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Inspection on 14/06/05 for The Yelverton Nursing and Residential Home

Also see our care home review for The Yelverton Nursing and Residential Home for more information

This inspection was carried out on 14th June 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The staff are enthusiastic and committed to ensuring the best care is provided for the residents in their care. The environment is comfortable and homely. The patio areas are well maintained and easily accessible to patients. The plans of care are excellent and include sufficient detail and are organised in such a way that staff can deliver the care required by each individual client. The patients spoken to and the completed comment cards returned prior to the inspection had high praise for the home and the staff. The staff observed during the inspection were polite and considerate to patients.

What has improved since the last inspection?

The manager has begun to study for an NVQ4 in Management.

What the care home could do better:

The complaints procedure could be more prominent within the home as 2 out 0f the 5 completed relatives/visitors comment cards indicated they were not aware of the complaints procedure. No requirements or recommendations were made following the inspection.

CARE HOMES FOR OLDER PEOPLE The Yelverton Nursing & Residential Home 2/4 Greenbank Terrace Yelverton Devon PL20 6DR Lead Inspector Mandy Norton Announced 14 June 2005 th 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 Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service The Yelverton Nursing & Residential Home Address 2/4 Greenbank Terrace, Yelverton, Devon, PL20 6DR 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) 01822 852641 01822 854419 Lark Castle Limited Mrs Jessica Sheila Powell Care Home with nursing 27 Category(ies) of Old age, not falling within any other category registration, with number (18), Physical disability over 65 years of age of places (27) The Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: One Service User can be accommodated with Category of Mental Disorder (MD) The Home is registered as a Care Home with Nursing for a maximum of 27 Service Users in the categories of PD(E) 27, OP 18 Date of last inspection 23.11.04 Brief Description of the Service: The Yelverton Nursing and Residential home is a Victorian house that has been successfully modified over the years to provide nursing and residential care to 27 Service Users. Yelverton village is very close to the home and there is level access to local amenities. The home is on three floors with passenger lift or stair lift access to all parts of the building. It offers a variety of accommodation, to include two double rooms and many rooms with en suite facilities. There is a pleasant patio approach to the home and a large patio area at the rear.The home employs registered nurses to deliver nursing care and to support care staff in the delivery of care. The home is well equipped to deliver the care for which it is registered. A varied in house activities programme is available for those able to take advantage and appropriate transport can be hired as necessary when trips are arranged. The Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place over 6 3/4 hours between 08.45am and 3.30pm and was conducted with the matron the provider. The inspector spoke to 6 residents and observed several others taking part in a variety of activities. A number of completed comment cards were received from residents (5) and relatives/representatives (5) prior to the inspection. A tour of the premises took place and a variety of records were inspected. What the service does well: What has improved since the last inspection? What they could do better: The complaints procedure could be more prominent within the home as 2 out 0f the 5 completed relatives/visitors comment cards indicated they were not aware of the complaints procedure. No requirements or recommendations were made following the inspection. The Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 6 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 Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection The Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 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 standard(s) 3 and 5. Comprehensive pre admission assessments are made and therefore people are admitted to the home appropriately. Clear information and opportunities to visit the home are given to people to help them to decide if they want to live at Yelverton Nursing and Residential Home. EVIDENCE: The matron said that prospective patients and/or their representatives are able to visit the home when they like to look around. The matron said that the trained nurses within the home go out and complete pre admission assessments using the ‘activities of daily living’ as a basis. Individual records examined had completed pre admission assessments included. The Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 10. The health care needs of the residents are identified and met. Interactions between staff and residents promotes and protects patients privacy and dignity. EVIDENCE: The plans of care examined were excellent and included general information about the resident and a daily statement about their wellbeing, nutritional assessments, tissue viability assessments, wound care assessments ( where necessary), manual handling assessments and are drawn up and reviewed with the residents, where this is possible, signatures of residents were included in the plans of care. Service User comment cards completed (5) and residents spoken to indicated that patients feel well cared for and safe and have their privacy respected. The Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 10 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 and 15. The staff have a good understanding of the patients cultural, social and recreational needs and the importance of maintaining contact with family and