Inspection on 21/07/05 for Tregertha Court

This inspection was carried out on 21st July 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

Tregertha Court 02/11/07

Tregertha Court 23/01/07

Tregertha Court 09/12/05

Tregertha Court 06/10/04

Tregertha Court 16/06/04

Tregertha Court 23/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE Tregertha Court Station Road East Looe Cornwall PL13 1HN Lead Inspector Philippa Cutting Unannounced 21 July 2005 09:30 a.m. 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. Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tregertha Court Address Station Road East Looe Cornwall PL13 1HN 01503 262014 01503 262014 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) Tregertha Court Limited Lorna Catherine Elizabeth Jee Care Home 38 Category(ies) of Dementia - over 65 years of age (3) registration, with number Mental Disorder, excluding learning disability or of places dementia - over 65 years of age (3) Old age, not falling within any other category (35) Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 6 October 2004 Brief Description of the Service: Tregertha Court is part of the Aldington group of homes, a privately owned family run company. It is situated in Looe overlooking the river and activity on the outskirts of the town. An older property with an interesting history, it now offers care and accommodation on three floors to older people. The upper floors are reached by stairs or stairlifts. A number of rooms are ensuite and those in the front of the home have good views. There are two communal sitting areas at the front of the home and seating outside for use in good weather. The home had a lovely display of flowers, which several service users pointed out to the inspector and it enters the local in bloom competion regularly. A new garden has been made for people to use at the side of the home. There is limited car parking available. Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 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 4.40 pm. Lorna Jee, the registered manager, was present. The inspection included the inspection of records – particularly care plans – a tour of the premises, observation, and discussion with service users, their relatives and staff. Four people were looked at in greater detail in order to track their care and records. Service users appeared to be content and those who made comments were very favourable about the care and attention they received. Relatives who visited the home that day confirmed their satisfaction as well. The home provided care for a number of local people who liked the fact that they could still see landmarks that were familiar to them. In summary Tregertha Court was felt to be a well run home offering the care and attention the current group of service users require. What the service does well: What has improved since the last inspection? What they could do better: Access to the home ( & therefore security) at pavement level needs to be considered. This is likely to affect staff more than service users but is none the less important. Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 Page 6 For some people who have particular problems a more detailed risk assessment needs to be done. This would be relevant for example if someone has a tendency to fall or chooses to go out alone. This was discussed with the registered manager. 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. Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 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 Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 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) 3,4,5, Service users’ needs are assessed prior to admission to ensure these can be met. Accommodation would not be offered otherwise. EVIDENCE: The registered manager visits all prospective service users prior to offering accommodation to ensure that Tregertha Court can meet their needs. A number of service users have had day care or respite stays in the home before moving in permanently, otherwise people are invited to visit the home to look round, meet staff etc.. All stays are offered on a one month’s trial basis initially. A copy of the home’s service users guide was seen in service users rooms. Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 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 is documented and reviewed regularly to enable needs to be met appropriately. Service users’, or their families’ approval should be sought to signify agreement with the arrangements. EVIDENCE: Care plans are drawn up for each person and these identify where additional advice or help is needed from other professional agencies. These are mainly the community nursing service and the chiropodist but physiotherapy, the speech & language therapist and community psychiatric nurses have been involved. The care plans are reviewed monthly and any changes noted. A senior carer who is responsible for the care plans of a number of the service users said that each plan is re-done completely every six months. She said that this gave the opportunity to consider the needs and goals carefully rather than just copying out the existing plan. A signature from the service user or his/her representative should be sought to show their agreement with the care. Medication is administered via a monitored dose system with additional packets if tablets cannot be blister packed. The system appeared to be well Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 Page 10 managed with a blister to service user method being used. Medication was dispensed individually, ‘block dispensing’ is not practised. The controlled drugs (CD) register accorded with the CDs in stock. The registered manager said that the supplying pharmacist had audited the medication and the home’s procedures recently. Staff were heard speaking to service users in a friendly manner. They knew with whom they could joke and when to be more serious. A good example of practice was heard when a carer was trying to help a service user remember that her parents were no longer living. Service users said the staff were ‘excellent’, ‘very kind’ & ‘helpful’. Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 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 The home aims to provide opportunities and activities to help service users to remain alert and stimulated. Service users and relatives expressed satisfaction with the home. EVIDENCE: Although the home has two lounges in the front of the home and another quieter room, the majority of service users prefer to sit in one lounge, usually in ‘their’ chair. There is more happening and people moving about in this part of the home, which service users seem to like. One member of staff arranges activities for service users and although she was not there at the time of the inspection, examples of artwork were seen. Service users said they also liked bingo sessions, quizzes and music. Photographs and information about people’s lives during the World War ll were displayed as part of a recent a VE/VJ celebration. The hairdresser was busy during the day with a regular clientele who wanted to have their hair done. Visitors called at the home during the day and those with whom the inspector spoke said they were very satisfied with the care their relative received. The home is close enough for people to go into the town although the majority now Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 Page 12 need to be accompanied or taken in a wheel chair. People are also encouraged to go to relatives’ and friends’ houses when invited. The home will look after savings for service users but prefers people to make their own arrangements for collecting benefits etc. Meals can be served either in the dining room or in peoples’ rooms as they wish although everyone is encouraged to come to the dining room as a social part of the day. Lunch is served in two sittings, the dining room being a pleasant room with small tables for up to four, nicely laid and set out. People are offered a choice for their meals. The registered manager said that people often asked to have a cooked breakfast when they wanted to. Service users said the food was good and supplied in plentiful quantities. Several people said the portions were often too large for them to manage as they had reduced appetites. Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 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) 16,17,18 The home would deal with any complaints or concerns thoroughly. EVIDENCE: The home’s complaints procedure is displayed in the home and included in the service users guide. Some service users are unlikely to remember this and therefore it is important to record any concerns or problems. Correspondence relating to a complaint was available for inspection but the registered manager is advised to keep a book listing any comments (praise and critical) with the problems and action taken to resolve it, as evidence of the home’s attention to this. Service users were offered postal votes in the recent election and some chose to exercise this. The home has policies on the protection of vulnerable adults (POVA) and the registered manager is aware of the process to be followed if a case was suspected. Social Services are currently offering a series of seminars on POVA & whistle blowing which staff are urged to attend. Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 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) 19,20,21,22,23,24,25,26 Service users’ rooms were individually arranged and decorated to a good standard. The home was well maintained throughout although there are long passages in some parts, which some service users found daunting. There is a need to consider the security in parts of the home not used by service users. EVIDENCE: A tour of the building was undertaken with service users’ rooms being viewed. These are all different colours and it was nice to see so much variety and individuality, coupled with peoples’ own personal items, rather than uniform colour schemes throughout. There are adequate bathrooms by number throughout the home but it was apparent that most are not used, as an increasing number of service users need a bathroom that has suitable hoists etc. Equipment to assist service users was noted in some ensuite bathrooms so that the people in the ensuite rooms could benefit from this facility. The home has equipment to assist service users who are less able; this includes hoists. All staff undertake moving & handling training. At present the Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 Page 15 majority of service users in the home are fairly able although some need a wheelchair to help them cover the distance between their room and the lounge for example. Equipment to assist with mobility and independence, such a frames and sticks etc and toilet aids, are in use. The home has a good housekeeping team who work hard to keep the home clean and tidy. The laundry handles a lot of washing and although the laundry person was elsewhere at the time the inspector visited the laundry, there appeared to be a system for handling the volume of clothes. It seemed as though anyone working in the laundry could be on their own for considerable periods of time. It would be prudent to make sure there is a method of calling for help in a emergency. The situation of the home means that the main entrance is up steps or a ramp. There is a large workshop leading through to a staff room at pavement level. Consideration needs to be given to security here as, for a large part of the day, the people who use this area were elsewhere and anyone could have walked in off the street and taken items from either room, which included sets of keys. Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 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) 27,28,29,30 The staff team have the service users’ interests in mind at all times when assisting them. The home has a stable group of carers who receive appropriate training. EVIDENCE: There are sufficient staff for the current service users’ needs. The registered manager reported that they were a stable group who worked well together. All are encouraged to undertake National Vocational Qualifications training and an assessor was in the home during the inspection observing the practice of a number of candidates. Individual staff files showed that references, POVA and Criminal Records Bureau checks are completed before a person takes up a position in the home. A new person works under supervision until his or her induction programme has been satisfactorily completed. Two members of staff are responsible for staff training and development. Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 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) 31,32,33,36,37 The registered manager is supported by the home’s owner and has herself the skills to manage efficiently, seeking help if she has any difficulties. EVIDENCE: The registered manager is working toward her National Vocational Qualifications level lV. Staff and service users obviously felt free to approach the manager with any queries or comments and they said that any ideas for changes in practice would be listen to and evaluated. An independent person visits the home regularly to seek the views of service users and their families about the care and services offered in the home but the surveys were not viewed on this occasion. The home has insurance cover. Staff supervision is on going. Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 Page 18 Fire records showed that alarms and emergency lighting were tested regularly within the recommended time scales and staff received regular training. Accidents should be recorded in the book that conforms to the requirements of the Data Protection Act 1998. One record of an accident was discussed with the registered manager as the inspector felt that a fuller explanation should have accompanied the report. This is an area that the responsible individual should look at during visits. He is reminded that copies of his reports need to be forwarded to Commission for Social Care Inspection on a regular basis. Health & safety policies were not inspected. The home has an outside consultant who undertakes an annual audit. Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 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 x x 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 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 Standard No 16 17 18 Score 3 3 3 3 3 3 x x 3 2 x Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 Page 20 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard OP7 OP37 OP37 Regulation 15 26 17(2) Schedule 4 Requirement Service users or their representatives should sign care plans. The responsible individuals monthly visit reports must be forwarded to the CSCI. Accidents should be recorded in a book that conforms with requirements of the Data Protection Act 1998. Timescale for action 1st September 2005. 1st Septemebr 2005 !st September 2005 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. 4. Refer to Standard OP16 OP18 OP38 Good Practice Recommendations A book to record concerns/complaints should be kept. The registered manager should attend a POVA /whistle blowing seminar organised by Social Services. The security and access to the building at ground level should be reviewed. Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 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 Tregertha Court D52-D04 S9233 Tregertha Court V227823 210705 Stage 4.doc Version 1.30 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. 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