Inspection on 31/10/06 for St Breock

This inspection was carried out on 31st October 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

St Breock 30/09/08

St Breock 31/01/06

St Breock 05/08/05

St Breock 11/01/05

St Breock 27/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE St Breock Whiterock Wadebridge Cornwall PL27 7NN Lead Inspector Mike Dennis Key Unannounced Inspection 31st October 2006 10:00 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 St Breock DS0000009067.V318069.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. St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Breock Address Whiterock Wadebridge Cornwall PL27 7NN 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) 01208 812246 01208 815944 Cornwall Care Limited John Phillips Care Home 38 Category(ies) of Dementia - over 65 years of age (12), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (12), Old age, not falling within any other category (26) St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 2 adults aged between 55 and 65 years Total number of service users not to exceed a maximum of 38 Date of last inspection 31st January 2006 Brief Description of the Service: St. Breock is one of 18 care homes registered by Cornwall Care Ltd. Cornwall Care Ltd is registered in respect of St.Breock to provide personal care and accommodation for up to 38 older persons, some of whom may also have dementia. The building is an H shape with the entrance hall and communal space in the middle and two wings on either side containing the service users bedrooms, bathrooms and toilets. The accommodation is offered in 34 single rooms with 2 shared rooms available, all on the ground floor with level access. St.Breock is situated close to the local shops, public transport and community facilities of Wadebridge. The home is a large building situated in wellmaintained grounds with car-parking facilities available. In addition to the registered care home services, various community services are organised from the building and a day centre accommodating 15 older people is provided St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 31st. October 2006 over a seven hour period. The inspector met with the Registered Manager and an assistant manager. A selection of staff were spoken with and four service users. One relative also stated their views concerning the home which proved to be positive. During the course of the day the inspector observed groups of service users engaged in a number of activities. Staff were observed to be tending to service user needs whilst respecting their dignity. Various records, policies and procedures were inspected. The inspector visited all parts of the building and noted a satisfactory standard of hygiene and maintenance. Service users commented favourably on the overall service received, and acknowledged the dedication of staff. Positive outcomes were noted. What the service does well: What has improved since the last inspection? The recommendations made by an environmental health inspection have been complied with. Staff turn over has improved and the use of agency staff has been greatly reduced. As a consequence staff appear settled and positive. St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 6 The number of staff that have now obtained an NVQ award has increased to 75 . In discussion with the manager, he felt that there was more choice available in the activities offered. He also felt that communication with, and involvement of relatives, had improved. 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. The summary of this inspection report can be made available in other formats on request. St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are given comprehensive information about the home to enable them to make the choice of whether or not they wish to live there. Each service user has a written contract/statement of terms and conditions. Service users are fully assessed prior to admission to the home. EVIDENCE: The inspector discussed the home’s Statement of Purpose. This document is currently being reviewed to ensure it reflects the service provided by the home. St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 9 Four service user files were inspected and case tracked. All contained information pertaining to pre-admission assessment. The information provided included :- continence assessment, pain assessment, risk assessments and general details of daily care requirements, medication and health care requirements. The pre-admission assessments form the basis of the initial care plan. Training is supplied to support this programme. The assessment process is undertaken by the managers of the home. Assessments are undertaken with the service users family or representatives, health professionals, and a copy of the social services assessment is obtained where applicable. The assessment includes a scoring system for calculation of dependency. A contract or statement of terms and conditions is in place in respect of each service user. Prospective service users and their relatives are given every opportunity to visit the home prior to making decisions about admission. St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health care needs of service users are identified, planned for and met. Comprehensive policies and procedures for dealing with medicines are followed Service users are treated with dignity and respect. EVIDENCE: The service user’s health, personal and social care needs are set out in an individual plan of care, that is based on the pre admission assessment and reviewed monthly. Service users and / or their representative are included within the planning of care wherever possible. St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 11 The daily recording is, in the main, full and detailed, evidencing social and health needs of individual service users. These continuity records should depict a picture of each persons life at the home to include interests and activities accessed, outings and other significant events. In a few cases there is a gap in records for up to five days. Appropriate professionals from other disciplines frequently visit the home to provide for general health care, ie. G.P’s, Community Nurses, Opticians, Dentists etc. The home has full and comprehensive policies in relation to medication. A rigid procedure for the administration of medicine is followed at all times. The controlled drugs register was inspected and quantities of tablets counted. They were correct. Storage of controlled drugs complies with drug regulations. Two service users are self-medicating and have lockable facilities in their rooms. Staff were observed to treat service users with respect and it was noted that staff knocked at bathroom and bedroom doors before entering. General practitioners examine and treat all service users in the privacy of their own bedrooms. Service users expressed satisfaction with the care they are receiving. St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines of daily living and activities made available are flexible and varied. Service users receive visitors at any reasonable time throughout the day. Service users dietary needs