Inspection on 24/02/06 for Underhill House

This inspection was carried out on 24th February 2006.

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

Underhill House 30/10/06

Underhill House 04/05/05

Underhill House 07/10/04

Underhill House 14/05/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Underhill House Underhill Road Stoke Plymouth Devon PL3 4BP Lead Inspector Sheila Giblin Unannounced Inspection 15:30 24 February 2006 th 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 Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 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. Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Underhill House Address Underhill Road Stoke Plymouth Devon PL3 4BP 01752 561638 01752 606377 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) Mrs Linda Ruth Turner Mr Michael Turner Mrs Linda Ruth Turner Care Home 28 Category(ies) of Dementia (28), Dementia - over 65 years of age registration, with number (28), Old age, not falling within any other of places category (28) Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age 60yrs Date of last inspection 4 & 5 may 2005 Brief Description of the Service: Underhill House is a Residential Care Home owned by Mr and Mrs Turner. Mrs Linda Turner is also the Registered Manager. Underhill House is a large detached property in the residential area of Stoke Village, Plymouth. The home is within walking distance of the local shops, facilities and amenities and close to the bus route into the city centre. The home provides care and support for up to 28 older people, including those with dementia. The home has 4 double bedrooms and 21 single rooms. Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which took place on the evening of Friday 24th February 2006. The deputy manager was on duty and the Registered Manager attended as soon she was informed of the inspection. The inspector toured the building, met and talked with 6 residents, 1 family member and saw all the other residents in their rooms, in the dining rooms and in the lounge. The purpose of the inspection was to monitor the requirements from the previous inspection and to meet with residents and gather their views about the quality of care being provided in the home. What the service does well: What has improved since the last inspection? What they could do better: Mrs Turner feels that the care services being provided at Underhill House cannot be improved upon. Risk assessments must be carried out by the managers of the home for all the health and care needs as revealed by the care needs assessment prior to admission. Mrs Turner is planning to change a bathroom into a shower cubicle to improve the care for residents with incontinence problems. Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 Page 6 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. Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 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 Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 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 the following standard(s): 1, 3, 6 Prospective residents cannot be confident that their care needs have been fully assessed and recorded prior to being admitted. EVIDENCE: The Statement of Purpose and service users guide were available for prospective residents to give them all the information they may need to make a choice about the home. However, all those residents who gave an account of their admission to the home said they had chosen the home because of its good reputation and its local position. When they or their relatives had visited they had been impressed by the high standards of the accommodation and the friendliness of the staff and the manager. The files of two recently admitted residents were inspected. One file had no pre admission assessment or any risk assessments despite there being physical and medical conditions present. The other file showed a Social Services care plan, and a brief risk assessment for falls. Other health care needs had not been risk assessed. Underhill House does not provide intermediate care. Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 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 the following standard(s): 7, 10 The introduction of the new care plans will ensure residents care needs are fully recorded and so inform staff of how the care needs will be met. EVIDENCE: The new care plans are being rewritten and those seen showed a much more detailed record of the residents’ care needs. Risk assessments have not been reviewed. Those files seen did not hold appropriate risk assessments to ensure residents’ health and care needs were fully protected. All the residents who spoke to the inspector felt that they were treated with dignity and respect, and their wishes and choices respected. Residents who wished to spend time in their rooms, could do so. Family members said that they were always notified if their relative was unwell. There had recently been an outbreak of ‘Norwark’ sickness in the home. The home had been closed to visitors and staff had tended residents who had been affected with the advice of the community nursing services and the GP. Everyone had made a complete recovery. Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, Residents can be assured of living in a warm and friendly atmosphere that is kind and caring EVIDENCE: All the residents interviewed said their lifestyle had improved immensely since moving into the home due to the care and attention, good food and friendly company offered to them by the managers and staff team. Residents are encouraged to join in with the activities programme which included ‘chairobics’ on Tuesdays, a sing a long with Margaret on the key board on Wednesdays and bingo on Fridays. Mrs Turner said she takes residents out to Dingles department store for tea and shopping. During the evening of this inspection residents were seen in their rooms reading or watching TV, others were in the lounge chatting and socialising with each other and with the staff. A relative seen during the inspection spoke highly of Mrs Turner saying she provides many extras for residents to brighten their lives. When she goes on holiday she brings a small gift back for every resident. She buys gifts for Christmas and birthdays for all the residents. The evening routine was described and night drinks are given out at about 7pm with biscuits and sandwiches for those who want them including any diabetics. After this time residents start going to their bedrooms. Night time medication is given at 10pm. Breakfast is served between 8am and 10am, but is flexible for anyone who has a lie in or earlier for those who are early risers. Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 16 Residents can be confident that their complaints will be taken seriously and acted upon appropriately. EVIDENCE: There have been no complaints received about this home since the last inspection. One resident said she had reason to raise a concern with the manager some time ago and the problem was resolved. She’d felt confident about speaking up and was satisfied with the outcome of the complaint. A number of complimentary cards were seen on the notice board in the hall. Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 19, 23, 26 Residents live in a well maintained home that is clean and free from offensive odours. EVIDENCE: On arrival at the home the warmth and comfort were noted immediately. During the tour of the home residents’ bedrooms and the living rooms were seen to be clean and tidy. The décor is constantly being updated with attractive coordinated bedding and curtains. Mrs Turner employs a housekeeper and three domestic assistants to ensure the highest level of cleanliness and hygiene is maintained. A vacant room is to be refurbished prior to it being offered to a prospective resident. Washable cushion flooring is provided as an alternative to carpets in some bedrooms to help maintain a clean and odour free home. Residents and their visitors said how pleased they were with the furnishings and décor in their rooms and in the sitting rooms. There is ongoing discussions between the home, some relatives and the Commission about locks on bedroom doors. Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 The residents can now feel confident that new staff are being vetted prior to being employed to ensure residents and their property are well cared for by suitable workers. EVIDENCE: On arrival at the home at 3.45pm the deputy manager and four care staff were on duty with 26 residents. The home has two waking staff at night who come on duty at 9pm when the day staff go off. The home has improved its recruitment process and both recently employed staff had two references, proof of identity, a POVA first check, a photograph and a CRB disclosure recorded on their files. The new night care assistant had a daytime induction then worked 2 nights with two other staff for two weeks to learn the routines and Tasks required. Staff on duty were friendly and helpful. They socialised with residents in their rooms and in the lounge. Residents said how wonderful the staff were, and a relative praised them for all the help and support they had given him and his parent following admission to the home. Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35 The home is well managed with the best interests of residents at heart. EVIDENCE: The Registered manager is the co owner, Mrs Linda Turner, who has been working with older persons with dementia for almost 20 years. She is a very caring person who ‘mothers’ the residents and uses her larger than life personality to reassure them and to give them confidence when they are worried and afraid. Evidence of this was seen during this inspection when a very tearful resident was unsure of the future and what should be done for the best. Confused residents recognised her and greeted her with great affection. The atmosphere in the home was positive and lively. Staff and residents enjoyed a joke and the ambience was relaxed and very comfortable. Residents’ financial records have been reviewed and improved. One resident’s cash is held for safe keeping and the record showed entries for receipt and expenditure of cash and the balance held in the safe. Receipts had been kept in the file. Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 Page 15 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 3 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X 3 2 X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 X X X Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 Page 16 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 OP3 Regulation 14 Requirement A comprehensive pre admission assessment must be completed for each resident prior to being admitted to the home. The Registered Manager must then write to the resident/relative to confirm in writing that they are able to meet those assessed needs. Outstanding since the previous inspection. Comprehensive risk assessments must be completed by the senior staff for each resident in keeping with the assessed needs as written in the care plan. Outstanding since the previous inspection. Residents’ bedrooms must be fitted with appropriate door locks suited to their capabilities and accessible to staffing emergencies. Ongoing requirement under discussion Timescale for action 01/05/06 2 OP7 15 01/05/06 3 Op24 16 01/06/06 Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 Page 17 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Underhill House DS0000003486.V253555.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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