Inspection on 18/07/06 for Puddavine Court

This inspection was carried out on 18th July 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

Puddavine Court 14/07/08

Puddavine Court 19/07/07

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Puddavine Court Ashburton Road Dartington Totnes Devon TQ9 6EU Lead Inspector Judy Cooper Unannounced Inspection 18th July 2006 9.30 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 Puddavine Court DS0000003783.V300351.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.V300351.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 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 Mrs Valerie Hilda Austin 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.V300351.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 17th January 2006 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.V300351.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on a Tuesday between 9.30-5.40 p.m. It was conducted by two inspectors. Opportunity was taken to observe the general overall care given to residents. The individual care provided for four residents was also followed in specific detail, from the time they were admitted to the home, which involved checking that all elements of their identified care needs were being met appropriately. A tour of the premises, examination of some records and policies, discussions with the owner (who was present for part of the inspection), the registered manager, residents and staff all formed part of this inspection. Staff on duty were also observed, in the course of undertaking their daily duties. Other information about the home, including the receipt of nine completed questionnaires from residents, five staff at the home one from a visiting G.P and three from visiting professionals has provided further feedback as to how the home performs, and this collated information has been used in the overall writing of this report. All required core standards were inspected during the course of this inspection process. What the service does well: Puddavine Court continues to provide a comfortable, clean, well maintained environment, where residents’ care is provided for by a relatively stable and well trained staff group. The home continues to maintain a welcoming, comfortable atmosphere, where residents are freely able to choose how they spend their time. Visitors continue to be welcomed and encouraged to the home. Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 6 The staff endeavour to maintain individual resident choices to good effect which facilitates residents to be able to pursue their own interests and choice of lifestyle. The owner and manager endeavour to encourage community contact, with both considering Puddavine Court to be an extended part of the local community. What has improved since the last inspection? General, on-going, routine maintenance work, within the home, continues to ensure that the physical environment of the building continues to provide a good standard of accommodation. Since the last inspection the owner has upgraded a communal toilet on the first floor and is in the process of providing an additional, adjoining shower room. A new, large bedroom has been created out of what was originally a private lounge area for a previously accommodated married couple. An en-suite has also now been added to this room, which is now used for single occupancy. A privacy lock has now been provided to each resident’s bedroom door, which enhances residents’ rights to privacy if desired. Any use of supplementary heating has been risk assessed and all measures put in place to ensure that the use of this heating is as risk free as possible. This has included ensuring these heaters are now fixed within residents rooms rather than remaining portable. The management of the home have worked hard to ensure residents and/or their families/advocates are involved at all stages in planning how to meet the residents’ individual care needs. The home’s staffing procedures were now seen to be in order with all staffing requirements being upheld such as ensuring that there are two written references and an enhanced CRB disclosure in place for all staff. Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 7 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. Puddavine Court DS0000003783.V300351.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.V300351.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. (6 is not applicable to this home) The quality in this outcome area is good. The admission process is managed appropriately and residents and/or their next of kin/advocate are given the necessary information regarding the service prior to admission so that they can make an informed decision. EVIDENCE: Since the last inspection the home has admitted some new residents. One such resident’s admission process was looked at in detail, along with the details for two other residents who had been admitted within the past twelve months and one who was admitted two years ago. All of these residents were spoken with during the inspection to ascertain their own thoughts as to the admission process and the subsequent care provided to them. Three were able to confirm that their admission had been undertaken in such a manner as to allow them and/or their relatives who were choosing a home on their behalf, to be aware of what services the home could offer. The manager had visited one of the residents prior to admission to the home, another had Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 10 visited the home herself prior to admission and in the other two cases family members had been involved in the admission process, due to the prospective resident living out of the area. An assessment of need had been undertaken at this point from which a care plan had later been drawn up. It was pleasing to note that, where possible the resident had been invited to be fully involved in the assessment process with one choosing to personally write a detailed history of her life to allow the staff to better understand all aspects relating to her previous lifestyle. The prospective residents and their families had been given access to necessary information including the home’s statement of purpose. During the inspection it was noted that a prospective respite client was visiting the home with their next of kin. It was noted that both were made welcome and that the deputy manager along, with the resident and their next of kin, undertook an assessment of needs of the prospective respite resident. The next of kin confirmed that they had been given appropriate information regarding the home and had visited the home previously before they made the decision, to go ahead with the intended