Inspection on 25/06/09 for Sea Point

This inspection was carried out on 25th June 2009.

CQC found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Sea Point 24/07/08

Sea Point 02/08/07

Sea Point 25/07/06

Sea Point 22/11/05

Sea Point 07/06/05

Sea Point 19/11/04

Sea Point 20/07/04

Sea Point 06/03/04

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 17/02/2010.

Key inspection report CARE HOMES FOR OLDER PEOPLE Sea Point 14 Adelphi Road Paignton Devon TQ4 6AW Lead Inspector Rachel Proctor Key Unannounced Inspection 25th June 2009 09:45 DS0000018423.V376384.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sea Point Address 14 Adelphi Road Paignton Devon TQ4 6AW 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 556899 01803 556899 glen.rees@live.co.uk Paignton Guild of Social Services Housing Associations Limited Mrs Glenis Mary Rees Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12), Physical disability over 65 years of age of places (12) Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th July 2008 Brief Description of the Service: Sea Point is registered to provide accommodation and care for a maximum of twelve service users who are over sixty-five years of age and who may also have physical disabilities. The home is situated in a quiet area of Paignton and is within a short and level walking distance of the sea front, town centre, bus and railway stations. Information about the service is available from the home in a Statement of Purpose and in a brochure. Copies of inspection reports will be made available on request or can be obtained from the CSCI website. The current fees range from £308 to £333 a week. Additional charges are made for optional extras including professional hairdressing and chiropody, personal toiletries, newspapers and magazines. Sea Point DS0000018423.V376384.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 one star. This means the people who use this service experience adequate quality outcomes. This was a key unannounced inspection, which took place over two days on 25th & 30th July 2009. The manager provided an (AQAA) Annual Quality Assurance Assessment for the Commission when it was asked for. This provided information about how the home manager viewed the services provided at the home and what planned improvements would take place in the next 12 months. Two people living at the home had their care followed. Discussion with the manager, staff team on duty and people living at the home took place during the inspection. Relative’s visiting the home at the time of the inspection were also spoken with. Surveys were returned from 2 people living at the home, and 3 staff members prior to this inspection. Some comments made in the surveys and some comments made during the inspection have been included in this report. A tour of the home was completed and some records were inspected. What the service does well: The very experienced registered manager has a good understanding of the needs of the people living at Sea Point. She carries out needs assessments with prospective new people and their representatives to ensure that the home can meet their individual needs. The people who use the service are satisfied that the service provided meets their needs. Comments received included; Sea point is a small home, where residents come together as a large family, we cater for all their needs whatever each individual requires. My family and I are happy at Sea Point, “Look after all my needs People living at Sea Point are offered a choice of good quality meals. People asked said they enjoyed the food, some saying they looked forward to meal times. Staff understand personal preferences and choices for food and endeavour to ensure people have food they like to eat. Complaints are listened to and taken seriously and policies are in place to protect the people from abuse. The complaints policy was easily available for people. Those people asked and the surveys returned by people living at Sea Point knew who to speak to if they had any concerns and knew how to make a complaint. The people who live at Sea Point are cared for by a staff team who are willing and helpful. This means people feel that they are treated with dignity and respect. Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 6 Sea Point is ideally located for access to the beach and to the town centre. People’s accommodation was comfortable and has a homely appearance. People asked said they liked living at Sea Point. What has improved since the last inspection? What they could do better: Information relating to the involvement of the multi disciplinary team in the decision to use bed guards was not being kept in the new care plans. Risk assessments for use of bed guards had not been completed for all the people using bed guards. This means the risk to the person or the suitability of the bed guards for their care needs had not been fully recorded as assessed. By not ensuring the multidisciplinary team, the person and/or their representatives’ are involved in the assessment, people who use bed guards may be put at risk of injury. Risk Assessments, which include actions taken to reduce the identified risk, had not been completed for people in rooms above the ground floor that have windows that open more than 4 inches. This has the potential to put people at risk of falls from windows above ground floor. Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 7 The manager had not ensured that the recruitment practice operating with in the home includes a completed enhanced police check (CRB) for all staff prior to them starting work. This practice puts people at risk from unsuitable staff. The current system call bell system can be unreliable and cannot always be heard by the staff. A new call bell system, preferably one that can only be cancelled at source, would ensure people living at Sea Point always get help when they need it. Although the laundry walls had been re-plastered they had not been painted to make them easily cleanable to reduce the risk of infection. This could put people at risk of cross infection. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Sea Point DS0000018423.V376384.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 Sea Point DS0000018423.V376384.