Inspection on 24/01/06 for Trenant House

This inspection was carried out on 24th January 2006.

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

Trenant House 14/05/07

Trenant House 12/04/05

Trenant House 25/01/05

Trenant House 24/05/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

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 Trenant House Queens Road Lipson Plymouth Devon PL4 7PJ Lead Inspector Jane Gurnell Unannounced Inspection 24th February 2006 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 Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 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. Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Trenant House Address Queens Road Lipson Plymouth Devon PL4 7PJ 01752 663879 01752 663879 peter@pbaps.fsnet.co.uk 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) Mrs Julie Lynn Franks Mr Peter John Woodworth Franks Mrs Julie Lynn Franks Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (24) of places Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12/04/05 Brief Description of the Service: Trenant House is a large, detached house, which stands in its own grounds and is situated in the Lipson area of Plymouth, close to local amenities, the park and public transport links. The Home is registered to provide residential accommodation with personal care to a maximum of 24 service users, both male and female, from the age of 65years for reason of old age and dementia. The accommodation for service users occupies two floors, with access assisted by the use of stair lifts as well as a shaft lift. The Home has 22 bedrooms, 20 single and 2 double rooms, with 12 of the single rooms and both double rooms having en-suite facilities. Ten rooms have en suite shower facilities. The home has 4 bathrooms, 2 of which have baths fitted with hoists and these are more commonly used by the service users. The Home offers two pleasant lounges, one with access to a conservatory area, and a dining room with a bar area. There is a call bell system throughout the Home and due to the layout and size of the building staff carry an intercom system to support the call system. The home is a no smoking home however a covered area is provided outside of the main house for service users who may wish to smoke. The email address for Trenant House is: trenantpl4@btopenworld.com and is no longer that identified on the previous page. Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was undertaken on 24th January 2005 by Jane Gurnell, Regulatory Inspector and Judith Thomas, CSCI Director of Communication and Service User Involvement. The focus of the inspection was to consult with the service users about their experiences of living at Trenant House and to review the care planning and quality assurance processes. Mr and Mrs Franks, the owners were present and they and their staff team assisted the inspector throughout the inspection. The inspector spoke to 15 service users and each member of staff on duty, toured the building and reviewed a sample of service users’ care plans as well as documentation relating to the management of service users’ finances; quality assurance consultation with service users; fire safety issues and accidents. A number of comment cards were provided prior to the inspection for service users and relatives to pass on their comments to the inspector and these provided very positive feedback. What the service does well: What has improved since the last inspection? What they could do better: The laundry room refurbishment is almost complete with the floor still to be sealed. The method of taking the temperature of the fridge should be amended to ensure it provides a more accurate reading. Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 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. Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 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 Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 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): 3 Thorough and comprehensive systems for admission allow service users and their relatives to be confident that their needs can be met. EVIDENCE: Pre-admission assessments are undertaken by the home’s care manager to ensure the service users’ needs are known prior to their admission. These assessments were evident in 2 of the 3 care plan’s sampled. The 3rd care plan related to a service user who had lived at the home for nearly 20years and it would not be expected to have a pre-admission assessment documented for this service user. Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 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, 8, 9, 10, 11 Service users’ health, personal and social care needs are being met and service users are treated respectfully and with dignity. The home’s practices relating to medication administration protect the service users from risk. EVIDENCE: Service users confirmed that they feel very well cared for and can ask at any time for assistance: a number of service users said that nothing was too much trouble for the staff. Service users’ care needs were described in detail in the individual care plans sampled. Further assessments were recorded and included moving and handling, skin care and nutritional assessments to ensure that any additional support needs could be identified and other health care professionals involved if necessary. Significant events were recorded in detail. Many service users are unable to participate in the review of their care needs due to their level of dementia however it was evident that staff reviewed the care plans monthly and recorded any changes. Relatives are invited to be involved in the care plan reviews. Medication administration records were well maintained and medication was stored safely. Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 Page 10 The owners confirmed that service users with terminal illnesses could remain at the home if the care staff could meet their needs with support from the District Nursing Service. The owners employ additional care staff to ensure that terminally ill service users are not left alone when death is imminent. Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 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, 13, 14, 15 Social activities are managed well and provide daily interest for the service users. Meals are nutritious and varied. EVIDENCE: Twice daily activities are organised by the home’s Activity Co-ordinator: these are planned in advance with the service users. Service users commented that they can chose which activities they wish to participate in and how much they enjoy these and that their relatives and friends are invited as well. At the time of the inspection the service users were enjoying a singing session in the morning and a quiz in the afternoon. A Drama Therapist is employed once a month to engage service users in drama and reminiscence sessions enabling them to share their experiences with each other. A minibus has been purchased to facilitate trips out of the home to local places of interest. A Newsletter, the “Trenant Tribune” provides information about the activities offered and other matters of interest to service users. Service users said that the food was plentiful and particularly commented on the quality and variety of the home cooked meals, desserts and cakes made by the new chef. Drinks and snacks were available at all times: those who were able could prepare themselves drinks and snacks in the bar area of the dining room. Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 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, 18 Complaints and suggestions from service users, relatives or other visitors to the home, are treated seriously. Service users are listened to and issues resolved promptly. EVIDENCE: Service users said that the owners, Mr and Mrs Franks, and their staff team were very approachable and they were confident that any issues of concern would be listened to and dealt with. The home has received no complaints since the last inspection. The owners keep a record of any concerns raised by service users or relatives as well as the action taken to resolve issues promptly. A copy of the complaints procedure is available to all service users and visitors to the home and detailed in the home’s Statement of Purpose and Service User Guide; a copy of each is available on the notice board in the entrance. Both the owners and the care staff have demonstrated their responsibilities relating to the protection of vulnerable adults. Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 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, 20, 24, 25, 26 The service users live in a pleasant, well-maintained home that is comfortable and warm and which provides sufficient facilities to meet their needs. EVIDENCE: Service users said that they found the home warm, spacious and comfortable. The home had been in a poor state of repair when purchased by the current owners and through sustained investment the redecoration and refurbishment of the building is being undertaken to a high standard. Work undertaken since the last inspection include renewing the main lounge room carpet, refurbishing one of the bathrooms and replacing the central heating and hot water boilers. The refurbishment of the laundry room is almost complete with the floor still to be sealed. Radiators are covered to reduce the risk of burns to service users, and where a risk of scalding has been identified the temperature of the hot water has been controlled. The home was found to be very clean indicating that regular cleaning is taking place. Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 Page 14 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, 28, 29, 30 Service users are cared for by well-trained and motivated staff in sufficient numbers to meet the needs of those currently living in the home. Recruitment practices protect vulnerable service users. EVIDENCE: Service users described the staff as very kind and caring and confirmed they responded promptly to requests for assistance indicating that there are sufficient care staff employed to meet the needs of those currently living in the home. Care staff are supported by catering, laundry and domestic staff. The owners have a positive approach to training and all staff had either completed or were undertaking NVQ training ensuring that they have the skills to care for older people and those with dementia. A number of senior care staff are undertaking NVQ 4 in Care which provides a high standard of training relating to the management of care services. Those staff files examined contained the required pre-employment documentation indicating that recruitment practices ensure service users are protected. Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 Page 15 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): 31, 32, 33, 35, 36, 37, 38 Service users live in a well managed home. The owners and their staff team strive to provide a stimulating, safe environment that respects and protects service users’ rights. EVIDENCE: Service users said that they feel safe and secure in their home and that the home was well managed. Staff are provided with regular individual supervision sessions to review their personal development and training needs. The Activity Co-ordinator regularly meets with the service users not only to plan future activities but also to consult on issues relating to the running of the home and the services provided. An example of this is a recent review with the chef of the menus and the rearranging of the seating in the dining room to make conversation easier. Relatives are also formally consulted about their views of the home: a sample of these were available and included comments Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 Page 16 such as “excellent” and “always listen to my concerns” when describing the home and the owners. Documentation relating to service users’ money held for safe keeping by the home was examined and those sampled indicated that these were wee managed. Inspection of the fire logbook indicated that the required weekly and monthly testing of the fire alarm system was being undertaken. Staff had received regular fire safety training to ensure they are aware of their responsibilities in the event of a fire. The fire alarm system was serviced this month. The kitchen was found to be clean and tidy indicating that regular cleaning and monitoring were being undertaken. The temperature of the fridge appeared to be high: this may have been due to the type of thermometer being used and the chef was advised to review this to ensue the fridge temperature is accurate. Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 Page 17 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 X 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 3 3 X X 3 3 3 2 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 4 X 3 4 4 3 Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 Page 18 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. 1 Standard OP26 Regulation 13 Requirement The laundry room floor must be sealed to ensure it is easily cleanable. Timescale for action 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP38 Good Practice Recommendations The method of taking the fridge temperature should be reviewed to ensure that it is accurate. Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Trenant House DS0000003517.V269117.R01.S.doc Version 5.1 Page 20 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!