Inspection on 27/07/06 for St Petroc`s Care Home

This inspection was carried out on 27th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

St Petroc`s Care Home 06/11/07

St Petroc`s Care Home 17/11/05

St Petroc`s Care Home 15/06/05

St Petroc`s Care Home 02/12/04

St Petroc`s Care Home 20/07/04

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 Petrocs Care Home St Petrocs Care Home St Nicholas Street Bodmin Cornwall PL31 1AG Lead Inspector Anita Sutcliffe Unannounced Inspection 27th July 2006 08:15 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 Petrocs Care Home DS0000051613.V302887.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 Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Petrocs Care Home Address St Petrocs Care Home St Nicholas Street Bodmin Cornwall PL31 1AG 01208 76152 01208 264663 stpetrocs@stone-haven.co.uk 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) Stonehaven (Healthcare) Ltd Miss Fiona Mary Searle Care Home 30 Category(ies) of Dementia - over 65 years of age (6), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (3), Old age, not falling within any other category (30) St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To admit one named service user between the age of 60 & 65 years Total number of service users not to exceed a maximum of 30 Date of last inspection 17th November 2005 Brief Description of the Service: St. Petrocs Care Home is registered to provide accommodation and personal care for up to 30 older persons six of which may have dementia or three of which may have a mental disability. The home is situated in Bodmin, Cornwall benefiting from its closeness to shops, public transport and local community facilities. It is a detached house, set back from the road within large wellmaintained grounds and ample parking space provided to the front of the property. There are bedrooms on the ground and first floors with a passenger lift and stair lift provided to assist service users. Shared communal space is provided through the lounge, dining room and conservatory areas. The home has been under the ownership of Stonehaven (Healthcare) Ltd since November 2003 and the management of Fiona Searle since December 2002. Fees are between £293 and £400 per week. Additional charges are made for chiropody, hairdressing, toiletries, newspapers, taxis and transport. Prospective residents are sent a brochure containing the home’s Statement of Purpose, Service Users’ Guide and information about Stonehaven Healthcare Ltd. The last inspection report is openly displayed in the front conservatory. St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 6 hours on the 27th July 2006. The purpose of the inspection was to assess the homes compliance with Key National Minimum Standards. The inspector reviewed progress on a previously set requirement and recommendation communicated following the homes last inspection in November 2005. . Care Practise was observed, care records and documentation were viewed. Four residents (service uses), five staff members and the registered manager were spoken with. The majority of residents were met either in the communal areas or in the dining room. Prior to the visit written feedback was received from seven resident’s family, and verbal communication from a health care professional that regularly visits the home. What the service does well: What has improved since the last inspection? What they could do better: It is unsafe practice to dispense medicines into pots prior to taking them to the resident. Medicines must only be dispensed directly to the resident for who they are prescribed so that mistakes are avoided. Where an entry is made in the Controlled Drugs record the correct balance should be recorded. In this case staff were recording the number returned not the number remaining. St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 6 Where it is necessary to hand write an entry in the medicines administration record it is recommended that two staff check the entry and sign to confirm its accuracy. This will help prevent mistakes. The resident surveys, used to help identify areas for improvement in the service, should be improved as currently the information requested is very limited. The registration certificate of the home must reflect its true and up to date situation. A change in information had not been reported to the Commission so that the certificate could be updated. 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. St Petrocs Care Home DS0000051613.V302887.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 Petrocs Care Home DS0000051613.V302887.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 does not apply to St. Petrocs) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care needs are met following thorough assessment and planning. EVIDENCE: The care records of two newly admitted residents were examined. Although still incomplete, one resident having only been admitted the day before, all relevant information was available. One of the residents was spoken with in her room. This visit confirmed the accuracy of the written assessment. Either the manager or senior care assistant undertake assessment when the admission is from within the district. If outside the district the home never admits without receipt of an assessment, from which the care needs of the resident are identified and a plan of how to meet those needs is formulated. It was not evident in every case who was involved in the assessment and care planning. St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Health care needs are understood and met by caring, knowledgeable and competent staff. The system used for the recording and storage of medicine to be administered to the residents had the potential to place the residents at risk. Residents are treated with respect and with full regard for their privacy and dignity. EVIDENCE: Care plans contained the detail from which the health, social and personal care needs of