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given sufficient information about Sea Point and its services to make an informed choice about whether the home can meet their needs. The new assessment process adopted by the home manager should ensure that peoples care needs are adequately assessed and their care needs are meet. The home does not provide intermediate care EVIDENCE: The Service Users Guide and Statement of Purpose had been up dated since the last inspection. These were available in the home’s reception area. The manager confirmed that people could have a copy of the Service Users Guide Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 10 in their room. Five people and/or their representatives spoken with during the inspection said they were given information about the home prior to admission, which had helped them to decide about staying there. Four people spoken with said that staff had discussed their care with them to find out what was important to them. Two people also commented they had not visited the home before admission but a relative had on their behalf. Two relatives visiting a person who had been admitted recently advised that they had chosen the home for their relative and were very happy with the care they were receiving. The person living in the home commented that they had been helped to settle in and had been given information about home by the staff. Two of the nine people living at Sea Point had their care followed as part of the inspection. The manager has introduced a new care planning assessment process since the last inspection. An assessment of need had been completed for both people using the new assessment process. A care plan had been developed with the individuals from their assessment of need. Sea Point does not provide intermediate care. However people can be admitted for short-term respite care if the accommodation was available and staff can meet their needs. Sea Point DS0000018423.V376384.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the majority of care plans were up to date and reviews had been completed monthly. One person’s care needs changes had not been fully reflected in their care plan. This means that person was reliant on staff remembering what to do without reference to full written details. This could put them at risk. Medication practices are safe at Sea Point Staff appeared to be skilled caring for people, they were polite and respectful to the people they care for. There was a genuine rapport between the staff and the people living at the home. People’s privacy and dignity was being upheld and they were being valued as individuals. Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 12 EVIDENCE: Two of the nine people living in the home had their care followed as part of this inspection. This involved speaking to the person where possible, visiting the room they occupied in the home. And looking at their care plan and other information related to their care being kept in the home. The care planning system has been changed since the last inspection in July 2008. A pre-printed care planning system was being used. This provided a template, which covered the activities of daily living for people. The assessment care plan identified the care needs people had and what they needed help with. The manager advised that she had a training manual provided with the new care planning system that she and the staff team were using this to ensure the care plans captured all they needed to. Both people whose care was followed had clear care plans in place, which provided staff with information about the persons care needs. However one person who had been admitted to hospital following a fall had decreased mobility since their return to the home one month earlier. The care plan and assessments had not been updated to reflect the changed dependency of the person. Additional short-term care plans had been written following their discharge from hospital. However their manual handling risk assessments and their ability to mobilise had not been clearly updated to reflect the changes in their ability. Staff spoken with during the inspection were aware of the persons changed care needs. The person was being cared for in bed and said they were satisfied with the care they were receiving. Visiting relatives commented they were looking after the person very well. The manager advised that the hospital had provided information that the person should rest for six weeks following the hospital discharge. Physiotherapy and district nursing but had been organised and the person was receiving this. It was clear from the daily statements in the persons care plan that health professionals had been involved and they had advised staff how the persons care needs should be met. Care staff were following the advice given by the health professionals who have assessed the person. The persons care needs were being met by staff who knew the person and their care needs well. Date and signature had been recorded each month the care plan had been reviewed for the two people whose care was followed. However it was clear from the information in one persons daily care records that their care needs had changed. However these changes have not been recorded as part of the monthly care plan review. This means care plan reviews did not have a clear links for all their care needs between their assessments of need and care plan review. Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 13 Two people visited in their own rooms had bed guards fitted to their beds. One person commenting bed guards made it easier to sit up in bed. The manager was asked for the bed guard risk assessments and consent of both people. Neither person had signed a bed guards consent form, which showed that they, their family and the multidisciplinary team had been involved in the assessment for use of the bed guards. One person had a risk assessment for the use of the bed guards completed with their care planning information. The manager advised that the hospital style beds and bed guards had been provided by the district nurses team who visited both people on a regular basis. She also commented that the bed guards were specifically designed for the hospital beds that people were using. On the second day of the inspection the manager advised that she had spoken to the district nurse who would be completing the bed guard risk assessment and consent used by Torbay Care Trust. The manager had also completed the homes risk assessment for bed guards for this person. Both people whose care was followed had manual handling risk assessments in place. However one person whose manual handling needs had changed following a fall had not had their manual handling risk assessment up dated. However there was information in the care plan regarding this and a manual handling hoist was provided for their use by the Community nurse team. Medication records were checked for the two people whose care was followed. These medication records had been signed by the staff member administering the medication. Medication storage was in a locked cupboard in an office. A separate lockable space was provided inside the cupboard for controlled drugs. One person was receiving controlled drug medication at the time of this inspection. The record was checked against the stock as correct. The manager advised that none of the current people living at Sea Point were able to administer their own medication. A risk assessment process was available for this. A record of medication returned to the pharmacy was being kept. The manager confirmed that all staff who assist with and administer medication had received training. Personal preferences for food had been recorded as well as the person’s interests. This included the type of activities they enjoyed. Staff were heard speaking to people respectfully using their preferred form of address, which had been recorded in their plan of care. Staff were observed knocking on peoples doors before entering their rooms. Four people asked said the staff are kind and respectful to them. Some of the comments received in the anonymous surveys from people who live at Sea Point were: - “Friendly staff, My family and I are happy with Sea Point, “Look after all my needs Sea Point DS0000018423.V376384.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Sea Point are given the opportunity and encouragement to make choices about their day-to-day lives. People’s personal preferences for food are taken into account when meals are planned. This should ensure meal times are a pleasant experience for people who live at Sea Point. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) returned to the Commission stated that Sea Point: - “Provide as many activities and leisure facilities we can to improve the daily life of our service users. Continue to involve as many service users as possible in these activities.” Two people returned anonymous survey prior to the inspection. These indicated that activities are always or usually provided that they can take part in. One person spoken with said since there were less people in the home there were not as many people they could talk with. Some of the newer people liked to stay in there own rooms. They Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 15 went on to say they were still able to meet up with friends locally and the staff were friendly and helpful to them. People’s individual care plans had a record of what the person enjoyed doing. One person was watching television in there room. The care plan had a record of the type of programme they liked to watch. The manager advised that the person’s family visited regularly and often told them about the programmes they knew they would like to watch that week. When the person was spoken with they said they enjoyed watching television. They also commented that because they had poor hearing they found it difficult to talk to people as they did not always hear what was said. This information was also recorded in the person’s plan of care. The lunch time meal observed was unhurried with people eating their meals at their own pace. Four of the people had chosen to have there meal in the dining room, the others had chosen to eat their meals in their own rooms. People were asked if they wanted more food during the lunch time meal. The manager advised that people are always given the opportunity to choose where they eat their meals. The people asked said they enjoyed the food, one commenting “lovley food”. Very little wastage was seen at the lunch time meal observed. The anonymous surveys returned indicated that people always or usually like the food. One comment recieved stated. Any resident’s birthday they make a cake and party food for everyone and any family who come to see you Discussion with the manager revealed that they continue to regularly speak to people about the type of food they enjoy and the menu reflected the choices people have made. The information in the care plans indicated what people liked to eat and their personal preferences or diatary needs. Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Sea Point can have confidence that any concerns they have will be dealt with sensitively by the staff team who care for them. EVIDENCE: The revised Statement of Purpose and Service Users Guide have a copy of the homes complaints policy provided with them. The manager confirmed that all the people living at the home could have a copy of the Service Users Guide in their rooms. One safeguarding referral has been made since our last inspection. The information provided showed that the home manager had acted swiftly when an incident occurred and all the relevant professionals were informed. This shows that good systems are in place for protecting people. Three people living at the home spoken with during the inspection said they knew who to speak to if they had any concerns. They also said they had confidence that any concerns they had would be dealt with. The anonymous surveys forms returned both indicated they knew how to make a complaint and who to speak to if they had any concerns. The home has a policy in place for staff regarding protection of vulnerable adults. The manager confirmed that staff had received training for this. The records of training seen during the inspection for staff confirmed this. Sea Point DS0000018423.V376384.