Inspection on 02/08/05 for Strand House

This inspection was carried out on 2nd August 2005.

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

Other inspections for this house

Strand House 23/11/06

Strand House 16/03/06

Strand House 18/01/05

Strand House 15/06/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Strand House The Strand Starcross Exeter EX6 8PA Lead Inspector Rachel Proctor Announced 2 August 2005 nd 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 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. Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Strand House Address The Strand, Starcorss, Exeter, Devon, EX6 8PA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01626 890880 Mr P E Pigott Mrs Pigott Mrs Piggott Care Home 8 Category(ies) of Old age, not falling within any other category registration, with number (8), Physical disability over 65 years of age (8) of places Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18/01/05 Brief Description of the Service: Strand House is a listed building that is registered as a Care Home for eight people over the age of retirement. It is a family run home which is set back from the main road that passes through Starcross, which is a small seaside town close to Exeter in the county of Devon. There are excellent views first floor front rooms over the estuary to Exmouth and beyond. Close to the home is the Starcross railway station offering direct access to Exeter and Cornwall via Newton Abbot. The home is registered to meet the needs of the elderly and the elderly physically disabled. It has been registered and run by the present owner’s since 1988 and has been improved and adapted to its present attractive and functional state over that time. The owner’s live on the premises and with the help of a small number of staff they run the home for the residents. There are six single rooms and one double room divided between each of the two floors that the Service Users accommodation is on. There is also a chair lift available for the residents to use if they wish. To the rear of the home there is a patio area and small area lay to lawn that is used by the residents when the weather is suitable. Being a small establishment the staff and Service Users have intimate knowledge of each others likes and dislikes that is often only possible in a small family type of home environment. Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The commission for social care inspection has introduced key standards to be inspected over each inspection year. Therefore, unless it is felt necessary by the inspector, some standards will not be inspected. To obtain a full picture of the home it is recommended that previous reports also be taken into consideration. This was an announced inspection and took place on the 2nd August 2005 between 9:30 a.m. and 3 p.m. The inspector talked to the residents and staff. A tour of the home and garden was completed with the manager and some records were inspected. What the service does well: What has improved since the last inspection? What they could do better: Only minor adjustments are required to enable the manager to fully meet the standards. Attention to detail and stock control of the medication will prevent out of date preparations being used thereby protecting the residents and ensuring the treatment creams they have will still benefit them. Cleaning chemicals used in the home were not stored in a locked cupboard and the information about the chemical content of the cleaning material (COSHH data sheets) had not been provided. This could pose a potential risk to the residents if they ingested or spilt chemicals on themselves. Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 Page 6 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. Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 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 standard(s) 1, 2, 3, 5, The commitment to continued re-assessment and re-evaluation of the residents care needs enables them to have confidence that their changing care needs will be met. EVIDENCE: The service users guide and statement of purpose were available in the reception hallway of the home. This contains the information about the care and the services provided. Copies of the service uses contracts were available in their files and contained all aspects expected. The information explained the services provided, the terms and conditions of occupancy, the notice period and the fees payable by whom. The registered manager has developed an assessment format that is used to assess the new residents referred. These were in use in the residence files viewed. The assessment template allows for the individual care needs of the residents to be re-assessed on a monthly basis. The way the assessments are provided allows for easy identification of changes in the care needs of the residents. Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 Page 9 Two residents told the inspector that they had been given the opportunity to meet staff at the home and visit prior to their admission to the home. The manager confirmed that prospective residents are encouraged to visit the home before making a decision to stay. A trial period of four weeks is provided for new residents to settle into the home and only a short notice period is required should they wish to leave during that time. Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10, The way the manager directs the care of the residents values their privacy, dignity, and choice and encourages independence in those things they are able to do for themselves. More care should be taken to ensure prescribed treatment creams for the residents are still within their use by date and will continue to benefit the residents. EVIDENCE: The care plan is produced from the initial assessment. These are easy to read and provide a clear picture of the individual care needs of the residents. Examples of the completed plans of care were seen during the inspection. There are systems in place to review the plans of care on a monthly basis. The ongoing assessment system in place is completed on a 4-6 monthly basis or less if the residents care needs change. The residents asked said the staff had discussed their plan of care with them. The residents said they were happy living and Strand