Inspection on 21/04/05 for The Retreat, Plymouth

This inspection was carried out on 21st April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Retreat, Plymouth 29/05/07

The Retreat, Plymouth 25/08/05

The Retreat, Plymouth 10/08/04

The Retreat, Plymouth 08/04/04

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 Retreat Belle Vue Road Hooe Plymouth PL9 9NR Lead Inspector Jane Gurnell Announced 21/04/05 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. The Retreat D52-D04 S3516 The Retreat V211096 210405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service The Retreat Address Belle Vue Road, Hooe, Plymouth, Devon, PL9 9NR 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) 01752 402566 01752 313074 The Retreat Care Home Limited Mr Paul Iverson Constantine Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places The Retreat D52-D04 S3516 The Retreat V211096 210405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age 60 Date of last inspection 10/08/04 Brief Description of the Service: The Retreat Residential Care Home is a large period house set in its own grounds on the outskirts of the village of Hooe near Plymouth. The home provides accommodation with personal care for up to 20 men and women over the age of 65. the home does not offer care to people diagnoded with dementia or those whose physical mobility is significantly impaired. the home provides 16 single bedrooms, 8 of which have en suite facilities, and 2 double bedrooms both of which have en suite facilities. Accommodation is providd over three floors and hair lofts provide access to the first and second floors, although there are a numbetr of steps to some of the bedrooms. The lounge and dining room are on the ground floor. The Registered Providers are Mr Paul and Mrs Sue Constantine who live at the home and manage the home on a day to day basis. Service users are enabled to access any health and social care services they require and variuos social activities are organised by the home. The garden is attractive, spacious and accessible to service users. The Retreat D52-D04 S3516 The Retreat V211096 210405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and took place over 4 hours. As Mr and Mrs Constantine, the owners of The Retreat have consistently met or in many instances, exceeded the National Minimum Standards the focus of the inspection was to consult with service users and review the care planning processes and related documentation. Mr and Mrs Constantine were present and they and their staff team assisted the inspector throughout the inspection. The inspector spoke to 13 service users, toured the building and examined care records and other documents. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Retreat D52-D04 S3516 The Retreat V211096 210405 Stage 4.doc Version 1.20 Page 6 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 The Retreat D52-D04 S3516 The Retreat V211096 210405 Stage 4.doc Version 1.20 Page 7 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, 4 and 5 Thorough and comprehensive systems for admission allow service users and their relatives to be confident that their needs can be met. EVIDENCE: A statement of Purpose and Service User Guide were available for prospective service users and provided a clear description of the services offered: a Service User Guide was available in each bedroom as well as upon request. Assessments were undertaken to identify service users’ needs prior to admission. Service users said that they and their families had been able to visit the home before making a decision to move in. The Retreat D52-D04 S3516 The Retreat V211096 210405 Stage 4.doc Version 1.20 Page 8 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 and 11 Service users health, personal and social care needs are being met and service users are treated respectfully. The home’s practices relating to medication administration protect the service users from risk. EVIDENCE: Service users said they could not be treated better and described living in the home “lovely” and “excellent”, saying that nothing was too much trouble for the staff. Care plans detailed service users’ care needs: these plans were reviewed regularly and, where able, the service users had signed their plans. The visiting District Nurse confirmed that she had a good relationship with the owners and staff and was confident that service users’ health care needs were being met. Service users with terminal illnesses could remain in the home as long as the District Nurse and the care staff could continue to meet their needs. Medication administration records, including the controlled drug register, were well maintained and medication was stored safely. The Retreat D52-D04 S3516 The Retreat V211096 210405 Stage 4.doc Version 1.20 Page 9 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, 13, 14 and 15 Social activities are managed well and provide daily interest for the service users. Meals are nutritious and varied. EVIDENCE: The service users described that activities are provided daily and that they receive a programme of activities monthly. Service users’ families and friends are invited to participate in the activities including the trips to local places of interest. “Friend of The Retreat”, a group of residents and family members, supports fund raising and social activities