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 People using the service experience Adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sea Point is clean, comfortably furnished and homely and provides a pleasant environment for people to live in. Access to parts of the home may be difficult for people who use wheelchairs. Although the environmental risk assessment completed included a statement that risk assessments for each person in rooms above ground floor; with access to a window, which opened more than 4 inches would be carried out; this had not been completed. Risk assessments had not been completed to show this was safe, this means people may be at risk. Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 18 EVIDENCE: A tour of the home including most people’s individual rooms was completed. The home was fresh and clean in all areas entered. People who returned surveys indicated that the home was always fresh and clean and their rooms are cleaned regularly. The spacious lounge and dining room are situated on the ground floor. The dining room is next to the lounge. This room has a small room leading off it that has a sink, kettle and toaster in it so it could be used by people to make them selves a hot or cold drink and snacks. There is a food-warming unit in the dining room, which had been risk assessed because a touch test that was carried out found to be very hot. Warning notices had been put up to alert people that the cabinet was hot since our last inspection. The manger advised that the time the cabinet was hot had been reduced and people are always supervised in the dining room. Two windows looked at in the home for rooms that were above ground level could be opened more than the recommended 4 inches. A risk assessment for window opening had not been completed for these rooms. The manager advised that the people using the rooms would need assistance to open the windows. Although an environment risk assessment indicated that peoples individual rooms would be risk assessed for use of the windows above ground floor this had not been done. This means people in rooms or other people who could have access to these rooms could be put at risk. Sea Point is situated in a quiet road that is a short and level walk from the seafront and the town centre. Limited off road parking was available and visitors may need to use the public car park, which is a five-minute walk from the home. There was an attractive and accessible garden to the back of the house. The AQAA (Annual Quality Assurance Assessment) provided by the homes management team stated that the garden has continued to be improved since the last inspection. One person living in the home said they liked to sit in the garden weather permitting. Five steps have to be negotiated to reach the front door of the home. Better access was provided to the side of the home for people who use wheelchairs, but this was not ideal, as people would have to negotiate a slope and a small step to gain access into their home. The manager advised that disabled access to the home was being discussed. However the changes would be dependent on feasibility as well as cost. One person used a disabled access scooter to go out with a family member during the inspection. They used the side entrance to get into the home. A new blind had been fitted to the front of the home. This provided cover for the entrance to the home and covered the top steps in to the home. The manager said she hoped this would prevent further damage to the laundry. Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 19 The laundry room, sited on the lower ground floor has a small area, which was under the front steps. This had some areas of damp, which had been replastered since the last inspection. The manager confirmed that the laundry room was in the process of being redecorated to make the walls easily cleanable at our last inspection in July 2008. Although the laundry walls had been re-plastered since our last inspection they had not been painted. This means the laundry walls were still not easily cleanable; this may pose an infection control risk. The Annual Quality Assurance Assessment (AQAA) indicated that this was something they were planning to do when finances allowed. A small lift, which was not large enough to accommodate a person in a wheelchair, provides access between floors. It was noted at our last inspection that this would not be large enough to take a persons wheel chair and alternative arrangements would need to be made. The majority of rooms have en-suit facilities or a toilet close to individual rooms or communal areas. There are two bathrooms; the bathroom on the second floor has a ‘Bathmaster’ hoist and shower cubical. All of the bathrooms and communal toilets have been fitted with locks for privacy. The manager confirmed that water was regulated to close to 43 °C to reduce the risk of accidental scalds. Radiators in the home were covered with guards. People’s rooms entered had been personalised with items of the individual’s choice. The manager advised that people are encouraged to bring small personal items when they enter the home. One person spoken with in their own room said how much they liked the view of the sea they had from their window. Another person was pleased they were able to use a special bedcover they had brought with them. Although the home has shared rooms that could be used for two people these were being used for one person during the inspection. Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The way staff are deployed and the numbers of staff on duty are sufficient to meet peoples care needs. Staff who work at Sea Point are given the opportunity to improve their knowledge and skills through training. This means that people have a knowledgeable staff team to care for them. Although the home has a recruitment policy in place this had not been fully followed. This could mean people could be put at risk from unsuitable staff. EVIDENCE: The manager provided the duty rota, which showed how many staff were on duty each shift. The pre inspection information (AQAA) (Annual Quality Assurance Assessment) provided shows that the home has more full time staff than at the last inspection and the manager advised that the increased management time to allow her to complete management tasks in the home has continued. The staff spoken with during the inspection said they had sufficient staff to meet the current peoples care needs. The information indicated that the care hours provided were less than the last inspection. Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 21 However the occupancy number had decreased since our last inspection from eleven to nine. On the day of this inspection seven people were in the home. Three other people had been admitted to hospital. One for a planned admission to hospital for treatment the others following deterioration in their health. The AQAA (Annual Quality Assurance Assessment) indicated that nine of the thirteen staff employed have achieved an NVQ (National Vocational Qualification) level 2 in care or above. This has increased since the last inspection and shows the homes management team are committed to ensuring staff have training that helps them to do their work. The manager has a recruitment policy. However this had not been followed for all the staff appointed since the last inspection. This may not protect people from unsuitable staff. Two staff files viewed did not contain all the preemployment checks expected. The police check had been returned after the staff member had started work in the home for both staff. One new member of staff who had been working in the home for two weeks did not have references or a police check completed in their staff file. The manager advised that they had worked at Sea Point before and they were in the process of completing these checks. She also advised that staff were always supervised and did not work alone until the police check has been returned. The manager advised that the induction programme for new staff employed would be improved at our last inspection. Examples of the induction used in the past were available. This was a check list signed by the staff member and the senior staff member supporting their induction as they completed each area. The three staff surveys returned to the Commission prior to the inspection indication that the induction covered everything they needed to know about the job very well or mostly. All three indicated they were receiving training relevant to their role. When asked in the anonymous survey, “Are there enough staff”? Two responded always and one responded usually. Comments received from staff included Sea point is a small home, where residents come together as a large family, we cater for all their needs whatever each individual requires. “Sea point is a lovely small home with a family quality. The training provided for staff since the last inspection was discussed with the manager. She advised that staff had received manual handling, fire safety and food hygiene training up dates since the last inspection. She also advised that key staff had completed infection control and dementia care courses. She commented that she was developing a matrix to show the training staff had completed in the last twelve months. And this would enable her to monitor when training up dates were due easily. The AQAA (Annual Quality Assurance Assessment) indicated: - The plans for the next 12 months included continuing the improvements over the last twelve months, including staff supervision and Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 22 appraisals. And “Investigate applying for entry to the “Investors in People Award” Improvements noted to have taken place since our last inspection included; The number of staff who had achieved an NVQ level 2 in care has increased. This provides the home with 69 of its staff team trained to this level. Staff supervision had increased and the staff appraisal system had been put in place. The manager advised that Torbay Care Trust Team had helped them do this. Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36, 38.People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was generally well run and managed by a management team that has several years experience. Improvements in the way the home was managed and run have been made since the last inspection. This should ensure the management of the home continues to improve for the best interests of the people who live there. Staff say they are supported to do their work and receive relevant training. Documentation to support staff are receiving formal supervisions was being kept. This should ensure that people continue to be cared for by a staff team who understand them. A lack of attention to environmental Health and Safety risk assessments and potential hazard management could put people living and working at the home at risk of injury. Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 24 EVIDENCE: The homes Statement of Purpose identifies that the registered manager has twenty one years experience in care work. She has been the manager of Sea Point for seven years The Annual Quality Assurance Assessment (AQAA) information provided indicated that the managers role and responsibilities with in the home had been re-defined and staffing levels had improved to allow her more time for general management and administrative matters. The manager confirmed that she has more time to complete mangement tasks than she did at the last inspection. She also advised that she spends the majority of her time completing managemnet tasks and was only covering shift short falls occassionally. She advised that this had enabled her to start to catch up with outstanding paperwork. The Registered Provider is The Paignton Guild of Social Service Housing Association Limited. The members of the Committee carry out regular monthly visits to keep the Committee informed of the conduct of the home and over see the management of the service. These reports are forwarded to the Commission. The chair of the organisation was spoken with during the inspection. They confirmed that it was their intention to continue to improve the way people experience care at Sea Point. They had ensured that the AQAA was returned to the Commission when it was asked for. The manager advised that the Quality Assurance audit questionnaires had been completed for people living in the home and the staff team. She stated that the results of the audit would be provided for the people living in the home, their representatives and the Commission when analysis of the results had been completed. The completed forms were