Care Home: Polventon House

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What the care home does well Service users are assessed prior to being admitted to the home so that they can be sure it will be suitable for them. They are encouraged to contribute their own views to the assessment process so that their care can be better tailored to their preferences. The systems for managing service users` medicines are safe and sound and ensure that they are generally well protected from medication errors. Service users interviewed at the time of the inspection said that staff look after them well and visiting relatives confirmed this. Staff were observed to treat service users with respect at all times during the inspection and records suggest that they are appropriately consulted about matters relating to their privacy and dignity so that their wishes are known and followed through. The home aims to ensure that service users enjoy a good quality of life and this appeared to be the case at the time of the inspection. Service users were enjoying the reading session with the manager and their afternoon singalong. They are consulted on their social interests and hobbies and there is an activity on offer every afternoon. Service users are given a choice about whether they wish to join in with the home`s activities and are not pressured to take part if they do not want to. Some preferred to remain in their own rooms during the activity. Their views are regularly sought through the home`s quality assurance programme as well as the manager going to see all the service users every day. All of the service users expressed satisfaction with the food provided to them. There is a choice of foods at each meal and plenty of variety in the menus. Service users` dietary needs and preferences are considered as part of the assessment and care planning process so that their nutritional needs can be properly met. Service users interviewed stated that they feel safe and are well cared for and visitors to the home confirmed this. There are plenty of visitors coming and going from the home, so that it is part of the local community, which is important in protecting service users. Most of the home`s staff have qualifications in National Vocational qualifications so that service users can be confident of the competence and skills of people working with them. The home exceeds the recommended numbers of qualified staff with NVQ, which demonstrates the commitment to staff training.The home is competently managed for the benefit of service users. The registered providers are also actively involved in the day-to-day management of the home and are readily available to staff and service users. Service users` financial interests are properly managed, to ensure that they receive their legal entitlements. Where possible, they are encouraged to manage their own personal finances with the assistance of their relatives or independent advocates. Where this is not possible, the registered provider and manager assist them and full records are maintained. What has improved since the last inspection? The home`s environment is very pleasant and comfortable for service users. They are provided with a range of communal spaces in addition to their private rooms, and several parts of the home have sea views. The providers have had built a very large patio area which runs along side the full length of the extension. There is a ramped area for disabled people to access the patio and steps with rails provided. The providers have built an ensuite facility in the double room, which now accommodates one service user. Seven new chairs have been purchased and new carpets have been fitted in room 1,3,8 and 25. What the care home could do better: Comprehensive feedback was given to the provider and manager on the findings of the inspection. Assessments Whilst the home`s assessment formats consider needs relating to service users cultural backgrounds, such as their religious beliefs, there is a reliance on tick ing boxes. Discussion took place with the manager on providing information for staff that informs and directs them on assessments. Daily Records Daily records should be more informative so that the records paint a full picture of the day spent by the service users, action taken to follow up on anyPolventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 8issues and reference to social and emotional needs met. There was a pattern of recording day and night that only referred to phrases "all care given" Medication A policy and procedure on PRN medication would be helpful for staff to follow. One service users was prescribed Lorezepam PRN. The policy should relate to the maximum dosage and frequency of medication and reasons why given. Safeguarding Adults policies and procedures and training. The home`s internal written procedures to guide staff on how to recognise and prevent abuse should be reviewed to ensure that they are still up-to-date and contain relevant information. The manager should obtain a copy of the Cornwall Multi-Agency Code of Practice on the Protection of Vulnerable Adults. This report recommends that they obtain a copy of this from Cornwall Department of Adult Social Care and make all staff aware of the document. The manager should attend the multi agency training on safeguarding Adults. Environment. Throughout the home there are bolts on doors that can be opened from the outside with a nail attached to string that is secured by the door. It is recommended that consideration be given to replacing the bolts for something more sophisticated I.e. Proper locks on doors that can be overridden by staff in an emergency. Aesthetically it would look much better and be more in keeping with what someone would expect to see in his or her own home. The providers must also write to The Commission explaining how they intend to address the deficit of a bathroom now it has been converted to an office. Building Control, Environmental Control and planning should be