and meets with Mr and Mrs Constantine regularly to consult on the quality of the service and the day to day running of the home. Service users said that the food was good and plentiful and should the menu not be to their taste, alternatives were always available. The dining room is a very pleasant room with period features and antique furniture. Those service users who wished were supported to undertake food hygiene training to enable them to participate in meal preparation and baking. The Retreat D52-D04 S3516 The Retreat V211096 210405 Stage 4.doc Version 1.20 Page 10 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, 17 and 18 Complaints and suggestions from service users, relatives or other visitors to the home, are treated seriously. Service users are listened to and issues resolved promptly. EVIDENCE: Service users said that the owners and staff were very approachable and they were confident that any issues of concern would be listened to and dealt with. The home has received no complaints since the last inspection. A copy of the complaints procedure is available to all service users and visitors to the home and detailed in the home’s Statement of Purpose and Service User Guide. Staff have received training in issues relating to abuse and the protection of vulnerable adults and described the actions they would take should an issue of abuse be suspected. The Retreat D52-D04 S3516 The Retreat V211096 210405 Stage 4.doc Version 1.20 Page 11 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, 22, 23, 24, 25 and 26 The service users live in a very pleasant, well-maintained home that is comfortable and warm and which provides sufficient facilities to meet their needs. EVIDENCE: All communal rooms and bedrooms were pleasantly decorated and furnished and service users said that it is always very clean. A programme of planned refurbishment details further improvements to the building, such as new windows and the decorating of the exterior, ensuring that the building remains in a good state of repair and adheres to Grade II listed requirements. An Occupational Therapist’s reports confirmed that the facilities meet the needs of the current service users. The Retreat D52-D04 S3516 The Retreat V211096 210405 Stage 4.doc Version 1.20 Page 12 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, 28, 29 and 30 Service users are cared for by well-trained and motivated staff in sufficient numbers to meet the needs of those currently living in the home. Recruitment processes protect vulnerable service users. EVIDENCE: Service users described the staff as very kind and caring and confirmed they responded promptly to requests for assistance. A training programme detailed the ongoing training undertaken by staff ensuring that they have the skills to care for older people. A dedicated training budget indicated the owner’s commitment to training. Staff files contained application forms, written references, Criminal Record Bureau disclosures, and photographic identification. The Retreat D52-D04 S3516 The Retreat V211096 210405 Stage 4.doc Version 1.20 Page 13 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) 31, 32, 33, 34, 35, 36, 37 and 38 Service users live in a well managed home. The owners and their staff team strive to provide a stimulating, safe environment that respects and protects service users’ rights. EVIDENCE: Service users said that they feel safe and secure in their home and that the home was well managed. Mr and Mrs Constantine are available each day during the week and meet with service users and staff on a daily basis. Staff confirmed that they meet with the owners regularly to ensure that service users’ needs continue to be met and any issues dealt with promptly. Records confirmed that staff met regularly for individual supervision with Mrs Constantine to review their work performance and training and development needs. The Retreat D52-D04 S3516 The Retreat V211096 210405 Stage 4.doc Version 1.20 Page 14 Sampling of service contracts indicated that equipment was being regularly serviced and well maintained. Fire safety training for staff was documented and included unannounced fire training drills to ensure staff were aware of their responsibilities should a fire be discovered. An annual self-audit against the National Minimum Standards, as well as formal service users’ consultation, contributes to the owner’s quality assurance processes. The Retreat D52-D04 S3516 The Retreat V211096 210405 Stage 4.doc Version 1.20 Page 15 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. Where there is no score against a standard it has not been looked at during this inspection. 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 4 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION 4 4 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 4 3 4 4 3 3 2 4 3 The Retreat D52-D04 S3516 The Retreat V211096 210405 Stage 4.doc Version 1.20 Page 16 no 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations The Retreat D52-D04 S3516 The Retreat V211096 210405 Stage 4.doc Version 1.20 Page 17 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. Extracts may not be used or reproduced without the express permission of CSCI The Retreat D52-D04 S3516 The Retreat V211096 210405 Stage 4.doc Version 1.20 Page 18 - 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!