Inspection on 06/09/05 for Torpoint Nursing Centre

This inspection was carried out on 6th September 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

Torpoint Nursing Centre 10/01/07

Torpoint Nursing Centre 16/03/06

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 Philippa Cutting Unannounced 06 September 2005 09:30am 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. Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Torpoint Nursing Centre Address Vicarage Road Torpoint Cornwall PL11 2BW 01752 813677 01752 816323 antony@torcare.co.uk Torcare Limited 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) Mrs Elizabeth Margaret Fourniss Care Home 57 Category(ies) of Dementia - over 65 years of age (30) registration, with number Mental 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 D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 12 August 2004 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 person’s 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. Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place between 9.30am and 5.0pm. The inspector met with the home’s nurse manager, Ann Newcombe, senior carers, carers, occupational therapy staff and service users plus some relatives. There was a discussion about the home’s philosophies and how it would tackle different situations and problems. Staff described the training and tasks that they undertook; service users and relatives were asked how they found the care that was provided. All those with whom the inspector spoke were very positive. Care records were inspected, as were those required by statute. Staff records were not looked at on this occasion but one of the administrative staff described the processes that the home follows when recruiting a new person. The inspector walked around the different areas of the home and saw the communal rooms, bedrooms and bathrooms/WCs. 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. What the service does well: There is a good commitment to training for staff. People who attend outside courses are expected to cascade the information down to others. Staff are tolerant and patient if a service user presents with problems or behaviours that are difficult to manage; they seek help from other agencies when needed. The psychological well being of service users is afforded a high priority. This is the responsibility of all staff but in particular of the three staff who provide occupational therapy on a daily basis to both individuals and small groups of service users. The premises continue to be well maintained. Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 Page 6 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. Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 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 Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 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) 1,2,3,4,5, Good information is provided by the home about the services that it offers and it seeks sufficient information on prospective service users to ensure that it can meet their needs. EVIDENCE: Copies of the home’s statement of purpose & service users guide plus inspection reports are displayed in the reception area for anyone to read. The terms and conditions of occupancy at Torpoint Nursing Centre are provided for each service user or more generally their family. Prospective service users are assessed and information is sought about their needs. The home will only offer a place if there is a suitable room in the appropriate area. It does not therefore keep a waiting list of a ‘first come, first served’ basis. In some instances people’s needs are felt to be best served by sleeping in one area where there is close observation at night, for example, but spending their waking hours in another unit, where people are more communicative. Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 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 Service users’ care needs are carefully recorded and reviewed. The practice in the home allows for people’s needs to be met in as individual way as possible. EVIDENCE: Each service user has an individual file with his/her details, care needs and care plan as well as daily entries as to their wellbeing. The care plans were seen to be reviewed monthly. There was some good recording in daily notes and also an example of poor recording, which was discussed. The home is experimenting with a pre printed core plan of needs. This assumes that where a problem is identified, e.g. washing and dressing, the components needed to achieve a satisfactory result are the same. How these components are met is then recorded individually for each service user, in order to meet their specific needs. The inspector queried how any special attention to infection control should be notified to staff. Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 Page 10 Staff are reminded that national minimum standard 7.6 recommends that care plans should be signed by the service user, (or - more likely in the case of those living at Torpoint Nursing Centre - their relative), to show their involvement and agreement with their care plan. Medication is undertaken by the trained staff. The receipt of new medications is carefully checked, recorded and stored. The home actively seeks, with the GPs’ cooperation, to use as little medication as possible to ensure people’s health and welfare. For example, dietary considerations are used rather than laxatives etc. Syrups are supplied if this is easier for a person to swallow and time is allowed to coax a person to take medication if there is initial reluctance. Force is never used if medication is refused. There are currently no controlled drugs in the home but the correct recording and storage facilities are available. Comments made to the inspector and observations indicated that people are treated with respect and dignity. Many of the very frail are afforded loving cuddles and attention if this is what they seek. Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 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) ,13,14,15 The home is aware of the need and benefits of people’s psychological well being and tries to provide opportunities for service users and their families to be involved in exercising autonomy and choice. EVIDENCE: Staff are largely reliant on relatives to advise them of a service user’s previous interests and hobbies. Many are not able to express their wishes succinctly but demonstrate this through their behaviour. It was noticeable that staff who cared for the frailest service users had become experienced at ‘reading’ the service users’ feelings through their body language and responded to this. There are also people in the home who are able to exercise a good degree of independence and they are encouraged to do so. Like-minded people who have common interests are introduced to each other. Some were seen to seek one another out The staff who arrange activities and outings are closely involved in maintaining service users’ interests etc. although all staff participate in promoting social contact with and amongst service users. The weekly programme of events and activities is displayed in the reception area so that families and friends who are visiting are aware of what is Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 Page 12 happening as well as staff. Few service users were seen in this area so they may be less sure of what is arranged? The staff will spend a lot of time with families, especially in the weeks following an admission, as this can be a difficult period for relatives, having to adjust to the changed circumstances. The manager said that she always tries to involve families when a service user may be reluctant to allow all the care that the staff would like to give. At mealtimes, food is presented in a way that makes it easiest for people to manage independently, with time being allowed where necessary. The inspector observed a number of people who needed feeding and was impressed with both the approach to persuade people to move to the table or the close attention when everything had to be done for them. Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 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) 16,18 Any complaints or suspicion of abuse are taken seriously and dealt with correctly. EVIDENCE: The complaint’s procedure is prominently displayed throughout the home as well as being included in the information provided to service users & families. There have been no complaints since the last inspection. Staff have received PoVA (protection of vulnerable adults) training. Staff with whom the inspector spoke, were aware of the action that should be taken should they have concerns. Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 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) 19,20,21,22,23,24 People living in the home can be assured that their rooms are well maintained and decorated and that there is sufficient communal space to meet people’s needs. EVIDENCE: The home has wide corridors and doorways of a width to allow the easy passage of wheelchairs and other wheeled equipment. There was some evidence that more turning space needs to be allowed when moving hoists in and out of doorways. There is sufficient room but where the angle of approach is too sharp, door surrounds are being scrapped. The décor throughout the home was in good order with evidence of new carpets in upstairs corridors. More colour is being introduced and planned in corridors although service users’ rooms are already decorated in different colours and contained items to personalise the room for the occupant. Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 Page 15 Bathrooms and toilets were seen to be clean with equipment to promote independence or assist staff when helping a service user. The manager undertook to remind staff not to leave creams prescribed for named people in bathrooms after use. All areas have the equipment needed to care for the service users. This included pressure relieving mattresses, cushions, chairs, toilet equipment and hoists etc. The manager said that plans were being drawn up to alter the two rooms that still accommodate three people per room. A new small conservatory to provide a quiet area for families or private space is underway. Sitting areas on patios and in the garden are readily accessible for people to use in fine weather. The laundry was not inspected on this occasion. Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 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) 27,30 The home puts great store by its staff, ensuring that they are properly recruited, trained and deployed in sufficient numbers to provide a good service. The staff group were very positive about their roles and said they enjoyed working for the home. EVIDENCE: Staffing rotas showed that the staffing levels are good and can be adjusted if the needs of a service user or unit indicate that this required. This has occurred in one area recently, with staffing levels being increased so that service users receive more time. Staff were positive about the different training initiatives that are provided. As well as basic and mandatory training, courses of relevance and interest are organised. The manager said that approximately 60 or the staff now hold, or are on, National Vocational Qualifications courses. The inspector noted that administrative staff were in the process of obtaining checks and clearances for a person who was due to join the staff group shortly. Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 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) 31,32,33,37,38 The home has efficient systems to oversee the management and administration of the home which help protect the best interests of the staff and service users. EVIDENCE: The owners of the home are closely involved it and spend time with staff and service users on a regular basis. The manager, who is a trained nurse, has almost completed her registered manager’s award but said that this sometimes had to take second place to other pressing matters in the home. She makes herself readily available to anyone who needs to see her, especially relatives who have concerns about a service user. She has been involved with starting the ‘self assessment’ Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 Page 18 initiatives in the home. The home’s committee are also closely involved in scrutinising what goes on and provide a ‘layman’s view’ for consideration. Records required by statute were seen to be current. All accidents are recorded even if only minor. A initiative to look at falls and any patterns arising has been started. Fire testing and training is up to date; the home has had a practical session recently when an injury and evacuation was simulated. A weekly walk round is made to check for any Health & Safety issues although all staff report anything they notice for the attention of the maintenance team. An external consultant conducts an annual review of the health & safety policies etc. Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 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. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 x x STAFFING Standard No Score 27 3 28 x 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 4 3 x x x 3 3 Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 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 Regulation Requirement There are no statutory requirements 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 OP7.6 Good Practice Recommendations Service users, or a relative, should be asked to read and sign care plans to show their understanding and agreement with the care planned. Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall, PL25 4AD 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 Torpoint Nursing Centre D52_D04 S9252 Torpoint Nursing Centre V246601 060905 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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