Inspection on 24/07/07 for The Troc Residential Home

This inspection was carried out on 24th July 2007.

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 Troc Residential Home 21/08/06

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

CARE HOMES FOR OLDER PEOPLE The Troc Residential Home 256 Beacon Hill Road Newark Nottinghamshire NG24 2JP Lead Inspector Elisabeth Pinder Unannounced Inspection 24th July 2007 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 Troc Residential Home DS0000066952.V340790.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. The Troc Residential Home DS0000066952.V340790.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Troc Residential Home Address 256 Beacon Hill Road Newark Nottinghamshire NG24 2JP 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) 01636 671342 01636 671914 soniaghai@hotmail.com Reason Care Limited Mrs Lesley Ann Lanham Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places The Troc Residential Home DS0000066952.V340790.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Troc Residential Care Home is registered to provide personal care for up to 2 service users whose primary needs fall into the service category DE(E) The maximum number of service users to be accommodated at The Troc Residential Care Home is 25 21st August 2006 Date of last inspection Brief Description of the Service: The Troc is a care home providing accommodation and personal care for up to twenty-five older people of both sexes. The home was opened in the 1980’s and consists of a two-storey building in its own grounds. The home is situated in a suburban area on the outskirts of the historic market town of Newark. It is two miles from the town centre with its shops, leisure, entertainment, historic sights and other facilities. Public bus services pass the home, offering transport into Newark. The home has twenty-three single and one double bedroom, none en-suite. Communally, there are three lounges and a dining room area. There are three bathrooms and six communal toilets to meet the needs of the residents. Inside, the home is pleasantly decorated throughout. An extension is currently being built which has impacted on residents using the gardens, however, the provider said that this should be completed within the next couple of months. Car parking is at the front of the building. The fees range from £370 to £390 per week, additional charges are made for chiropody, newspapers/magazines and personal toiletries. Fortnightly hairdressing is included in the fees, however, if residents choose to have additional hairdressing charges are made. The Troc Residential Home DS0000066952.V340790.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit to the home was undertaken by one inspector and formed part of a key inspection. The visit lasted five and a half hours and took into account previous information held by The Commission for Social Care Inspection (CSCI) including previous inspection reports and their service history. Prior to the visit the providers had returned their Annual Quality Assurance Assessment (AQAA) and this will also be mentioned throughout this report. However, information provided was very limited and a discussion was held with the manager and one of the providers regarding what information should be included in an AQAA and how to access the guidance regarding this. During the visit five residents ‘Have your say about’ questionnaires were received and comments from these will be mentioned throughout this report. The site visit focussed on all the key standards and consisted of case tracking a sample of four peoples’ records, talking to them, observing staff interaction and assessing their care. A general conversation was held with some people whilst they were sitting in the lounge and a period of observation was undertaken during lunch. Two members of care staff, one visitor, the manager and one of the providers were spoken with. What the service does well: What has improved since the last inspection? The safety of residents has been considered and radiators with a hot surface temperature have been covered. Questionnaires to monitor the quality of care provided have been sent out to relatives, visitors and other professionals, and action has been taken to address any issues raised. The Troc Residential Home DS0000066952.V340790.R01.S.doc Version 5.2 Page 6 Senior care staff have been trained to provide supervision to junior staff to ensure each member of staff receives regular one to one sessions and staff have undertaken safeguarding adults training. 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 summary of this inspection report can be made available in other formats on request. The Troc Residential Home DS0000066952.V340790.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 The Troc Residential Home DS0000066952.V340790.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 3 standard 6 is not applicable Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People coming into this service have access to information to help them make a decision about moving into the home. However, information gathered prior to admission is limited so their needs may not be assessed and planned for. EVIDENCE: The Statement of Purpose and Service User Guide contain sufficient detail about the home to help people understand the services that are offered. The guide details what people can expect and gives clear information about the fees payable and any additional costs. However, neither detail how this service will meet the equality and diversity needs of people or how people can access inspection records. The manager said that this information is given verbally to prospective residents and their relatives/representatives and also agreed to include it in the Service User Guide. The Troc Residential Home DS0000066952.V340790.R01.S.doc Version 5.2 Page 9 All of the resident questionnaires received identified that enough information was received about the home before they moved in. Two residents spoken with said their admission was arranged by their daughter and so far they were very satisfied with the home. The records of two new residents admitted since the previous inspection showed that information obtained before their admission is very limited and did not provide staff with a clear knowledge of their needs. This was discussed with the manager and one of the providers who both agreed and will take action to address this issue. Terms and conditions/contracts are held on a separate file in the administration office. The Troc Residential Home DS0000066952.V340790.