Inspection on 17/11/05 for Trelawney House

This inspection was carried out on 17th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Trelawney House 18/11/08

Trelawney House 21/05/08

Trelawney House 09/07/07

Trelawney House 02/11/06

Trelawney House 06/06/06

Trelawney House 17/05/05

Trelawney House 04/11/04

Trelawney House 14/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Trelawney House Polladras Carleen Helston Cornwall TR13 9NT Lead Inspector Diana Penrose Unannounced Inspection 17th November 2005 09:00 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 Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 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. Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Trelawney House Address Polladras Carleen Helston Cornwall TR13 9NT 01736 763334 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) Christine Anne Gatzianidis Rigas Gatzianidis Care Home 11 Category(ies) of Old age, not falling within any other category registration, with number (11) of places Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include one named service user with dementia which is outside the registered category. 17th May 2005 Date of last inspection Brief Description of the Service: Trelawney Care Home is situated in the village of Polladras, about five miles from the town of Helston. The property used to be a hotel until the year 2000. The home is set in its own spacious grounds and has gardens with seating provided for residents. There is sufficient car parking space at the front of the home. The home offers residential care for up to eleven elderly people. Daycare is also provided. Accommodation is on two floors; the first floor can be accessed by a shaft lift. There is one large lounge with another smaller lounge. There is also a games room with pool tables, this is the room designated for residents who wish to smoke. Meals are cooked in a large kitchen and served in the dining room. Trelawney provide a meals on wheels facility and supply around ten meals to people in the community each day. The homeowners live on site in a mobile home and are actively involved in the day-to-day running of the home. Care staff provide personal care and the home has a friendly, atmosphere. There are opportunities for socialising and visitors are openly encouraged. Residents gave very positive views of the home. Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector visited Trelawney Care Home on the 17 November 2005 and spent seven and a half hours at the home. This was an unannounced visit. The purpose of the inspection was to gain an update on the progress of compliance to the requirements that were identified in the last inspection report dated 17.05.05. In addition the inspector focused on the following key areas of care: choice of home, care planning, leisure, complaints, adult protection, some of the environment and some management areas. On the day of inspection 8 residents were resident in the home. The methods used to undertake the inspection were to meet with a number of residents, staff, and the registered providers to gain their views on the services that Trelawney offers. Trelawney’s records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. The inspector entered the building via the laundry as no one answered the front door bell; the external door to the kitchen was also unlocked. The providers must ensure these doors are secure for the safety of the residents; an immediate requirement was issued. There were two care staff working upstairs in the home, the registered providers arrived a little later. 16 requirements and 7 recommendations are notified in this report. What the service does well: What has improved since the last inspection? The kitchen refurbishment is in progress with new units and a double sink now in situ. Tall trees around the building have been removed and allow more natural light and extended views over the countryside. Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 Page 6 Some of the bedrooms have been re-decorated and others are in line to be done. The daily records and food records have improved since the last inspection. The environmental risk assessment has been completed. 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. Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 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 Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 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 the following standard(s): 1 According to the registered provider prospective residents are given information about the home; this information is not available in the home. EVIDENCE: The statement of purpose and residents guide were not available for inspection; the registered provider said they are stored on the computer and she would send a copy in a few days. She said new residents are given a copy of the statement of purpose and residents guide. She is hoping to produce a brochure that will include the residents guide. Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 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 the following standard(s): 7 and 9 Individual care plans are generated for each resident; when all documents are amalgamated they will fully inform and direct staff in the care provision. There is a system and policy in place for dealing with residents medicines; some additions to the policy and extra vigilance in record keeping will help to ensure residents safety. EVIDENCE: Each resident has a written care plan and a staff support level assessment. It is recommended that the two documents be kept together to fully inform and guide the staff. The text written regarding the care to be given is personalised and gives good direction on the care to be provided. All care plans and reviews must be dated and signed by the people involved. The resident or representative should also be involved and should sign to agree the care plan and any review. Relevant risk assessments are undertaken and there are photographs of each resident on file. Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 Page 10 The registered provider said the care plans are reviewed every six months; this must be evidenced in the paperwork. The daily records have improved since the last inspection. The nomad medication system is used in the home. There were no Controlled Drugs, Schedule 3 medicines or medications requiring storage in a fridge and there were no residents on oxygen therapy, on the day of inspection. Medicines are stored securely in a locked cupboard. Patient Information Leaflets are provided. Transcribing of medicines onto the MAR charts must be witnessed with two signatures recorded. The home has a policy but a copy of the ‘The Royal Pharmaceutical guidelines for the administration of medicines in care homes’ could not be found. Medicinal creams and lotions should be dated when first opened to ensure the correct disposal date. The medicines policy must include the use of medicinal creams and lotions. Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 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 the following standard(s): 12 The home provides a range of activities and aims to offer a lifestyle that meets individual residents needs. EVIDENCE: A new senior care assistant said she would be taking responsibility for activities in the home. She said she is doing some research with the residents to find out what they want. There is a games room in the home with a pool table, which is rarely used. Activities include dominos, crosswords, knitting, massage, music and movement, a monthly church service and walks outside. Singers come into the home and there was a husband and wife team there on the afternoon of the inspection. A carer was dancing and the residents were thoroughly enjoying themselves. Trips out are organised at random. Residents said they are happy with the activities provided and they can go out when they like. Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 16 and 18 The home has a satisfactory complaints procedure that should ensure that complaints are listened to and acted upon. Some arrangements are in place for the protection of residents; further safeguards are required to ensure they are free from harm or abuse. EVIDENCE: There is a suitable complaints procedure in the home. The home has had no complaints but there has been a complaint investigation by the Commission that included several concerns regarding care provision and safety, staffing, family pets and the attitude of the registered provider. Thank you letters and cards are kept. There is a draft adult protection policy and a separate whistle-blowing policy. The adult protection policy must be completed to include the new inter-agency policy for Cornwall. The registered provider said that POVA training for staff is in hand she is waiting for a response to her enquiry. Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 19 and 26 The home and grounds are well maintained securing external doors will ensure a safer environment for residents, staff and visitors. The home is clean and free from offensive odours; further controls could be in place to improve infection risks EVIDENCE: The Inspector entered the home via the laundry and walked around the home; the back door to the kitchen was also unlocked. External doors must be secure to ensure residents safety an immediate requirement was issued. The home is clean, warm and comfortable. The registered providers are making every effort to combat the odours present in one room. Residents say they like their home and are happy living there. The garden is tidy and accessible the tall trees have been removed letting in more light. There is an ongoing programme of maintenance and refurbishment. One bedroom was in the process of being refurbished. It is recommended that suitable net curtains / blinds be provided in rooms overlooking the neighbours, for privacy. There have been no changes to the layout of the home. One resident now has a cat, Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 Page 14 which was in the lounge with her. Another cat belonging to the registered providers came into the home but was put out again. The laundry is suitable with two washers and one drier. There are suitable hand-washing facilities for staff in most areas; a hand-wash sink, with soap and paper towels in dispensers must urgently be provided in the kitchen. At present staff say they are using the facility in the staff toilet. Alcohol hand gel is provided for staff and protective clothing is used. Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 Staffing levels generally meet the needs of residents; a more permanent workforce would be beneficial. Recruitment procedures are not robust enough to offer maximum protection to the residents. The home provides some training for staff; more evidence is needed to show they have the knowledge and skills to fulfil their roles. EVIDENCE: The registered providers continue to have problems sustaining a stable workforce. The rota indicates a six-hour shift pattern with two care staff on duty during the daytime; they are also responsible for the laundry and the cleaning. A new cleaner is due to commence work on the 21/11/05. Staff said that at night one of the registered providers is in the home and the other is on call in their mobile home next door. They have a radio system for contacting each other. Mr Gatzianidis is responsible for the catering. A letter of resignation was received from a senior carer during the inspection. Prospective employees complete an application form and a health questionnaire prior to an interview with the Registered Provider. Some interview records are maintained. References are sought prior to employment but none were available on the files inspected. CRB and POVA checks have been applied for, not all the files inspected held current checks. The registered provider said there have been problems with the POVA checks coming through. Staff must not commence work in the home until a satisfactory POVA check and two references have been received. Staff must work under constant supervision until their CRB check has been received. The registered provider Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 Page 16 said that all employees are given a job description and a statement of terms and conditions of employment. There was a contract on one file inspected. The registered provider said the staff training profiles are held on computer but these were not evidenced. She said that training needs including induction are identified through staff supervision. She said the registered providers and one carer (no longer at the home) have undertaken training in dementia care. Mrs Gatzianidis said she has achieved the intermediate certificate in nutrition and Mr Gatzianidis said he has achieved the Intermediate Food Hygiene Certificate and undertaken infection control training. All training records must be available for inspection. There must be evidence that appropriate induction training is undertaken. Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 The registered providers promote the health, safety and welfare of residents, staff and visitors, further training and safety measures will enhance this. EVIDENCE: There were some fire training records in a file the training and the records must be up to date. The registered provider said that all staff have completed first aid training and that the district nurses provide training in the use of the hoist. She hopes to get a member of staff trained as a moving and handling trainer. All necessary service and equipment checks are undertaken regularly. There is a satisfactory fire risk assessment. Accidents are recorded and reported appropriately. There should be evidence in the home that the animals do not pose a risk of spreading infection in the form of veterinary care records; the registered provider said she would forward a copy of these records to the Commission without delay. Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 Page 18 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 2 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 2 Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 4 Standard OP1 OP7 OP9 OP9 Regulation 4(2) 15(2) (b) 13 (2) 13(2) Requirement A copy of the statement of purpose and residents guide must be sent to the Commission There must be evidence that care plans are reviewed regularly The medicines policy must include the use of medicinal creams and lotions. The Royal Pharmaceutical Guidelines for the Administration of Medicines in Care Homes must be obtained and be available to staff Transcribing of medicines onto the MAR charts must be witnessed with two signatures recorded The adult protection policy must be fully updated and include the inter agency policy All staff must attend appropriate training in respect of Adult Protection. Staff must not commence work until a satisfactory POVA check and two references have been received Staff must work under supervision at all times until a DS0000053715.V267833.R01.S.doc Timescale for action 12/12/05 13/02/06 03/04/06 12/12/05 5 OP9 13(2)(4)( c) 13(6)12(1 ) (a) 13(6)12(1 ) (a) 19 17/11/05 6 7 8 OP18 OP18 OP18 13/02/06 13/02/06 17/11/05 9 OP18 18(2) 19(11) 17/11/05 Trelawney House Version 5.0 Page 20 10 11 12 13 14 OP19 OP26 OP30 OP30 OP33 15 16 OP38 OP38 satisfactory CRB check has been received. 13 (4) External doors must be secure to ensure residents safety 13(3)(4)( A hand washbasin and with soap c) and paper towels in dispensers must be supplied in the kitchen 18(2) There must be evidence that appropriate induction training is undertaken 18(1) (c ) All training records must be available for inspection 24 (2) A report of the quality assurance results must be compiled annually and a copy sent to the Commission. 23 (4) (d) Fire training and the records must be up to date 13(3)4a14 A copy of the risk assessment for (4)c23(2) the presence of animals must be o sent to the Commission 17/11/05 12/12/05 13/02/06 13/02/06 12/12/05 13/02/06 12/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 6 7 Refer to Standard OP7 OP7 OP7 OP9 OP19 OP29 OP38 Good Practice Recommendations The resident or representative should be involved and sign to agree the care plan and any review The staff support level assessment should be kept with the care plan All care plans and reviews should be dated and signed by the people involved Medicinal creams and lotions should be dated when first opened to ensure the correct disposal date Suitable net curtains/blinds should be provided in rooms overlooking the neighbours, for privacy. Interview records should be maintained for all prospective employees A copy of the veterinary care records should be sent to the Commission Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection St Austell Office 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 Trelawney House DS0000053715.V267833.R01.S.doc Version 5.0 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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