friends and engage the patients in a variety of ways. The meals in the home are good offering both choice and variety and cater for special dietary needs. EVIDENCE: Care plans examined contain information about interests and hobbies. The manager and one of the residents said that knitting is popular at the moment. Completed Service User comment cards and patients spoken to had high praise for the home. A tour of the home saw patients engaged in a variety of activities independently and with the support of the staff. Menus provide prior to the inspection show that a balanced diet with plenty of variety is offered, with alternatives to the menu always available. All 5 completed Service User comment cards said that they ‘like the food’. A mealtime was observed during the inspection and was seen to be unhurried , a time for socialising and assistance was offered as required. Residents spoken to said the lunch they had just had was ‘tasty’ and the meals were ‘always nice’. The Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 11 The Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. The home has a satisfactory complaints system. Clients in the home are protected by staff having a knowledge and understanding of Adult protection issues. EVIDENCE: The complaints log examined had details of complaints received and the actions taken to resolve the matter. No complaints have been made since August 2004. The complaints procedure is displayed within the home but could be more prominent as 2 out of the 5 completed relatives/visitors comment cards indicated that they weren’t aware of the homes complaints procedure. The policies and procedures around protection examined were up to date and robust and available to staff at all times. The manager updates staff annually about adult protection and recognition of abuse. Several staff are currently undertaking NVQ 2 & 3 training which includes adult protection issues. The Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,23,24,25 and 26. The standard of the environment within the home and the grounds is good providing clients with attractive and homely place to live. The overall quality of the furniture and fittings is good providing a safe environment. The home is clean and hygienic. EVIDENCE: A tour of the home confirmed that all of the communal facilities (2 ground floor lounges and a dining room) and the gardens are accessible to clients. The decoration makes the rooms light and airy. Residents rooms seen were comfortable, clean and contained many of their own possessions. Repairs needing to be done are detailed in the handyman’s book and are acted upon as soon as possible. Entries are dated and signed. The Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 14 Domestic staff were seen cleaning the home during the inspection. The Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 and 30. Clients needs are met by a satisfactory mix of nurses, carers and ancillary staff who are trained and competent to do their job. EVIDENCE: The duty rota provided with the pre inspection questionnaire details the number of staff on duty and during the inspection people looked well cared for. The pre inspection questionnaire indicates that staff turnover is low. All 5 of the completed relatives/visitors comment cards returned prior to the inspection indicated that they feel that there are ‘sufficient staff on duty at all times’, and all 5 of the completed Service users comments cards returned prior to the inspection indicated they felt ‘well cared for’. There are currently no staff vacancies. Training records examined were up to date and covered a variety of subjects, including care of ageing skin, continence care, manual handling, fire training and first aid. The pre inspection questionnaire stated and the manager confirmed that over 90 of the 13 care staff have or have nearly completed NVQ levels 2 and /or 3 in care. During the afternoon of the inspection some of the care staff were completing some of their paperwork for their NVQ’s. The Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 16 The Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 17 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) 31,32,35 and 38. There is good leadership and guidance for staff to ensure residents receive consistent quality care. The systems in place in the home promote and protect the health and safety and welfare of the clients and staff. EVIDENCE: The manager has managed the home successfully for many years and is currently undertaking her NVQ level 4 – in Management. The residents money is managed by the trained nurses within the home. Records were examined that detailed any expenditure a resident has on their own account sheet, receipts are also kept as evidence of the expenditure. Two clients monies were checked by the inspector and were found to agree with the amount documented on the account sheet. The Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 18 The matron supervises staff regularly and dates and subjects covered are documented and were detailed in the pre inspection questionnaire. The accident book and fire-log book were examined and found to be up to date. The fire alarm went off during the inspection, the staff were observed reacting appropriately and in a timely fashion. A water leak was detected that was setting off the alarm and a contractor and the fire alarm company were called out immediately. The Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 19 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 x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 3 3 3 STAFFING Standard No Score 27 4 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x 3 x x 3 The Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 20 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 Yelverton Nursing & Residential Home D54-D07 S3619 The Yelverton V213636 140605 Stage 4.doc Version 1.20 Page 21 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. 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