residents can be consistently and effectively met. Few residents were able to contribute an opinion about the care provided, but one said he felt well looked after. A district nurse who attends the home said: “The staff identify health care problems and access help quickly. The standard of care is pretty good”. Residents appeared well care for and family comments were unanimously positive and include: “Staff treat residents as individuals and St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 10 cater for their needs. A lot of time is given if a resident falls ill. Well done!” and “Excellent caring staff”. The main quantity of medication is stored safely at the home. Although not yet available a medicines fridge, and more robust controlled drugs cupboard, is being purchased. In the interim storage is still satisfactory. Medicine records were well organised and all medication was checked into the home for safety. It is recommended, so as to further increase safety, that two staff check and record the accuracy of hand written entries. Named labels found indicate that staff are putting medicines into labelled pots prior to administration. This is unsafe practice. The registered manager, and senior care assistant who organises medication at the home, said this was not the home’s policy and would correct it immediately. The controlled drugs record was orderly but did not state the correct balance due to a misunderstanding by the staff. Stock was checked as correct. Staff were observed being respectful to residents and information received from the district nurse confirmed that this is normal. Residents have the option to lock their door should they wish, and those who have chosen to share a room have screens available to them. St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to have a fulfilled life. Residents receive a nutritious varied diet, which meets individual choice and health care requirements. EVIDENCE: A full programme of events provides residents the opportunity to join in many activities, including musical, exercise, social (including BBQ and fete) and ‘pampering’. Evidence was seen of recent word games, and a new cards table has been provided. Residents confirmed that these events take place, but say that few residents choose to participate. Assessment records contain information on each resident’s hobbies and interests, and the manager said that each is helped to pursue those interests, which may not be as a group activity. A resident confirmed that he is able to spend the day as he wishes, and another had chosen to spend the morning resting. The home’s staffing arrangements provides opportunity for assistance at times more suited to the St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 12 resident, rather than staff. There are no visiting restrictions at the home, and visitors are provided with tea or coffee. Two residents confirmed that they enjoyed their lunch, and the inspector sampled fish cake and salad, which was pleasant. Fresh fruit is now available at the home, and drinking water was available in bedrooms and from a cold drinks dispenser in the entrance lobby. The dining room is extremely attractive and trays are neatly laid for those residents who wish to eat in their room. Staff have received training in nutrition and diet, and the home monitors the weight and diet of residents, providing supplements where concerns are identified. St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from the way complaints to the home are managed. Residents are protected from abuse. EVIDENCE: The home’s complaints procedure is well displayed for resident or relative/visitor use. Relatives also confirmed prior to inspection that they were aware of how to complain, but none had done so. The home has not received any complaint in years. Neither has the Commission received a complaint about the home. Staff receive training in the protection of residents from abuse. The manager is fully aware of how to respond to an allegation of abuse, and has recently acted promptly and correctly to such. Staff have a Whistle Blowing policy and complaints policy available for their use. These contain contact details for the Local Authority Vulnerable Adults team and the Commission. This further protects residents as concerns can be taken ‘out of house’ should staff feel the need to do so. St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, homely, and pleasant and meets current residents needs. Hygiene is well maintained. EVIDENCE: The home is very attractive, with quality fittings historic to the house. There is a choice of sitting room and attractive entrance, conservatory and dining room for resident’s use. Although there are no adaptations specific for residents with dementia, the registered manager felt that currently this did not pose a problem for them. Staff work hard to maintain cleanliness, a resident commenting: “They’re always hoovering here”. Staff have protective clothing, liquid soap and paper St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 15 towels available to them to maintain hygiene, and prevent cross infection. The laundry contains equipment suitable to the home’s needs. The gardens are attractive. There are handrails available on the pathway. However, the lawns slope, which restrict their use to the more mobile residents. The home contains many steps. There are stair and vertical lifts available in most cases. Residents would benefit from additional handrails in the wide hallways, but the unique layout of the home restricts this possibility. Service records indicate that all equipment is serviced and problems identified are dealt with. Currently areas identified for maintenance are a stair lift with an arm missing, ceiling damaged by water, a bath and a corridor carpet. The stair lift and carpet are hazards to resident safety, but arrangements are in hand for replacement and maintenance. Fire safety is well handled; staff were knowledgeable and consistent on