Inspection on 06/05/05 for Trewan House

This inspection was carried out on 6th May 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

Trewan House 06/10/05

Trewan House 23/09/04

Trewan House 21/05/04

Trewan House 24/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Trewan House 335 Ditchfield Road Widnes Cheshire WA8 8XR Lead Inspector Paul Ramsden Unannounced 6 May 2005 10:25 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. Trewan House F51 F01 S5200 Trewan House V224507 060505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Trewan House Address 335 Ditchfield Road Widnes Cheshire WA8 8XR 0151 423 6795 0151 423 2212 info@trewanhouse.co.uk Mrs Maria Carmela Evans 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) Mrs Imelda Anne Youds Care Home 28 Category(ies) of Old age, not falling within any other registration, with number category(27) of places Dementia - over 65 years of age (27) Dementia (1) Trewan House F51 F01 S5200 Trewan House V224507 060505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 The home is registered for a maximum of 28 service users to include:* Up to 27 service users in the category of DE(E) (Dementia over 65 years) * Up to 27 service users in the category of OP (Old age, not falling within any other category) * 1 named service user in the category of DE (Dementia) aged over 63 years 2 The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 23/09/04 Brief Description of the Service: Trewan House is a two-storey family owned care home standing in its own grounds, access between floors is via a shaft lift or the stairs. Personal care and accommodation is provided for 28 older people with dementia. The home is located in the Hough Green area of Widnes, close to a church, shops and a pub. It is on a bus route and is close to Hough Green railway station. There are adequate car parking facilities available. The residents accommodation consists of 10 single and 9 double bedrooms, all of which have en-suite facilities except for 1 double room that has a wash hand basin fitted. A variety of lounge and dining spaces are provided for residents. Adequate numbers of toilets and a variety of bathrooms are available. Trewan House F51 F01 S5200 Trewan House V224507 060505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day (7.15 hours). There were 23 residents living in the home on the day of the visit. A discussion took place regarding the proposed new extension to improve the facilities at Trewan House. If the plans are agreed the work will commence shortly afterwards. Care records were inspected. Comment cards for residents and relatives/visitors were given to the home upon arrival. The four resident and seven relative cards returned to the CSCI were complimentary about the home. Eight of the twenty-three residents and three visiting family members were spoken with during the day. What the service does well: The home has an established group of staff, most of whom have worked there for a relatively long time. They are keen to provide a good standard of care to the residents that live at Trewan House. Good relationships exist between residents and staff. One of the residents said that; “ staff are excellent and marvellous. They treat people with a lot of dignity, care and respect”. She also said that she is “able to remain as independent as possible”. One of the visiting relatives said that he was always made to feel welcome by the manager and her staff. Trewan House F51 F01 S5200 Trewan House V224507 060505 Stage 4.doc Version 1.30 Page 6 Assessments are carried out to ensure the home will be able to meet the resident’s needs. Trewan House provides a safe and well-maintained environment for service users. There is a good choice of lounges available. A good variety of food is provided. Residents confirmed they could choose what to eat. The home has a competent and experienced manager. A deputy and administrator support her. The home regularly reviews its performance through an internal quality assurance system. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Trewan House F51 F01 S5200 Trewan House V224507 060505 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 Trewan House F51 F01 S5200 Trewan House V224507 060505 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 Residents are assessed prior to admission to ensure that the home will be able to meet their needs. EVIDENCE: Pre admission assessments had been carried out for the residents whose records were inspected. Those seen contained enough information for staff to be able to meet individual needs. Residents, relatives and other healthcare professionals are involved with the pre-admission assessment. Various risk assessments were also completed. Trewan House F51 F01 S5200 Trewan House V224507 060505 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 and 10 Residents had a plan of care providing details of their needs. The systems used to identify and meet an individual residents needs are good. The health, social and emotional needs of people living at Trewan House are being identified and met. EVIDENCE: Trewan House F51 F01 S5200 Trewan House V224507 060505 Stage 4.doc Version 1.30 Page 10 The home manager or deputy managers are responsible for drawing up a resident’s plan of care. The four care plans seen as part of the case tracking process provided staff members with the necessary information for them to look after a person’s needs. These care plans were being reviewed on a monthly basis. All personal care is carried out in the privacy of a resident’s bedroom or one of the bathrooms. Residents spoken with confirmed that they had been able