Care Home: Penrose

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What the care home does well If someone were considering moving into the home there would be a detailed assessment completed before a decision was made. The provider would consider the views of the other people living in the service as part of the assessment process. Each person has a care plan which details their assessed needs, this means that anyone working in the home knows how to provide support and care to the individuals living there. People are encouraged to make decisions where possible about their daily lives. Risk assessments are in place to support people in living the life they want to. People living in the home are part of the community and participate in activities they want to. People in the home are encouraged to eat healthily. Personal support is provided in the way people prefer. Physical and emotional needs are identified and healthcare professionals involved. Policy and practice in the home with regard to medication means that people are protected. Complains and concerns are taken seriously and acted upon. The people who own the home listen to the people living there. Training in safeguarding adults means that the individuals living in the home are protected. People live in nice home where they feel part of the family. The home is clean. The registered providers have a robust recruitment procedure, which ensures that people are protected as far as possible. The registered providers take training seriously and use organisations such as partners in care to source appropriate training. The registered providers have the skills and abilities to ensure the home is well run in the interests of the people living there. The health, welfare and safety of the people living in the home are important to the providers and records demonstrate they are proactive in ensuring standards are maintained. What has improved since the last inspection? This was the first key inspection since the home registered. Therefore there are no outstanding requirements or recommendations. What the care home could do better: At the end of this inspection there were no requirements or recommendations. The registered providers continue to work hard to provide care and support in a flexible family environment. CARE HOME ADULTS 18-65 Penrose 6 Filleul Road Sandford Wareham Dorset BH20 7AP Lead Inspector Tracey Cockburn Key Unannounced Inspection 2nd September 2007 10:00 Penrose DS0000069739.V353305.R01.S.doc Version 5.2 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 Penrose DS0000069739.V353305.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 Adults 18-65. 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. Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Penrose Address 6 Filleul Road Sandford Wareham Dorset BH20 7AP 01929 480764 01929 480764 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) Penrose Residential Ltd Mrs Jane Clair Wills Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning Disability (Code LD) The maximum number of service users who can be accommodated is 3. 2. Date of last inspection New service Brief Description of the Service: Penrose is a family run residential home in a small rural village. It is registered to provide care, accommodation and support to 3 people who have a learning disability. The accommodation is on the ground floor with 3 bedrooms. There is a kitchen and a large lounge with a dining area in the conservatory. There are gardens to the rear of the property, which are accessible and provide opportunity for outside activities. It is also in easy access to the towns of Wareham and Poole where there are a range of community facilities. The family use the 1st floor and this is not registered. The weekly fees range from £680 to £1200. F Further information on fees and contracts can be found at the Office of Fair Trading website: www.oft.gov.uk Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection, which took place without any warning. On the first visit there was no one home. A further visit took place however the people living in the home were about to go out to a health care appointment. On the 3rd visit the key national minimum standards were reviewed with the assistance of the registered providers. At the time of the inspection there are 2 people living at Penrose. Both people were spoken to and observed as part of the inspection and 2 survey forms were returned. As part of the planning process information was gathered from the Annual Quality Assurance Assessment, also information passed to the commission since the last inspection from the local authority planning department and regulation 37 reports sent in by the home. A tour of the premises was undertaken, individual files viewed, other relevant documentation inspected. What the service does well: If someone were considering moving into the home there would be a detailed assessment completed before a decision was made. The provider would consider the views of the other people living in the service as part of the assessment process. Each person has a care plan which details their assessed needs, this means that anyone working in the home knows how to provide support and care to the individuals living there. People are encouraged to make decisions where possible about their daily lives. Risk assessments are in place to support people in living the life they want to. People living in the home are part of the community and participate in activities they want to. People in the home are encouraged to eat healthily. Personal support is provided in the way people prefer. Physical and emotional needs are identified and healthcare professionals involved. Policy and practice in the home with regard to medication means that people are protected. Complains and concerns are taken seriously and acted upon. The people who own the home listen to the people living there. Training in safeguarding adults means that the individuals living in the home are protected. People live in nice home where they feel part of the family. The home is clean. The registered providers have a robust recruitment procedure, which ensures that people are protected as far as possible. Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 6 The registered providers take training seriously and use organisations such as partners in care to source appropriate training. The registered providers have the skills and abilities to ensure the home is well run in the interests of the people living there. The health, welfare and safety of the people living in the home are important to the providers and records demonstrate they are proactive in ensuring standards are maintained. 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 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. Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who are considering living in this service have their needs fully assessed before a final decision is made. This means people will know that the service can meet their needs before they move in. EVIDENCE: The file of 1 person living in the home was looked at as part of the inspection. The file contained a detailed assessment from the funding authority. This was completed before the person moved in. The manager said that trial visits took place. The file also contained a personal care assessment completed by the individual. The person was not able to say if they were involved in the assessment process. In the AQAA (Annual Quality Assurance Assessment) submitted by the service 1 of the things they do well is have a good process of introduction to the service including tea visits, overnight stays and a getting to know each other process. Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in this service have their assessed and changing needs reflected in their individual plan of care. They are enabled to make decisions and take risks in their everyday life. EVIDENCE: 1 file was seen as part of the inspection. This contained information on how to support and meet the needs of the person. It was difficult to establish if the person in question was involved in the process of completing the care plans as they have limited verbal communication. However they are able to express their wishes and during the inspection it was observed that the providers clearly understand the individual and are able to respond well to specific signs and indicators of unhappiness. There was also evidence that care plans are reviewed. Neither person living in the home manages his or her own finances. Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 10 Daily records demonstrate when individuals have made choices such as meals and activities. Risk assessments are in place for individuals living in the home and cover day to day activities as well as activities in the community. In the AQAA the home say they try to be flexible and adapt to the changing needs of the people living in their service. This was evidenced in their daily records and care plan reviews. Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in this service are able to lead the lives they want to and participate in activities in the community, which interest them. EVIDENCE: The AQAA states that people in the service are able to access activities in the community including clubs. The providers also state that they involve family and friends in the lives of the people living in the home. 1 person living in the service no longer attends day activities at a day centre. Both people living in the home also visit the providers other home and mix with the people living there. Both people living in the service do not have any educational or occupational activities. The provider said that family visit 1 person in the home and they maintain contact with other family members. Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 12 Files seen demonstrate that people are able to have routines in the home which suit their needs. The provider said that if someone is unwell then routines are flexible to meet these changes. The providers are trying to encourage the 2 people living in the home to participate in household chores. Food is healthy and people living in the home are offered a range of fresh fruits and vegetables. Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People receive support in the way they prefer; their physical and emotional health needs are addressed. EVIDENCE: The file looked at contained a detailed medical history. It also contained information on how often the person had seen the GP, dentist, community nurse and attended other healthcare appointments. 1 person said that they see the GP when they are unwell and attend appointments to get their eyes checked and the dentist. The provider said that they access local healthcare training such as “nail care” and healthy lifestyle. All medication is in a monitored dosage system kept in a locked cabinet. Any one working in the home has received training in the safe handling of medication. The MAR charts were seen and appeared up to date. Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People feel listened to and their concerns acted upon. EVIDENCE: Both Mr and Mrs Wills have completed training on adult protection and there is a policy in place. There is a complaints policy, which is detailed, in pictorial format as well as words to support access. There had been no complaints since the last inspection. Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use this service live in a homely and comfortable environment, which is clean. EVIDENCE: The home is suitable for its stated purpose to provide accommodation, care and support to people with a learning disability. All the bedrooms are on the ground floor, which means as the people in the home become older the worry about using the stairs is not an issue, and was 1 of the reasons for the service moving from a home with stairs. 2 of the bedrooms were seen and both were personalised with the possessions of the individuals living in the home. The home is comfortable, clean and homely. Both the people living in the service were observed in the living room and they were relaxed in their surroundings. The home is in keeping with other homes in the residential street. Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 16 The fixtures and fittings in the home are of good quality. At the time the home was registered it met the requirements of the local fire service and environmental health. During the inspection the people living in the service were observed being able to move freely around the home. There are some shops in the village, which are close to the home. There is transport available and the registered providers take both the people living in the service out and about in the community. The home has an infection control policy in place. Laundry facilities are, as you would expect in a small family style care service. Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. EVIDENCE: At present the registered providers are the main carers in the home. However the recruitment practice the registered provider implement is very thorough and was reviewed at their other care home Peverill and found to be very robust. The registered providers have the same processes at the new service. Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living in the service benefit from a well run home, which takes into account the views of the people living there when developing the service. People have their health, safety and welfare promoted and protected. EVIDENCE: Mr and Mrs wills are in day-to-day control of the home. They have both successfully completed the registered managers award. The home has a quality assurance system in place. They consult with people who live in the service and other people such as family and health and social care professionals. The providers wrote in their Annual Quality Assurance assessment that this is an area they wish to improve in over the next 12 months. Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 19 The service implements requirements within agreed timescales. Fire safety records were up to date and accurate. Hazardous substances were stored safely. The premises were secure. Kitchen equipment is maintained. The garden and paths were well maintained. Safety notices are posted in the home. Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X Penrose DS0000069739.V353305.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action 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 Penrose DS0000069739.V353305.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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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