respite break. The Court Group, overall, have recently introduced an initial risk assessment based on the admission process. This includes such areas as ensuring glasses and other personal necessary items arrive with the resident and that information noted within the pre-assessment continues to be valid. It also determines whether there is a need to contact other professionals to inform them of the new resident’s admission. This is to ensure that the resident will “feel at home” as quickly as possible and will ensure that all required care can be made available at the commencement of the stay. The Court Group are also in the process of issuing feedback questionnaires to all newly admitted residents to try to build up a true picture of how each new resident felt and to see if the admission process can be improved on. This is a positive move and should be commended. There was a discussion in respect of the home’s discharge policy. The manager and owner are clear as to the extent of what care needs they can safely provide for and if a resident’s care needs begin to extend beyond what the home can safely provide for the manager will involve other relevant professionals with a view to the resident moving to a more appropriate care setting. The home does not provide intermediate care. Puddavine Court DS0000003783.V300351.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The quality in this outcome area is good. Residents are looked after well in respect of their health and personal care needs. Residents’ privacy and dignity is upheld and their life style choices are respected, however there were some feedback comments received that indicated that one particular staff member’s attitude was compromising residents’ feelings of being treated with respect. EVIDENCE: Care plans were seen in respect of the four permanent residents whose admission process had been inspected. The care plans examined were thorough and covered all required care needs. There were appropriate risk assessments in place including a moving and handling assessment, a pressure area risk assessment and a self medication assessment (where appropriate). 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. Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 12 This has been an issue that the management of the home have been working towards since the last inspection and for which they should be commended as it was clear that residents, who wish to and are able to be, are now fully involved in planning for all aspects of their care needs. One of the four residents stated that they felt lucky to be at Puddavine and that their next of kin was also welcomed when visiting. The resident felt the staff were great and that they had been made welcome and comfortable at the home since admission. Another comment received indicated that the resident felt that they were free to come and go as they wished but understood and valued the fact that the staff were responsible for their care needs and this gave the resident confidence. 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. It was noted that one resident was in bed after not being well. All appropriate care was being given with the resident receiving frequent visits from the staff. The day of inspection was a very hot one and it was pleasing to note that staff were continually encouraging residents to drink and that residents in their own rooms had been provided with extra juice. Wheelchairs were available if required fro transport purposes as was amobile hoist. The home’s medication cupboard was inspected and the home’s medication procedures and records were noted as being in order with regular training provided for the named carers who administer medication. A further training session was being provided, by the home’s supplying pharmacist, two days after this inspection. Two of the senior staff have also undertaken an in depth distance learning course in medication awareness and it is these two members of staff only that have responsibility for the ordering, receipt and checking of medication into the home. Very positive comments were received back from the home’s supplying pharmacist, in relation to the professional manner the staff administer medication, and the pharmacist confirmed that the staff receive regular training in respect of medication awareness. A medical fridge has also been provided for the storage of insulin or eye drops. The home keeps records of when residents have taken showers or had baths. It was noted that these were filled in with some residents having weekly showers/baths and others more frequent. Some residents had declined to have their showers and this was also recorded. A resident confirmed that they were always offered their shower on a weekly basis, and they did not wish to have any more than this. There were some feedback comments received, prior to the inspection, from a visiting professional and family member in relation to staff not always ensuring privacy and dignity for the residents. During the inspection other comments were received along the same lines and one resident actually named a carer who the resident felt “was always grumbling and was brusque”. Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 13 This was discussed with the manager who stated that she was currently addressing a problem of this nature with a specific member of staff who had had a complaint made against her during the course of her work. It was pleasing to note that the manager was already “on top” of the situation and was already dealing with it accordingly, but would now take further action in the light of the additional comments received during the inspection. Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 14 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): 12,13,14,15 The quality in this outcome area is adequate. Residents enjoy a peaceful life at the home, with visitors encouraged and welcomed. Choices are made available to residents regarding their day to day living and these are respected and upheld by the management and staff. Links are also encouraged and maintained with the local community. Residents are able to participate in various informal activities, when offered, and can take advantage of weekly outings (which are charged for at £4.00 per outing). The home provides nutritious and varied meals. EVIDENCE: It was noted that residents feel they can take advantage of the informality of the home’s routines and consequently choose how they spend their time. One resident confirmed that they could choose how they spent their time and another stated they able to go to a church of their choice every week, whilst another confirmed that “they and their visitors were quite free to come and go as