Inspection on 17/01/06 for The Grand Panorama

This inspection was carried out on 17th January 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

The Grand Panorama 30/09/08

The Grand Panorama 05/11/07

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Grand Panorama 57 South Road Weston Super Mare North Somerset BS23 2LU Lead Inspector Alison Murray Announced Inspection 17th January 2006 09:30 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 The Grand Panorama DS0000065085.V277853.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. The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Grand Panorama Address 57 South Road Weston Super Mare North Somerset BS23 2LU 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) 01934 417791 Alutarius Ltd Mrs Catherine Mutongwizo Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 23 people aged 65 years and over who may require nursing care. May also accommodate one person aged 50 years and over, who has a physical disability (subject to the inspectors agreement) May continue to accommodate those residents aged less than 65 years, who were placed prior to November 2005 The registered provider must provide CSCI with a detailed plan for refurbishment within three months of registration, to improve the quality of the accommodation, access arrangements and bathing facilities Patients with mobility problems must not use those rooms accessed by steps. N/A 2. 3. 4. Date of last inspection Brief Description of the Service: Grand Panorama is registered to provide nursing and personal care to up to 23 older people. The converted property is situated on the hillside above Weston Super Mare. Many rooms enjoy panoramic views over the town and bay. There is a bus stop just outside the home, but a steep drive means that visitors with restricted mobility may find it difficult to reach the building. Internally, the home is in need of major redecoration and refurbishment. Mr and Mrs Coombes, trading as Alutarius Ltd bought Grand Panorama less than a month ago. They have successfully carried out similar refurbishment projects in other areas, and have provided CSCI with detailed plans for the proposed work. In particular they plan to improve access arrangements and communal bathing facilities within the home. Mrs Mutongwizo is the registered manager of Grand Panorama. She and the existing staff have remained in post over the transfer period. Mr Plummer, senior manager for the company, supports Mrs Mutongwizo in her role. The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was planned to give Mr and Mrs Coombes, a ‘baseline’ assessment of how Grand Panorama performs against the National Minimum Standards. They bought the home less than a month before the inspection, so have had little opportunity to influence the service offered. A significant proportion of the 8.5-hour inspection was spent reviewing documentation, and in discussion with Mr and Mrs Coombes, Mr Plummer, and Mrs Mutongwizo. The estates manager for the company provided a detailed overview of the proposed refurbishment work. All areas of the home were inspected. During the inspection, nine of the fifteen residents, and one visitor were consulted. Comments cards were received from 6 residents and 5 relatives. The inspector spoke informally to 4 staff members, and observed others as they went about their work. What the service does well: What has improved since the last inspection? N/A The Grand Panorama DS0000065085.V277853.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. The Grand Panorama DS0000065085.V277853.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 The Grand Panorama DS0000065085.V277853.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): 1, 2, 3, 4, and 5. Standard 6 does not apply New residents will be provided with good information about the home and the range of services it offers. The current terms and conditions document does not make it clear what fee is to be charged, and who is responsible for paying this. EVIDENCE: Mr and Mrs Coombes have produced a new statement of purpose and service user guide. These are both well presented, and contain all the relevant information. None of the residents have been given a new copy of the company terms and conditions of residence. The template Mr and Mrs Coombes use in their other homes does not contain a detailed breakdown of the fees, and who is responsible for their payment. No new placements had been made since the change in the home’s ownership. Mrs Mutongwizo said that she always visits prospective residents before admission to the home. Care records for a resident recently admitted for a respite stay indicated that a comprehensive pre admission assessment had The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 Page 9 been carried out. Staff said that this placement had gone very well, and the individual was hoping to return for a further stay. The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 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 and 10 Residents’ health and care needs are well met. The standard of emotional support they receive from staff is commendable. EVIDENCE: Many of the residents of Grand Panorama are very frail. It was clear that most required assistance with their personal hygiene. All were neatly dressed in appropriate clothing. Residents said that the staff were very good at encouraging them to stay as independent as possible. One person commented, ‘I always dress myself in the morning. I am proud of that. I am very slow, but the staff are so patient with me. They don’t make me feel a nuisance, or jump in to help’. Care records for three of the current residents were reviewed. These were very well completed and provided staff with good guidance to meet identified needs. One of the residents was admitted to the home with severe pressure sores. The care plan relating to this showed that staff had taken into account a wide range of factors influencing the healing of the wounds, from practical wound care, and pressure relief equipment, to pain relief, nutritional supplements and emotional support. The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 Page 11 Some of the residents have complex emotional needs. The care plans relating to these were of a particularly high standard. They demonstrated a commendable respect for each person’s individuality, and offered staff clear guidance to help them manage any potentially challenging behaviour. All of the staff consulted during the inspection were aware of this guidance. It was apparent that they were very fond of the residents. Medicine administration systems confirmed good practice. There was a clear audit trail of medicines received into the home, and administered to the resident. At present medicines are supplied in bottles. Mr Plummer is meeting with local pharmacists with a view to introducing a monitored device system in the near future. Staff were enthusiastic about this proposed change. The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 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 and 15 Residents enjoy the current programme of activities. The appointment of a designated ‘activities organiser will enable this to be more focused to individual wishes and preferences. The standard of food served is good. EVIDENCE: All of the residents consulted said that they were able to organise their day as they saw fit. One person said that she goes to a club once a week. On that day, the staff always make sure that she is up in plenty of time for her transport. Residents said that they enjoy the activities offered at Grand Panorama. One person said ‘there is something happening every day’. Two ladies spoke about the musician who visits regularly. They have different tastes in music, but said that this person ‘keeps both of us happy’. During the inspection, staff led a group of residents in a game of bingo. When this finished