Inspection on 27/06/07 for Tracey House

This inspection was carried out on 27th June 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

Tracey House 06/07/09

Tracey House 01/03/06

Tracey House 17/05/05

Tracey House 09/11/04

Tracey House 04/05/04

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 Tracey House Haytor Road Bovey Tracey Newton Abbot Devon TQ13 9LE Lead Inspector Andrea East Unannounced Inspection 27th June 2007 10:00 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 Tracey House DS0000003846.V327627.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. Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tracey House Address Haytor Road Bovey Tracey Newton Abbot Devon TQ13 9LE 01626 833281 01626 833070 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) Mr R J Cooksey Mrs C M Cooksey, Dr J T Zakrzewski, Mrs J T Zakrzewski Mr R J Cooksey Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24), Physical disability over 65 years of age of places (24) Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st March 2006 Brief Description of the Service: Tracey House is a care home for twenty-three older people who may have a degree of physical disability, in the categories of OP and PD(E). The ground floor has two lounge areas, a large sun lounge, a smaller lounge and a dining room. Four ground floor bedrooms have their own sun lounge, and six rooms had patio doors, that led out to the garden area. The home has twenty- two bedrooms. One bedroom could be used as a double room and would be large enough to accommodate a couple. All but three upstairs bedrooms can be accessed via a passenger lift or stair lift. Most bedrooms have en-suite facilities, eighteen rooms include a shower, and all enjoy attractive views. There are two bathrooms with hoists, one on each floor. The house is situated about a mile from the centre of Bovey Tracey and has two and a half acres of attractive grounds with far reaching views of the surrounding countryside. There are level paths around the beautiful garden, with benches and seats at many vantage points. There are flowering shrubs, fruit trees and a productive vegetable garden. The range of weekly fees for the home ranged from £353 to £ 486.00 Additional charges were made for toiletries, clothes, hairdresser, some transport costs, and days out. The information about charges was provided as part of the homes pre inspection questionnaire on 30/01/07. The homes service users guide and a copy of the last inspection report could be found in the homes office. Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection site visit was carried out over a day. The inspector examined a range of documents including, staff files and files holding information about the people using the service, policies, procedures and the homes service users guide. People using the service were spoken too in the homes lounge and in private rooms and members of staff were also spoken with. The homes manager was present throughout the inspection. Feedback about the home was also received by post in quality questionnaires provided by the Commission and in a pre inspection questionnaire submitted by the home prior to the inspection visit. What the service does well: The service had good pre- admission processes that ensured that those people considering moving into the home, were welcomed and were well informed before coming to the home. This also included a discussion with the person or their advocate about their assessed needs and how those needs would be met. The team of staff provided an excellent standard of care that was based on the individuals assessed and changing needs. Individual’s needs were clearly set out in a range of documents that helped staff to consistently care for people in the way they wished to be cared for. The home provided a range of activities and stimulation for the people using the service. This included supporting people to carry on with past hobbies and interests and to join in with the local community and the many events in the home, such as coffee mornings, attending clubs and church. The home was well maintained, clean, tidy and personalised to provide a good standard of accommodation. The staff in the home was praised by those using the service and their advocates, being described as “kind and caring”. Staff, were trained, competent and showed a keen interest in making sure those people using their service were well cared for. The management approach in the home was excellent as the management and staff team actively sought to involve those using the service to take part in the day to day events in the home. The manager, owners and staff team worked together to develop quality monitoring, processes, polices, procedures and practices, to ensure the health safety and welfare of those people living and working at the home. Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people using the service were confidant that their care needs had been assessed and that their needs could be met, right from the start of their stay in the home. The services provided did not include intermediate care. EVIDENCE: The manager confirmed that before coming into the service people were offered the choice of visiting the home. The manager, owners or a senior member of staff completed pre-admission assessments and discussed with the people planning to use the service and their families, peoples needs and likes and dislikes. This was to ensure that the care needs of the people planning to use the service were identified, discussed and agreed before the person moved into the home. Files maintained on behalf of the people using the services included initial summary assessments, notes of telephone enquiries and more detailed Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 9 assessments that had been completed with the person planning to come to the home and their family. These assessments showed the person’s individual needs, wishes and interests and indicated that staff had considered how the person using the service would be best cared for. Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People using the service had their health, personal and social care needs fully met and this was set out in an individualised plan of care. Individuals are involved in decisions about their lives, and played an active role in planning the care and support they receive. People were treated with dignity and respect and their privacy was upheld EVIDENCE: Surveys, which had been completed by relatives and friends on behalf of the person using the service, consistently said that the people living at the home felt that “one could not wish for a better home and “we are all very well looked after. Surveys consistently praised the standard of care provided in the home. Care plans described individual’s personal care and health needs in detail and showed that these needs were reviewed and re-assessed. Staff confirmed that they regularly consulted with the person using the service or/and their families on how they wished to be cared for and this was recorded in ongoing records, care plans and communication books. Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 11 Care plans and ongoing records clearly showed how people were supported in attending health care appointments inside and outside of the home. This demonstrated how the home had sought assistance when needed either from outside professionals are the team of nurses and experienced staff at the home. Medication administration policies, procedures and practices actively involved the people using the service and ensured that medication was administered safely. A member of staff had been delegated as ‘Medication Officer’ to monitor and review practice and procedures and this was working well in continually improving medication administration. Staff were observed discussing medication needs with individuals, checking if that person was happy to continue to take medication and they did not require any further assistance. People were observed being actively supported to administer their own medication safely. This included written risk assessments. Members of Staff were observed following good medication administration practices such as staying with the person receiving medication until the medication had been taken. This ensures that medication has been taken as prescribed and that individuals have an opportunity to discuss any issues with staff. Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People’ s lifestyle in the home met their expectations and satisfied their needs. People who used the services were able to make choices about their life style, and were supported to develop their life skills. Social, educational, cultural and recreational activities met individual’s expectations. People enjoyed an appealing, varied diet in pleasant open surroundings, at a time that suited them, with attentive considerate support from staff EVIDENCE: People consistently said that they enjoyed living at Tracey House. The homes pre- inspection questionnaire listed a range of activities including video and music afternoons, exercise classes, choir visits, attending church and a gardening club. The people using the service and the staff said that these activities were part of the everyday life in the home and were flexible based on individual’s needs and interests. Individuals had also continued to pursue personal interests such as attending the gardening club and local church service. For those less able staff made the Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 13 time to chat on a one to one basis and encouraged people to use the extensive gardens. A range of documents including risk assessments, care plans and ongoing daily records showed how those people using the service were encouraged to maintain links outside of the home and with families and friends. This included colourful newsletters informing the people using the service of past and present events and sharing information on the positive things the people in the home had achieved. For example the people living in the home and staff had raised money for charity. The people using the service praised the quality of the meals provided and said that they were pleased with the level of choice of menu on offer. Surveys said “we are given a very good variety of food. The food is always well cooked and it is always very nicely served out.” The people using the service said that they were able to choose when they ate and what they preferred to eat at a pace they felt comfortable with. This included if they wished to have afternoon tea and cakes served in their room or in the lounge or conservatory areas. Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who used the service were able to express their concerns, and complaints and suggestions from those using the service, relatives or other visitors to the home were treated seriously. People were protected from abuse, and had their rights protected EVIDENCE: The people using the service said that they felt able to talk to all the staff including the manager and owners about any concerns issues or worries. Most of the people spoken too said that they knew how to raise complaints if they wished to do so. People using the service were supported to raise areas of discussion and improvements through a “residents meeting”. The meeting had been recorded and the record showed that the people in the home had been listened to. Complaints procedure were included in contracts, displayed in the home and were part of the home service users guide, so that everyone in the home has access to a complaints procedure and knew how to raise concerns. The format for recording complaints had not been used. The manager said that this was due to having not received any formal complaints and that any issues raised were quickly addressed and noted in daily records. Using a more formal Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 15 complaints format would make it easier for the manager of the home to monitor concerns and address any reoccurring issues. A more formal format would also demonstrate the action taken to address concerns and could be used as part of the homes quality assurance. Staff records showed that care staff had received training in issues relating to the protection of vulnerable adults. Tracey House DS0000003846.V327627.