Inspection on 09/01/07 for Quintaville

This inspection was carried out on 9th January 2007.

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

Quintaville 27/04/09

Quintaville 18/06/08

Quintaville 02/07/07

Quintaville 20/12/05

Quintaville 29/09/05

Quintaville 11/02/05

Quintaville 06/07/04

Quintaville 24/03/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Poldhu

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

CARE HOMES FOR OLDER PEOPLE Quintaville 1 Quinta Road Torquay Devon TQ1 3RJ Lead Inspector James Rose Key Unannounced Inspection 9th January 2007 09:00 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 Quintaville DS0000018414.V318836.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. Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Quintaville Address 1 Quinta Road Torquay Devon TQ1 3RJ 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) 01803 328289 L Murphy & Co Ltd Mr John Francis Murphy Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Learning registration, with number disability over 65 years of age (25), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (25), Old age, not falling within any other category (25), Physical disability over 65 years of age (25) Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20/12/05 Brief Description of the Service: Quintaville is a residential home that is registered for persons in the categories of: Dementia, Old Age, Learning disability, Mental Disorder and Physical Disability. The home has 25 beds in a range of single and double rooms many with on suite facilities. At the front of the building there is a small well tended garden and a courtyard area is found at the rear, which can be accessed by service users through a large patio door. On road parking is available at the front of the home. The home has three floors and a vertical lift is provided for service users who have mobility issues. A Parker bath is available for persons who need this facility. Three lounges are available which provides different environments in each. Meals are taken in a separate dining room at small tables seating up to four persons. Off the dining area there is a dedicated room provided for hairdressing. The home is within walking distance of local shops. The weekly cost of care at Quintaville is between the lowest at £313.00 to the highest £367.00. Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken over eight hours in January 2007, a sample of care records were examined and four residents were consulted individually others were see in a group. Evidence was also taken from returned questionnaires. Three carers were interviewed individually and healthcare professionals that provide a service to the home were also consulted. A complete tour of the building was undertaken and the way care was delivered was observed. The registered manager/proprietor assisted throughout the inspection process. What the service does well: What has improved since the last inspection? The home continues with the redecoration and running maintenance programme. Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 6 What they could do better: Comprehensive assessments have not been completed of new residents in a way that covers their needs in the areas of health, personal and social and a requirement has been raised to ensure this is undertaken and all needs are in place that provide the foundation of the service user plans. Service user plans must contain the residents’ needs in the areas of health, personal and social and set out what action needs to be taken to ensure all aspects of care are met. The plan should also contain risk assessments with particular attention given to the prevention of falls. Currently the care planning undertaken by the home is not reviewed monthly a requirement has been raised in this report to ensure this is undertaken in future. All care plans should be drawn up with the resident concerned or their representative and agreed and signed by them to demonstrate their agreement. The recording of the administration of medication in the home was examined and a requirement has been raised calling for secure storage to be provided for all medication including medication in cream form and for recording to be completed in the same way as it is undertaken for oral preparations. A tour of the home was undertaken as part of the inspection process and all rooms were seen. Requirements have been raised calling for the odour problems in some of the rooms to be dealt with and for the drafts from the windows to be eliminated. Some windowsills need to be redecorated or replaced and the worn stair carpet needs to be replaced. Currently the home does not have an electrical installation certificate, a requirement has been raised to ensure this is provided without delay to ensure the building is safe for residents. Samples of the personnel files in the home were examined and several gaps were apparent in the necessary documentation to ensure residents are in safe hands. A requirement has been raised to ensure this is rectified. The home did have a quality assurance system based on the views of residents, however this had been allowed to lapse and a requirement has been raised to ensure this is re-established. Quintaville DS0000018414.V318836.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. Quintaville DS0000018414.V318836.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 Quintaville DS0000018414.V318836.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): 3 and 6. Quality in this outcome area is adequate. Some assessments were apparent that needed to be expanded to cover all the needs of the prospective resident in the areas of health, personal and social. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four assessments were examined residents that were the last to be admitted into Quintaville. Some of the assessments did not cover the needs of the individual in a comprehensive way and therefore would not provide a suitable foundation for a detailed care plan. It is essential that a detailed care assessment is carried out for each resident particularly those who are self funding, the assessment should cover: • Personal care and physical well-being: • Diet and weight, including dietary preferences; • Sight hearing and communication; • Oral health; Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 10 • Foot care; • Mobility and dexterity; • History of falls; • Continence; • Medication usage; • Mental state and cognition; • Social interest, hobbies, religious and cultural needs; • Personal safety and risks; • Carer and family involvement and other social contacts/relationships. A requirement has been raised in this report to ensure that detailed assessments are undertaken of all the needs of a prospective resident to enable a foundation to be provided for the care planning process. Quintaville DS0000018414.V318836.