informed so that the position of the ensuite in the double room and office can be regularised. Training The manager gives all staff induction training. However the industry standard is Skills for Care Induction and this should be implemented forthwith. Management and Health and Safety Polventon is registered as a company Melita Care Homes Ltd. The providers visit the home every week and are very much in touch with the day-to-day activity. However there is a legal requirement for The Responsible Individual to submit a Regulation 26 report to the Commission and the company on the conduct of the home. This will be made a requirement in the report. The manager should record what action she has taken after the accident book has been completed by the staff. The evidence shows that where someone has fallen, cut or hurt themselves there is no action recorded in the accident or kardex to detail what action has been taken. The key National Minimum Standards under outcomes groups are generally met but the areas detailed above require improvement and we are confident the manager will put them right. CARE HOMES FOR OLDER PEOPLE Polventon House High Street St Keverne Helston Cornwall TR12 6NS Lead Inspector Stephen Baber Key Unannounced Inspection 10:00 22nd January 2008 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 Polventon House DS0000066615.V349878.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. Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Polventon House Address High Street St Keverne Helston Cornwall TR12 6NS 01837 849029 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) Melita Care Homes Ltd Mrs Christine Stewart Care Home 19 Category(ies) of Dementia - over 65 years of age (5), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (5), Old age, not falling within any other category (19), Physical disability (1) Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th September 2006 Brief Description of the Service: Melita Care Homes Ltd trading, as Polventon is a private residential care home providing personal care and accommodation to 19 older people some of whom may have a dementia or other mental health problems. The home is a detached house with a modern extension in the village of St Keverne approximately eleven miles from Helston town. The home provides respite and day care facilities. All bedroom accommodation is single with the one registered double currently being used as a single with new ensuite facilities. Polventon has bathrooms and toilets spread out throughout the home. There are facilities for disabled service users to access the home and there is a shaft lift that serves ground to first floor in the main building. All accommodation is on one level in the extension. The home is privately owned and the registered providers are closely involved in the day-to-day management and administration. The home also has a manager registered with the Commission, a team of care staff, ancillary staff and a maintenance man employed to assist in the smooth running of the home. There is communal space available throughout the home for service users to have quiet or listen to music. There are ample, very well maintained and safe grounds for service users to enjoy. The health centre provides medical cover, which is next to the home. Fees range from £300, £349 for dementia beds and £425 per week. I asked the manager to explain the philosophy of the home. She said that the home is committed to continuous improvement, quality services, support, accommodation and facilities that ensure a good quality of life and health for service users. Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection (CSCI) have made changes to the way we inspect services. Known as Inspecting for Better Lives (IBL). We are now more proportionate when reporting our findings, and more focused on the experience of people using services. The purpose of the inspection was to ensure that resident’s needs are appropriately met, with good outcomes provided to them. This was a key inspection, which was unannounced. It took place on 22nd January 2008 and lasted for approximately 7hours. The purpose of the inspection was to ensure that service users needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus is on ensuring that service users placements in the home result in good outcomes for them. The inspection included interviews, some held privately in service users rooms and some in the communal area of the home, with service users and visiting relatives. Several members of staff were interviewed and there were opportunities to directly observe aspects of service users’ daily lives in the home and staff interaction with them. Other activities included an inspection of the premises, examination of care, safety and employment records and discussion with the manager and provider who were present throughout the inspection. The provider explained that the company are making major improvements throughout so that service users receive quality care in a comfortable environment. The principle method of inspection was “case tracking”. This involves interviews with a select number of service users; staff caring for them and/or their representatives, and examination of records relating to their care. This provides a useful impression of how the home is working overall. At this inspection three service users were case-tracked, with particular reference to their individual and diverse needs relating to their age, culture and ethnicity, religion, gender, sexual orientation and disabilities. Overall the home is meeting the needs of service users well, in a warm and friendly, homely environment. Service users and their relatives who were interviewed at the time of the inspection confirmed this. One relative wished to be quoted and he said “That his father is very well cared for. He visits three times a week and is always impressed by the manager and staff”. