Latest Inspection
This is the latest available inspection report for this service, carried out on 6th December 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.
For extracts, read the latest CQC inspection for Philadelphia House.
What the care home does well Philadelphia House continues to provide consistent good quality care for those who live there. There is a core team of well trained staff who care about their jobs and the residents benefit from a management team who bring energy and a desire for improvement to their roles. What has improved since the last inspection? Since last inspected the homes dining facilities have been refurbished and a restaurant service has been introduced at the home. As such people enjoy better quality meals with extended variety and choice. In addition to this the home is now ensuring that anyone at possible risk of malnutrition receives a nutritional assessment and associated care plan. What the care home could do better: Although staffing levels were judged to be satisfactory, people spoken to felt that dependency was rising and the provider should keep staffing under review to ensure it continues to allow adequate delivery of care. Work commenced to improve decoration should be continued. The management team needs to improve its systems to ensure that all staff receive regular supervision. CARE HOMES FOR OLDER PEOPLE
Philadelphia House Penn Grove Norwich Norfolk NR3 3JL Lead Inspector
Mr Pearson Clarke Unannounced Inspection 6th December 2007 09:55 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 Philadelphia House DS0000035164.V356360.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. Philadelphia House DS0000035164.V356360.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Philadelphia House Address Penn Grove Norwich Norfolk NR3 3JL 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) 01603 419175 01603 409636 www.norfolk.gov.uk Norfolk County Council-Community Care Ms Elizabeth Helen Rayman Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Philadelphia House DS0000035164.V356360.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Wheelchair users can only be admitted to bedrooms of at least 12sq metres i.e Rooms numbered 25 and 26 (as at 31 March 2002) Thirty five (35) Older People, not falling into any other category, may be accommodated. 27th November 2006 Date of last inspection Brief Description of the Service: Philadelphia House is a registered care home and can provide accommodation and care to 35 older people. The home is owned and managed by Norfolk County Council and has a registered manager. The accommodation consists of 35 single bedrooms situated on the ground and first floor. A number of the rooms have a view of a nearby park that is in walking distance. There are two rooms on the first floor that are the appropriate size to accommodate wheelchair users. Access to the first floor is by a shaft lift or stairs if the service users are able to negotiate them safely. There are a number of communal areas that service users can choose to access according to their preference and need. The home is situated in a residential area of Norwich and is a short bus ride to the city centre. At the time of this inspection the services maximum fee was £368.72 with each service users fee individually assessed according to individual circumstance. Philadelphia House DS0000035164.V356360.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out by using information from previous inspections, information from the providers ,the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home and this report gives a brief overview of the service and current judgements for each outcome. During the site visit the inspector spent time with service users both in a group and on an individual basis and views expressed have helped shape the judgements made. In addition time was spent observing life in the home and staff on duty were spoken to as was the service manager. A tour of the premises was undertaken and relevant records were inspected. What the service does well: What has improved since the last inspection?
Since last inspected the homes dining facilities have been refurbished and a restaurant service has been introduced at the home. As such people enjoy better quality meals with extended variety and choice. In addition to this the home is now ensuring that anyone at possible risk of malnutrition receives a nutritional assessment and associated care plan.
Philadelphia House DS0000035164.V356360.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. Philadelphia House DS0000035164.V356360.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 Philadelphia House DS0000035164.V356360.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 Quality in this outcome area is ( good). That people admitted benefit from a thorough assessment of their needs being used to establish a plan of care, which helps to ensure that those needs are fully met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit the inspector tracked three recent admissions to the home and discussed the admission process with the homes management. The paperwork relating to admission was in good order with a recorded pre admission assessment which identified each persons needs and wishes. Comprehensive short term care plans were established based on these assessments and information obtained during the first few days after admission. The homes manager confirmed that care is taken to ensure that the service can meet the needs of people referred and a visiting social worker told of how well the home had been able to identify and meet the needs of clients he had placed there. Residents recently admitted spoke in positive terms about the experience and the good quality of care.
