Inspection on 04/05/05 for Underhill House

This inspection was carried out on 4th May 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

Underhill House 30/10/06

Underhill House 24/02/06

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 Helen Tworkowski Announced 4 & 5 May 2005 9.00 am 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. Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 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 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 D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Age 60yrs Date of last inspection 7th October 2004 Brief Description of the Service: Underhill House a residential home and is owned by Mr. Turner and Mrs. Linda Turner; Mrs Turner is also the Registered Manager. Underhill House is a large detached house in the residential area of Stoke. The home is within walking distance of local shops, facilities and amenities. The home provides care and support for older people, including people with dementia. At present the home has 4 double bedrooms and 21 single rooms. There are 2 dining rooms and 3 lounge. Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over two days, lasting in total 12 hours. The inspection included a tour of the building, two meals with service users, and discussions with staff, service users, managers and visiting relatives. Staff, service user and maintenance records were also looked at. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 Page 6 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 Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 Page 7 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) 3, 5 Pre-admission assessments are carried out but they lack detail. Assessments need to be detailed and thorough so that residents can be confident that the home knows what their needs are before they move, and the home will be able to meet these needs. EVIDENCE: Before a resident (service user) moves to the home, staff meet with the resident and carryout an assessment. Not all of the information collected at this assessment is written down, which means that it may be forgotten or lost. Many of the residents have an assessment completed by Social Services, however Mrs Turner (Registered Manager) said that these were sometimes received two weeks after the person had moved. Prospective Residents and their relatives had the opportunity to visit the home before a move and many took the opportunity to do this. Relatives said that they were welcomed and felt that the information that they were given before the move reflected the service when their relative moved. Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 Page 8 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 and 10 The home provides a good standard of care, however Service User Plans (care plans) and risk assessments lack detail and are not comprehensive. These documents are important as they specify the actions staff are to take to meet needs and to protect residents from unnecessary risks. EVIDENCE: There are Service User Plans (sometimes called Care Plans) that describe how the needs of the resident will be met. These lacked detail. Service User Plans need to be based on an assessment of need, and should set out in detail the actions staff take to meet needs. Where residents have issues relating to safety risk assessments must be drawn up. Where it is necessary to place limits on a person’s movements for their safety, for example locking the front door, then this should be included as part of the Service User Plan. Service Users confirmed that they felt well cared for and that their privacy is respected, staff knock on doors before they enter. Feedback from a visiting health professional was that the home offers a very good standard of care. Staff follow the advice offered by District Nurses, and calls appropriately for support from health care professionals. Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 Page 9 The home uses a monitored dose system for medication; this is where tablets are pre-packed by the pharmacist. This provides an additional level of safety in medication management. The medication system is well managed. Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 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 standard(s) 12, 13, 14 and 15 A good range of activities are provided in the home, are there are sufficient staff for to spend time with individual residents. Residents are able to make decisions about how they spend their time. The home provides a good range of food, which is well cooked, which residents enjoy. EVIDENCE: Residents are offered a range of activities in the home, including trips out. Residents spoken to said that they particularly enjoyed these. An Easter Bonnet parade had been held last month, and residents and their relatives enjoyed the photos taken of the event. Activities in the home include armchair aerobics and bingo. Staff, residents and visitors confirmed that staff had time to sit and talk with residents, and to take them out to visit the local shops. Residents are able to get up and go to bed when they choose, and although encouraged to go to the dining room are able to have meals in their rooms. Residents said that the food is very good: well cooked and wholesome. Where residents need assistance, there are sufficient staff on duty. The home keeps a record of residents’ weights, so that they are able to monitor any unusual changes. Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 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 standard(s) 16 and 17 There are proactive systems in placed to deal with any concerns or complaints raised by residents or there people. EVIDENCE: Residents and relatives said that they felt able to raise any concerns they had with Mrs Turner or other staff. Mrs Turner said that as she was in the home everyday she felt that any issues were dealt with at an early stage. This inspection was took place on the day of the general election. None of the residents had wanted to vote in person though a number had exercised the right to a postal vote. Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 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 standard(s) 19,20,21,22,23,24,25 and 26. The care home is well maintained and in good decorative order. EVIDENCE: Underhill House is spacious, light, airy and well decorated. The home is very clean and both visitors and residents commented on the high standards of hygiene in the home. Bedrooms are brightly decorated and some residents have chosen to bring in some of their own personal items into the home. Residents said that staff always knock and respect their privacy, however none of the bedrooms have door locks. Bedroom door locks mean that residents can lock their door for privacy, if the wish. They also enable residents to lock their doors when they leave their room. Door keys are symbols of independence and can help people maintain self-esteem. As has already been noted the home is well decorated and some thought has gone into making the home accessible. There is a shaft lift, the home is well lit, and there are contrasting “nosings” on stairs- so that steps are more visible. Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 Page 13 Mrs Turner felt that the patterned carpets posed no issues for people with dementia in the home. Sometimes people can perceive patterns as uneven surfaces. It is recommended that the home review the use of patterned carpets, and where these are to be replaced to consider carpets that might be more appropriate. The home is relatively large with a number of staircases and communal areas. This did not appear to be an issue for the people in Underhill House, however it may be confusing for some people, and it is recommended that the home considers how it can aide people with dementia to find their own way around. Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 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) 28,29, and 30 Residents may be placed at risk because the home’s staff recruitment processes are not as robust as they might be. However residents can be confident that staff receive a reasonable level of training including an induction, and are competent and caring in their work. EVIDENCE: The files of recently recruited staff showed that the recruitment system is in need of improvement. Written references must be taken prior to recruitment and that Criminal Records Bureau checks must be started. The Registered Manager must ensure that they have checked that the person is physically and mentally fit to work in the home. New staff go through a period of induction and then are involved in on going training in the home. Almost half the staff have now achieved their NVQ2 or above, and a number of other staff have started their NVQs. Feedback from staff was that they felt well supported, that they had sufficient time to do their work and that there was a good team spirit. Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 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) 33,35 and 38 Underhill House is generally well managed. EVIDENCE: The Registered Manager sends out questionnaires to find out if people are satisfied with the care provided at Underhill House, these show that people are very satisfied. It is recommended that thought is given to developing this system so that feedback be taken into account in plans for the home. The home holds money for one person in the home, there are records of spending and receipts, however these are difficult to follow and establish a running balance. It is recommended that a proper account of this money is kept, so that it can easily be audited. The Registered Manager bills all other Service Users for any expenditure that the home makes on their behalf. There are good systems in place for the management of health and safety, and regular checks are made for example in relation to fire and legionella. Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 2 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 2 3 3 STAFFING Standard No Score 27 x 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x x x 3 x 3 x x 3 Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 Page 17 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 OP3 Regulation 14 Requirement A comprehensive assessment must be completed for each Servie User before they move to the home, as described in the National Minimum Stradards. The Registered Manager must confirm in writing that they are able to meet assessed needs before a move. Comprehensive Service User Plans and risk assessments must be developed for each Service User. These must be based on an assessment of need. Service User Plans must include specific details of the actions staff are to take to meet needs. Service Users bedrooms must be fitted with bedroom door locks, suited to their capabilities and accessible to staff in emergencies. The Registered Provider must ensure that staff are fit to work in the home, prior to starting work in the home. This included having two written references and having started a CRB check. Timescale for action 1/7/05 2. OP7 15 1/9/05 3. OP24 16 1/9/05 4. OP29 19 1/6/05 Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 Page 18 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 OP22 OP33 OP35 Good Practice Recommendations The Registered Provider must review the homes layout and carpet replacement policy, so that the needs of people with demenita can be taken into account. A system must be developed so that the feedback from questionaires is taken into account in future plans for Underhill House. A better account of Service Users money should be kept. for ease of auditing. Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 Page 19 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton Devon 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. Extracts may not be used or reproduced without the express permission of CSCI Underhill House D52-D04 S3486 Underhill House V215393 040505 Stage 4.doc Version 1.20 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. 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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