Inspection on 04/07/06 for Templeman House

This inspection was carried out on 4th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Templeman House 01/08/07

Templeman House 24/02/06

Templeman House 27/10/05

Templeman House 02/12/04

Templeman House 11/08/04

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 Templeman House Leedam Road Bournemouth Dorset BH10 6HP Lead Inspector Martin Bayne Key Unannounced Inspection 8:45 4th July 2006 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 DS0000003903.V303087.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. DS0000003903.V303087.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Templeman House Address Leedam Road Bournemouth Dorset BH10 6HP 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) 01202 537812 01202 535022 www.care-south.co.uk Care South Mr Iain Slack Care Home 41 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 (6), Old age, not falling within any other category (41) DS0000003903.V303087.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 41 in the Category OP (Old Age) including up to 6 in the Categories DE(E) and/or MD(E). 24th February 2006 Date of last inspection Brief Description of the Service: The local County Council originally built Templeman House as a residential home in the 1960’s. The home is part of Care South - a non-profit making organisation and registered charity formerly known as The Dorset Trust. The Registered Individual (RI) for the company is Roger Fulcher. Templeman House is registered to accommodate 41 people over the age of 65 and in need of personal care and a maximum of 6 people with a mental health disorder or dementia. The home is situated in the residential area of Kinson - a suburb of Bournemouth, close to bus services, shops and local amenities. Residents’ accommodation is arranged over three floors. A passenger lift and two staircases enable easy access to all floors. All bedrooms are for single use although the home currently accommodates a married couple that have adjacent rooms close to a small communal lounge. Assisted bathing facilities are located on each floor. There home has two lounges, a spacious and comfortably furnished entrance and a large separate dining room on the ground floor with an additional small quite lounge. There are two smaller lounges and dining rooms/ kitchenette areas available on other floors. The home has off road parking for residents, visitors and staff and is set in mature enclosed grounds and gardens with a pond, raised boarders, lawns and a patio area. DS0000003903.V303087.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection of the home and took place between 8.45am and 3.15pm. The aim was to follow-up on the five requirements and five recommendations made at the last inspection and also to evaluate the home against the core standards. Mr Iain Slack, the registered manager assisted throughout the inspection. Twelve of the residents, two relatives who were visiting the home, and four members of staff were spoken with during this visit to the home. The case files for four residents and two members of staff were used throughout the inspection to track paperwork and records that the home is required to maintain. The fees for the home range from £425 - £515 per week. What the service does well: What has improved since the last inspection? What they could do better: Gaps in the recording of medication administered to residents were identified. An entry should be made on each occasion medication should be administered to residents. The uncovered radiators, particularly those in the communal areas pose a high risk to residents and action needs to be taken to have these covered. DS0000003903.V303087.R01.S.doc Version 5.2 Page 6 The staff recruitment form would benefit from being reviewed to seek information from candidates required by recruitment regulations. When new staff are recruited to work in the home they must not work with residents until the POVAfirst check has been returned. 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. DS0000003903.V303087.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 DS0000003903.V303087.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&6 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a needs assessment being carried out prior to being offered a place at the home. EVIDENCE: At the last inspection a recommendation was made that the Statement of Purpose be amended to inform of the room sizes, as some do not meet the standard of 10 square metres. Mr Slack informed that this was on the list of jobs to do but had not yet been done. The recommendation remains and it was also agreed that Mr Slack would check the information sent out to people who enquire about the home that there is locked door policy in place to protect those residents at risk of wandering from the home. The categories of registration were also discussed, as there is an identified need to accommodate more people in the category of dementia. It was agreed that Mr Slack would write to CSCI about this matter. When there is a vacancy at the home and a person is referred, the deputy manager is the person delegated to visit the person and carry out a preDS0000003903.V303087.R01.S.doc Version 5.2 Page 9 admission assessment. If the deputy manager is not available, the registered manager carries out the assessment. Prospective residents and relatives are also sent a full pack of information on the service that is provided. It was found in the cases of the residents sampled that a pre-admission assessment had been carried out and recorded. The form used by the organisation covered all of the topics detailed within the standards for older people. When a person is accepted for a place at the home they are informed in writing and a four week trial period is offered. The residents spoken with said that they or their relatives had been involved in the process of choosing the home. The home does not provide an intermediate care service and therefore standard 6 does not apply. DS0000003903.V303087.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 The Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from care plans being developed through the assessment process and their health needs met by a team of staff who respect their privacy and dignity. There could be some risks to resident through incomplete recording of medicines administered. EVIDENCE: At the last inspection a requirement was made with regards to the care plans as it was found that some care needs had not been updated onto the care plan. At that time a new system for recording care needs was being set up. At this inspection it was found that the majority of plans had now been updated to the new system. This format provides a clearer more user-friendly way of recording care needs for residents. It was also found that the plans were being reviewed each month and updated accordingly. The home has a good record management system. The residents’ files are divided into an archive file and working files. The working files are made available to the staff with a file for each floor of the building