CARE HOMES FOR OLDER PEOPLE
Priorsmead Priorsmead Canterbury Way Thetford Norfolk IP24 1EB Lead Inspector
Mr Jerry Crehan Unannounced Inspection 1st November 2005 09:30 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 Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 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. Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Priorsmead Address Priorsmead Canterbury Way Thetford Norfolk IP24 1EB 01842 752039 01842 750357 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) Norfolk County Council-Community Care Katrina Elizabeth Dixon Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. It is recommended that the home be registered to accommodate 16 Older People only. People who need wheelchairs to assist with independent mobility at point of admission can only be accommodated in rooms numbered 5, 7, 17 and 20. All of the bedrooms are to be used for single occupancy only. 7th June 2005 Date of last inspection Brief Description of the Service: Priorsmead is a care home situated on the outskirts of the town of Thetford and offers ground floor accommodation for up to 16 elderly people. It is owned and operated by Norfolk County Council. Nursing care is not provided. There is one day-care placement, and some respite placements are made. All of the bedrooms are designed for single occupancy with a restriction for service users who require wheelchairs for mobility to four of the homes larger bedrooms. The home has a call bell system installed so that service users are able to summon assistance from their rooms, communal areas or bathing and toilet facilities. Service users meetings are held to discuss issues residents wish to raise, and there is a programme of activities, including craft, games and quizzes and music. Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 3.5 hours. Opportunity was taken to tour the premises, look at care records and policies, and communicate with the majority of the fifteen service users and staff members in addition to the senior staff on duty. What the service does well: What has improved since the last inspection? What they could do better: Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 Page 6 A recommendation has been made that more prominence be given to the home’s ‘whistle blowing’ procedure within induction training for new staff. It is important that all staff, including newly appointed staff, are very familiar with this procedure from the outset. Infection control practices should be improved. A requirement has been made in this report in respect of the management of clinical waste; however, the implementation of the home’s infection control procedure would have undoubtedly prevented the risk developing in the first instance. Advice should be sought from the fire authority regarding the safe storage of waste at the home. 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. Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 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 Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 4&6 The home provides clear information that would assist service users in making an informed choice as to the home’s ability to meet their needs. EVIDENCE: The home has clear written information available to prospective service users, which would provide them with a good understanding of the home’s capacity to meet individual need. Service users spoken with confirmed that the home more than adequately meets their needs. The home does not provide intermediate care. Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8 & 10 Service users are treated with privacy and respect. Service users health care needs are fully met. EVIDENCE: Sample care plans referred to the involvement of a variety of community health professionals. Comments by service users spoken with supported this confirming that they have access to the GP, District Nurse and other professionals as required. A risk assessment for a service user identified to be at high risk of falling was reviewed. The risk assessment clearly set out appropriate interventions and involved the taking of specialist advice from the Occupational Therapist. A visiting G.P was spoken with who confirmed that the home uses their services appropriately and that care staff were always available to them when they visit the home. They also stated that care staff are aware of service users needs. Comments from service users and observation during the inspection showed that staff had an understanding of how to promote service users privacy and dignity. Communication between staff and service users observed was sensitive to the individual needs of service users. There is a telephone
Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 Page 10 available in the main corridor for service users to make or receive telephone calls; in addition to this a portable telephone is available for more private use. Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 14 Service users experience a variety of formal and informal social activities in conducive settings. Service users are able to exercise choice and control over their lives. EVIDENCE: Service users confirmed that a number of organised activities are arranged regularly including a visiting entertainer. Service users described various attempts to fund raise for activities including a Fete in August. A service user who has restricted mobility confirmed that there is ‘plenty to do in the way of activities’. Another service user indicated that they were able to come and go from the home as they please providing they inform staff. An activities agenda for the coming month was seen. This included a variety of options run by staff, visiting entertainment, shopping and a church service. It is also apparent that communal areas are set aside for activities including reading and gardening, and that service user appreciate time set aside by staff to speak with them individually. Residents meeting also take place on a regular basis and are publicised on the home’s notice board. Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 The arrangements for protecting service users legal rights are satisfactory. EVIDENCE: It was apparent that service users have access to relatives or friends, many of whom assist service user in managing their affairs, and that there are no independent advocates currently supporting service users. Service users are able to take part in the political process, voting by postal ballot or in person if preferred. Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25, 26 The home provides a good standard of accommodation. Issues concerning infection control and waste storage present potential risks to service users and staff. EVIDENCE: The home is well maintained externally and internally. The grounds to the front of the home are reasonably well maintained and accessible for service users and there is a patio area to the rear. Fire service and environmental health department reports were not available at the time of the inspection. However, a fire risk assessment undertaken by the home appropriately identifies the risks posed from the storage of wheeled waste containers against the rear of the home (it was also noted that four car tyres are stored against the rear of the home). Consequently the manager should consult with the fire authority as to alternative storage arrangements. Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 Page 14 Bedrooms are naturally and individually ventilated. All bedrooms and communal areas have natural light with artificial lighting supplementing the available natural light where necessary. Hot water temperatures were being tested and services at the time of the inspection and did not present concerns. The home was comfortably warm, although service users cannot independently control heating in their rooms. All areas of the home seen were cleaned to a high standard. The laundry area contains a ‘soft clinical waste bin’ that was overfull and therefore presented an infection control risk. Apparently the home usually has two of these bins, however the last time the contractor visited the home only one was provided. Action was agreed at the time of the inspection to make adequate arrangements for this waste until the waste bin is replaced. The ironing room contained an item of clothing with a label pinned to it indicating that it was ‘to be used by anyone who is going out’. Senior staff provided a clear explanation that all service users wear only their own clothes and that these are labelled, and could not account for why this item of clothing had been labelled in this way. Other clothing seen in the ironing room that was all labelled supported this. It was agreed at the inspection that this item of clothing would be removed. Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 & 30 Staff are well trained and maintain positive relationships with service users. Recruitment practices at the home support and protect service users. EVIDENCE: Staff files reviewed showed that service users are protected by good recruitment practices and this includes evidence of the carrying out of CRB checks on new staff. It is evident from staff spoken to and from training records seen that staff have access to induction training and a full range of mandatory training. It is recommended that more prominence be given to the home’s ‘whistle blowing’ procedure within induction training for new staff. Staff show interest and enthusiasm in their role. Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 36, 37, 38 Staff are appropriately supervised and service users further supported by the home’s policies and record keeping. Aside from specific issues identified below the home promotes the health, safety and welfare of service users. EVIDENCE: An effective staff team, who are well supported and supervised supports service users. The home has appropriate policies and procedures, and satisfactory record keeping practices. The home seeks to promote the health, safety and welfare of service users, though issues identified concerning infection control and fire risk from waste storage compromise this. Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 X 2 X X X X X 3 2 STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 3 3 2 Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 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. 1 Standard OP19 Regulation 23(4)(a) Requirement The registered person must consult with the fire authority with regard to storage arrangements of wheeled waste containers. The registered person must make suitable arrangements to prevent the spread of infection at the home. Timescale for action 17/11/05 2 OP26 13(3) 01/11/05 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 Refer to Standard OP30 Good Practice Recommendations It is recommended that more prominence be given to the home’s ‘whistle blowing’ procedure within induction training for new staff. Priorsmead DS0000034997.V262918.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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