Inspection on 26/03/07 for Troutstream Hall

This inspection was carried out on 26th March 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 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 25/01/06

Troutstream Hall 15/07/05

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 Patricia Rogan Unannounced Inspection 26th - 30th March 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Troutstream Hall DS0000019598.V335995.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. Troutstream Hall DS0000019598.V335995.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Troutstream Hall Address Chorleywood Road Rickmansworth Hertfordshire WD3 4EX 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) 01923 772 703 01923 770 486 Troutstream Hall Trust Ms Karen Steffe Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Troutstream Hall DS0000019598.V335995.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for 21 people with old age. Date of last inspection 25th January 2006 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 with toilet and bathroom facilities in close proximity. Two rooms have been converted to ensuite bedrooms. 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. The managers office and an equipped training room is on the top floor and there is a large room on the ground floor where medication and records are stored. The weekly fees range from £541 to £2,500 according to the size of the room and the facilities in the room. This is set out in the service user guide available in the home. Charges for additional services such as hairdressing and chiropody are priced individually and set out in the individual service contract. Troutstream Hall DS0000019598.V335995.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of all the key standards was carried out by one inspector. Time was spent in the home meeting residents and their visitors and speaking privately with them to find out what they thought of the care provided in Troutstream Hall. Several members of staff were also asked for their views during the inspection. Several residents and staff files were inspected. A tour was made of the premises and observations of the interaction between staff and residents was observed in the communal areas. A second part of this inspection included gathering opinions from a random selection of residents relatives and friends and from health and social care professionals who visit the home. The quality outcome for service users was good. What the service does well: What has improved since the last inspection? The bedroom with ensuite facilities is fully functional. All policies and procedures are being reviewed to ensure they contain up to date information. The manager is in the process of up dating all staff records to ensure compliance with the latest legislation and guidance. Recent photographs are being attached to the residents medication administration sheets. The water temperature control has been regulated to ensure the safety of the residents and staff. The long term problem with one of the communal toilets has been resolved. Troutstream Hall DS0000019598.V335995.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Troutstream Hall DS0000019598.V335995.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 Troutstream Hall DS0000019598.V335995.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 (Standard 6 is not applicable to this service) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have an assessment and are invited to visit the home and meet residents and staff prior to moving into the home. A service user guide is available for all prospective residents. EVIDENCE: Discussion with two residents and three relatives confirmed that there had been an assessment and an invitation to spend time in the home before making a decision to accept the offer of a place. All said they had been given a copy of the Service User Guide. Troutstream Hall DS0000019598.V335995.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans reflected individual health and personal care needs. The medication administration sheets were having up to date photos attached at the time of the inspection. Service users were treated with respect. EVIDENCE: Four care plans were examined and were satisfactory. When members of staff were asked about the care needs of different residents, their responses reflected the information in the files which showed that staff knew the residents well. Several favourable comments were made, including, These ladies really look after me and I feel better since I came here. Staff were seen to knock and wait before entering a bedroom and residents said they felt they were treated respectfully. Troutstream Hall DS0000019598.V335995.R01.S.doc Version 5.2 Page 10 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 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Group activities are offered every day. Some residents files did not have sufficient information about personal interests and hobbies. Contact with family and friends is encouraged. The menu is varied and nutritious. EVIDENCE: Varying activities such as craftwork, soft ball, quizzes, bingo and skittles take place and the manager is planning to take residents out, on a trip of their choosing, in a wheelchair accessible minibus. One resident prepares a newsletter on his computer. The social history, hobbies and interests were sometimes scarce and did not reflect the long life history of each resident which meant that less able residents were not enabled to continue with their previous hobbies and interests if they wished. The residents friends and family have a good relationship with the manager and staff in the home and feedback was positive. All residents are given private access to a telephone if they wish. Troutstream Hall DS0000019598.V335995.R01.S.doc Version 5.2 Page 11 Many positive comments were made about the meals, such as Just like home cooking. and The meals here are first class. Troutstream Hall DS0000019598.V335995.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There have been no complaints and there is a good system for addressing complaints should they arise. Staff have had training in Adult Protection issues and have a whistleblowing policy. EVIDENCE: Every relative and resident who was asked, said they felt confident that if they had a complaint, the manager would try to resolve it. The staff are aware of the whistle blowing policy and there is an expectation that all staff address any concerns as they arise. Recently there have been three training sessions for staff on Adult Protection and the policy and procedure guidance is held in the office. Troutstream Hall DS0000019598.V335995.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is domestic appearance but some internal and exterior areas are in need of refurbishment and redecoration in order to return it to the previous high standard throughout. The premises are clean and pleasant. Liquid soap and paper towel dispensers are needed for staff hand washing in some areas in order to comply with Department of Health Infection Control guidance. EVIDENCE: Many areas of the home have ornaments, paintings and flowers, creating a homely appearance. However this is marred by some areas in the home which are in need of repair, replacement or redecoration. This was discussed with the manager and there is a maintenance programme and this should be expedited for the benefit of the residents. Troutstream Hall DS0000019598.V335995.R01.S.doc Version 5.2 Page 14 The home is cleaned to a good standard. More liquid soap and paper towels should be available for staff hand washing to meet infection control guidance. Troutstream Hall DS0000019598.V335995.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have the experience and training to support the residents. Recruitment is robust. Training is ongoing. EVIDENCE: Several residents and visitors commented that staff work hard and are very helpful. The carers have become like old friends to me. and They are always very busy but always pleasant towards me. The staff rotas show that staffing levels are adequate, however, there were also a few concerns expressed that sometimes, if a member of staff is busy in the office doing paperwork, and a member of staff is assisting a resident in the bathroom or bedroom, there may be only one person out in the communal areas to attend to all the other residents. The manager ensures that recruitment policies are stringently adhered to and when agency staff have to be employed, the manager requests confirmation that the agency has made adequate checks on the agency worker. Troutstream Hall DS0000019598.V335995.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of Troutstream Hall is good. The policies and procedures are up to date. The home is run in the best interests of the residents. EVIDENCE: Many favourable comments were made about the manager, describing her as friendly and approachable. The manager was pro-active in responding to issues which arose or needed clarification during the inspection and she was knowledgeable about her management role and responsibilities. The manager has been looking at all the policies and procedures to ensure they contain up to date guidance. Troutstream Hall DS0000019598.V335995.R01.S.doc Version 5.2 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Troutstream Hall DS0000019598.V335995.R01.S.doc Version 5.2 Page 18 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP12 Regulation 16(2) Requirement Timescale for action 30/05/07 2. OP19 23(2) 3. OP26 13(3) Residents social and life history should be recorded in more detail so that activities are tailored to enable residents to follow his or her individual interests and hobbies. All areas of the interior and 30/06/07 exterior of the home must be maintained in good order. A programme of when the reoairs and refurbishment are to be carried out must be submitted to the Commission for Social care Inspection. The health protection Agency 30/05/07 Infection Control Guidance must be followed so that in addition to hand cleansing gel, liquid soap and soft paper towels is available for staff hand washing before and after providing personal care for a resident. Troutstream Hall DS0000019598.V335995.R01.S.doc Version 5.2 Page 19 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 OP27 Good Practice Recommendations The number of staff available on the floor should be monitored to ensure residents are able to gain the attention of a member of staff and receive assistance in a timely manner. Troutstream Hall DS0000019598.V335995.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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. 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