house, commenting the staff were very friendly. They were also positive about the care and services provided under the direction of the manager. The district nursing service monitors the resident’s health care needs. Three residents who required wound dressings were having these attended to by the Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 Page 11 district nurse team. The residents told the inspector that the district nurse visited regularly. The medication is stored in a locked cupboard in the pantry of the home. Medication records had been completed as required. The system for assessing the resident’s ability to manage their own medication is in place. The manager explained how the pharmacy provides support for the home. The staff responsible for assisting the residents with their medication had received training. The training staff had received was recorded in their personal files. A review of the medication stored in the medication cupboard and residents rooms revealed some out of date prescribed treatment creams and lotions. The manager removed these during the inspection. The manager was aware that the prescribed creams, which were out of date, may no longer have the therapeutic benefits the resident requires. There appeared to be a genuine rapport between the residents and the staff on duty during the inspection. The residents were being treated in a respectful friendly way and their views and concerns were taken seriously. Requests for assistance were dealt with in a non-intrusive supportive way by the staff. Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14, 15, The residents find the lifestyle experience in the home matches their expectations and preferences and satisfies their interests and needs. EVIDENCE: The home has a range of activities available for the residents. The residents confirmed that they are asked about the activities they would like to take part in. A notice board in the reception areas are home displays forthcoming events and other information for the residents. The manager and the staff team encourage the residents to be as independent as they are able. They have a choice of what clothes they wear, what food they eat and the activities they want to participate in. Three residents advised that they enjoyed the regular and visits of the minister from the local church. Impromptu hymn singing followed with all joining in. The manager provided a template for resident’s questionnaires that asks about their views, likes and dislikes. The residents confirmed that the manager and the staff asked them whats important to them and what they like. The manager and the staff team were encouraging the residents to be as independent as they are able during the inspection. The residents manage their own affairs, which gives them greater independence of choice in what they wish to do with the time. Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 Page 13 The resident’s assessments include nutritional needs, these assessments had been reviewed on a regular basis. The inspector shared the lunchtime meal with five for the residents all said the food is always really nice and plenty of it and theyre given a choice if they dont like whats on offer. The lunchtime meal was unhurried with the residents eating their meals at their own pace. Those residents who had chosen to eat their meals in their rooms were facilitated to do this. Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 The residents of the Strand house can have confidence that any concerns they have will be addressed in a sensitive way by the staff team. EVIDENCE: The residents told the inspector that the staff who cared for them were approachable and understanding, any concerns they had were dealt with sensitively. The complaints policy is easily available for the residents and staff; this includes information on how the complaint would be dealt with, timescales and contact numbers. The manager confirmed that any issues raised by the residents are dealt with in respectful way. The home has policies and procedures in place for adult protection. Staff have access to training material to improve their understanding. Courses for staff have completed recently included managing challenging behaviour. Although the manager confirmed that this is not an issue within the home at present. The home has a robust recruitment procedure that protects the residents from unsuitable staff. A whistle blowing policy is provided for staff. The manager confirmed that all staff have a CRB check before starting work. The staff files viewed had copies of CRB available. Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 Page 15 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 standard(s) 19, 20, 21,23, 26 The residents at Strand House live in a safe and well maintained attractively presented environment, which has been adapted and personalised to meet their individual and collective needs. EVIDENCE: The listed building is tastefully decorated. It is set back off the main road running through Starcross and is close to the train station, beach, local shops and a public house. The tour of the home revealed that it was clean and fresh in all areas and free from odour. The manager provided a list of the repairs and renewals for the home, it was noted that some of these had already been completed. Records were kept of routine services on the equipment used. The residents have a sunny patio area where they can sit outside and enjoy the garden. Several residents were sitting in the garden on the day of inspection, all said they regularly liked to sit in the garden and have a chat or a Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 Page 16 cup of tea. This area is easily wheelchair accessible, although none of the current residents require a wheelchair at present. The home has a kitchen dining area with the dining space able to accommodate all the residents at one sitting. Two lounges are available for the residents use. The furnishings and fabrics of a communal space are of good quality and domestic in character and suit the needs of the residents. Toilets are easily accessible from communal areas and the resident’s own rooms. The washing and bathing facilities provided meet the needs of the current residence. Each of the residents room entered was pleasantly decorated, bright