to express their opinions and wishes about their daily routines, for example times of rising and retiring and where to spend their time. Policies and procedures in relation to medication are in place. Medicines are administered using a blister pack system provided by a local pharmacist. The arrangements for the administration of medication during the inspection were satisfactory. Trewan House F51 F01 S5200 Trewan House V224507 060505 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 and 15 Residents staying at Trewan House can maintain contact with their family and friends and make choices regarding their own lives. EVIDENCE: Residents were able to move around freely within the home and a choice of sitting areas was available. Residents confirmed that they could receive visitors at any time in the lounges or in the privacy of their own rooms and that they could exercise personal choices whilst staying at the home. Meals can be taken in the dining room or in the privacy of residents’ own rooms. The kitchen area was well managed and organised. There is a menu that has the flexibility to meet individual needs and choices. All of the residents that commented said that the food was good and that choices were available. Special diets are prepared where necessary. Various activities are organised for the residents. Trewan House F51 F01 S5200 Trewan House V224507 060505 Stage 4.doc Version 1.30 Page 12 Trewan House F51 F01 S5200 Trewan House V224507 060505 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 and 18 Residents and family members are able to voice their opinions and are confident that appropriate action would be taken to address any problems or complaints. Policies, procedures and staff training are in place to protect residents from abuse. EVIDENCE: The complaints procedure was available to residents in the service user guide and on the notice board. Those residents and family members that commented said that they would inform the home manager or another senior employee of any concerns or complaints. They also said that they felt confident that appropriate action would be taken. The home has an Adult Protection procedure (including Whistle Blowing), which complies with the Public Disclosure Act 1998 and the Department of Health Guidance No Secrets. Staff confirmed that they had received training regarding Adult Protection. Trewan House F51 F01 S5200 Trewan House V224507 060505 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 and 26 The environment within the home is good, providing residents with a pleasant place to stay; this will be improved further when all of the refurbishment work is completed. EVIDENCE: The home was clean and well maintained throughout. Since the last inspection the entrance hall has been redecorated. Thermostatic valves have been fitted to the sinks in communal bathrooms/WC’s and bedrooms since the last inspection. Trewan House F51 F01 S5200 Trewan House V224507 060505 Stage 4.doc Version 1.30 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 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 and 30 Staff morale is high, resulting in an enthusiastic workforce that works positively with residents, families and visiting professionals to improve the quality of life of people living in the home. Staffing levels and staff training ensure that individual needs can be met. EVIDENCE: Staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff is adequate to meet the needs of the residents within the home. Staff members were cheerful and friendly and residents were complimentary about staff attitude and competence. One of the senior staff spoken with said that staff members were like a family. The home administrator confirmed that in excess of 50 of staff members are qualified to NVQ level 2 in care, a recognised qualification for staff involved in delivering care. Trewan House F51 F01 S5200 Trewan House V224507 060505 Stage 4.doc Version 1.30 Page 16 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 and 33 The home is well run and is managed on a day-to-day basis by a person who is fit to be in charge. EVIDENCE: The home has an experienced and competent manager who is registered with the Commission for Social Care Inspection. Both she and the deputy manager have recently completed the registered managers award. The resident and family members that commented said that the home managers were approachable and supportive. A quality assurance survey to ascertain whether residents and families are happy with the standards of care being provided was being undertaken. Copies of the results will be made available to residents, families and the Commission. Trewan House F51 F01 S5200 Trewan House V224507 060505 Stage 4.doc Version 1.30 Page 17 All staff members are supervised on a continuous basis; in addition they all receive formal supervision six times a year. The fire precautions record book was up to date and demonstrated that checks of the alarm system, emergency lighting, fire drills and staff training were taking place at the recommended intervals. Trewan House F51 F01 S5200 Trewan House V224507 060505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x 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 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x x x x Trewan House F51 F01 S5200 Trewan House V224507 060505 Stage 4.doc Version 1.30 Page 19 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Trewan House F51 F01 S5200 Trewan House V224507 060505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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. 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