Inspection on 11/01/06 for Priors Piece

This inspection was carried out on 11th January 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

Priors Piece 28/02/07

Priors Piece 13/07/05

Priors Piece 25/11/04

Priors Piece 18/05/04

Priors Piece 02/03/04

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

CARE HOME ADULTS 18-65 Priors Piece Priory Drive Totnes Devon TQ9 5HU Lead Inspector Graham Thomas Unannounced Inspection 11th January 2006 10:00 Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 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 Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 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 Adults 18-65. 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. Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Priors Piece Address Priory Drive Totnes Devon TQ9 5HU 01803 865473 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) Mr Simeon Ramsden The Very Rev Archpriest Benedict Ramsden, Katherine H L Finnigan, Mrs Lilah Ramsden Daniel Alexander McGill Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th July 2005 Brief Description of the Service: Priors Piece is a small, single storey residential home on the outskirts of Totnes providing care for up to three service users with mental health problems. The home is part of the Community of St. Anthony and St. Elias which has a number of homes in the Plymouth and South Hams areas. For ease of reference this will be referred to as the Community throughout the report. Each service user has a single bedroom and access to a kitchen and lounge / dining room. There is a small garden. Parking is limited as canoes and vehicles belonging to the Community are stored at the site. The Community provides a well-established outdoor activities programme for service users. Arts activities are also organised through the Communitys own arts co-ordinator. Other local opportunities for the maintenance and development of life skills in the home and local community are provided. Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection was to complete the inspection of “key standards” and review progress in respect of previous requirements and recommendations. On the day of inspection, the Registered Manager was on sick leave. Two staff were on duty with whom the inspector spoke. One service user spent some time talking with the inspector. Another who was seen, was unable to conduct a conversation. The third service user was lying in as it was his birthday and was not seen. Records including care plans were examined and the system for administering medicines was inspected. 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: None of the above standards was inspected on this occasion. Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 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 the following standard(s): 6 and 9 Service users can feel confident that their particular needs and goals are reflected in their individual plans. Service users are supported to take responsible risks and appropriately protected by risk management strategies. EVIDENCE: All the care plans were examined. Individual files were well-organised and upto-date. The plans for each service user were clear and focussed on goals relevant to each individual. All had been reviewed with the service user within the last three months. In one case, the service user had declined to sign the care plan and this was noted. Restrictions on service users’ freedoms and choices were recorded and each file contained up-to-date risk management plans. The files also showed evidence of review under the Care Programme Approach. Discussions with one service user confirmed that his plan fairly reflected his goals and needs. In discussion, staff showed an awareness of individual need and the planned programmes for each of the service users. An unexplained absence since the last inspection had been appropriately notified to the Commission and recorded by the Community. Records showed that this had been reviewed at managerial level. Since this incident, risk had been minimised by the fitting of new garden gates with a warning bell system when these are opened. Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 Page 9 Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 11, 12, 13, 14, and 15 Service users are well supported to maximise their lifestyle choices and develop their individual interests. EVIDENCE: On the day of inspection, one service user was enjoying an extended stay in bed as it was his birthday. Staff stated that a choice of activity for the afternoon was planned as well as an evening meal out. Discussion with another service user confirmed that he had stayed with family over the Christmas period and arrangements for this were documented in his file. This service user was looking forward to pursuing his interest in music in the afternoon in a music theory session. This is a service provided by the Community’s own specialist staff. Other information in care plans and activity timetables confirmed that the Community continues to provide a commendable range of outdoor activities as well as arts and crafts activities. The Service Users at Priors Piece require a high degree of support and none is currently in open employment. However, access to the local community is promoted and supported through the use of local cafes, shops and other facilities. This was evident in individual plans and confirmed by the service user with whom the inspector spoke. Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 Page 11 Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 18, 19 and 20 Service users receive adequate personal and healthcare support to meet their individual needs and preferences. EVIDENCE: The one service user with whom the Inspector conversed expressed satisfaction at the support he received from the Community and its staff. Individual choices and preferences in daily matters of dress, diet and activity were recorded in individual plans. On the morning of the inspection, staff supported one service user to attend the Doctor’s surgery for a routine treatment. Healthcare needs, both routine and specialist, were well documented in individual plans. The recommendation regarding key working made at the last inspection was not fully reviewed due to the absence of the Registered Manager. Records concerning the administration of medicines in the home were examined. These were found to be accurate and up-to-date. None of the current service users administers their own medication. Medicines were securely stored in a cabinet in the home’s office. Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 Page 13 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 the following standard(s): EVIDENCE: None of the above standards was inspected on this occasion. Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 24 Priors Piece provides service users with an adequately clean, homely and comfortable home. EVIDENCE: The home’s premises provide a comfortable and homely living environment for service users and are close to local amenities. Communal space includes a lounge – dining area and gardens to the rear of the property. On inspection, the home was found to be generally adequately clean and free from offensive odours. Furnishings and décor are of a domestic type. One staff member stated that the lounge furniture had been cleaned since the last inspection. The carpet in the lounge/dining area has been clean and has an improved appearance since last inspected. Some necessary redecoration had apparently been completed in the bathroom. There is a comprehensive set of health and safety policies in place and the home has a current fire risk assessment. Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 Page 15 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 and 35 Recruitment practices adequately promote the safety of service users. Service users are supported by a generally well-trained staff group. EVIDENCE: Recruitment policies and procedures are adopted for the whole Community. These include a request for two references, checks against criminal records and the national list for the protection of vulnerable adults, and an interview. Prospective staff have the opportunity to spend time in the home prior to their application. New staff receive statements of terms and conditions and all appointments are subject to a probationary period. Planning for staff training is conducted centrally within the Community. Staff receive intensive induction training for two weeks prior to working within the Community’s homes. This is followed by a period of further foundation training which is recorded in an individual files held by the staff member. This training programme encompasses health and safety issues as well as topics specific to individual need. This is being revised in line with revisions in national training. There are plans to seek accreditation for this training which could be further developed for the completion of NVQs. Discussion with staff and individual files also confirmed that staff have access to training in health and safety topics including, for example first aid updates. Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 Page 16 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 Service users are supported in a well run home. EVIDENCE: On the day of inspection the Registered Manager was on sick leave. The staff on duty were able to identify the on-call management support available. Service users’ individual needs (e.g. medical appointment, birthday celebrations, activity programmes) were being met and staff were clear about their roles and what needed to be done. Clear and well kept recording systems helped to facilitate this process. It was evident from the records inspected and his contact with the Commission over specific issues that the home’s Registered Manager is effective. This includes identifying and dealing with issues such as future planning for service users, responding to identified risks and the physical maintenance of the home. Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 Page 17 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. 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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X X X X X X Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 Page 18 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 YA18 Good Practice Recommendations The informal arrangement of key working for one service user should be formalised and extended to all service users Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 Page 19 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 Priors Piece DS0000003781.V262473.R01.S.doc Version 5.1 Page 20 - 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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