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People enjoyed living in a very pleasant, well-maintained house, which offered a range of facilities and was comfortable, clean and safe. EVIDENCE: The home presented as a clean, tidy home decorated, furnished and maintained to a high standard. The people using the service said that all the staff team worked together to keep the home clean and tidy. One area of the home was being decorated at the time of the visit and the manager confirmed that equipment was being replaced and décor upgraded around this area in the near future. The lounges, dining and conservatory areas presented as pleasant, welcoming areas, that the people using the service were observed enjoying, as they were Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 17 using these areas to socialise and dine in. The people using the service also said that weather permitting they enjoyed the extensive gardens and seating areas outside the home. A range of documents, including risk assessments for the premises, fire risk assessments, receipts and contracts, showed regular, planned and routine maintenance of the premises and equipment. Action had been taken to ensure the safety of those using the service by ensuring that risk assessments included key areas, such as infection control and manual handling. Practical measures had been taken to reduce potential risks in the home for example radiators had been guarded and hot water temperatures controlled to prevent the risk of injury. The manager confirmed that all those people using the service had been asked if they would like a lock fitted to their private rooms. The use of locks and keys had been detailed in individuals care plans. Tracey House DS0000003846.V327627.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people using the service, were supported by Staff, who were trained, skilled and competent. Staff had been subject to rigours recruitment checks EVIDENCE: The people using the service described the staff as kind and caring and they said that, “staff were lovely always want to help” and that staff were “friendly, helpful and caring”. Surveys said that staff, “were always available when needed and that staff listened and acted on what was said”. Many of the staff had been employed in the home for a long time (some years) and when spoken too had a detailed knowledge of the way the home is run and the needs of the people using the service. The manager said that the home continued to support staff to complete a range of training based on the needs of the people using the service. This included training in key areas such as infection control, health and safety and first aid. Staff training records and supervision records for staff showed that staff had completed internal and external training. This included completing National Vocational Training in Care at level two or above. Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 19 A sample of staff files were examined and they included completed application forms, interview notes, proof of identity, reference and police checks. Staff files also held details of staff induction into the home, staff supervision and any disciplinary action the home had taken. These records demonstrated the homes commitment to ensuring that only those suitable to work with vulnerable adults were employed in the home. The application form currently in use, is one that has been used for some time and while the forms meets the basic requirements of the home, a more modern updated form would give much more information about candidates. This would allow the manager to make a more informed decision about interviewing potential staff, earlier in the recruitment process. Tracey House DS0000003846.V327627.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People lived in a well managed home, with the management, administration and staff team, working together to provide a stimulating, safe environment that respected and protected peoples’ rights. EVIDENCE: The people using the service consistently said that they felt safe and well cared for in the home. Surveys returned to the Commission from visitors to the home consistently said that they felt the home was well managed and that they were kept informed of any changes in the home or in the care of their relative. Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 21 A range of documents and systems such as accident monitoring, Health and Safety policies and procedures, risk assessments, staff training and induction showed how the manager and staff team worked together to ensure the safety of those people living and working in the home. The manager and staff team had introduced a range of ways of consulting, informally and formally, with the people using the service and their families. This included quality questionnaires, that were audited and showed how improvements had been, made after suggestions by the people using the service. The newly introduced residents meetings also showed how people are encouraged to have a voice in the home and how people are listened too. Tracey House DS0000003846.V327627.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 x 3 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP16 OP19 OP29 Good Practice Recommendations Use the written format for recording complaints and audit the forms as part of the monitoring of quality in the home Complete the planned redecoration of the stairway and hall. Consider a more up to date format for application forms for staff being recruited into the home. Tracey House DS0000003846.V327627.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Tracey House DS0000003846.V327627.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. 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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