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 6 What the service does well: Service users are assessed prior to being admitted to the home so that they can be sure it will be suitable for them. They are encouraged to contribute their own views to the assessment process so that their care can be better tailored to their preferences. The systems for managing service users’ medicines are safe and sound and ensure that they are generally well protected from medication errors. Service users interviewed at the time of the inspection said that staff look after them well and visiting relatives confirmed this. Staff were observed to treat service users with respect at all times during the inspection and records suggest that they are appropriately consulted about matters relating to their privacy and dignity so that their wishes are known and followed through. The home aims to ensure that service users enjoy a good quality of life and this appeared to be the case at the time of the inspection. Service users were enjoying the reading session with the manager and their afternoon singalong. They are consulted on their social interests and hobbies and there is an activity on offer every afternoon. Service users are given a choice about whether they wish to join in with the home’s activities and are not pressured to take part if they do not want to. Some preferred to remain in their own rooms during the activity. Their views are regularly sought through the home’s quality assurance programme as well as the manager going to see all the service users every day. All of the service users expressed satisfaction with the food provided to them. There is a choice of foods at each meal and plenty of variety in the menus. Service users’ dietary needs and preferences are considered as part of the assessment and care planning process so that their nutritional needs can be properly met. Service users interviewed stated that they feel safe and are well cared for and visitors to the home confirmed this. There are plenty of visitors coming and going from the home, so that it is part of the local community, which is important in protecting service users. Most of the home’s staff have qualifications in National Vocational qualifications so that service users can be confident of the competence and skills of people working with them. The home exceeds the recommended numbers of qualified staff with NVQ, which demonstrates the commitment to staff training. Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 7 The home is competently managed for the benefit of service users. The registered providers are also actively involved in the day-to-day management of the home and are readily available to staff and service users. Service users’ financial interests are properly managed, to ensure that they receive their legal entitlements. Where possible, they are encouraged to manage their own personal finances with the assistance of their relatives or independent advocates. Where this is not possible, the registered provider and manager assist them and full records are maintained. What has improved since the last inspection? What they could do better: Comprehensive feedback was given to the provider and manager on the findings of the inspection. Assessments Whilst the home’s assessment formats consider needs relating to service users cultural backgrounds, such as their religious beliefs, there is a reliance on tick ing boxes. Discussion took place with the manager on providing information for staff that informs and directs them on assessments. Daily Records Daily records should be more informative so that the records paint a full picture of the day spent by the service users, action taken to follow up on any Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 8 issues and reference to social and emotional needs met. There was a pattern of recording day and night that only referred to phrases “all care given” Medication A policy and procedure on PRN medication would be helpful for staff to follow. One service users was prescribed Lorezepam PRN. The policy should relate to the maximum dosage and frequency of medication and reasons why given. Safeguarding Adults policies and procedures and training. The home’s internal written procedures to guide staff on how to recognise and prevent abuse should be reviewed to ensure that they are still up-to-date and contain relevant information. The manager should obtain a copy of the Cornwall Multi-Agency Code of Practice on the Protection of Vulnerable Adults. This report recommends that they obtain a copy of this from Cornwall Department of Adult Social Care and make all staff aware of the document. The manager should attend the multi agency training on safeguarding Adults. Environment. Throughout the home there are bolts on doors that can be opened from the outside with a nail attached to string that is secured by the door. It is recommended that consideration be given to replacing the bolts for something more sophisticated I.e. Proper locks on doors that can be overridden by staff in an emergency. Aesthetically it would look much better and be more in keeping with what someone would expect to see in his or her own home. The providers must also write to The Commission explaining how they intend to address the deficit of a bathroom now it has been converted to an office. Building Control, Environmental Control and planning should be informed so that the position of the ensuite in the double room and office can be regularised. Training The manager gives all staff induction training. However the industry standard is Skills for Care Induction and this should be implemented forthwith. Management and Health and Safety Polventon is registered as a company Melita Care Homes Ltd. The providers visit the home every week and are very much in touch with the day-to-day activity. However there is a legal requirement for The Responsible Individual to submit a Regulation 26 report to the Commission and the company on the conduct of the home. This will be made a requirement in the report. The manager should record what action she has taken after the accident book has been completed by the staff. The evidence shows that where someone has fallen, cut or hurt themselves there is no action recorded in the accident or kardex to detail what action has been taken. The key National Minimum Standards under outcomes groups are generally met but the areas detailed above require improvement and we are confident the manager will put them right. Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 9 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. Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 10 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 Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 11 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): Standard 3 was assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are only admitted to the home following an assessment of their needs to ensure the home can provide suitable care. The assessments follow headings that are completed by the manager but these could be improved to inform and direct the staff. Views expressed by a number of service users & relatives showed that they had made a positive choice by selecting Polventon and that the home had sought sufficient information before a placement. EVIDENCE: The manager completes assessments for all prospective service users to ensure that the home can meet their needs. The relative I spoke with said that his mother and father recived thorough information and assessment from the manager before they made a decision to come and live at the home. The service users I spoke with said that the manager was very thorough when she Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 12 visited them to assess them for coming to live at the home. The assessments cover specific headings, which were completed by the manager. However in some instances there was a reliance on ticking boxes which did not ensure that all staff had sufficient information that would inform and direct them. “The Company have said in their AQAA that their plans for improvement in the next twelve months are: “We are looking to working with Care Aware so that service users have contact with an independent body for impartial advice.” Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 13 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): Standards 7,8,9and 10 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual care plans are generated for each service user, they are all being reviewed and updated to fully inform and direct staff in the care provision. Service users have access to health care services as necessary to ensure their assessed needs are met. There are systems and policies in place for dealing with service users medicines that assure their safety. The homes policies, procedures and culture ensure that service users are respected and their privacy and dignity is upheld at all times. EVIDENCE: Service users have detailed written care plans, which address all their personal, health and social care needs, including needs relating to their religion, culture and ethnicity. Their care plans state the aims and objectives of their placements in the home. There is evidence that service users are consulted on key aspects of their care planning, which directly affect them. Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 14 There are suitable procedures and systems in place to protect service users from harm through medication errors and the medicine charts are signed as they medication is administered. Service users interviewed confirmed that they are well cared for and staff treat them respectfully. Relative visiting the home confirmed this. There are records to indicate that they are consulted on important matters relating to their care, privacy and dignity. We observed the good practice of staff respecting the privacy and dignity throughout the inspection. Service users were called by the name of their choosing, staff knocked on doors and help with personal tasks were explained by the staff. “The Company have said in their AQAA that their plans for improvement in the next twelve months are”: “Coninued staff development and looking at individual needs” Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 15 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): Standards 12, 13, 14 and 15 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users take part in appropriate activities and are encouraged to maintain their independence and individuality. Links with the local community are excellent and allow service users the opportunity to socialise. Service users have appropriate contact with family and friends according to their wishes. Service users rights and individual choices and preferences are respected. Dietary needs of service users are well catered for with a varied selection of food available to meet their taste and preference. The standards in the dining room are conducive to a pleasant dining experience. EVIDENCE: There is a white board, listing activities available daily, the manager visits all service users daily to see if they are well and service users and views are sought through the home’s quality assurance programme. We spoke with a relative who expressed his satisfaction with the manager and staff and said that his father was very well cared for and comfortable at the home. Service users’ assessment and care records indicate their social and recreational interests, which they are encouraged to pursue following admission. There are Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 16 no restrictions on visitors and service users are able to go out with relatives whenever they wish. Service users confirmed that they are able to choose whether or not to join in with activities and some chose to remain in their rooms and enjoy their own company. All those interviewed and their relative stated that they are satisfied with the care and services provided to them at the home. There are records on their personal files relating to important