Inspection on 09/08/05 for Tremanse Care Home

This inspection was carried out on 9th August 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

Tremanse Care Home 27/07/09

Tremanse Care Home 12/08/08

Tremanse Care Home 22/08/06

Tremanse Care Home 26/01/06

Tremanse Care Home 07/03/05

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Tremanse Care Home Fore Street Bodmin Cornwall PL31 2HR Lead Inspector Philippa Cutting Unannounced 09 August 2005 09:15 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Tremanse Care Home Address Fore Street Bodmin Cornwall PL31 2HR 01208 74717 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) Vivacare Limited Suzanne Vanda Dennis Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (14) of places D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 07.03.2005 Brief Description of the Service: Tremanse is a large older style house situated in the centre of Bodmin. Whilst within walking distance of the town, the immediate access to the home is up a steep hill so that anyone with reduced mobility might find it difficult. It provides rooms on three floors although not all are registered to provide care and accommodation. Those that are, are registered for people with mental health problems. There are communal rooms on the ground floor that comprises a large sitting room, conservatory and dining room.There is a garden in the front of the home with a small level patio area. The company that have recently bought the home have also purchased a second, unregistered property behind Tremanse. D52-D04 S61991 Tremanse Care Home V234124 090805 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 carried out between 9.15 am and 4.15pm. The inspector spoke with the manager, staff and service users and was shown around the premises. Care plans and records were inspected and there was discussion about various issues. The home’s new owners are in the throes of a much needed refurbishing in the home which, so far, has provided service users with new beds and furniture as well as chairs in some of the communal rooms. Redecoration throughout is planned. In addition to the service users living at Tremanse there are eight rooms available for people on a ‘supported living’ scheme. There were six people in this category at the time of this inspection. What the service does well: What has improved since the last inspection? What they could do better: In order that staff will respond in a consistent way care plans need to be specific and detailed where a potential problem has been identified. Recording the help given to service users with their personal activities of daily living would demonstrate the level of care that people need more fully. Such information could be helpful when negotiating changes in care packages and funding. D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 6 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. D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5 The home provides information for new and prospective service users to ensure that it can meet people’s needs. EVIDENCE: A new statement of purpose has been produced for the home, which is full and details all the required points. An assessment of peoples’ needs is sought prior to admission although the home has been full for sometime with no new admissions. Service users are reassured that the home will meet their needs but some - due to their illness – have low aspirations. Copies of individual contracts for service users were seen in their files. D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9, Service users are encouraged to be an active party to all discussions concerning their care and contribute to the running of the home. EVIDENCE: Care plans are kept for each person in individual files. These have been revised and are now more readily available to all staff for information, which they have found helpful. There was a discussion about the need for generalised statements, such as ‘continue to offer help’ to contain more specific detail as to how, why and when help should be offered. The files contain ‘pointer details’ which indicate when a person might be at risk and the signs for which staff should be alert. This is good practice. There was a discussion about peoples’ functional ability. The staff are aware of who needs help to maintain their personal care but this has been absorbed into the care provided and is not documented anywhere. It would be good practice to record service users’ abilities to carry out personal activities of daily living so that there is a record of progress – improvement or deterioration – and as evidence if more help is needed for someone. D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 10 Service users are encouraged to participate in the running of the home and are given opportunities to voice their opinions at meetings. The registered manager commented that most of the comments centred around food and any activities that have occurred or are to be planned. D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16,17 People are encouraged to be active and independent. The staff seek to provide opportunities both inside and outside the home for personal development and the exercise of choice. EVIDENCE: Most service users have opportunities to develop skills outside the home, some of which rekindle previous interests; others try to create new ones. The staff at the home have been largely responsible for finding these situations. People who have spent considerable time in institutions tend to have fewer interests than others who have had more community contact and present as more of a challenge. The home could consider enlisting the help of a Disablement Resettlement Officer, via the Job Centre, to see what else might be available for the service users. People can travel to and attend their activities alone if an assessment of their abilities shows this to be appropriate, otherwise staff would accompany the D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 12 service user. Family contacts are encouraged but not everyone has relatives who have kept in contact. A ‘healthy eating’ regimen is promoted with menus to encourage this being prepared. Fresh fruit and vegetables have been incorporated into the diet. People can request an alternative to the main set meal if it is not something they like. D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 The health and general well being of service users is met. EVIDENCE: Generally speaking the majority of service users are physically well and they would visit their local surgery on an ‘as needed’ basis. The registered manager said that she