containing a copy DS0000003903.V303087.R01.S.doc Version 5.2 Page 11 of the current care plan. There is also another file for all the working documents for each resident, such as the daily recording sheets, treatment charts, a record of activities with residents and continence charts. At the last inspection a requirement was also made with respect to risk assessment, particularly where residents take responsibility for aspects of their own care. A new risk assessment form has been devised by the organisation that was very detailed and gave outcomes on how to reduce risks. Risk assessments were found to have been completed appropriately. On the day of inspection the weather was very hot and staff had been directed to ensure that residents were offered plenty of drinks. Fans were also available in some areas. Those residents who suffered form the heat had been identified and staff requested to keep an eye on them through the day. From the sample of care files seen there were examples of where the staff had supported residents to receive appropriate medical care. All residents are registered with a GP and appointments are made when there is a need. On the day of inspection the district nurse was visiting the home and the manager said that there were good relationships with the GP surgeries and the district nurses. A chiropodist visits the home every 12 weeks; an optician visits the home and also a dentist. The residents spoken with said that the staff respected their privacy and dignity. Staff knock on residents doors before entering and residents can lock their bedroom door should they choose. Staff are trained at induction on how to treat residents and the expectations of the organisation concerning values. A referral has been made to the CSCI pharmacist to carry out an inspection of the medication procedures for the home and therefore not inspected on this occasion. It was noted however that there were some gaps in the medication administration records within the archived files for the residents tracked though the inspection. A requirement was made as a record needs to be maintained for all occasions when medicines are administered. DS0000003903.V303087.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit through being supported with recreational and spiritual needs and also through being able to maintain contact with their families. Residents benefit from a wholesome, balanced diet. EVIDENCE: Within each assessment for the residents files sampled there was a brief history taken so that activities appropriate for that person can be organised. The history can often also be helpful in understanding the behaviours of the residents accommodated with dementia. At the last inspection a requirement was made concerning the development of activities for residents. Mr Slack has met this through introduction of a recording sheet that staff complete regarding individual activities with residents. The home employs an activities co-ordinator, who is due to shortly return to work after a period of maternity leave. On the day of inspection one of the staff was taking an exercise group with some residents in one of the lounges and in another area music was being played. Other activities organised in the home include ‘Pat the dog’, bingo, quizzes, and sing-alongs. Mr Slack said that he hoped in time to develop one DS0000003903.V303087.R01.S.doc Version 5.2 Page 13 of the lounges into a room specifically to meet the needs of the residents with dementia. In respect of spiritual needs, a catholic priest visits the home for a Holy Communion Service and a group from the local Methodist church visit for hymn singing. Mr Slack informed that this was to be developed with a full service being held in one of the lounges. The residents spoken with informed that their visitors were made welcome at the home and there are small lounge areas where residents can receive their guests. On the day of inspection one resident was being visited. They informed the inspector that they visit from another county every month and that they were very happy with the care provided at the home. The residents spoken with said that they were able to exercise control over their lives in relation to what time they chose to go to bed and when to get up. One resident said that they had special dietary needs that were catered for and that they could have meals in their rooms if they chose. All of the residents spoken with said that the food was of good standard and that a choice of meal is always provided. DS0000003903.V303087.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Residents are protected through a well-publicised complaints procedure, policies and procedures for adult protection and staff training in this field. EVIDENCE: The home has a full complaints procedure that complies with the standards for older people. The complaints procedure is displayed on the residents’ notice board, within the terms and conditions of residence and also within the Statement of Purpose, so relatives and residents are both well informed on how to complain. Since the time of the last inspection there has been no complaints made to the management of the home. One concern was made known to CSCI and it was requested that that registered manager investigate. This matter was resolved to the satisfaction of all parties. The home has all of the policies and procedures for the protection of vulnerable adults. All of the staff receive training in this field. DS0000003903.V303087.R01.S.doc Version 5.2 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 the following standard(s): 19 & 26 The Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The high risks posed by some of the radiators and the hot water outlets of some taps, poses a significant risk to some of the residents. Residents benefit from infection controls measure being in place at the home. EVIDENCE: The home has three floors and a passenger lift that allows level access to all areas of the home. Mr Slack informed that the lift is going to be out of action for a period of about 10 days due to major maintenance. This will mean that the residents who are not able to manage the stairs will have to remain on the floor of their bedroom for this period and use the communal areas on their floor. Residents and relatives have been informed of this situation. The home has six lounges and three dining rooms. The four main lounges are sited on the ground floor, as is the main dining room. One of the lounges has been designated a smoking area for the resident who smoke. Mr Slack DS0000003903.V303087.R01.S.doc Version 5.2 Page 16 informed that the residents do not use some of the lounge areas. This had been the case for one of the small lounges on the ground floor, which was redecorated with a small feature fireplace making this a cosy and now popular room with some of the residents. He explained that it is his intention to work with residents to make all the lounges more pleasant and useful to the residents. At the last inspection a requirement was made to update the risk assessments concerning the radiators and the hot water