how to respond to the fire alarm. St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff are appropriate to meet the needs of current residents, who benefit from their professionalism and competence. Residents are protected by robust recruitment practice. EVIDENCE: Residents, their families and a health care professional who visits the home, expressed complete confidence in the staff knowledge and competence. Staff are professional in their work and undertake regular training. This has included: dementia care, first aid, equality and diversity, safe handling of medicines, healthy eating, fire safety and protection of vulnerable adults from abuse. Nearly 60 of care staff have achieved NVQ level 2 in care, some level 3 and one has nearly completed level 4, another indicator of staff competence. Recruitment at the home proves to be difficult and staff are working additional hours to maintain a satisfactory ratio of staff to resident. Staff confirmed that they are happy to do this. One resident commented that the home is: “terribly understaffed” but confirmed that he was worried about them working so hard, not that he was affected by a lack of staff. One relative also commented on staff numbers. Care staff are also expected to undertake domestic duties in addition to providing care. These include laundry and cleaning. There is currently no indication that residents’ needs are not fully met. St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 17 The registered manager has the responsibility for staff recruitment at the home. Records indicate that this is done correctly, so that only staff suitable to work with vulnerable adults are employed. St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 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 home is very well managed and run in the best interest of residents. The health and safety of residents could be more fully promoted. EVIDENCE: The manager has achieved the Registered Manager’s Award and has maintained her registration as a general nurse. She has much experience in managing the care of older people and those with dementia. She has a relaxed, open approach but expects and achieves high standards from staff. Both residents and staff have confidence in her management. She is well supported by a senior member of the care staff who has almost achieved NVQ level 4 in care. St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 19 The provider’s quality assurance policy ensures that residents may have a say in the service they receive. The surveys provided are however very limited in their scope and there are plans to develop new, and more informative ones. The manager also undertakes her own surveys, looking at specific areas such as food and activities. There are regular resident and staff meetings and evidence that areas identified for improvement have been so. These include improved quality in food provided and choice of activities. Professional opinion on the service is also sought. The providers are required to undertake a monthly, unannounced visit to the home so assess standards. The July report from this visit was detailed and informative and should lead to continuing improvement at the home. Few residents are able to look after their own finances. An allowance is kept on behalf of some residents. This was kept in a secure place and with good records kept and a monthly audit of the amount. Each resident has a lockable storage space within their room for the safe keeping of items of value. A senior member of staff supervises practice. Staff felt that they were appropriately supervised and supported in their work. Each staff member receives a yearly appraisal. They also receive a two monthly one to one supervision, at which care practice is discussed and training needs identified. The home is required under the Care Standards Act 2000 to display their certificate of registration, which must reflect the true status of the home. The certificate displayed at St. Petrocs contains inaccurate information, which has not been brought to the attention of the Commission. Health and safety at the home are managed through staff training, the purchase and servicing of equipment and a programme of maintenance. There are maintenance issues (see Environment) currently being dealt with. The home should expand the scope of risk assessments; one pond was risk assessed but not the other. Individual risk assessments were also limited, an example being the hazard of having to use steps to reach a bedroom. St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 2 2 St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? 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 OP9 Regulation 13 Requirement Medicines must be administered directly to the resident for whom they are prescribed, not put into medicine pots prior to their administration. The Registered Provider must ensure that the certificate of registration contains accurate information. Timescale for action 27/07/06 2. OP37 S 28 C.S. Act 2000 31/08/06 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. 3. 4. Refer to Standard OP9 OP9 OP9 OP33 Good Practice Recommendations The Controlled Drugs record should reflect the true balance of those drugs stored within the home. Hand written entries in the medicines record should be checked and signed by two staff to ensure accuracy. The home should acquire a dedicated medicines fridge and Controlled Drugs cabinet to conform to the Misuse of Drugs (safe Custody) Regulations 1973. The registered person should expand the scope of the surveys so that service users may express their views DS0000051613.V302887.R01.S.doc Version 5.2 Page 22 St Petrocs Care Home 4. OP38 fully. The home should expand its assessment of risk at the home to include all potential hazards, including those to individual service users. St Petrocs Care Home DS0000051613.V302887.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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