are well catered for with a balanced and varied selection of food and drink available that meets tastes, and choices EVIDENCE: The service users individual care plan has a detailed section regarding their interests and choice, and activities are planned to encompass these interests. The home arranges and facilitates visiting entertainment and in-house activities. Regular outings are arranged. Planned activities are displayed on a notice board. Flexibility is achieved throughout all aspects of daily living. St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 13 Social Profiling or Active Care is promoted at this home. This in turn allows staff to target individual service users with activities most likely to provide stimulation The above statements were confirmed by service users and staff. The kitchen and food preparation areas were inspected. Before entering the kitchen, the inspected was asked to don an apron and sterilise his hands. All areas were clean and food was appropriately stored. Records relating to temperature control and cleaning schedules were in evidence. The requirements made by an environmental health inspection last January have been complied with. The main meal of the day was observed. It proved to be a very social occasion with all seemingly enjoying their meal. Service users stated that they enjoyed the various activities arranged for them. St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered persons ensure that service users are protected from all forms of abuse. The legal rights of service users are protected. The complaints procedure is well publicised and used when required with staff having knowledge through training of Adult Protection issues which helps to protect service users EVIDENCE: A comprehensive complaints policy and procedure is kept within the home. This procedure includes timescales and who will deal with the complaint. The home also keeps a complaints log for ease of reference. Service users indicated that they were aware of the procedures. There have been no recorded complaints since the last inspection. The home is registered under the Data Protection act. Solicitors and advocates are arranged for those who require such services. The home has a comprehensive policy and procedure in place to protect service users from abuse. Staff are made aware of these procedures during the induction period. The manager is also aware of the local social services St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 15 procedure within “No Secrets” to investigate any complaints regarding the suspected abuse of any service user. CRB and POVA checks are undertaken, with Cornwall Care being the umbrella body to obtain these checks. St Breock DS0000009067.V318069.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, 20, 21, 22, 23, 24 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The location and layout of the home is suitable for it’s stated purpose and provides a safe and well maintained environment. Private and communal accommodation is of a good standard although some bedrooms are on the small side. The home was clean, hygienic and free from offensive odours providing an attractive and homely place to live. EVIDENCE: St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 17 The home provides a safe and well-maintained environment for the service users. The manager discusses refurbishment and development issues with the company at the annual finance meeting. This results in a maintenance and improvement plan being implemented. The home employs a general assistant who deals with minor defects and maintains general standards within the home. Re-decoration of bedrooms occurs when each room becomes vacant. . It was noted that, on inspection of the premises, all was found to be clean and tidy. Equipment was working correctly and in order. Policies and procedures for the control of infection were available and in order. Service users stated they were happy with the accommodation and their surroundings. The building was inspected and communal areas and private bedrooms were pleasantly decorated. Bedrooms displayed the personal effects of their occupant. St Breock DS0000009067.V318069.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, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust recruitment policies and procedures are implemented. All staff are supported and Inducted through good training opportunities. A positive number of staff are on duty to meet the service user’s needs EVIDENCE: The staff team shows a positive regard for service users and appears very organised. Additional staff are on duty at peak times of activity during the day. The home provides up to 4 care staff at peak times of activity with reduced levels supported by management staff during other periods. 2 waking night staff plus an on-call manager are provided for service users that require attention at night. A general assistant/driver, catering, laundry and domestic staff are employed. Staff recruitment is conducted in line with the home’s policies and procedures. Evidence obtained from staff files indicates that references, CRB and POVA checks are taken up prior to interview. All staff undertake Induction Training. . NVQ training is encouraged as demonstrated by the majority of staff having obtained awards at various levels (75 ). Individual training profiles for staff St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 19 are kept up to date with accurate information of progress made. Staff are receiving supervision and an appraisal system is in place. Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their quality of life. St Breock DS0000009067.V318069.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, 32, 33, 36, 37 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of St. Breock strive to maintain and improve a good quality of care and lifestyle for the service users and promote their health, safety and welfare EVIDENCE: St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 21 The manager has a range of experience and qualifications to include an NVQ level 3. He is now commencing the NVQ4 award and the Registered Managers Award. The annual Quality Assurance survey is currently underway. The records of the home demonstrated that all staff are appropriately supervised and subject to annual appraisals. General records as required by legislation were found to be appropriately maintained. The health and safety file and attendant documents were inspected. It was noted that all was up to date. St Breock DS0000009067.V318069.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 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 3 St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? None 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. Refer to Standard OP7 Good Practice Recommendations It is recommended that a daily entry is made in the continuity records so that a full picture of each service users life at the home is discernable. St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 St Breock DS0000009067.V318069.R01.S.doc Version 5.2 Page 25 - 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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