outlets. Radiators in residents’ bedrooms have been covered but not those in some communal areas, corridors, bathrooms and toilets. Thermostatic mixer valves have been fitted to the outlets of the baths but not to the wash hand basins in residents’ rooms. It was found that the risk assessment have been updated with reference to the current residents. A tour of the building was made and the temperature of the water felt from some of the hot water outlets. It was evident that some radiators and for some residents the hot water outlets, could pose a high risk. Where a risk assessment has identified that a radiator poses a high risk to residents, it must be covered and where a hot tap poses a risk to a resident the home must be able to demonstrate what action has been taken to minimise the risk. The home must send a plan to CSCI on the actions to be taken for these risk assessments that identify a high risk. The home was found to be clean and free from unpleasant smells. The home has a large well-maintained garden to the rear that is enclosed. The pond has been made safe with a fence around its perimeter. All of the staff have been trained in infection control issues and are provided with protective clothing. The home has policies and procedures and notices for hand washing were displayed around the home. The home has a sluice and there are plans for one to be provided on each floor. The home has two commercial washing machines and two dryers. Alginate bags are used for soiled linen. DS0000003903.V303087.R01.S.doc Version 5.2 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 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 The Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents needs are met through a well trained staff team. Having staff work shadow with another member of staff before the POVAfirst check has been returned, poses a small risk to residents. EVIDENCE: In addition to the registered manager the home has a deputy manager; four care team managers, a senior care assistant and 22 care staff. Between 7.15 – 14.30 there are 5 staff on duty; between 14.30 – 15.00, 3 staff; 15.00 – 15.30, 6 staff; 15.30 - 21.30, 5 staff and between 21.30 – 22.00, 3 staff. During the night time period there are two waking night staff and an on-call duty manager. The home also employs a laundry assistant 7 days a week for 4 hours a day, a dining room assistant 7 days a week for 3 hours a day, five domestic staff, a chef and assistant chef, four kitchen assistants, an activities co-ordinator and an administrative. A staff duty roster was seen that reflected the above. The residents spoken with and Mr Slack felt that this level of staffing met the needs of the current resident population. 48 of the care staff have now been trained to NVQ level 2. New staff receive induction training that is compliant with best practice guidelines. The home provides core mandatory training to staff in health and safety, moving and handling, infection control, basic food hygiene, first aid and DS0000003903.V303087.R01.S.doc Version 5.2 Page 18 adult protection. There is also a range of other care related courses to which staff can be nominated. A small group of four staff were spoken with who informed of the high demands of the job and the higher level of dependency of the residents now accommodated in the home. Staff identified training needs for residents who present with challenging behaviour and it is recommended that this be looked at through the supervision and appraisal system for the organisation. A sample of two staff recruitment files were seen, one for a member of staff recruited since the last inspection and one for a member of staff recruited prior to this. For the member of staff recruited since the last inspection all the required checks and records were in place, however for the other member of staff it was found that they had started their induction by shadowing another member of staff in the home prior to the POVA First check having been returned. Staff should not have contact with residents or access to confidential information concerning residents until they have been checked against the protection of vulnerable adult list. It is recommended that the staff application form be amended to request information reflecting changes to the Regulations of July 2004, such as a reference from the applicant’s previous place of employment working with vulnerable adults. DS0000003903.V303087.R01.S.doc Version 5.2 Page 19 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 38 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and run in the interests of the residents. Small sums of money deposited for safe keeping is well audited. Health and safety is promoted in the home. EVIDENCE: Since the time of the last inspection Mr Slack has been registered as manager of the home. Effective systems were in place for planning and delivering care to residents. The home carries out an annual quality assurance survey involving residents and relatives. The recommendation made at the last inspection that recommendations from the previous audit be actioned will be met on the return of the activities coordinator, as they are instrumental to this process. DS0000003903.V303087.R01.S.doc Version 5.2 Page 20 The home safe keeps small sums of money on behalf of residents. This is managed through the registered manager or deputy. The records and balance of money for three residents were checked and the records tallied with the balance of money held. On the day of inspection the fire safety system was being serviced through a contractor. DS0000003903.V303087.R01.S.doc Version 5.2 Page 21 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 X 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 1 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000003903.V303087.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 1. OP9 Regulation Schedule 3 (3) (k) Requirement Records of medication administered must be maintained with no gaps in the record Where a risk assessment has identified a significant risk, such as the risk posed by the radiators or the hot water, action must be taken. Staff must work with residents, i.e. work shadow until the POVA first check has been returned. Timescale for action 24/07/06 2. OP19 13(4)(c) 01/10/07 3. OP29 Schedule 4 24/07/06 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. Refer to Standard OP1 OP33 Good Practice Recommendations The homes statement of purpose should provide information about the undersized bedrooms in the home. The temporary manager should draw up an action plan to demonstrate the actions taken to meet the recommendations identified in the homes’ quality assurance audit report dated May 2005. It is recommended that the staff application form be amended to seek information to changes in the regulations of July 2004 3. OP29 DS0000003903.V303087.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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. Extracts may not be used or reproduced without the express permission of CSCI DS0000003903.V303087.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!