Philadelphia House DS0000035164.V356360.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). People living at Philadelphia House benefit from good care plans and a sound approach to medication and health. The approach of staff helps to ensure that care is delivered with attention to peoples privacy and dignity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Six care plans were inspected during the site visit, including some recent admissions and others who had been at the home for a longer time. In all cases seen the plans were well constructed, easily readable and up to date. Plans contain appropriate risk assessment, include nutritional assessment and a mental capacity assessment. There is evidence of review and signatures of acceptance of the plan were seen. From these records and discussion with residents, staff and the manager it was evident that the health care needs of residents are appropriately met. The arrangements for the storage and
Philadelphia House DS0000035164.V356360.R01.S.doc Version 5.2 Page 10 management of peoples medication were inspected. Records seen were accurately maintained and observation of part of the medication round indicated good practice was observed. The service has a regular medication audit and from records of this it was possible to see that where errors occur appropriate action follows to address problems. All medication was securely stored. People spoken to said that staff respect their privacy and dignity and this was supported by the inspectors observations of interaction on the day. Philadelphia House DS0000035164.V356360.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is ( good). That residents benefit from a relaxed and open home where they can exercise freedom of choice on a daily basis. People are offered a reasonable range of activity and enjoy catering of a good standard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since last inspected the provider has introduced a restaurant style of food service to the home. From discussions on the day it was apparent that despite initial teething problems this has been a success and has enhanced the enjoyment of residents at mealtimes. The inspector observed part of the lunch time service and could see the meal being enjoyed in a relaxed atmosphere with appropriate levels of help being given to residents from staff on duty. The service continues to make well publicised activity available and the regular newsletter is still published and enjoyed. Once again residents told the inspector that the atmosphere in the home was relaxed and that they felt able to exercise choice and control over their daily lives.
Philadelphia House DS0000035164.V356360.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). That people benefit from a service where there is a robust approach to complaints and to safeguarding, which helps ensure their overall protection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Through inspection of training records and the homes record of complaints the inspector could see that complaints and protection are robustly managed. Residents told the inspector they were confident that they could raise any issues with staff or the manager and that these would be addressed. Records seen showed that complaints were properly investigated with action taken to address any failings. Philadelphia House DS0000035164.V356360.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 ( good). That residents benefit from a clean and hygienic home which is well maintained and comfortably furnished and which will further improve when planned work is completed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Based on a tour of the building and discussion with the homes manager and residents, the inspector found a clean, fresh and well maintained environment. Since last inspected there has been some redecoration and refurbishment and there are firm plans for more work to be carried out. Residents confirmed that the picture seen by the inspector is consistent with that normally found. Philadelphia House DS0000035164.V356360.R01.S.doc Version 5.2 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 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). People using the home benefit from staff who are good at their jobs, well trained and available in sufficient numbers to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As at the time of the last inspection the home was found to have staffing levels which were adequate to meet the needs of residents. During the site visit the views of residents staff and management were considered, as was written comment received. As in other homes there would appear to be a general rise in the dependency levels of those cared for and staff felt that this placed them under more pressure, however it was still felt that an effective service could be provided when fully staffed. Residents were very positive about the staff describing them as hard working and good at their jobs. Inspection of training records and information in the homes Annual Quality Assurance Assessment showed that the service has a positive approach to staff training, with government targets for NVQ qualified staff met and a good range of other training. The provider has a robust approach to staff recruitment and staff files seen at the site visit confirmed this.
Philadelphia House DS0000035164.V356360.R01.S.doc Version 5.2 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 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). The home is effectively managed and operates in the best interests of those living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From the views of residents expressed on the day of the site visit and those received in writing, this is a well managed home which operates in the best interests of those living there. The service has a quality process based on survey and at the time of the visit the results of the latest survey were being collated. The provider has robust systems for the management of residents finances and a thorough approach to health and safety. Although staff supervision has improved since last inspected there is still room for improvement, although staff told the inspector that they felt generally well supported.
Philadelphia House DS0000035164.V356360.R01.S.doc Version 5.2 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. 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 x 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 3 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 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 3 x 3 x 3 x x 3 Philadelphia House DS0000035164.V356360.R01.S.doc Version 5.2 Page 17 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. 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 Philadelphia House DS0000035164.V356360.R01.S.doc Version 5.2 Page 18 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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
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