Inspection on 11/09/07 for Tropicana

This inspection was carried out on 11th September 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Tropicana 15/05/06

Tropicana 10/11/05

Tropicana 14/06/05

Tropicana 10/02/05

Tropicana 05/08/04

Tropicana 22/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE Tropicana Newquay Road St Columb Major Cornwall TR9 6SD Lead Inspector Alan Pitts Unannounced Inspection 11th September 2007 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 Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 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. Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tropicana Address Newquay Road St Columb Major Cornwall TR9 6SD 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) 01637 880779 01637 880779 info@trop.ssnet.co.uk Mrs Marina Westbrook Mr Ernest Westbrook Position Vacant Care Home 10 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (3), Old age, of places not falling within any other category (10) Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th May 2006 Brief Description of the Service: Tropicana is a large Victorian house with well-kept secluded gardens to the rear of the home and a small car park to the front of the home. It is situated within a short distance of St. Columb Major town centre. The house has been extended to provide a small quiet home for up to ten residents who require personal care and are over the age of sixty-five. This is a family run home, the registered providers with their daughter manage the day to day running of the home and live on site. Accommodation is on two floors. There is no lift or stair lift to the first floor. There is large lounge and a comfortable dining room on the ground floor. Wheelchair access is available to the side of the property. Regular contact with friends and family is encouraged; visitors are welcomed, and the home enjoys good relations with the local community. Fees are in line with the current basic rate of Social Services funding. Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over a period of approximately 5 hours. The inspector met and spoke with all of the six residents, the staff, the registered providers and their daughter. The documentation, policies and procedures, and the environment were inspected. Tropicana is a ‘family-run’ home, which provides a comfortable and appropriate home for up to 10 residents. On the day of the inspection there were six residents living at the home. The relaxed family atmosphere, and the evident contentment of the residents impressed the Inspector. The registered providers should attend to the record keeping/managerial requirements and recommendations, but these should not detract from how highly the residents speak about their home, the staff, and the care that they receive. Although the registered providers will continue to accept respite stays they advised the inspector that it is their intention to “wind down” and do not therefore intend to accept any future permanent admissions to the home. What the service does well: What has improved since the last inspection? What they could do better: The registered providers must take note of the requirements and recommendations identified in this report to better demonstrate the work they Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 Page 6 put in, and to meet the National Minimum Standards and relevant regulations in respect of records and record keeping. Time must be allowed for administrative tasks to enable effective management. At the time of the inspection, the registered provider’s daughter undertook to ensure that at least one day per week was available to her for managerial tasks. Training and supervision must be prioritised. 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. The summary of this inspection report can be made available in other formats on request. Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 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 Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The most recent admission to the home was properly assessed prior to finalising the move. Intermediate care is not offered at Tropicana. EVIDENCE: The registered providers have produced a Statement of Purpose and Service User Guide, which is provided to every resident or their representative. The care documentation shows that the most recent admission to the home was properly assessed prior to admission, and a plan of care was in operation. Residents confirmed that they feel informed and included in the daily running of the home. Intermediate care is not offered at Tropicana. Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each resident has a plan of care. The care documentation shows the involvement of other health care professionals, and residents confirmed that they receive a good standard of care and felt well looked after by staff. Medicines are handled appropriately, and the home has a relevant procedure. The residents could not speak highly enough of the care, attention, and respect shown by the staff at Tropicana. EVIDENCE: Residents’ care plans and documentation were inspected. The residents’ health, spiritual, social and personal care needs are set out in an individual plan of care and these are being reviewed with resident and/or representative involvement, where possible. Daily entries in the care documentation show the involvement of other healthcare agencies as appropriate to the needs of the resident. Residents are Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 Page 10 registered with a GP, and professional advice is sought as needed. The residents confirmed that they have the opportunity for exercise and activity. A medicines cupboard and fridge, in addition to a cupboard for the storage of controlled drugs is provided. A Controlled Drugs register is in use. A medicine policy is in operation. Medicine Administration Records were seen to be in order. Residents and their representatives or relatives are treated with respect and their right to privacy is upheld. Staff were observed to treat people with respect and dignity at all times throughout the inspection. The residents’ preferred name is documented. People spoken with confirmed that they are treated respectfully; their privacy and rights to make decisions are supported, and they spoke very highly of the staff and the autonomy that they are afforded. Residents confirmed that they are able to meet relatives and friends within the communal areas, in the garden or in their own rooms. Two residents have their own telephones, whilst the remainder have access to the home’s phone. Mail is delivered unopened to the relevant person. The size of the home means that it runs as a large extended family, with the established and experienced staff having an in-depth understanding of the residents and their needs. Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents said that the staff could not do enough for them, and that they were free to see visitors as they wished. They also confirmed that they have enough to do to keep themselves occupied. The residents said that they enjoyed the food that was provided, and confirmed that they were offered a choice. EVIDENCE: The residents informed the inspector that they were able to make choices about how to spend their time, and they felt that their recreational interests were being met on an individual basis. Individual interests are recorded at initial assessment. People were observed to be able to choose where to eat e.g. dining room, lounge or in their room. Spiritual and social needs are included in the care plans. There is a broad range of reading matter and a large selection of videos/DVD’s available within the home. Residents have a daily paper delivered if desired. Preferred meal, waking up and getting up times are clearly documented and respected. The residents were happy with the flexibility within the home and felt that it met their needs and wishes. There are few regular activities and the care documentation could better show the quality of the residents’ day and the options offered (even if declined). Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 Page 12 Residents are able to meet relatives and friends within the communal areas, in the garden or in their own rooms. Visitors are welcomed to the home, depending on the residents’ wishes, which are respected at all times. The likes and dislikes of each resident are noted and an alternative provided if the resident is known not to like something. Residents are offered a set menu at lunchtime. Those spoken with said that they usually liked what was offered, but were less sure about whether they would feel able to ask for an alternative. Residents were not aware what was for lunch that day. Choice is provided at teatime. Residents did say that they could have anything at all that they fancied. Food records are kept and special diets are catered for, as required. Fresh fruit and vegetables are readily available. Baking takes place on a regular basis. The residents were complimentary about the food. The dining room provides an attractive, comfortable setting that is laid up for residents who choose to eat there. There is no menu, the registered providers deciding what to cook the day before. Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Neither the home nor the Commission for Social Care Inspection have received any complaints since the last inspection. The registered providers and staff were seen to interact well with residents, who confirmed that they would feel able to raise any concerns. Residents welfare is protected. EVIDENCE: There is a complaints procedure in operation, and residents confirmed that they would feel able to express any concerns. The complaints procedure does not include the current contact details for the relevant Adult Social Care Department or the Commission for Social Care Inspection. The residents said that they knew who to talk to if they had a concern, and would feel able to do so. There is a Protection of Vulnerable Adults policy and a whistle blowing policy. Contact details for adult protection agencies are clearly displayed on the notice board. Residents are additionally safeguarded by the ‘family’ approach of the home and the small, established staff team. Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents said that they were comfortable and very happy with their accommodation. Residents’ rooms were personalised and comfortably furnished. There is no lift or other aid to assist access between floors. The environment is clean, and homely, though the laundry could be improved. EVIDENCE: The grounds are accessible and attractive. There is a small extension of five rooms to the rear of the property, all having easy access to the gardens through individual french doors. Four rooms are situated on the second floor. There is no lift. The home meets the needs of the current residents, and offers a relaxed homely atmosphere for the people to relax in. The home is decorated with paintings, pictures and fresh flowers. Residents said, without exception, that they found their accommodation very homely, comfortable and it met their needs. Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 Page 15 There is a designated dining room and a large lounge. There is an attractive, private garden to the rear of the home and seating to encourage people to go outside and enjoy the grounds, though in practice many prefer to sit out the front where they can say hello to passing locals. The registered providers said that the total immersion facilities (baths and showers) are fitted with thermostatic valves. The home is clean, pleasant and free from any odours. Gloves and aprons are available within the home. Hand towels and a soap dispenser are available. The laundry facility is small, but functional. The registered providers could improve the storage space available in the laundry room. The kitchen is domestic in nature, but perfectly adequate for the size of the home. The kitchen was seen to be clean and new kitchen cupboards have been fitted since the last inspection. New double-glazing has been fitted in some rooms and the front door to the property. New additions to the fire system have been fitted. Bedrooms have also been fitted with suitable locks to ensure residents privacy. Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The current training records could be improved to better demonstrate that staff are provided with the skills and knowledge to perform their roles, though residents were very complimentary about the care provided, and a National Training Organisation compliant induction programme has been introduced. The home uses a robust employment procedure to protect residents. EVIDENCE: This is a small establishment with a small team of mostly long-serving staff. Staffing levels are recorded in the diary. Staff often share roles within a shift, such as cooking and caring or cleaning and caring. Residents were, without exception, complimentary about the staff and the care they provide, saying “nothing is too much trouble”. Staffing levels were appropriate to the care needs of the residents at the time of the inspection. Staff were observed to be caring and respectful during their interactions with each other and the residents. There is an evident rapport with residents and a relaxed atmosphere that is the result of attention to individual needs and preferences. Staff training records offer insufficient information and should be improved to demonstrate a commitment to furthering the staff’s skills and knowledge base. Only one staff member has achieved the NVQ Level 2 qualification. Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 Page 17 A staff personnel file was inspected and seen to be satisfactory, though as discussed care should be taken to ensure that the references provided clearly cross-reference with the referees given on the application form. A sample of a staff induction programme showed that the home is running a National Training Organisation compliant induction programme. Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The inspector is of the opinion that the registered providers have the residents’ best interests at heart, and this is supported by the positive comments received from residents. There must be adequate administration and management time to ensure this is reflected in the home’s policies and procedures, staff training and staff supervision records. EVIDENCE: The registered providers are in day-to-day control, assisted by their daughter, and have been working within the care profession for over thirty years; running this home since 1984. Their daughter is the senior carer within the home. There are clear lines of accountability within the home. The registered Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 Page 19 providers are aware of the need to have a National Vocational qualification at level 4 in management and care. The registered providers do not use a quality assurance system to ascertain the views of others, especially those that use the service, though they have done so in the past. The Commission for Social Care Inspection have not received any complaints about this service since the last inspection. The registered providers keep letters and cards received complimenting them on the care provided. The home enjoys close links with the local community and are able to respond to feedback received. The registered providers do not handle any residents’ money, and there is a relevant policy in place. If a resident needs to purchase anything and does not have ready access to the amount needed, the home will provide the money or purchase the item and invoice the resident or their representative. Staff supervision has started, but this is infrequent. The recording and storage of documents has generally improved since the last inspection. The registered provider’s daughter agreed to ensure that she would have at least one day per week for managerial tasks. The home is well maintained, clean, and safe for residents, staff, and visitors. Residents and staff were complimentary about the home and the people. Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 Page 20 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 Page 21 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. Standard OP36 Regulation 18 Requirement Timescale for action 01/10/07 2. OP28 3. OP33 4. OP38 The Registered Provider must arrange for the regular and recorded supervision of staff to occur at least six times a year. 18 The registered provider must do more to ensure that training needs are monitored and opportunities provided for staff training. 24 The registered providers must establish and maintain a system for reviewing and improving the quality of care. The report must be provided to all Service Users, their representatives and the Commission for Social Care Inspection. 10, 12, 13 The registered providers must provide for administrative/managerial time, and provide the required records (staff training, maintenance) to ensure compliance with regulations 10, 12, and 13. 01/06/08 01/11/07 01/10/07 Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 Page 22 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 OP15 Good Practice Recommendations The registered provider should ensure there is a planned menu. The registered provider should ensure that residents are aware of the menu, and ensure an alternative is offered. The registered provider should review and amend the complaints procedure to ensure that it includes the contact details for the relevant Adult Social Care Department and the Commission for Social Care Inspection. The Registered Provider should consider the replacement of the existing washing machine with an industrial-type machine with a sluice facility to be better able to cope with soiled linen and enhance infection control within the home. At this time the Registered Provider should then introduce the use of dissolving sacks for the handling of soiled linen. 2. OP16 3. OP26 Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Tropicana DS0000009243.V345142.R01.S.doc Version 5.2 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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