Inspection on 15/07/05 for Troutstream Hall

This inspection was carried out on 15th July 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

Troutstream Hall 21/01/09

Troutstream Hall 26/03/07

Troutstream Hall 25/01/06

Troutstream Hall 20/09/04

Troutstream Hall 28/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Troutstream Hall Chorleywood Road Rickmansworth Hertfordshire WD3 4EX Lead Inspector Yoke-Lan Jackson Unannounced 15 July 2005 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. Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Troutstream Hall Address Chorleywood Road, Rickmansworth, Hertfordshire, WD3 4EX 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) 01923 772 703 01923 770 486 Troutstream Hall Trust Ms Karen Steffe CRH Care Home 21 Category(ies) of OP-21 registration, with number of places Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registration. Date of last inspection 20 September 2004 Brief Description of the Service: Troutstream Hall is a residential home for 21 service users in the Old Age category. It is provided by Troutstream Hall Trust, a Christian Charitable Trust. The building is a large detached house that has been converted into a care home. It is situated in a quiet residential area near to the village of Rickmansworth. The M25 and M1 motorways are a few minutes drive away. There is a driveway with parking spaces to the side. The spacious entrance hall leads to the dining room and kitchen. The administrative office, staff room and the laundry room are all on the ground floor. The bedrooms, of varying sizes, are on all three floors. Each bedroom has a hand basin. The toilet and bathroom facilities are nearby. The communal rooms include two well proportioned lounges. There is an attractive front and back garden, surrounded by mature trees and bushes. The patio areas have garden furniture and potted plants. The home has a lift to all the floors. All the rooms and gardens are accessible to wheelchairs. Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection (unannounced) for the year 2005. The registered manager was present. The inspection began with a tour of the premises. General observation was conducted of the lunchtime routine, including observation of staff performance and staff interaction with service users. Staff were interviewed individually. Several service users were spoken to and their feedback regarding the services and care has been positive. (Please see below for the details of the inspection findings). What the service does well: What has improved since the last inspection? The home has appointed a deputy manager to assist in the day to day management of the home. The management restructuring is a positive move to provide a more efficient system of management of services. Senior staff roles and responsibilities are since the restructuring. The home has made arrangements for the garden to be maintained by a contract gardener on a regular basis. Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 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. Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 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 Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 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, 2, 3, 4, 5. Opportunities are given to the prospective service user and relatives to view the home before taking up residency. The registered manager ensures that a full assessment is carried out prior to admission. On one occasion, the home admitted a service user whose needs could not be met. EVIDENCE: Each service user has a signed copy of the written contract and the Service User Guide. The home admitted a service user in spite of the fact that there was clear evidence that the service user was out of category. The admission was as a result of arrangements with Hertfordshire Adult Care Services. It was for a trial period. Within 24 hours, the service user was readmitted to the hospital. The registered manager has assured the inspector that such an incident will not be repeated. Admitting a service user outside the registered category is an offence against the Care Standards Act 2000. (Please see statutory requirements). Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 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, 10, 11. The service users appeared neat and clean. The service users and their family were treated with care, sensitivity and respect. The care planning system ensures that the needs of the service users are met in an appropriate way. If necessary, a referral is made to a health care professional. A trained member of staff administers the medication. EVIDENCE: On the day of the inspection, the majority of the service users were in the lounge. They appeared neat and clean and were dressed in their own clothes. The service users interviewed gave positive feedback regarding the services and care they have received. One commented: “Everybody is very kind and thoughtful. I am very fortunate to be here.” The other service users who were in the lounge echoed similar remarks. It was noted that support and care were given at all times to one service user, whose physical condition had deteriorated. A member of staff was readily available to support the family and to ensure that the service user was comfortable at all times. Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 Page 10 The care plans examined were maintained and up to date. A system is now in place to ensure that the administration of medication is up to standard and is maintained consistently. The deputy manager is reviewing the issues around the order and supply of medicines to ensure that only the correct and required amount is reordered in the case of repeat prescriptions. Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 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, 15. The service users have choices in the daily living routine in the home. Their preferences are respected. Service users are encouraged to maintain links with family and friends. Meals are a highlight of the day. The meals presented are appealing and nutritious. EVIDENCE: The service users spoken to confirmed that they have choices with regard to activities and menu. Mealtimes were unhurried. The home has employed a new chef and the service users are very pleased with the meals served to them. Several service users commented: “The food is very good.” A member of staff was seen assisting one service user with her daily walking exercise in the front garden. One service user was relaxing on the front patio. Family members were seen visiting the respective service users throughout the day. Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 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 standard(s) 16, 17, 18. There is a complaint system that all service users can access, both formally and informally. The service users are protected from abuse and their legal rights are protected. EVIDENCE: Regular residents and relatives meetings are held and any issue raised is addressed immediately. The home follows the Hertfordshire Vulnerable Adult Policy and Procedures. Members of staff are trained to ensure that service users are protected from abuse. They are aware of the Whistle-Blowing Policy and Procedure. Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 21, 23, 24, 25, 26. Troutstream hall is comfortable and homely. The bedrooms are safe and odour free. The external grounds and patio to the back of the building have not been consistently maintained and are not safe and tidy. EVIDENCE: The interior of the premises appeared homely, clean and comfortable. The bedrooms examined were neat and clean with personal items on display. The front garden is neat and well-maintained. However, the back garden and patio appeared untidy and the fencing by the patio appeared unsafe. The manager agreed to rectify the situation immediately. On the day of the inspection, the contract gardener was present in the afternoon and arrangements have been made to ensure that the garden is maintained consistently. The registered manager must ensure that the external grounds are safe and accessible to service users at all times. (Please see Statutory Requirements). Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 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 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, 29, 30. The home has an effective and dedicated team of workers. The skill mix of the staff benefits the service users. The home complies with legislation with regard to recruitment and selection of staff. EVIDENCE: The home has recently recruited a senior care worker who is on probation as a deputy manager. Police and the Protection of Vulnerable Adult checks were done prior to her employment. Team working and team building were evident on the day of the inspection. The members of staff spoken to confirmed that they have undergone appropriate training to meet the assessed needs of the service users. Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 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 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, 32, 34, 35, 36, 37, 38. The standard of care and services provided are maintained in a positive way. The home is run in the best interests of the service users. The external environment has not been kept safe and accessible at all times EVIDENCE: The new management structure is a positive move towards a more efficient service. Prior to this change, the registered manager was the sole administrator and manager of the services and care. The appointment of a deputy manager and the delegation of defined roles and responsibilities to senior staff can only improve the services and care to the benefit of the service users. Members of staff spoken to welcome the change and team working was evident on the day of the inspection. Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 Page 16 The service users’ personal allowances are safeguarded by the accounting and financial procedures. The registered manager must ensure that the external environment is kept safe and accessible to service users at all times. (See Standard 19 and Statutory requirements). Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 1 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 x 3 3 3 3 2 Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 Page 18 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 3 Regulation Section 24 National Care Standard Act 2000 23 ( 2 ) (o) Requirement It is an offence to fail to comply with registration conditions. A service user has been admitted out of category. The registered manager rectified this situation within 24 hours of admission. The external grounds which are suitable for, and safe for use by service users are provided and appropriately maintained. Timescale for action 15/07/05 Henceforth 2. 19.3 38.3 15/07/05 Henceforth 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 Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City, Herts AL7 3BQ 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 Troutstream Hall I52 s19598 Troutstream Hall v238692 150705 Stage 4.doc Version 1.40 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. 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