another person gave some of the ladies a manicure, whilst the gentlemen watched snooker on the television. A resident commented that the staff kept her well supplied with magazines to read. At the moment, staff do not have a formal record of residents’ likes and dislikes. Mrs Coombes said that she hopes to employ a designated ‘activities organiser’ in the near future. She anticipates that this person will be able to The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 Page 13 work with residents and their families, to devise a ‘pen portrait’ of each person. From this, they hope to devise a more ‘creative’ programme of activities, to cater for specific interests. Mr and Mrs Coombes have set up accounts with local food suppliers, to ensure a regular supply of fresh produce. All the residents said that the meals provided are good. They said that they are offered a choice of meal, but that the cook knows what they like anyway. The cook demonstrated a very good knowledge of the residents’ nutritional needs. The lunchtime meal looked and smelt appetising. Several residents were provided with adapted cutlery to enable them to eat independently. The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 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 and 18 Residents and their relatives feel able to raise concerns or complaints with staff in the home. EVIDENCE: All those consulted during the inspection said that they would have no hesitation raising concerns, if they felt it necessary. They were keen to stress that they had not needed to do so. Since the home was last inspected (in June 2005, under the previous ownership) there have been three adult protection referrals. Two of these were unsubstantiated. The third related to the behaviour of one specific resident. This person is no longer resident at Grand Panorama. Mrs Mutongwizo and her staff co-operated fully with these investigations. All the staff consulted during the inspection showed a good awareness of adult protection issues. The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 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, 20, 21, 22, 23, 24, 25 and 26 The accommodation at Grand Panorama is dated. Mr and Mrs Coombes to carry out an extensive programme of refurbishment and redecoration to ensure that the home meets the needs and expectations of the client group. EVIDENCE: Much of the accommodation at Grand Panorama is in need of refurbishment and redecoration. Steps limit access to a number of the bedrooms, and the bathing facilities are inadequate. Mr and Mrs Coombes have already produced a detailed plan to address these issues. Staff and residents have been asked for ideas to place on a ‘wish list’ of equipment and facilities they would like Mr and Mrs Coombes to provide. The home was clean and tidy. There was a slight residual odour in a small number of bedrooms. Mr Coombes has just purchased a new carpet cleaner, which he hopes will resolve this problem. The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 Page 16 Gloves and protective aprons were readily available for staff use. Some concerns were raised about infection control procedures in the home. Staff were observed to carry dirty laundry around the home, rather than place it in a linen skip. The staff records indicated that infection control training has not been provided recently. Mr Plummer said that he has already planned an infection control audit. When this has been completed, he said that updated training would be provided. The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 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 and 30 Staffing levels meet the needs of the current residents. Staff training needs are not formally identified, so there is no plan in place to ensure that they receive appropriate training. EVIDENCE: Conversations with residents and comments received from regular visitors to the home suggested that staffing levels are appropriate. The duty rota suggested that one staff member was working well in excess of 48 hours a week. Although this was clearly her choice, Mrs Mutongwizo should monitor this closely. No staff have been appointed since Mr and Mrs Coombes took over ownership. Records for staff employed since the home was last inspected demonstrated good practice. There was no training plan in place for any of the staff. Mr Plummer said that he plans to address this over the coming months. The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 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, 34, 35, 36, 37 and 38 It is too early to make a judgement about the impact of the change in ownership on the day to day running of the home. Residents and staff feel that initial impressions are positive. EVIDENCE: Since the last inspection, Mrs Mutongwizo’s application to become the registered manager of Grand Panorama has been approved by CSCI. She said that she appreciated the support she was receiving from Mr and Mrs Coombes and Mr Plummer. It was not entirely clear where accountability rests between Mrs Mutongwizo and Mr Plummer. This should be clarified. As the home changed hands so recently, it was not possible to make a judgement relating to the home’s ethos. Residents said they appreciated that Mr and Mrs Coombes, and Mr Plummer had taken time to introduce themselves. An open evening is planned in the near future for all those involved in the home to meet together informally. This is a good idea. The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 Page 19 The home holds pocket money for a small number of residents. The records kept in relation to this were clear. The previous owners were appointees for some residents. Mrs Coombes is in contact with the local authority to resolve this. Staff have not been receiving regular formal supervision. Mr Plummer has already recognised this, and plans to introduce a programme in the near future. All the records seen at the inspection were up to date and accurate. Conversations with the estates manager confirmed that relevant health and safety checks are carried out. The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 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 3 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 2 2 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 3 2 3 3 The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? N/A 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 OP2 Regulation 5.-(1) Requirement The terms and conditions of residence must be amended to include a clear breakdown of fees payable. A copy of this must be issued to all residents. The planned programme of refurbishment and redecoration must be implemented Accessible communal bathing facilities must be provided. Plans to improve the accessibility of the home must be implemented. Staff must receive infection control training Staff training needs must be identified, and a plan put in place to meet these A programme of formal staff supervision must be devised and implemented. Timescale for action 17/05/06 2 3 4 5 6 7 OP19 OP21 OP22 OP26 OP30 OP36 23.-(2) 23.-(2) 23.-(2) 13.-(3) 18.-(1) 18.-(2) 17/01/07 17/07/06 17/01/07 17/07/06 17/07/06 17/07/06 The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 Page 22 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 OP12 OP26 OP29 OP31 Good Practice Recommendations Residents interests should be recorded in more detail in the plan of care. Carpets should be replaced if attempts to remove residual odours are not successful The number of hours staff work should be carefully monitored to ensure that they are not overtired. There should be clear lines of accountability between Mr Plummer and Mrs Mutongwizo The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 The Grand Panorama DS0000065085.V277853.R01.S.doc Version 5.1 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. 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