Inspection on 14/07/08 for Puddavine Court

This inspection was carried out on 14th July 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

Puddavine Court 19/07/07

Puddavine Court 18/07/06

Puddavine Court 17/01/06

Puddavine Court 20/04/05

Puddavine Court 12/10/04

Puddavine Court 27/04/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 27/06/2009.

CARE HOMES FOR OLDER PEOPLE Puddavine Court Ashburton Road Dartington Totnes Devon TQ9 6EU Lead Inspector Susan Samways Key Unannounced Inspection 11:00 14 & 31st July 2008 th 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 Puddavine Court DS0000003783.V367792.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. Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Puddavine Court Address Ashburton Road Dartington Totnes Devon TQ9 6EU 01803 866366 01803 866366 courtgroup@btinternet.com 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) Manor Collection Ltd Vacant Care Home 38 Category(ies) of Dementia - over 65 years of age (38), Old age, registration, with number not falling within any other category (38), of places Physical disability (38), Physical disability over 65 years of age (38) Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. PD Category is from age 55 yrs only Date of last inspection 19th July 2007 Brief Description of the Service: Puddavine Court is a large detached house on the edge of Totnes, substantially extended a few years ago. Accommodation is provided over three floors and there are thirty-six single rooms (the majority of which are en-suite) and one double en-suite room. There are two lounges and the main dining room on the ground floor, and also lounge and dining areas on the other two floors. All floors are accessed via a shaft passenger lift. The garden is large, accessible and attractive. There is ample car parking space. The home is registered to care for people aged sixty-five years and over, who may or may not be, suffering from dementia. The home also provides care for service users from the age of fifty-five years who have some form of physical disability. The current fees charged range from £350-£450 per week. Puddavine Court DS0000003783.V367792.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 stars. This means the people who use this service experience good quality outcomes. This was an unannounced inspection which took place over two days. Time was spent examining records and documents, speaking to people living in the home and some of their relatives and talking to staff who were on duty. Surveys had also been completed by ten residents and one member of staff. The new manager had been in post since April but had not yet applied for registration with the Commission for Social Care Inspection. Prior to the inspection the Annual Quality Assurance Assessment, completed by the new manager, had been received. This provided information about how the national minimum standards had been met, what had improved since the last inspection and future plans for Puddavine Court. What the service does well: Puddavine Court provides a comfortable and well maintained environment for those living there. Those spoken to during the inspection and those who completed surveys generally spoke well of the staff. They said that they listen and act on what they say. Visitors are made welcome and are able to visit at any reasonable time. Staff said that they have a good training programme. Staff recruitment procedures ensure that residents are protected. The new manager was observed to be approachable and all those spoken to were very positive about the way she was running the home. Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The range of activities needs to be improved to provide suitable things to do for all those living in the home. Trips out in the minibus need to be re-instated as soon as possible as these are obviously missed by several of the residents. The quality of the meals needs to be improved. Some residents complained that they had been cold during the winter and this needs to be addressed. Some people felt that there were insufficient staff on duty to provide adequate care and to respond to them promptly. Others said that they felt that several of the staff were inexperienced. The Statement of Purpose needs to be updated to accurately reflect what Puddavine Court provides. Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 7 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. Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 8 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 Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 9 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): 1,3,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s admission procedure is good but prospective residents need more detailed information on which to base their decision whether to move in. EVIDENCE: Some of those completing surveys and some of those spoken to during the inspection said that they did not have sufficient information about the home prior to moving in. The Statement of Purpose was clearly written but was not up to date and had insufficient information specific to Puddavine Court. The most recent results of the home’s quality assurance surveys should also be included. This needs to be addressed as soon as possible. Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 10 Pre-admission assessments are clear and comprehensive and give a clear indication as to whether the needs can be met at this home. A letter is sent to the prospective resident and or their representative or placing authority confirming that a place will be offered if the manager feels their needs can be met. There is additional information and referral documentation on files from placing authorities, GP’s or previous care homes. The new manager described the assessment process which includes talking to the relatives and/or the social worker and visiting the person concerned. She also confirmed that people are admitted for a trial period of one month. Quality Assurance questionnaires are issued to all newly admitted persons and those who stay in the home on a short–term basis. Puddavine Court does not provide rehabilitative or intermediate care. Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 11 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. The health and social care needs of those living in Puddavine Court are well met and regularly reviewed. EVIDENCE: Care plans were seen in respect of three people living in this home. The care plans examined were thorough and covered all required care needs. Residents who wish to are involved in both the drawing up of their care plan and the regular monthly review process of the care plan and this was confirmed by some of those spoken to. Full risk assessments are carried out in relation to falls, medication control and self medication where appropriate, moving and handling and pressure area care. Individual’s weights are recorded and when Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 12 required food and fluid intake records are implemented. Regular reviews are carried out and recorded. The manager stated that end of life care plans need to be addressed. The manager has produced a list of all the residents with a brief description of their needs as a quick reference for new staff to assist them while getting to know the residents. People moving into the home are given the choice of G.P. wih whom to register and referrals to other health care professionals are sought where necessary. There is a visiting hairdresser and chirpodist and sight and hearing tests are arranged as required. The home maintains a comprehensive list of any health care visits which ensures all staff are easily able to be aware of what each professional may have prescribed/suggested. Daily records were seen to have been completed appropriately. The new manager has produced detailed instructions for the staff to ensure that relevant information is recorded using appropriate language. The medication system was found to be stored, administered and recorded appropriately. The staff responsible for the administration of medications have received training and ongoing monitoring and supervision from the manager. A six monthly drug audit is carried out and recorded by the company’s Health and Safety Officer. During the inspection staff were observed to treat those living in the home with respect. Those who completed surveys described the staff as willing and approachable and said that they listened to them. Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 13 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 adequate. This judgement has been made using available evidence including a visit to this service. A range of activities needs to be provided on a frequent basis to meet the needs of all those living in the home. The quality of the meals needs to be improved taking into account individual preferences wherever possible. EVIDENCE: The manager stated that someone is employed to provide activities for two hours per week. This session includes craft activities, word games and music. One person said how much they had enjoyed the craft session. At other times staff endeavour to provide activities such as quizzes, armchair exercises and skittles. Several residents choose to spend their time in their rooms watching television, listening to the radio, knitting, doing crosswords and other hobbies. Some of these said that there was not sufficient to do organised by the home. Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 14 They said that activities were advertised on the notice board but frequently these did not happen. Some residents questioned the lack of trips out especially as they had been told that a new minibus had been purchased. The manager stated that the minibus was currently at another of the group’s homes but that they should have it later in the year. Relatives spoken to said that they were made welcome but that information given to staff or requests made were not always acted upon e.g. how someone likes their hair to be done or that they be taken out for some fresh air. Residents meetings are held every three months where all those living in the home have an opportunity to express their views about the home. The notes of the most recent meeting showed that activities and meals were discussed. Several of those who completed surveys expressed dissatisfaction with the standard of the food. For example one person said that puddings were particularly dull and another said that there were few fresh green vegetables or fresh fruit. This was discussed with the manager during the inspection. She was aware that people were not happy and had introduced mini surveys following each lunch to get instant feedback about the meal. She was then going to use these in discussion with the cook about improving the standard of the meals provided and meeting, as far as possible, individual preferences. Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 15 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. The arrangements for protecting those living in the home and responding to their concerns are satisfactory. EVIDENCE: All but one of those who completed surveys said that they knew how to make a complaint. A copy of the complaints procedure was seen displayed in the entrance hall. One person living in the home said that comments made were often taken as complaints which was not what was intended. They felt that it was not always understood how difficult it was for elderly people to adjust to a different way of living. A record of all complaints and incidents is kept with the action taken. All staff have training to recognise the signs of abuse and the action they should take and this was confirmed by the staff spoken to. The local Adult Protection policy is readily available to all staff. Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 16 Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 17 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): 19,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Puddavine Court is very comfortable, generally clean, well maintained and provides a safe standard of accommodation for those living there. EVIDENCE: During the last inspection complaints were made about the cleanliness of the home. The registered manager at the time undertook to ensure that this was addressed. A tour of the home was included in this inspection. The cleanliness of the home was found generally to be good. The responses in the surveys returned said that the home was usually clean but one person said that some Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 18 staff were better than others. The manager stated that all the bedrooms have a thorough clean at least twice a week. Two people said that they had been cold during the winter particularly during the afternoons. This needs to be investigated. The gravel area in front of the home has been replaced with tarmac and the side garden has been enclosed to provide safe access for the residents. Health and safety within the home is monitored on a monthly basis by an officer employed by the home who keeps detailed records and identifies any remedial work required. This person works closely with the manager to ensure that the residents have a safe environment in which to live. Staff have training in infection control and food hygiene. Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 19 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. Those living in the home are protected by the staff recruitment procedures and the staff training programme. EVIDENCE: The manager stated that there are six care staff on duty each morning, four in the afternoon/evening and two awake staff at night. This was reflected in the staff rotas seen. However several of the people living in the home, some relatives and some staff said that they felt there were insufficient staff to adequately care for the residents. Some commented that staff were sometimes slow to answer call bells. Staff were observed to treat people with respect and to endeavour to respond to them promptly. The files for four members of staff were examined. They were found to be in good order with all the necessary documentation, including police checks, in place. Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 20 Staff spoken to said that the training they have is good and covers a wide range of topics including manual handling, dementia care, first aid, pressure care, and challenging behaviour. More than half of the staff have NVQ level 2 in care and at the time of the inspection three more staff were working towards it. Staff meetings are held quarterly with records kept. Staff are also asked to complete an annual quality assurance form to ascertain their views about the service they are providing. The manager stated that staff supervision had lapsed with the change of manager but that she had started to book the first sessions with the staff. Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 21 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): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed. Safe working practices, which are regularly monitored, protect those living and working in the home. EVIDENCE: Since the last inspection the registered manager had left and a new manager appointed. Although the new manager had only been in post since April she Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 22 clearly new the residents and staff well and had a good understanding of the running of the home. She was able to answer questions confidently and was able to produce all documentation required during the course of the inspection. She was seen to be approachable and open to all those involved with the home. She is experienced having managed other care homes. She has not as yet applied for registration with the Commission for Social Care Inspection and this needs to be addressed as soon as possible. The views of those living in the home are regularly sought through the quarterly residents’ meetings and through annual quality assurance surveys. The results of the most recent surveys should be shared with all those involved with the home and included in the home’s Statement of Purpose. The people living in the home or their families/advocates mostly deal with any financial matter although the home does hold small amounts if requested to do so. There were detailed records in respect of these and the Court group senior management team undertake a monthly review of all monies held. This ensures residents’ monies are secure. The home ensures that safe working practices are used by regular staff training and by the monthly monitoring of health and safety issues. The hot water supply is regulated throughout the home to a safe temperature and all hot surfaces are covered or have low surface temperatures and it is reported that all windows are fitted with restrictors. Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 23 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 2 x 3 x 3 N/A 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 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x 2 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 x x 3 Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 24 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. 1 Standard OP1 Regulation 4 Requirement Timescale for action 30/04/09 2 OP12 16 3 OP15 16 The Statement of Purpose must be updated to accurately reflect the service provided by Puddavine Court. The results of the most recent quality assurance surveys and the most recent inspection report should also be included. This is to ensure that prospective residents have relevant information on which to base their decision whether to move in to the home. The range of activities needs to 30/04/09 be improved to provide suitable things to do for all those living in the home. The quality of the meals needs 30/04/09 to be improved taking into account individual preferences wherever possible. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 25 No. 1 2 3 Refer to Standard OP12 OP27 OP25 Good Practice Recommendations The use of the home’s minibus for outings should be reinstated. Staffing levels should be reviewed to ensure that there are sufficient staff on duty to meet the needs of those living in the home. Temperatures within the home during cold weather should be monitored to ensure that everyone is warm enough. Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA 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 Puddavine Court DS0000003783.V367792.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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