs to be met on a daily basis. The assessments cover the individual needs of the service user and they are recorded under various sections that include personal needs, mobility and personal hygiene and health issues. The service user has a trial stay in the home for six weeks to see if they like living there and for the home to ensure they can meet their needs. A review meeting is then held between representatives of the home, service user, family and care manager. No service user is admitted until the home has received the care managers care plan. The home does not accept emergency admissions and does not provide a rehabilitation service. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are well supported by good care planning and regular involvement from other professionals. Some improvement could be made in the quality of the regular monitoring of plans to further promote person centred care. Evidence: Shortly after admission people are assessed to determine their physical and mental needs. Identified needs are then included in the persons plan of care. However, assessment tools to determine nutritional and pressure care needs are not currently used in this process. Care plans are produced, daily record sheets are kept and key staff produce reviews each month. These details could be improved to provide a more person centred approach to ensure the care provided is individualised. Some comments were limited to A enjoyed a bath, B to daughters, chatted to C. The files are regularly reviewed by the manager for quality. Care Homes for Older People Page 12 of 25 Evidence: Records demonstrated that residents regularly see health care professionals to promote their good health with details of health checks, visits to their GP and hospital appointments being recorded in the individual files. People are weighed regularly and this is recorded as a monitor of their health. Three residents spoken to all stated the home provides a good standard of support and staff were observed throughout the inspection talking to residents and involving them in ad-hoc activities. The manager is concerned that all residents are treated individually and promotes this within the staff team. All senior staff that dispense medicines have had training and further training in the safe handling of medication has been arranged. The home has systems in place to manage peoples medication safely. The medication records checked were free of errors, with no signature gaps found on the MAR (medication administration record) charts. Storage of medicines was appropriate and procedures that promote the safety and well-being of residents are in place. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents take part in regular activities of their choice. Visitors are made welcome. A good standard of healthy food is provided. Evidence: The home has a substantial activities budget that subsidises people to go on regular trips out to places of local interest. On the day of inspection the majority of people living in the home were on a day trip. People have care plans for activities and a record sheet is kept of activities people are involved with. These sheets showed people are involved with church and enjoy knitting, crafts, movies and keep fit. Risk assessments were seen to promote people Independence in going out alone and making hot drinks for themselves. People spoken to after they had returned from the trip said that they had really enjoyed the day. People said they enjoy some of the activities provided but choose for themselves what they do and where they go. People said they can have visitors at any time and can choose to meet privately with Care Homes for Older People Page 14 of 25 Evidence: them if they choose. People are encouraged to manage their own finances but if required there is a system in place to hold monies for individuals. This system includes keeping receipts for all purchases and each transaction is evidenced by two signatures. The kitchen is was well stocked and good systems are in place to promote healthy eating and safe food practices. The cook has prepared a menu with choices and she is also aware of peoples likes and dislikes. She is trained to NVQ level 3 in catering. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home takes complaints seriously and staff are well trained to ensure everyone is protected from abuse. Evidence: A copy of the complaints procedure is in the Service User Guide, a copy of which is given to all new residents. The procedure is written in a language that is easy to understand and is available in large print to make it easy to read. The home has not received any complaints since the last inspection. The manager also records any dissatisfaction raised by people in the home and addresses these issues to ensure a quality service is provided. People spoken to had no complaints but demonstrated they are aware of how to complain and who to complain to. During the inspection the manager was informed by staff that one resident was unhappy with the quality of meat provided at dinner. Action was taken straight away to address this with the supplier. Safeguarding training to protect vulnerable people is available to all new staff and those spoken to during the inspection were aware of their responsibilities in this area. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Princess House provides a comfortable and well maintained environment for the people who live there. There is a good standard of cleanliness and hygiene that protects people from the risks of the spread of infection. Evidence: The home that is converted from a large family residence is in keeping with other houses in the area. The standard of furnishings, fittings and decoration throughout the home are good and provide a comfortable and homely place for people to live. Bedrooms seen were individual in character and contained personal items of furniture and memorabilia. Bedroom doors were lockable with a key but did not have thumb turn locking for ease of use and safety. The home has a laundry containing suitable equipment. Housekeeping audits are done and the home has good procedures in place for infection control that helps to keep service users healthy and safe. Issues identified at a recent Fire Authority visit have been addressed as has the Care Homes for Older People Page 17 of 25 Evidence: requirement following a local authority visit. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff to meet the needs of each resident and recruitment procedures ensure people who live in the home are safe. Staff get regular training and supervision to ensure the necessary skills are available to provide the people who live at the home with good care. Evidence: Information provided by the home manager showed that all of the staff have an appropriate vocational qualification. The manager meets with each member of staff on a yearly basis for a development interview. Staff strengths and training requirements are identified and a training programme is put in place to ensure staff receive the training they need to care for older people and people with a dementia. The range of training provided this year included; first aid, fire, mental capacity, dementia awareness and training dealing with the safeguarding of vulnerable people. During the inspection sufficient staff were on duty to meet the needs of the residents. The staff rota demonstrated that the normal care staffing levels, in addition to the manager who normally works Monday to Friday, are a senior care and two care staff through the day with two care staff on duty through the night. Also the manager uses 16 care staff hours each week to support people on outings. Domestic, maintenance and kitchen staff are employed to complete the staff team. Care Homes for Older People Page 19 of 25 Evidence: Only one member of staff has been recruited since the last inspection. Their staff file contained appropriate information in the form of application forms, references and Criminal Record Bureau (CRB) checks to ensure residents can live in a safe environment. A system is in place to ensure all new staff receive an induction that demonstrates they are able to care for people living in the home and staff are provided with regular supervision to ensure they are supported in the provision of good care. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Princess House is a home that is well run for the benefit of the people who live there. Evidence: The manager, who is registered by The Commission, is aware of the needs of older people. She has the Registered managers Award to demonstrate her abilities and undertakes regular training and manager workshops run by the Health Authority as part of her continuing development. Regular meeting for staff, residents and visitors are held to ensure people have a say in the way the home is run. Staff and residents spoken to were happy with the way the home is run. There is a quality monitoring system in place. There are forms available in the lobby of the home requesting people to provide information that will enable the home to maintain and improve its high standards. These forms are analysed and any issues are Care Homes for Older People Page 21 of 25 Evidence: addressed. The manager meets with the proprietor each month to review the care provided. The home has procedures in place that make sure residents finances are safeguarded. The manager demonstrated that regular servicing of equipment takes place, that staff, through training, promote safe working practices to ensure the safety and welfare of people who live in the home. Portable appliances have been tested since the last inspection to monitor their safety. A fire risk assessment has been produced. Staff have received fire instruction and fire drills take place to ensure residents are maintained in a safe environment. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Ensure staff monitoring care write meaningful assessments that can be used to identify individual needs and promote person centred care. Use specific assessment tools to identify peoples needs in relation to nutrition and tissue viability. Consider changing the locks to peoples bedrooms to provide a thumb turn system for locking that can be overridden from outside by staff in the event of an emergency. Should anyone lock their door currently and leave the key in the lock, access to the room would prove difficult. In the short term a risk assessment should be produced for anyone who locks their door when inside the room. 2 3 8 19 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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