Inspection on 14/06/05 for Tropicana

This inspection was carried out on 14th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Tropicana 11/09/07

Tropicana 15/05/06

Tropicana 10/11/05

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 announced 14 June 2005 09:30 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. Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tropicana Address Newquay Road, St Columb Major, Cornwall, TR9 6SD 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) 01637 880779 01637 880779 info@trop.fsnet.co.uk Mrs Marina Westbrook Mr Ernest Westbrook 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 DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10/02/05 Brief Description of the Service: Tropicana is a large victorian house set in well-kept secluded gardens, 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 Service Users 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. Nine service users are currently in residence. 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. There is a small car park to the front to the home. Regular contact with friends and family is encouraged, visitors are welcomed. Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Tropicana is a ‘family-run’ home, which provides a comfortable and appropriate home for up to 10 service users. The relaxed family atmosphere, and the evident contentment of the service users impressed the inspector. The Registered Providers must give priority to the requirements and recommendations identified in this report, which are of a managerial nature. What the service does well: What has improved since the last inspection? The Registered Providers continue to offer a stable, relaxed and comfortable home for the service users. Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 Page 6 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. Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.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 Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.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) 1, 3, 4, 5 Service users are well informed and clearly enjoy a relaxed relationship with the Registered Provider and their daughter. EVIDENCE: The Registered Providers have produced and Statement of Purpose, which includes the information required. The Service Users Guide requires a couple of further minor adjustments, but it meets the requirements and is provided to prospective Service Users. There was documentary evidence of service users being assessed prior to admission. As discussed, it is suggested that the Registered Provider’s make use of their fax facility for future out of county referrals. The last service user to be admitted stayed for two weeks prior to deciding to stay permanently. The Registered Provider stated that prospective service users are welcome to visit prior to making a decision. Intermediate care is not offered at Tropicana. Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 Page 9 Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 Page 10 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, 11 Care plans are in use. Service users confirmed that they receive a good standard of care and felt well looked after by staff. EVIDENCE: Service users health, spiritual, social and personal care needs are set out in an individual Plan of Care and these are being reviewed at least monthly. There was evidence that the plan of care is being devised and reviewed with service user and/or representative involvement, though care should be taken to ensure this continues. Daily entries in the care documentation show the involvement of other healthcare agencies as appropriate to the needs of the service user. Medicines were not fully inspected, but the recommendation from the last inspection, namely that the home should purchase a Controlled Drugs Book remains. The Registered Provider said that this was ordered at the time of this inspection. Information relating to service user wishes following their death was noted in the care documentation of the most recent admission. Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 Page 11 Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 Page 12 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) 13, 14 Service users said that the staff could not do enough for them, and that they were free to see visitors as they wished. EVIDENCE: All the service users have family contact. Friends and relatives are welcome to visit at any reasonable time. Visitors can be seen in the privacy of the service users own bedroom or if preferred in the lounge. All service users have access to a telephone. A visitor’s book is kept within the home. Service users confirmed that they are free to determine their own lifestyle within the confines of their individual care needs. Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.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, 17, 18 Neither the home nor the Commission for Social Care Inspection have received any complaints since the last inspection. The Registered Provider and staff were seen to interact well with service users, who confirmed that they would feel able to raise any concerns. EVIDENCE: The service users receive mail unopened, and the Registered Providers will discuss the contents with the individual service user where necessary. The service users are entered on the electoral roll and a number participated in the recent government elections. A complaints procedure is in use, but this requires review and amendment to provide information such as the 28-day time limit for responding to complaints. There is a protection of vulnerable adults policy and a whistle blowing policy. The Registered Provider stated that staff have received training regarding No Secrets guidance. The protection of vulnerable adults and related policies should be reviewed to ensure that staff know how and to whom concerns may be brought, along with the relevant contact details. Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.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, 20, 25 Service users said that they were comfortable and very happy with their accommodation. Service user rooms were personalised and comfortably furnished. There is no lift or other aid to assist access between floors. 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 service users. The home is decorated with paintings, pictures and fresh flowers. Service Users informed the Inspector, without exception that they found their accommodation very homely, comfortable and it met their needs. The home is non-smoking. Service users have access to safe and comfortable indoor and outdoor communal facilities. 