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Care plans contain sufficient information to ensure peoples’ health and care needs are met but there is a lack of resident involvement in this process. Medication is given using safe procedures and staff respect the wishes and preferences of people living in this home while maintaining their privacy and dignity. EVIDENCE: Care plans are currently being re-written and those completed set out clear information on how residents’ needs should be met. However, care plans must cross-reference with information obtained prior to admission. These are signed and dated by care staff and evaluated monthly. Some evaluations are signed by residents showing their involvement but most are only signed by staff. Three residents ‘have your say about’ questionnaires identified that they ‘always’ receive the care and support needed, one indicated ‘usually’. The Troc Residential Home DS0000066952.V340790.R01.S.doc Version 5.2 Page 11 Residents spoken with during the visit said that they felt their current needs were being met but they were unaware of their care plan. This was discussed with the manager who agreed to ensure these are shown to residents every time they are reviewed or amended. Medication policies are available, although these have not been reviewed for a number of years. Medication given to residents at lunch time was given using correct, safe procedures and the staff member administering medicines confirmed that she had received relevant training and felt confident with this task. Staff members spoken to had a good knowledge of residents’ needs and the action required to meet these. Staff were observed carrying out their duties with kindness and sensitivity towards the residents, especially when attending to their personal needs. The Troc Residential Home DS0000066952.V340790.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples’ interests are generally accommodated and they are able to enjoy a lifestyle which is flexible and are able to make choices with regards to activities. Meals provided are well balanced and nutritional. EVIDENCE: Although this home does not have a designated activity co-ordinator a lot of the activities are undertaken by volunteers who have been coming into the home for many years and have developed a good rapport with residents. Care plans that have been re-written now include social interests and residents spoken with said that they enjoy the activities available, especially the reminiscence. However, some residents commented about the garden being unavailable due to building work and this was raised with the manager. Three residents questionnaires identified that activities are ‘usually’ available that they can take part in and two ‘sometimes’. During the visit volunteers came in to have a game of bingo with residents. The Troc Residential Home DS0000066952.V340790.R01.S.doc Version 5.2 Page 13 A varied response was received regarding the meals, two questionnaires identified that they ‘always’ like the meals provided, two ‘usually’ and one ‘sometimes’. People spoken with about the food and meal times said ‘choice is available for the main course’, ‘we are not able to contribute to the menu, however, the food is very good’ and ‘good food, good variety, my favourite is breakfast’. Menus seen showed that a varied, well balanced diet is offered and the midday meal was observed to be nutritious. Tables were nicely laid with tablecloths/napkins and condiments. Staff spoken with had a clear knowledge of residents dietary needs including their likes and dislikes and were observed to assist residents at lunch time when needed. As previously mentioned the Statement of Purpose and Service User Guide do not detail how the service will meet the equality and diversity needs of residents in relation to activities, cultural and religious needs, however, the manager and owner both agreed to address this. Regular in-house church services are held and residents spoken with said they enjoy these. The Troc Residential Home DS0000066952.V340790.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in this home are confident that any concerns would be addressed appropriately and there are satisfactory procedures in place for reporting allegations of adult abuse. EVIDENCE: The complaints procedure is available in the Statement of Purpose and Service User Guide. Since the previous inspection there has been no complaints and no adult protection referrals. Resident questionnaires identified that all residents know how to make a complaint, who to speak with if unhappy and felt staff listen to them and act on what they say. People spoken with during the visit said that they felt confident to raise any concerns with either the manager or provider. Staff spoken with had a good knowledge of abuse and the procedures to take should an allegation be made and records showed that adult protection training was completed on 21/02/07 and future training includes challenging behaviour. The Troc Residential Home DS0000066952.V340790.