Inspection on 10/05/05 for Three Corners Nursing Home

This inspection was carried out on 10th May 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.

Other inspections for this house

Three Corners Nursing Home 02/04/09

Three Corners Nursing Home 12/04/07

Three Corners Nursing Home 27/04/06

Three Corners Nursing Home 26/10/05

Three Corners Nursing Home 03/08/04

Three Corners Nursing Home 18/05/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Three Corners Nursing Home 4 Greenway Road Churston Ferrers Brixham TQ5 0LW Lead Inspector Fiona Cartlidge Announced 10 May 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. Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Three Corners Nursing Home Address 3 Greenway Road, Churston Ferrers, Brixham, Devon, TQ5 0LW 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) 01803 842349 01803 846079 threecorners@btconnect.com Mrs Elizabeth Agnes Hunter Vacantll Care Home with nursing 40 Category(ies) of Dementia (7), Mental disorder, excluding registration, with number learning disability or dementia (7), Old age, not of places falling within any other category (7), Physical disability (40) Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. To undertake update/training in adult protection - recognising and reporting allegations of abuse, within 3 months of the registration being granted. 2. Service Users aged 65 years and over 3. PD Maximum registered 40 service users (both) 4. OP Maximum registered 7 service users (both) 5. DE Maximum registered 7 service users (both) 6. MD Maximum registered 7 service users (both) Date of last inspection 12/08/04 Brief Description of the Service: Three Corners is situated in a level position on the edge of the village of Galmpton, which lies between Brixham and Paignton, a car park is available in the front of the home. The access to the home is via a modern porch. The same family has owned the home for twenty years. The home is registered to provide care for up to forty older people of either gender who have personal care and general nursing care needs. The accommodation is provided in twenty-two single rooms and nine shared rooms. Each room has a nurse call system and is equipped with the furniture and adaptations required for individual Service Users. A variety of equipment and adaptations are provided to meet the needs of disabled Service Users. There is at least 1registered nurse on duty at all times supported by a team of Health Care Assistants. Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 and a half hours and was announced. Information was received from the registered provider before the inspection as was verbal feedback from 1 relative/visitor. A full tour of the home took place and personal records of 3 residents and 3 staff were inspected. The inspector spoke to 2 members of staff on duty and 15 of the residents as well as the registered owner, acting manager and administration manager. What the service does well: What has improved since the last inspection? The documentation in the home has been reviewed and updated this provides clearer information about individuals needs and has lead to a more consistent approach by staff to meeting those needs. Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 Stage 4.doc Version 1.20 Page 6 Communication systems have been improved through formal meetings and provision of questionnaires - findings and comments have been acted on to improve the service offered in the home. Protection of vulnerable adults policy has been reviewed and communicated to all staff which will ensure that any actions or allegations are acted on and external agencies are informed and involved in the process in a timely fashion to promote the safety of those living and working in the home. The medication administration system has been changed, records of all medication entering and leaving the home are clear and accurate. Administration is well recorded and managed by registered nurses providing a safe system for medication administration to people living in the home. 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. Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 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 Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 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 The admission procedure is adequate and provides enough information to guide staff on the actions to be taken to ensure new resident’s needs are assessed and planned for. EVIDENCE: Progress has been made to improve the admission procedure to ensure that there is a proper assessment prior to people moving into the home. This provides an assurance that care needs will be met. Individual records are kept for each of the residents and inspection of the records for 3 residents provided evidence of the level of information staff in the home receive prior to their admission, which allows them to make a decision about if/how those needs will be met. Documents included a nursing needs pre admission assessment performed by registered nurses employed at the home who visit prospective service users in their current setting to perform the assessment. In addition to transfer letters from hospitals, placing authorities had provided needs assessments and care plans. Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 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) 7,8,9,10 Care plans show some improvement but lacked detail about social activities and past experiences, which may impact on the standard of individual social care provided. Assessment of skin integrity does not follow ‘best practise’ guidance i.e. where a high risk is identified appropriate pressure- relieving equipment needs to be in place to minimise that risk. Communication between the nursing staff and external health and social care professionals has improved. He medication system showed much improvement providing a higher level of safety to people living in the home. EVIDENCE: Individual plans of care are available; some progress has been made in identifying and communicating levels of risk that some residents may pose to themselves or others through their activities of daily living. The plans did lack detail about past experiences, activities and hobbies which may impact on the level or appropriateness of social activities arranged or offered to individuals in the home. Daily entries are made; these did not always include a complete record of the actual care given. Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 Stage 4.doc Version 1.20 Page 10 Assessments of nutritional status and skin integrity lacked detail, one resident identified as high risk and who had developed pressure sores had not been provided with a treatment mattress of sufficient quality to meet their needs. There was a treatment plan for the sores but this did not give specific information about the type of mattress required, this resident did however tell the inspector that they were ‘very happy’ with the care they were receiving. Records confirmed that residents are referred to community or hospital health professionals such as continence advisors, chiropodists, Macmillan nurses, speech and language therapists as well as physio and occupational therapists. The medication systems in the home are managed by registered nurses much improvement has been made since the last inspection and the inspector found that policies and procedures where in place and that medication is recorded and stored in a manner which promotes the safety of residents living in the home. Most Residents told the inspector that they feel their privacy and dignity is respected and staff were witnessed speaking to residents in a respectful manner and knocking on doors before entering the private accommodation of those living in the home. 1 resident felt their dignity was compromised, as they were unable to access their en suite WC because the hoist required for their manoeuvrability was too large to provide access. Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 Stage 4.doc Version 1.20 Page 11 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) 12,13,14,15, Social activities meet the needs of the current residents. Meals are nutritious and well presented and appreciated by the residents. The arrangements for visitors is open and friendly. EVIDENCE: A number of people living in the home were spoken to and everyone who commented on the food said how much they liked it. The inspector spoke to people about choices in the menu and people were unsure about whether there was a choice, records are kept of individuals likes and dislikes and their meals are catered around this rather than advertising and communicating a choice for each meal and allowing the individual to chose their preferred meal for that day. The home lacks a separate dinning room/area, which the inspector feels detracts from the ‘dining experience’ although none of the residents spoken to raised this issue. An activities programme has been devised some of which includes simply having music on or watching television/videos together in the lounge, staff are being encouraged to sit with individuals and offer games or crafts which suit individual needs although there was little evidence of this happening on the day of the inspection. People living in the home told the inspector how much Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 Stage 4.doc Version 1.20 Page 12 they enjoyed entertainment from outside musicians such as organists. A library is available in the home providing books with large print. Residents told the inspector they are able to chose how and where they spend their time and are able to receive visitors at times that suit them in their own accommodation or in the lounge. Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 Stage 4.doc Version 1.20 Page 13 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 Improvements have been made in how complaints are received and handled. The communication of the homes vulnerable adult procedure to all staff ensures people living in the home are protected. EVIDENCE: The home has a detailed complaints procedure it does not make clear that a complaint can be referred to the Commission for Social Care Inspection at any time. Records of complaints were detailed and provided evidence that they are acknowledged, investigated and responded to in a suitable and timely fashion. Following a recent incident, the protection of vulnerable adults procedure has been reviewed and communicated to all staff working in the home. Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 Stage 4.doc Version 1.20 Page 14 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 and26 Some improvements to the décor and structure of the home have been made. There are a number of areas outstanding that are needed to provide a suitable number of bathing facilities, dining experience and equitable standard of private accommodation. EVIDENCE: A number of rooms have been upgraded in terms of decoration and furnishings, the people living in theses rooms said they were very satisfied with their accommodation a number of other rooms are looking shabby and in need of a lick of paint and new furniture. The handle on one set of furniture was broken and this was reported at the time of the inspection. Some floors in private accommodation are covered with vinyl, others with carpet some carpets were looking stained. A bathroom on the first floor is awaiting refurbishment and the bath cannot currently be used although the room does provide a communal WC facility. Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 Stage 4.doc Version 1.20 Page 15 The lounge on the ground floor is a conservatory and on the sunny (but not over warm) day of this inspection the people in the lounge complained of feeling hot - requiring the inspector and staff to improve ventilation by opening the doors leading to the garden, putting on a fan, removing cardigans from residents and opening sky lines. This uncomfortable temperature in the lounge was reported last year. A leak to the roof in the conservatory (problematical for a number of years) appears to have been fixed. A smaller lounge on the first floor was not in use at the time of the inspection. The home does not provide a separate dining area/room. The home was clean and odour free and adequate supplies of disposable gloves, aprons and hand washing facilities were found throughout the home. One large tub of cream prescribed for an individual was found in 1 of the communal bathrooms with the name removed this was reported and requested to be removed immediately at the time of the inspection. Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 Stage 4.doc Version 1.20 Page 16 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) 27,29 and 30 The procedures for the recruitment of staff are robust and offer adequate protection for people living in the home. The deployment and number of staff available varies and is not always sufficient to meet all of the needs of people living in the home. The organisation of staff training has been improved since the last inspection. EVIDENCE: There has been a reasonable turnover of staff in the past 8 months. The staff files of two recently employed staff members indicated that the home have undertaken all the necessary recruitment checks to ensure protection of residents. Records of another member of staff supplied evidence that the homes disciplinary policy and procedure has also afforded that same level of protection. Residents spoken to said that staff at the home were ‘kind and caring’ but that sometimes they were very busy particularly at weekends. 1 visitor reported the same concern. On the day of inspection there were adequate numbers of staff on duty and call bells were responded to in a timely fashion. The inspector was provided with pre-inspection information of past and planned training for staff and spoke to 1 new member of staff about their induction training. Training needs analysis is or has been performed through recent staff appraisals records of this were seen. Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 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) 31,33,35,37 and38 The home has changed management 3 times in 2 years, which has lead to inconsistencies in leadership. The current manager has been in post for 8 months her consistent approach in staff leadership have helped to promote and safeguard the health, safety and welfare of people using the service. EVIDENCE: There is an acting manager who has been in post for 8 months the nursing home has lacked a registered manager therefore a requirement to register a manager with the commission within the next 3 months was communicated to the provider and acting manager during this inspection. Residents, visitors and staff made positive comments about the manager and sited examples of improved communication leading to staff being clear about what is expected of them and practises based on policies and procedures being more consistent. Formal systems of communication are now in place recorded Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 Stage 4.doc Version 1.20 Page 18 meetings between the management team people living in and visiting the home and staff were seen. Records provided for this inspection indicate that fire drills and instruction take place regularly and fire, electrical gas and moving equipment is serviced as recommended. Policies and procedures were available for infection control, control of Substances hazardous to Health, disposal of clinical waste, health and safety at work, hygiene and food safety. A policies and procedures manual (containing these) was found in the nurses office. The storage of personal money held on behalf of residents has been improved and records of all transactions are maintained and checked by the registered provider regularly. A sample of actual balances were checked against records by the inspector and were found to be correct. All incidents of accidents and/or injury had been documented. Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 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 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 2 2 2 2 x x 2 STAFFING Standard No Score 27 2 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 2 x 3 x 3 x 3 3 Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 Stage 4.doc Version 1.20 Page 20 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 31 Regulation 8(1)(a) Requirement The registered person must appoint an individual to manage the care home who is registered by the commission as required by this regulation.i Timescale for action 01/09/05 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 7.2 Good Practice Recommendations To inform the care planning process it is advised that a more formal best practise aproach be taken to assessing the nutritional needs and integrity of skin for all people living in the home and a more detailed account of peoples past life experiences, interests and contacts be available to ensure social activities meet the individual needs of those living in the home. Suitable equipment should be available to enable all individuals to access their en suite WC. People living in the home should be offered a choice for all meals which is given, read or explained to them so that they are able to chose their preference. Written information should be provided to all people living in the home on how to refer a complaint to the Commission at any stage should a complainant wish to do so. D54-D07 S28760 Three Corners Nursing Home V214515 100505 Stage 4.doc Version 1.20 Page 21 2. 3. 4. 10.1 15.7 16.4 Three Corners Nursing Home 5. 19 6. 7. 8. 20.2 21.4 24 9. 10. 26 27 A revised plan for the improvement to the environment (including predicted timescales) should be submitted to the commission regarding an application to vary received in 2003 The above plan should include the provision of a dining facility to cater for people living in the home. revised timescales for improvement to the assisted bathrooms As per variation plan should be submitted to the Commission. A plan including timescales to redecorate and refurbish all those bedrooms which have not been done should be provided to the Commission to ensure an equitable standard of accomodation is available to all those living in the home. To prevent the risk of cross infection communal bathrooms should not be used to store tubs or jars or cream or soap bars. Adequate staff should be on duty all times to meet all the needs of people living in the home. Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 Stage 4.doc Version 1.20 Page 22 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 Three Corners Nursing Home D54-D07 S28760 Three Corners Nursing Home V214515 100505 Stage 4.doc Version 1.20 Page 23 - 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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