available during the inspection. The manager advised that she held money for one person. The records of the money held and expenditure were being kept. Receipts for expenditure were being kept and the amount of money received recorded. A running total of expenditure and balance of money held was also being recorded. This has improved since our last inspection. The way staff are supervised was discussed with the manager, she advised that she regularly worked alongside staff to assess their practice and staff discussions took place regarding care practices in the home. The manager provided supervision records she had completed for staff. This showed that supervision takes place regularly and covered what was expected. The manager advised that she had been supported and assisted by Torbay Care Trust to develop a supervision system that worked for Sea Point. Staff spoken with during the inspection said they felt supported to do their work and had good access to training. The pre inspection information indicated that completion of staff appraisals, which include training and development plans Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 25 and supervision for all staff continued to be target for the coming year. Training and development was part of the supervision records staff had completed with the manager. The manager provided one example of an appraisal system she intended to role out to all staff. This confirmed that there was a system for ensuring all staff had a training and development plan that meets their needs and the needs of the home and the people living there. Overall the home continues to be reasonably well maintained. Staff training provision in health and safety related areas were good and policies and procedures were in place to promote safe working practices. Although a risk assessments for the environment had been completed since our last inspection. This had not been followed up with a written risk assessment for individual people and the rooms they occupied in the home as stated in the homes own risk assessment for the environment. The manager advised that she had risk assessed people and only people who were deemed not to be at risk had windows opened by staff. The windows above ground floor opened more than the recommended 4 inches at the last inspection. These had not been risk assessed for individuals who had windows that opened more than 4 inches and were above the ground floor. This has the potential to put people living at Sea Point at risk. Ensuring health and safety risk assessments had been completed was a Requirement at our last inspection. The manger had not completed Regulation 37 notices for all the incidents that had occurred at Sea Point. Three people had been admitted to hospital for treatment and the Commission was not informed of this. It is the manager’s responsibility to ensure the Commission is kept informed of these instances that affect people living at Sea Point. Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 26 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 4 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 2 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 2 Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes 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 OP8 Regulation 13(8) Requirement On any occasion on which a service user is subject to physical restraint, the registered person shall record the circumstances including the nature of the restraint. Information relating to the involvement of the multi disciplinary team in the decision to use bed guards should be available in the new care plans. Risk assessments must be completed, which demonstrate assessment for the individual using bed guards has been carried out, which involves the multi-disciplinary team, the person and or their representative. 2 OP19 13(4)(c) The registered person shall ensure Unnecessary risks to health and safety of service users are identified and so far as possible eliminated Risk Assessments, which include actions taken to reduce the DS0000018423.V376384.R01.S.doc Timescale for action 01/09/09 01/09/09 Sea Point Version 5.2 Page 28 identified risk, must be completed for people in rooms above the ground floor that have window that open more than 4 inches. This should ensure that people are safe. 3 OP38 13(4)(a) The registered person shall ensure All parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety The manager must complete risk assessments for health and safety with in the environment accessible to people living in the home and take necessary action to reduce the identified risks. This Requirement was not met with in the time scales set at our last inspection of 01/10/08. Because some work had been done towards completing this and the manager confirm she had completed a risk assessment and people were not at risk the time scale has been extended The registered person shall 01/09/09 not employ a person to work 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 1-7 of Schedule 2 The registered manager must ensure that the recruitment programme operating with in the home includes a completed enhanced police check (CRB) for all staff Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 29 01/09/09 4 OP28 19(b) 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 OP7 OP8 Good Practice Recommendations The manager should ensure that the reviews of care plans record what has changed when changes to care needs occur. A new call bell system, preferably one that can only be cancelled at source, is installed as the current system is unreliable and cannot always be heard by the staff. The laundry walls should be easily cleanable to reduce the risk of infection. The results of the quality audit should be proved for the people living in the home and the Commission The manager should ensure that the Commission is kept informed of any incidents that affect people living at Sea Point. 3 4 5 OP26 OP33 OP37 Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 30 Care Quality Commission South West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.Southwest@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Sea Point DS0000018423.V376384.R01.S.doc Version 5.2 Page 31 - 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!