CARE HOMES FOR OLDER PEOPLE
Summercourt Shute Hill Teignmouth Devon TQ14 8JD Lead Inspector
Mark Sharman Unannounced Inspection 14th March 2006 12:15 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 Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 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. Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Summercourt Address Shute Hill Teignmouth Devon TQ14 8JD 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) 01626 778580 01626 778782 Classic Care Homes (Devon) Ltd Rebecca Louise Coulson Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Application approved subject to Mrs Rebecca Coulson completing NVQ level 4 and RMA 09/11/05 Date of last inspection Brief Description of the Service: Summercourt is registered to provide care to elderly people from the age of sixty five. It is a detached house (listed building) which has been extended, situated less than half a mile from the town centre. There are two residents lounges and a separate dining room, and the home has a shaft passenger lift. All of the bedrooms are single rooms with the exception of one double, and all have an en suite WC. There are good views of the sea from several of the bedrooms. There is level access from the home’s front door onto a sizeable patio area. The garden is landscaped, with a seating area and a level walk leading to a small pond. The home has its own limited car parking, and it is usually possible to park in the street nearby. Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. About four hours were spent at the home during this inspection. Time was spent with two of the home owners (Mrs Coulson and Mrs Coxon), and three of the staff were also spoken with. Eight residents were spoken with, and a small sample of care records was examined. All of the communal parts of the home were seen, and several of the bedrooms. What the service does well: What has improved since the last inspection?
Most of the requirements and recommendations made at the last inspection have been dealt with. In particular improvements have been made to the medication system, and the activities programme is being expanded. Further improvements have been made to the building and equipment (see above). Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 Page 6 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. Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 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 Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 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): None of these was considered. (Standard 6 is inapplicable). EVIDENCE: Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 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): 9 and 10. The medication system is generally satisfactory. Residents feel they are treated respectfully and considerately by the staff and owners. EVIDENCE: The medication cupboard, the medication trolley and a sample of medication administration recording sheets were seen. Previously the sheets were being signed by staff before the medication was given to residents but, as required, they are now being signed at the time it is given. For most residents their medication is administered by the staff, but two self-administer some of their medication. At present these residents do not have a lockable space in their bedrooms in which to store the medication, and this must be provided in line with the Standard (this was the only omission identified). Mrs Coulson is supervising the administration of medication by the staff, and evidence for this practice was seen. The residents certainly feel that they are treated with respect, and all of those spoken with were very complimentary about the attitude of the staff and the owners. They were described as being caring, helpful and courteous. Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 Page 10 Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 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 and 15. Efforts are being made to increase the range and frequency of activities, and most of the residents feel that their social care needs are being met. The catering arrangements are satisfactory. EVIDENCE: It is clear that the owners are investing time, energy and money into expanding the activities available to the residents. In particular a bank of people (occupational therapy students) is being put together to provide a variety of activities on two or three afternoons each week. In fact two people were interviewed by Mrs Coxon for this purpose during the inspection. A projector has recently been bought to provide cinema afternoons for residents. Some trips out have been arranged, for which a minibus is hired. In February a group of residents was taken to a nursery in Exeter, and the owners said there will be more trips when the weather is warmer. Musical entertainment will continue to be provided every two or three weeks, and a clarinettist had entertained residents a few days before the inspection. All of the residents spoken with said they were satisfied with the meals provided, both as to quality and quantity. The lunch served on the day of the inspection looked appetising. A large bowl of fruit was available for residents to help themselves from. Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 Page 12 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. Residents are confident that any complaint would be taken seriously and resolved if at all possible. EVIDENCE: All of the residents who were spoken with said they were sure that the owners would do their best to deal with any dissatisfaction brought to their attention, and the same was said of the staff in general. No complaint was expressed during the inspection, nor has any complaint been received by the Commission for Social Care Inspection since the last inspection. The home has an appropriate complaints policy and a copy of this was displayed on the ground floor, and there is now a complaints log. Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 Page 13 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 and 26. The home provides comfortable accommodation, is well equipped to cater for the needs of its client group and is being improved. It was warm and clean. EVIDENCE: The residents were satisfied with the accommodation provided. All of the bedrooms are occupied singly, and there is a programme to redecorate them. The home is well located near the town centre, and a few residents said they are able to go out unaccompanied. Disability equipment includes a shaft lift, mobile hoists and assisted bathrooms. A new kitchen was being installed on the day of the inspection, and the owners said this will include a kitchenette for the use of visitors and those residents able to make use of it. This work had inevitably created some disruption in the kitchen and dining area, but otherwise the home was clean and tidy. Residents said that it is kept in that condition. The building was warm (the day of the inspection was a cold one). Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 Page 14 The laundry (lower ground floor) is well equipped with commercial equipment, and a sluice has been bought recently (not yet installed). Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 Page 15 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 and 28. Staffing arrangements are satisfactory, and there is an NVQ training programme for the care staff. EVIDENCE: From observations made the staffing levels at the time of this inspection were sufficient to meet the needs of current residents. Those residents spoken with who use their call bell said that there is normally a quick response from staff when assistance is requested. The consensus among residents was that there are normally enough staff on duty in the home. Residents said the staff are helpful and kind. The owners calculated that out of eighteen care staff four have achieved NVQ level 2 or 3 (certificates not seen), and five more are presently working towards this qualification. Two more wish to start but have to wait until September this year. Thus good progress is being made towards the 50 NVQ target, and this Standard should be fully met when that is achieved. Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 Page 16 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): 32. The home is well run by a competent management team, with an emphasis on continual improvement of the service. EVIDENCE: The four owners all have relevant qualifications, and the manager (Mrs Coulson) has a nursing background (registered general nurse and registered mental nurse). Mrs Coulson and Mrs Coxon are responsible for the day to day running of the home, and the staff on duty were complimentary about their attitude to the home and to the residents. Staff morale appeared to be high. A survey of the residents’ views on the service has been carried out, and a sherry morning is planned partly to gather further information. Three monthly staff meetings are held. Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 Page 17 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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 x x x x x x Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 Page 18 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 OP9 Regulation 13(2) Requirement A lockable space for storing medication must be provided for any resident who selfadministers medication. All staff must receive formal certificated training in the protection of vulnerable adults from abuse. Timescale for action 30/04/06 2. OP18 13(6) 30/06/06 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. Refer to Standard OP28 Good Practice Recommendations A minimum of 50 of the care staff should be qualified to NVQ level 2 or equivalent. Summercourt DS0000063892.V286010.R01.S.doc Version 5.1 Page 19 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
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