found that the GPs were helpful in the management of psychiatric problems and they liaise with the other professionals in this field. The registered manager has good contacts with the mental health team if she needs advice. The day of the inspection was hot but it was noted that several service users were wearing thick jumpers and jackets. This suggests that these people may have become desensitised to the surrounding temperature and may need extra guidance regarding this? It also has safety implications for the heating system etc within the home as no radiator guards are fitted – see the comments in the section entitled ‘Conduct and Management of the Home’. Medication is handled mainly by the staff with tablets being supplied in a monitored dose system. A course in the safe handling of medication has been organised to supplement the home’s written policies and procedures. Senior D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 14 staff administer medication as a dedicated task. Medication administration record sheets were seen to be fully completed. Staff are currently attending a course on the control of infection & contamination. D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Any complaints are taken seriously and investigated. The home would seek to protect the service users from any abuse. EVIDENCE: A complaint has been addressed satisfactorily by the home but was not substantiated. One service user has been told that his behaviour towards staff and other service users was not acceptable. The registered manager has reserved a place on the current Social Services seminar on Whistle Blowing and PoVA issues. D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29,30 The home has become rundown, which is acknowledged by the new owners. Plans are in place to refurbish the property throughout. It is nevertheless clean although shabby. EVIDENCE: There are considerable areas that need attention within the home with regard to redecoration but a start has been made by providing new furniture and beds for service users. Parts of the home are dark due not only to the paintwork but also the surrounding trees and buildings. The registered manager said that it is planned that trees and vegetation will be cut back and lighter colours used internally. The windows in several rooms were very dirty, in one room it was covered in green algae. Ventaxias in shower and bathrooms need to be cleaned, as an accumulation of dust constitutes a fire hazard. One room of the non-registered rooms that had recently been vacated was, in the inspector’s view, not fit for occupation as a large area of the wall by the window was mouldy and had holes in it. The registered manager said that the occupant in that room had only just come to the home under the supported D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 17 living scheme in an emergency and was about to move to another room whilst the unsatisfactory one was dealt with. Speaking with service users the inspector felt that many were accepting of the run down condition of the home therefore it is important that these should be addressed as soon as possible in order to raise the service users’ aspirations. D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36 The staff caring for the service users appeared to have a good attitude and approach to their work. EVIDENCE: During the day the registered manager made adjustments to the rota to ensure that recent staff vacancies at night were adequately covered. Staff have job descriptions and contracts. A new document is about to be introduced to show that staff have read and understood the home’s policies and procedures. Increased training opportunities are being arranged with the new management. Information regarding the new standards for staff induction will be enclosed with this report so that the induction process can be reviewed and updated. Staff are receiving regular supervision and appraisals. Discussion with the staff on duty at the time of this inspection indicated that they were capable and caring towards service users. Areas where problems had been identified with some staff had been addressed. D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,41,42 Service users can be confident that the home is being run in their best interests. EVIDENCE: The registered manager is hoping to complete her registered manager’s award by September. It has been noted that the person undertaking the regulation 26 visits usually conducts these at weekends. It would sensible to vary the days and times in order to get a rounder picture of the service users, staff & home. The registered manager said that a form is being complied for completion by service users to gauge their satisfaction with the services offered by the home as part of their quality assurance system. Staff, as mentioned, will be asked to read and sign to say that they acknowledge the policies and procedures. The policies and procedures are based on Croner’s guidance. D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 20 Records required by statute that were inspected were the accident record, the fire log, the registration certificate and insurance documentation, CORGI gas checks, COSHH compliance. The five yearly electrical check is due for renewal shortly. It was noted that there are no radiator covers in the home. The risk of anyone burning or scalding themselves on any hot water outlet or source needs to be risk assessed initially and then the action to deal with any identified risks recorded and undertaken. D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 2 2 2 2 2 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 2 x D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 22 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 YA 9.3 YA 42.6 Regulation 12 Requirement The registered provider must assess the risk to service users from unprotected heat sources, such as radiators and hot water outlets and provide a written plan to address these. Timescale for action 31.10.2005 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. Refer to Standard YA6 YA6 Good Practice Recommendations Service users care plans should include an assessment of peoples functional abilities. Care plans should avoid generalised statements but be specific in details where an issue needing attention is identified. D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 23 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 D52-D04 S61991 Tremanse Care Home V234124 090805 Stage 4.doc Version 1.40 Page 24 - 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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