they wanted”. During the inspection it was noted that some residents had chosen to remain in their own rooms, others were socialising together, some had formed Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 15 friendships and were enjoying each other’s company, whilst others were enjoying the home’s pleasant and large gardens. One resident stated that: “although when they came to live at Puddavine they hadn’t expected to be happy at the home but they had found they were now very happy”. An example of how staff manage diversity to good effect was evidenced in the care provided for a resident whose condition means that they need to spend a large amount of time in bed. The resident has asked if it would be in order to have a fish tank installed in their room to allow her another interest. This was readily agreed to and now gives the resident pleasure. It was also noted that this resident is fully involved in the homes’ care planning processes addressing the resident’s care needs and is encouraged to contribute to planned changes. Visitors are welcomed and encouraged and the home’s visitor’s book evidenced many visits from many people at differing times. There is normally a weekly outing. However on the day of the inspection this did not take place as the Court Group mini bus was being serviced. There is a charge for these trips of £4.00 but all residents who were spoken with, who participate on these trips, thoroughly enjoyed them. The daily activities are currently provided in an informal manner within the home according to residents’ desires with detailed records kept. The staff at the home mainly provides these with some outside entertainment also brought in on occasions. There was some feedback that there this was not now considered to be enough activities for some residents and this information was passed to the manager for her consideration. Some residents also stated that they felt there was room for some improvement regarding the meals provided, in so far as their personal choices are not always catered for and the evening meal was not always up to the same standard as the lunch time meal. (The cook only semi-prepares the evening meal with the evening staff finishing and serving this meal). It was however noted that there was a varied menu provided daily with choices made available and that this information was displayed on a notice board within the home’s dining room. Residents who stay in their room, however were not always made aware of the choices available and consequently did not know what was to be served or what choice was available. Residents are aware that the home has had several changes of cook within the home in the past twelve months and are aware that this has made it more difficult for the home to provide consistently high standards of meals. The most recently appointed cook, who has been at the home since March 2006 has experience in cooking, having recently been employed within the catering industry and having already achieved an NVQ level 2 in catering. It was unfortunate that on the day of the inspection she was not working within the home, being unexpectedly unavailable. Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 16 In her place a care staff member was undertaking the cooking of the midday meal. The meal provided was sausages with gravy and onions, mashed potatoes and cauliflower, followed by fruit flan and cream. The standard of cooking was adequate, considering this had been an emergency measure, and the majority of residents appeared to enjoy the meal. Following on from the inspection the cook was contacted by telephone to discuss her role within the home. It was clear from speaking with her that she is endeavouring to meet the resident’s needs and is building on the knowledge that she has already been given by some residents as to their individual likes and dislikes. Although there were some mixed comments there were also some very positive comments received with some residents making such comments as: “the meals were lovely”, “we do get plenty” “I usually enjoy what I am given” and a resident with a medical dietary need stated that they felt the cook catered well for this need. The more negative comments were discussed with the owner, manager and later the cook who will all endeavour to provide a means to allow all residents the opportunity to be very specific about what they would wish to see on the menu and how exactly they feel the menus/ meals, including the evening meal, can be improved upon/changed for the better. Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 17 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): 16,18 The quality in this outcome area is good. Arrangements for protecting residents and responding to their concerns are satisfactory. EVIDENCE: The Commission has not received any formal complaints in respect of Puddavine, since the last inspection undertaken in January this year. The home’s complaint policy remains communally displayed in the home’s hallway and is also contained within the home’s statement of purpose. It was particularly pleasing to note the detailed way any in-house complaints are both treated and recorded, clearly evidencing what action has been taken to resolve them to the resident’s satisfaction. An example of a recent complaint involved the manager confronting a staff member’s approach to telling a resident that the call bell should only be used for an emergency. The staff member was clearly informed that this was not the case and that residents can ring at any time for assistance, which they can then expect to be given. The complainant had been informed of the action taken. This was all fully documented and made it easy to track how complaints are viewed and dealt with within the home. The conclusion was therefore that complaints are handled positively and dealt with effectively within the home. This was reflected in resident feedback as all residents spoken with were clear as to how to complain and felt they could easily approach the manager or deputy manager should they have any cause to. Returned questionnaires from several randomly selected residents, and comments received from those residents spoken with at the inspection, also Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 18 indicated that residents feel confident to speak to the manager or deputy manager if necessary over any concern they may have. Staff receive vulnerable adult training on a regular basis and there are records kept of when this training was both given and when it needed to be renewed. A current investigation is currently being conducted by the police, in relation to the death of a resident in June 2005, which involved the resident falling from a first floor window of the home. This has yet to be concluded. Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 19 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): 19,26 The quality in this outcome area is excellent. Puddavine Court is very comfortable, clean, well maintained and provides a safe standard of accommodation for the residents. EVIDENCE: The tour of the home confirmed that the owner and manager maintain very good environmental standards within the home, which makes Puddavine Court a pleasant place to live in. Routine general upgrading continues to take place as required. Since the last inspection the owner has upgraded a communal toilet on the first floor and is in the process of providing an additional, adjoining shower room. A new, large bedroom has been created out of what was originally a private lounge area for a previously accommodated married couple. An en-suite toilet has also now been added to this room, which is now used for single occupancy. Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 20 The manager ensures that the home’s fire precautions are maintained in line with the requirements of the local fire department, whilst a member of the Court group staff is employed specifically to ensure this, and all other areas associated with the health and safety of the residents, are maintained in accordance with the requirements associated with each area in all Court Group homes. There was a log of the Court Group’s health and safety officer’s monthly visits to Puddavine, detailing any remedial work that needed to be done to maintain the required environmental standards. The home’s fire log book was also inspected and found to be in order. Privacy locks to all residents’ bedroom doors have recently been fitted. Each resident has had a room risk assessment undertaken. The home presented as clean, although there had been a comment received, prior to the inspection, indicating that one resident’s toilet area was not always as clean as it could be, however on inspection all areas were noted as being very clean and well presented and resident feedback, overall, stated that the home was normally kept clean and pleasant. There was a slight incontinence odour noted in only one room, which considering the home provides care for several residents who have continence problems, was considered to be positive. The laundering needs of the residents are met appropriately with new improved laundry equipment ensuring that all residents’ laundry needs are undertaken as effectively as possible. A downstairs communal toilet, that was reported as being out of action, in a resident feedback questionnaire was now noted as having been mended and was back in operation. Staff receive regular cross infection training as part of the Court Group’s statutory training programme. Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 21 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): 27,28,29,30 The quality in this outcome area is adequate. The home’s recruitment policies are in order and protect residents. Staff at the home are appropriately trained and employed in adequate numbers so as to meet the residents’ needs. EVIDENCE: On the day of inspection there were thirty-two residents in the home and one was away on holiday. The staffing rota was inspected. Normally there are six carers in the morning, and four carers in the afternoon and into the evening. Two waking night staff provide night cover. There is also a daily weekday cook and a weekly domestic employed from 8.30 a.m. until 2.30 p.m. One day a week there is an extra cleaner who does the home’s stairs, landings etc. The registered manager works from 8.00a.m until 5.00pm Monday to Friday as well but her role does not involve “hands-on” care. The deputy manager, along with the duty officer, is currently working every weekend as well as part of the normal working week, and therefore provides management cover when the manager is off at the weekend or any other time. Very positive comments generally were received about the deputy manager and residents felt confident in her ability to meet their care needs. It was pleasing to note that the staff of the home also incorporates three male carers. This provides a good balance and allows any male resident the Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 22 opportunity to have care provided by a member of the same sex should they wish to have this option. The two male carers spoken with were also aware that not all female residents may want to receive personal care from a male and were sensitive to this. Staff, on duty, were noted as being well presented and polite towards the residents. Although there were some negative comments received regarding the staff being “rushed” and “there not enough to be able to care efficiently for all the residents”, in the main those residents spoken with during the inspection confirmed that the staff do answer buzzers reasonably quickly and do attend to their needs satisfactorily. However there were many other positive comments received including comment which referred to the home as “having an excellent staff, very kind and considerate” and several others stating how kind the staff are. A visiting professional also stated that the “staff always friendly and helpful. Willing to seek help when they need to”. The one specific negative statement made, regarding a named member of staff (mentioned previously) is being addressed appropriately by the manager and will ensure that residents do remain cared for by an understanding staff group. Since the last inspection one staff member has turned eighteen years of age and as such is now able to provide personal care. She was spoken with at the inspection and it was pleasing to note her enthusiasm and dedication. She is attending various training courses and is intending to take her NVQ level two in care in the near future to ensure she is fully aware of her role and is professionally trained to deliver a good quality of care. She has already undertaken a full induction programme provided by an external training provider as well as undertaking the homes own induction programme. Staff on duty were able to confirm that they had received a lot of in house training since their appointments and were happy to take advantage of the further training opportunities being presented. This level of training helps ensure that staff are appropriately trained and consequently able to provide suitable care for the residents at the home. The staff group remains relatively stable within the home with only three staff members having been employed since the last inspection. The records for these staff members were looked at in detail. The recruitment procedures within the home, including receipt of completed application forms, two written references, an enhanced CRB check, ensure that there are suitable staff working within the home and that residents are protected. All staff receive regular supervision and annual appraisals to allow them to fully understand their role/performance within the home. It was pleasing to note that those staff spoken with felt comfortable working at the home and felt that they were well supported and felt able to approach the manager should they have any concerns as they felt she was approachable and understanding. They also voiced the fact that they felt the staff group was strong and that they supported one another. Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 23 During the inspection it was noted that staff took pride in their role and tried to ensure that all residents had a good quality of life, irrespective of need or diversity i.e. it was noted that frailer residents were given choice as a matter of course, being helped to go outside and spend some time in the garden, and that the two male carers on duty were aware that not all female residents may want them to provide personal care. If this was the case other arrangements were made to ensure a female carer was available instead. There are regular staff meetings held with minutes kept. Information that may be useful to staff, including the Court Group’s corporate strategies, training etc are also made available to all staff. This allows them to have an awareness of all issues surrounding their roles and feel part of the larger Court Group team, in fact one of the male carers had transferred from another Court Group home to work at Puddavine, where he told me he was very happy and felt his job to be worthwhile. Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 24 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): 31,33,35,38 The quality in this outcome area is good. The management of the home provides the necessary support to staff and residents to ensure the home is well run and managed. Excellent quality auditing takes place to ensure that the home is run in the best interests of the residents. The home provides a safe, secure environment where residents’ safety and well being is maintained. EVIDENCE: Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 25 The registered manager has been in post for several years. She is therefore well acquainted with the day to day running of Puddavine Court. She has completed her NVQ level 4 in care and is considering undertaking the Registered Manager’s award. During the inspection several residents and staff fed back how approachable they found the manager with one comment being “Our manager is absolutely super” and that she is usually available within the home when anyone want to speak to her. Records inspected were up to date, concise and contained appropriate information. The residents or the residents’ families/advocates mostly deal with any financial matter although the home does hold small amounts as requested by residents or their families. 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. A member of the Court group senior management team undertakes a formal monthly in-depth review of the service and provides the manager with a written record of this visit as required under regulation twenty-six. The manager holds three monthly residents’ meetings with minutes kept. The home continues to operate thorough internal quality monitoring systems with residents’ feedback invited as part of the overall process. The home obtained “Investors in People” in February 2005. The Court Group Senior Management team are in the process of further improving their quality auditing approach to ensure that residents’ views are taken into account at all times. The home ensures that the residents receive feedback as to their in-put with the collated results of the questionnaires displayed on the home’s notice board. The residents and staff both receive a copy of the newly introduce Court Group newsletter, which allows all to know what is going on within the Court Group generally. An example of this is the recently introduced auditing of the admission process for the residents, where newly admitted residents are invited to feed back on how they felt their admission went. The appointment of the newly created quality audit officer also evidences that the Court Group are working towards ensuring that all of its homes are run in such a way as to be in the best interests of the residents. The home’s annual development plan was seen for 2006/2007 and it was noted that it contained relevant and realistic plans and appropriate time scales. The manager and the owner both confirmed that health and safety issues continue to be well managed within the home and records inspected supported this. The manger, in conjunction with the newly appointed health and safety representative, undertakes all required routine health and safety management including fire awareness and ensures all health and safety standards continue to be met. The home’s hot water supply is regulated throughout the home to a safe temperature and all hot surfaces are covered or have low surface temperatures and windows are fitted with restrictors. Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 26 This measure further helps maintain residents’ safety at all times. Comments received from some residents suggested that they would appreciate the manager paying more individual visits, particularly to those residents who stay in their rooms as they feel they would value more frequent visits than currently take place. The manager agreed to undertake resident visits on a more formal rotered basis to ensure she does get to speak to all residents more frequently. Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 27 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 3 x x 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 3 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x x x x x x 4 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 4 x 3 x x 3 Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP12 OP15 Good Practice Recommendations The manager should review the activity programme within the home, and ensure that it continues to be provided in such a manner as to satisfy all residents. The manager should continue to try to ensure that the menu choices offered meet all individual residents’ expectations and that those residents who remain in their rooms are made aware of the menu for the day. Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 29 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 Puddavine Court DS0000003783.V300351.R01.S.doc Version 5.2 Page 30 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!