and contained items of the resident’s personal choice. The manager confirmed that the residents are asked about the decor in their rooms. Each room is carpeted and has a hand washbasin with storage under for the residents use. One shared rooms available, screening is provided. At the time of the inspection one resident was occupying the shared room. A call system is in place in each of the resident’s rooms, when this is used it can only be cancelled at the point of call in the resident’s room. The home was clean and fresh in all areas during the inspection. The manager confirmed that staff had access to training. The prevention of infection training had been provided from an external source. The homes washing machine is sited separately from the kitchen area. The clothes dryer is provided in an external building to reduce the noise and condensation for the residents. Hand washing facilities for the staff using the laundry equipment is available in a bathroom, which is close by. Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30, The residents are cared for by a competent friendly staff team who have their best interests at heart. EVIDENCE: The duty rota was provided, which showed the numbers of staff on duty throughout the day and night time shifts. Two members of staff and the manager were on duty throughout the inspection. The manager advised that the staff team provides the hours required to cover care. They cover shifts shortfalls to enable the residents to have a staff team caring for them that they know. The manager confirmed that she had recently appointed two new members of staff and was working with them to help them settle in and understand the standards required of them. The staff files seen support that the manager follows robust recruitment procedures when appointing new staff. References, POVA and CRB checks are provided. Completed application forms were available in the staff files viewed. However photographs are not provided of the staff employed. The manager confirmed that there is a minimal turnover of staff. The staff spoken to during the inspection advised that they enjoyed working at the home. The information provided and the staff certificates seen support that the staff team have training relevant to their work. Information provided in the preinspection questionnaire included a list of training staff had undertaken in the last 12 months. This indicated that the two new members of staff appointed had completed an induction course. Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) , 33, 36, 37, 38 For the most part the health, safety and welfare of the residents and staff is promoted and protected. However the failure to lock away the chemicals used and provided the relevant chemical data sheets could pose a potential risk to the residents. EVIDENCE: The manager continues to use the national minimum standards as a basis to assess the quality of the services provided. A further questionnaire has been developed by the manager to enable the residents to feedback their views about the home anonymously if they wish. The formal supervision and appraisal system has still to be introduced by the manager. However she has recently completed a training course for supervisors of staff which she feels confident will help in developing a system for the home. She advised that she plans to start this process in the next few months. The staff spoken to during the inspection said they felt supported to Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 Page 19 do their work. The manager confirmed that she regularly works alongside each member of staff and is able to supervise them in this way. The records required for inspection were available. These have been completed as required. The residents were able to confirm that they had been involved in the development of the information held about the care they required. These individual records are securely stored, up-to-date and in good order. Health and safety policies are in place for the staff, which should ensure safe working practices. The training staff had received included manual handling, fire safety, food hygiene and infection control. The cleaning materials used by the home are stored on the lower shelves of the food store area. However this room was not locked and could be accessed by the residents. Furthermore the information data sheets for the chemicals used in the home had not been provided. These practices could pose a potential risk to the residents. Risk assessments are an integral part of the management system the manager uses. These include risk assessments related to the individual residents care and the environment they live in, records of these were available for inspection. A system for reporting accidents and injuries is in place. Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x 3 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 x 14 3 15 4 COMPLAINTS AND PROTECTION 3 3 3 x 3 x x 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 Standard No 16 17 18 Score 3 x 3 x x 3 x x 2 3 2 Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 Page 21 yes 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 OP 9 Regulation 13 (2) Requirement Timescale for action Immediate 2. OP 38 3. OP 36 Service users prescribed treatment creams which are past their expiry date must be disposed of in line with the practice recommendations 13 (4) (c.) Cleaning chemicals used in the home must be stored securely Data information (COSHH) for the chemicals used must be available 18 (2) A record should be kept to evidence that supervision is taking place and should include areas such as those mentioned in the standard. 01/11/05 28/02/05 Extended 01/11/05 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. Refer to Standard OP 29 OP 33 OP 38 Good Practice Recommendations Clear photographs of staff should be provided for their staff file The results of quality audit should be available for the residents and the Commission The manager should have a fax machine available at the home D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 Page 22 Strand House 4. Strand House D54-D07 S3816 Strand House V231774 020805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 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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