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, and 10. Quality in this outcome area is adequate. Some of the service user plans examined at this inspection did not cover the residents’ needs in a comprehensive way. Residents’ health needs were fully met. Residents are able to self medicate at the home. Some deficits were apparent in the administration of medication in the home. Residents were treated with respect and their privacy was maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four service user plans were examined at the time of the inspection and some deficits were apparent. Health needs appeared to be met but there were deficits in the areas of personal and social needs. The need for an urgent review was discussed with the registered manager who is going to carry out reassessment and produce new care plans where required within an agreed timescale; a requirement has been raised for this purpose. All care plans should be drawn up with the person concerned and agreed and signed by them. Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 12 It was understood at the time of the inspection that some of the new admissions into the home were unable to use the bathrooms available, a review should be undertaken of the issues involved and an occupational therapist should be consulted to find a solution, which should then be part of the care planning processes. Healthcare needs at the home were met appropriately and the healthcare professionals that were consulted expressed their confidence in the service provided and advised that they were always consulted appropriately. The recordings of the administration of medication undertaken by the home were examined; in general the recording was clear and up to date. Some deficits were found in the way medication in cream form was undertaken. In order to avoid misuse and the possibility of contamination all prescribed cream medication must be stored in a secure way and should be recorded in the same manner and medication taken orally. The daily records written by carers are going to be undertaken on the basis of one sheet per resident to ensure confidentiality of recording is appropriate. All residents that have the administration of their medication undertaken by the home should have their agreement to this approach recorded. Four residents were consulted individually as part of the inspection process and several residents were seen in a group. They all advised that they were very happy at the home and felt they received a good quality service. One resident advised, “ We are all well cared for, I wouldn’t want to go anywhere else” another person who had recently moved into the home said, “This suits me well, the staff a very good and the food is lovely”. All the residents seen in private confirmed that they were treated with respect and their dignity and privacy was maintained. It was also clear from observations made during the inspection that residents were not rushed by staff and personal care was delivered in a sensitive way. Quintaville DS0000018414.V318836.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 and 15. Quality in this outcome area is good. The lifestyle in the home was to the liking of the residents and the visiting arrangements were unrestricted. Residents were helped to have control over their lives and to exercise choice. The meals served in the home were wholesome and appealing and were served in a dedicated dining room that residents’ liked. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four residents were consulted individually and in private and others were seen as a group. They were all relaxed and well able to express their views. Everyone advised that they liked the life at Quintaville and felt that they had enough entertainments and interests made available to them. When asked no suggestions were made of any additions that persons would have liked added to the activities provided in the home. The home has an unrestricted visiting policy and procedure and the management of the home has always been prepared to offer additional support to visitors particularly if they have travelled to get to the home. Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 14 Examples were seen during the inspection of staff providing assistance and encouragement to residents to give them time and space to enable them to make their own decisions about matters that affected them and their lifestyle. Residents advised that they felt in charge of their own life and made their own decisions about issues that affected them. The foods served at the home are produced in their own kitchens and fresh produce is used. The diet is appealing and varied and meals are served in the dedicated dining room that is equipped with small tables seating up to four persons. Additional snacks and drinks are available to residents on requests. All the residents consulted advised that the liked the meals provided in the home and could not think of anything they would like added to the menu. Quintaville DS0000018414.V318836.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 and 18. Quality in this outcome area is good. Residents were confident that if they raised an issue it would be resolved quickly to their satisfaction and they are protected from all types of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the residents consulted were confident that if they raised and issue in the home it would be taken seriously and action would be taken to resolve it without delay. No complaints were received during the inspection process. The home has an adult abuse protection policy and procedure and carers and trained in its use. Three carers were interviewed individually and in private as part of the inspection process, they were all conversant with the protection of residents and recognised the different types of abuse and what action should be taken if they ever discovered abuse taking place. Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 16 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 and 26. Quality in this outcome area is good. Quintaville offers a safe comfortable environment to the residents; some items of maintenance were outstanding at this inspection. The home was clean, pleasant and good standards of hygiene were evident. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complete tour of the home was undertaken as part of the inspection process, in general the home has a comfortable and safe environment. Some items of maintenance were apparent and these are the subject of a requirement in this report. The issues were: (1) The alarm system was not working in room 1 and there were drafts from the windows. (2) There were malodour issues in room 1 and 9. (3) Drafts from the windows in room 12. (4) The windowsill in room 11 needs to be repairs or replaced. Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 17 (5) The stair carpet on the first staircase is badly worn and should be replaced as soon as possible. Good standards of hygiene were apparent throughout the building. Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 18 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 and 30. Quality in this outcome area is adequate. The experienced care team meets the needs of service users at all times. There were deficits in the personnel files. Carers were competent and trained to do their jobs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care hours available at the home are the same as at the last inspection. If more hours are required because a residents needs go up then they are made available. The staff are skilled, competent and experienced and meet residents needs appropriately. All the residents consulted advised that they were well cared for and that they had a good relationship with their carers. Samples of the personnel files maintained by the home were examined and several deficits were apparent. A requirement has been raised in this report for all the files to have the documentation necessary as called for is Schedule 2 of the legislation. A timescale has been agreed with the registered manager for completion. The home has a training record available of the staff team and new carers are able to undertake training and are supported by the management of the home. Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 19 Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 20 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 and 38. Quality in this outcome area is adequate. In general the home is run by and well-trained experienced manager. The current quality assurance system has lapsed. The financial interests of residents are appropriately safeguarded. Generally the health and safety in the home is appropriate, however, there was one important deficit. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A person with years of experience who is trained in social care and management and is also a trained nurse manages Quintaville. Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 21 The quality assurance system used by the home that is based on the views of residents has been allowed to lapse. A requirement has been raised in this report to ensure this is reinstated as soon as possible. The financial records of four residents were checked at this inspection, these were found to be correct in every respect including the cash available. Each residents has a bank account that requires support with the management of their pocket money, receipts are retained by the home for any purchases made on behalf of a resident. The registered manager takes the health and safety and welfare of residents and staff seriously. The recordings of the fire precautions undertaken by the home were examined and found to be up to date. The electrical testing of appliances was available. Hazardous chemicals were stored appropriately and used correctly and reports were made of any accident sustained in the home. The water testing for unwanted bacteria was up to date to ensure it was safe for use. At the time of the inspection the electrical installation certificate was out of date, a requirement has been raised in this report of a new certificate to be obtained to ensure the building is safe. Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 22 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 23 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 OP3 Regulation 14(1) (a) Requirement Needs of the service user have been assessed by a suitably qualified or suitably trained person; Timescale for action 28/02/07 The registered manager must ensure assessments are undertaken of all prospective residents that cover their needs in health, personal and social. 2 OP7 15(1) Unless it is impracticable to carry 28/02/07 out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan (“the service user’s plan”) as to how the service user’s needs in respect of his health and welfare are to be met. The registered person shall – (a) make the service user’s plan available to the service user; (b) keep the service user’s plan under review; The registered manager must Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 24 15(2) ensure that there is a comprehensive care plan that includes risk assessments available for each resident in the home that is reviewed monthly and agreed with the individual service user or their representative. 3 OP9 13(2) The registered person shall make 17/01/07 arrangements for the recording, handling and safekeeping, safe administration and disposal of medicines into the care home. The registered manager must ensure secure storage for all prescribed medicines and record their use. 4 OP19 23(1) Subject to regulation 4(3), the registered person shall not use premises for the purposes of a care home unless – (a) the premises are suitable for the purpose of achieving the aims and objectives set out in the statement of purpose; The registered manager must ensure that the following items of maintenance are addressed: 1. The alarm system in room 1 needs repair, the windows should be draft proofed and a solution should be found to the odour issue. 2. A solution should be found to the odour issue in room 9. 3. The windows in room 12 should be draft proofed. 4. The windowsill in Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 25 28/02/07 room 11 should be repaired or replaced. 5. The stair carpet on the first staircase should be replaced. 5 OP29 19(1) The registered person shall not employ a person at the care home unless – (b) subject to paragraph (6), he has obtained in respect of that person the information and documents specified in – (i) paragraphs 1 to 7 of Schedule 2; The registered manager must ensure that there are complete personal files in the home that cover all elements of Schedule 2 of the legislation. 6 OP33 12(3) The registered person shall, for 28/02/07 the purpose of providing care to service users, and making proper provision for their health and welfare, so far as practicable ascertain and take into account their wishes and feelings. The registered manager must reinstate the quality assurance system for consulting residents. Subject to regulation 4(3), the registered person shall not use premises for the purposes of a care home unless – (a) the premises are suitable for the purpose of achieving the aims and objectives set out in the statement of purpose; The registered manager must ensure that there is a current Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 26 28/02/07 7 OP38 23(1) 28/02/07 electrical installation certificate available for the home. 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 OP22 Good Practice Recommendations The registered manager should consult an occupational therapist to find a solution to bathing residents who are unable to use the facilities available currently. Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Quintaville DS0000018414.V318836.R01.S.doc Version 5.2 Page 28 - 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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