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. Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 Page 15 Furnishings are of good quality and suitable for service users. At the time of the inspection the home was in the process of having new kitchen units fitted. All radiators have been guarded in Service User areas. Risk assessments must be undertaken in areas where there is hot water that is not regulated. The lighting in Service Users’ rooms is homely and all rooms have plenty of natural light. Window restrictors have been fitted to all windows. The home is clean, pleasant and free from any odours. Gloves and aprons are available within the home. Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 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 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) 28, 29, 30 Unfortunately, with the current recruitment and training documentation the inspector is unable to judge that the home is supporting and protecting service users. EVIDENCE: Only one staff member has achieved the NVQ Level 2 qualification. The inspector was advised that three more staff will be undertaking this training shortly, but only one is currently booked on a course. One staff member has the Intermediate Food Hygiene Certificate. There are no individual staff training records, but the inspector was advised that all the staff have recently completed a health and safety course, medication training and a protection of vulnerable adults training course. The Registered Provider must keep staff records that show training undertaken and compliance with regulation 18. The personnel file of the most recently employed staff member was inspected. The application form was incomplete, only one reference had been received, and the Criminal Records Bureau check had not been sent for at the time of the inspection. The Registered Provider must operate a thorough and robust employment procedure to ensure the protection of service users. The Registered Provider should keep a record of interview. The Registered Provider must ensure that induction training for new staff complies with the National Training Organisation units and is completed within the first six weeks of employment. Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 Page 17 Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 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 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) 34, 35, 36, 38 The inspector does not doubt that the Registered Provider has the service users best interests at heart, but this must be reflected in the homes policies and procedures, staff training, and staff supervision records. EVIDENCE: Service users were seen to be comfortable in their interactions with staff and the Registered Provider’s. Service users confirmed that they would feel able to raise any concerns. The Registered Provider provided the Commission for Social Care Inspection with proof of financial viability following the last inspection, and this is held on file. The Registered Provider stated that the home does not handle any service user monies, but a significant amount was being held for one service user. The Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 Page 19 Registered Provider must ensure there is a policy in operation for the handling of service user monies/valuables. The Registered Provider should supplement the existing financial record with a duplicate book for all transactions. There are no supervision records. The Registered Provider must arrange for the regular and recorded supervision of staff to occur at least six times a year. Only one member of staff currently has a 1st Aid qualification. The Registered Provider must arrange for 1st Aid training to ensure that a designated 1st Aider is available at all times. The Registered Provider must arrange for moving and handling training for all staff. The Registered Provider must implement risk-assessments in relation to the risk of scalding from hot water outlets, whilst ensuring the fitment of hot water thermostatic valves on all total immersion areas (e.g. baths). Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 3 x x x x 2 x STAFFING Standard No Score 27 x 28 1 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 2 x x x 3 2 2 x 2 Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 Page 21 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 25 Regulation 13 Requirement Risk assessments must be undertaken in areas where there is hot water that is not regulated. The Registered Provider must keep staff records that show training undertaken and compliance with regulation 18. The Registered Provider must operate a thorough and robust employment procedure to ensure the protection of service users. The Registered Provider must ensure that induction training for new staff complies with the National Training Organisation units and is completed within the first six weeks of employment. The Registered Provider must ensure there is a policy in operation for the handling of service user monies/valuables. The Registered Provider must arrange for the regular and recorded supervision of staff to occur at least six times a year. The Registered Provider must arrange for 1st Aid training to ensure that a designated 1st Aider is available at all times. The Registered Provider must Timescale for action 01/08/05 2. 28 17, 18 01/09/05 3. 29 18, 19 Immediate 4. 30 18, 19 Immediate 5. 35 17 01/08/05 6. 36 18 01/09/05 7. 38 18 01/09/05 Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 Page 22 8. 38 13 arrange for moving and handling training for all staff. The Registered Provider must 01/08/05 implement risk-assessments in relation to the risk of scalding from hot water outlets, whilst ensuring the fitment of hot water thermostatic valves on all total immersion areas (e.g. baths). RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 9 16 18 Good Practice Recommendations The Registered Provider should purchase a Controlled Drugs Book. The registered provider should review and amend the complaints policy. The protection of vulnerable adults and related policies should be reviewed to ensure that staff know how and to whom concerns may be brought, along with the relevant contact details. The Registered Provider should keep a record of interview. The Registered Provider should supplement the existing financial record with a duplicate book for all transactions. 4. 5. 29 35 Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 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 Tropicana DD52 D04 s9243 Tropicana V229111 1406051 stage 0.doc Version 1.30 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. 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!