Inspection on 10/01/07 for Torpoint Nursing Centre

This inspection was carried out on 10th January 2007.

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

Torpoint Nursing Centre 16/03/06

Torpoint Nursing Centre 06/09/05

Torpoint Nursing Centre 12/08/04

Torpoint Nursing Centre 15/04/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

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 Torpoint Nursing Centre Vicarage Road Torpoint Cornwall PL11 2BW Lead Inspector Mike Dennis Key Unannounced Inspection 10th January 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 Torpoint Nursing Centre DS0000009252.V325668.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. Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Torpoint Nursing Centre Address Vicarage Road Torpoint Cornwall PL11 2BW 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) 01752 813677 01752 816323 torpoint@torcare.co.uk Torcare Limited Mrs Elizabeth Margaret Fourniss Care Home 57 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30), Old age, not falling within any other category (57), Physical disability (27), Terminally ill (27) Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. Service users to include up to 57 adults of old age (OP) Service users to include up to 27 adults with a physical disability (PD). Service users to include up to 27 adults with a terminal illness (TI) some of whom may have nursing needs. Service users to include up to 30 adults aged over 65 years with a mental illness (MD(E)). Service users to include up to 30 adults aged over 65 years with dementia (DE(E)). Total number of service users not to exceed a maximum of 57. Date of last inspection 16th March 2006 Brief Description of the Service: Torpoint Nursing Centre is one of two establishments owned by Torcare Limited. It provides nursing care for up to 57 people needing care and accommodation by reason of old age, some of who may be terminally ill, have a physical disability or be suffering from dementia or other mental disorder. Accommodation is provided mainly in single rooms, most of which are en suite. Although the home is divided in four areas these interlink and people can spend time in different parts of the home if this is to their advantage. There are however key pads at strategic points to safeguard people who might wander into an unsafe zone. The home is situated in the centre of Torpoint, accessible to shops and other facilities in the town. Outings are organised to take advantage of these as often as possible. Service users are encouraged to use the garden and patios where seating is provided when the weather is suitable. The home organises regular functions during the year to which family & friends are invited, regular contact being an important part of a persons care for the home. The home involves relatives of both past and present service users in discussing and reviewing the homes performance to measure how well it attains the standards & criteria that it has set for itself. Fees currently range from £444.25 to £575 per week. Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 5 Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 10th and 11th of January 2007 over a 13 hour period The inspector spoke to staff and service users. Relatives were also asked for their views. A sample of service users’ and staff records were inspected. Records required by statute were perused and the premises toured. The overall impression was of a caring establishment that looks after some very frail and, in some cases, demanding people. It takes note of comments by service users, relatives and staff and reviews its practice and policies regularly. No requirements nor recommendations are made as a result of this inspection. The overall standard of care delivered is considered to be very good resulting in a level 4 rating being achieved. What the service does well: Service users’ needs are kept under review and if their needs change, they may move to different wings where the care in the ’new’ areas is more suited to their present situation. Families are always consulted before any such changes occurred. The home pays great attention to keeping families involved with a person’s care. Staff training continues to receive a high priority with reviews of existing policies and procedures when necessary. Staff felt well supported in their roles and enjoyed the opportunities they are offered regarding training. Management are pro-active in maintaining and promoting self audit procedures in an effort to improve standards. Team work is given high priority, no specific equality and diversity issues were apparent. Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 7 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 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. Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 8 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 Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 9 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, 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Views expressed by a number of service users & relatives showed that they had made a positive choice by selecting Torcare and that the home had sought sufficient information before a placement. The care provided meets peoples’ needs. EVIDENCE: All service users and their appropriate relatives are given information about the home by way of the Statement of Purpose and service user guide. These documents were inspected and found to contain all relevant required information. Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 10 Contracts/statements of terms and conditions are given to all service users and include the current fee structure plus information as to when fees are to be reviewed, the current range of fees being from £444.25 to £467. The matron visits prospective service users to gain essential information from all those concerned with their care. This is converted into an immediate care plan on admission, which is then reviewed as the service user settles. The care plan is updated as needed at regular intervals. Service users and their relatives are encouraged to visit prior to taking up residence. Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 11 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 excellent. This judgement has been made using available evidence including a visit to this service. The health care needs of service users are identified, planned for and met. Medication policies and procedures are adhered to. Service users are treated with dignity and respect. The standard of care planning set is high and is being maintained EVIDENCE: The home maintains a comprehensive system of care planning. Service users are assessed at regular intervals. The care plan includes a photograph of the service user, physical and mental health assessments, GP and external health / social care professional visits, record of all meals and a daily record which Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 12 includes social activities and visits from friends and relatives. All service users are registered with a GP at the local practice. CPNs support some service users; and will visit otherwise as required following a GP referral. Chiropody and dentistry is available on a domiciliary basis. There was evidence that care plans are reviewed monthly. The home has a medication policy. Medication was appropriately stored in a locked medication room. MAR sheets were signed and dated appropriately. The Controlled Drugs register is appropriately maintained. All medication issues remain the responsibility of the trained staff with the home continuing its policy of minimal medication for service users as far as possible There are no service users self medicating at the present time. Service users informed the inspector that they were treated with due respect and dignity”. The home employs it’s own occupational therapy staff. Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 13 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. Staff pay particular attention to service users’ social needs and provide stimulation in the form of company, conversation and activities. Whilst there are dedicated staff who undertake this role specifically, all care staff assume responsibility for providing quality time with service users. Families and friends are encouraged to remain in contact with their relatives. Staff provide advice and support for them as well as the service users. Service users’ nutrition is well provided according to their need and preference. EVIDENCE: The occupational therapy team work with service users daily, including weekends. They arrange various activities more on a one to one basis rather than as group sessions - although these may be organised as well. The home plans regular events, usually to celebrate occasions such as Easter, Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 14 summertime etc. with staff and relatives being included as well as the service users. Opportunities to go out, either shopping locally, or a trip in the home’s bus etc are provided. The staff with whom the inspector spoke showed a good knowledge of people’s individual needs and circumstances so they were able not only to respond appropriately but were aware of a service user’s previous life or experiences and could thereby share conversations that sometimes seemed muddled. Families and friends can visit as they wish. Meals are presented in a way that is easiest for the service user to manage. For some this may mean meals to be cut up, for others sandwich and finger food is preferable. Kitchen staff are flexible and responsive to need. Meals are served in different settings, again according to individual need. An environment where the social setting for a meal prevails is provided for those who benefit from this whilst a quieter area, for people who require help, is arranged. The home has a trolley shop that visits each unit. The inspector noted that staff chose sweets and treats on behalf of service users (where they were unable to do this for themselves), which showed thoughtfulness. Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 15 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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Awareness of vulnerable service users’ needs is regularly updated through training for staff. Any complaints are taken seriously. EVIDENCE: The home’s complaints procedure is displayed at various points in the home. It is likely that many of the service users would be unable to initiate a complaint on their own behalf but staff all felt that for those people, their behaviour would show that something was amiss. Good contact is maintained with family members who in most cases visit frequently. They too are aware of reporting procedures. Staff receive regular training and updates relating to the prevention of abuse (PoVA). This training commences for new staff through the induction period and is consolidated by further “in house” training via the training officer and through external training such as NVQ and various other short courses such as the “Alerters” course, No Secrets etc. All staff are checked (CRB/POVA) re their suitability to work with vulnerable adults before starting work. Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 16 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): 19,20,21,22,23,24,26,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The location and layout of the home is suitable for it’s stated purpose and provides a safe environment. The home was clean, hygienic and free from offensive odours providing a homely place to live Bedrooms are comfortable and contain the personal possessions of the occupant EVIDENCE: There is level access to the home, with car parking next to the main entrance. Grounds are kept tidy and appeared generally well maintained. There is easy Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 17 access to the main garden area where there are tables and chairs arranged for the use of the service users. A lift is provided to gain access to the first floor for those with mobility problems. The home is generally homely and domestic in nature. Individual bedrooms are of a good size and were seen to be personalised according to the occupants taste. Bathing and toilet facilities are quite satisfactory, containing lifting equipment and various other aids. The home appeared clean, hygienic and generally free from offensive odours. Disposable gloves and aprons are available as required. Hand washing facilities were satisfactory, with liquid soap and paper towels provided. The home has an Infection Control policy. There is an ongoing program of maintenance. A two bedroom extension to the property is almost complete. This will negate the use of two multi occupied rooms. Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 18 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 excellent. This judgement has been made using available evidence including a visit to this service. The suitability of staff and their training needs is afforded a high priority. Procedures are in place to provide a good staff balance in all disciplines so that service users’ needs are met both by number and skill mix. EVIDENCE: The staff group are recruited following a full application and interview, with written references & statutory checks being taken up. Trained nurses and care staff work together in sufficient numbers to provide care for service users. They are supplemented by catering, housekeeping and maintenance staff. The nursing staff have specialities – such as tissue viability, infection control and medication etc – which keeps the home’s knowledge base updated. One member of staff has the responsibility for reviewing training needs and arranging appropriate sessions for all staff. Staff spoken with confirmed that there were good training opportunities to include a full induction program. The home has a good record for National Vocational Qualifications training with more than 50 of carers having either attained or being enrolled for this. Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 19 Training is regarded as a priority by the management and staff. Staff spoken with were enthusiastic about the courses and training made available. Mandatory training is repeated annually and consideration will be given to any other relevant courses that interest staff. Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 20 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, 32,33,34,35,36, 37,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This home has achieved a very good standard of open management and administration, which benefits service users, staff and relatives. Importantly it demonstrated that it does not stand still in that systems are reviewed and improved with new ideas being sought and implemented. The safety of all people within the building is considered. EVIDENCE: Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 21 The registered manager is a registered nurse with significant experience of caring for elderly people with mental health & problems of dementia. The home’s matron, who has completed her registered manager’s award and deputy matron, support her. The atmosphere within the home is good. Interaction between families and staff is encouraged with a representative committee who visit the home to assist with quality audits of the services provided. The different units are, in turn, involved in a self-audit programme, a copy of which is forwarded to the Commission for Social Care Inspection. The home is pro-active in setting and maintaining standards. A carers group meets monthly consisting of relatives of dementia sufferers and supported by a representative from the Alzheimer’s Society. A care standards group reviews progress and the maintenance of standards within the organisation. The home prefers not to involve itself with service users’ money but has an arrangement whereby any necessities needed by service users are either supplied by the family or supplied & billed. Fees & contracts are handled by one of the home’s administration staff who is available to answer any queries families may have. Staff appraisals and supervision have been established and take place regularly. The recording of supervision would benefit from a slightly more formal approach. The records required by statute are well kept. All accidents, falls or events are recorded and reviewed by the matron prior to being filed. Any points that need addressing are highlighted and dealt with. The work practices within the home promote health & safety with moving and handling techniques in evidence; first aid & fire training etc taking place and being recorded. Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 22 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 4 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 4 28 4 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 3 3 3 3 3 Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NONE 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 Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Torpoint Nursing Centre DS0000009252.V325668.R01.S.doc Version 5.2 Page 25 - 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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