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in this home live in a clean, pleasant and hygienic environment and they are able to personalise their rooms. EVIDENCE: The four bedrooms of residents ‘case tracked’ were viewed and all were clean and tidy and well personalised. Since the previous inspection the safety of residents has been considered and radiators are now covered. Three residents questionnaires identified that the home is ‘always’ fresh and clean and one ‘usually’. People spoken with during the visit were very satisfied with the cleanliness of the home. Areas of the home seen were clean, pleasant and homely with no unpleasant odours. The Troc Residential Home DS0000066952.V340790.R01.S.doc Version 5.2 Page 16 The Environmental Health Officer visited on 03/10/06 and recommended the document ‘Safer food, better business’ is obtained. The manager has also received a new publication called ‘Essential Steps’ and plans to update the infection control policy using this information. The Troc Residential Home DS0000066952.V340790.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing numbers are adequate to meet the needs of people currently living in this home and they are supported by staff who are appropriately trained. EVIDENCE: Staffing rotas examined showed that there are usually five care staff on duty in the mornings, four care staff each afternoon and two throughout the night. However, on occasions this is reduced to four and three. Four residents questionnaires read that staff are ‘usually’ available when needed and one ‘always’. People spoken to during the visit said that ‘at times they are short staffed but staff always give excellent care’ and ‘they realise we are getting older and need more care so they are giving us more staff’. All said they do not have to wait long at night if they use their call bells. The records of two new staff employed since the previous inspection were examined and these showed that they had been recruited using safe, robust procedures, one new member of staff was spoken with about her induction and her records showed that she was being inducted using ‘First Steps Common Induction’. Currently there are no male carers and therefore residents are unable to choose who provides their personal care. The provider said she is The Troc Residential Home DS0000066952.V340790.R01.S.doc Version 5.2 Page 18 trying to recruit male staff to enable residents the choice of gender regarding personal care. The AQAA identified that only 21 of staff have a National Vocational Qualification (NVQ), which is a recognised training award in care, 10.5 of staff are working towards this. The provider said that all new staff will complete NVQ training and she aims to reach the recommended 50 as soon as possible. Staff spoken with have completed statutory training and some equality and diversity issues are covered during induction, but no specific training has taken place. All care staff have been given copies of The General Social Care Council Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults. The Troc Residential Home DS0000066952.V340790.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed competently and the staff are supported and supervised in carrying out their respective roles. EVIDENCE: Although the home changed ownership last year the manager remained in post and has been for a number of years, achieving her Registered Managers Award in 2004. During the previous visit questionnaires were being developed to monitor the quality of care provided. These were given to relatives, visitors and other professionals and comments taken from those returned included ‘just continue as you are,’ ‘the Troc is a lovely caring home,’ and ‘no The Troc Residential Home DS0000066952.V340790.R01.S.doc Version 5.2 Page 20 improvements needed’. Negative comments were received from one relative and the provider said these have all been addressed. Information given in the AQAA read that policies are up to date, however, some viewed were dated 2004 and the manager agreed to review these, including health and safety policies. The AQAA also showed dates when equipment was serviced and fire alarms checked. Regular resident and staff meetings are held, relatives are invited to the residents meetings and records were available detailing the topics covered and any action taken. During the previous inspection a recommendation was made for supervision training to be given to senior staff to enable them to carry out supervision. This has now been addressed and all staff receive regular supervision where they can discuss any care practice issues and any training needs. Monthly reports are written by the provider and these were available for inspection. During the visit the passenger lift was out of action and the Commission had not been informed of this. The manager agreed to ensure all events which affect the well being of residents will be reported to us in the future. Residents’ finances held by the home were checked and found to be in order. The Troc Residential Home DS0000066952.V340790.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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Troc Residential Home DS0000066952.V340790.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 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. Refer to Standard Good Practice Recommendations The Troc Residential Home DS0000066952.V340790.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Nottingham Office Edgeley House Tottle Road Riverside Business Park Nottingham NG2 1RT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Troc Residential Home DS0000066952.V340790.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. 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