decisions about their care, which they have been consulted on. Menu folders are displayed on the dining tables with the choices recorded. Special diets are catered for and meals can be taken in the dining room or individual rooms. The dining room was conducive to a pleasant dining experience with views of Falmouth Bay. Tables were nicely laid with attention to detail on the dining tables. The meal served was nicely presented with staff knowing service users appetites and quantities they require. The service users were very complimentary about the quality and quantity of the meals they receive. The home’s menu plans indicate that there is a choice of home-prepared meals at every meal and there is plenty of variety in the food served Food served was well presented and looked very appetising. Service users are able to choose where they eat, either in the home’s communal dining room or their own rooms. Staff are available to provide them with assistance if necessary. Their individual care plans indicate their dietary needs and preferences. All of the service users interviewed stated that they are very satisfied with the food provided to them. The Environmental Health Officer inspected the kitchen in March 2007 and reported that everything was satisfactory. In the area of food storage and preparation all due diligence is being applied. The various documentation, discussion and observations throughout the inspection confirmed this “The Company have said in their AQAA that their plans for improvement in the next twelve months are: “We are at present developing our enclosed garden. We shall have easy access, a patio, seating area, flower beds and wheelchair high planters to grow your own. This will benefit all our service users and especially those who love their garden.” Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 17 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): Standards 16 and 18 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a comprehensive complaints procedure that ensures complaints are listened to and acted upon. Arrangements are in place for the protection of service users safeguarding them from harm or abuse but the policy and procedure on safeguarding Adults should be updated and it is recommended that the manager attend the multi agency training through The Department Of Adult Social Care. EVIDENCE: There is a detailed complaints procedure that reflects the different levels of complaints and includes the stages and timescales for the process and resolution of them. Staff training in this area commences from induction. The complaints procedure is included in the Statement of Purpose and Service User Guide. The home’s internal written procedures to guide staff on how to recognise and prevent abuse should be reviewed to ensure that they are still up-to-date and contain relevant information. The manager should obtain a copy of the Cornwall Multi-Agency Code of Practice on the Protection of Vulnerable Adults. This report recommends that they obtain a copy of this from Cornwall Department of Adult Social Care Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 18 and make all staff aware of the document. The manager should attend the multi agency training on safeguarding Adults. “The Company have said in their AQAA that their plans for improvement in the next twelve months are”: “Continue with Dementia Awareness training.” Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 19 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): Standards 19,21, 24 and 26 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users live in a comfortable and well-maintained home, which provides a safe and suitable environment that meets their needs. The bathing washing and toilet facilities have changed since the last inspection and have not been agreed with the registration authority. EVIDENCE: Polventon is a detached house with a modern extension that is maintained to a high standard. Wherever possible the fixtures and fittings and the furniture are domestic in nature and therefore a homely atmosphere is provided. However it is recommended that consideration be given to the removal of bolts on doors and replaced with more suitable locks that can be overridden by staff in an emergency. Whilst all bolts on doors can be opened from the outside with a nail attached to string. A more aesthetically looking lock would be more Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 20 pleasing to the eye to prospective service users and their families when looking around the home. The service users said they were very comfortable and the manager and staff did everything they could to make them safe. There are accessible gardens around the care home and ample car parking facilities at the entrance and to the side of the home. A great addition to the facilities is the new patio area that stretches from the main house to the end of the extension. There is a ramped area for disabled service users and a stepped area with handrails for those wishing to use the steps. The service users said they like to use this area in the better weather. The manager is also considering putting plant pots and seating for the service users to enjoy. Service users rooms are furnished to a high standard with their own possessions around them. We looked around the home and noted that some new chairs were in rooms and communal areas. A wide range of disability equipment is evident at the home and this includes hoists, specialist baths and mobility equipment. The assessment detail the equipment or adaptations they require to met their needs and promote their independence. Bathrooms and toilets are sited around the home. Since the last inspection in September 2006 the providers have reduced the occupancy of the double room to a single room and fitted an ensuite facility in that room. The providers have also moved the office from outside to what was the bathroom. This means that there are a reduced number of bathing facilities especially to the bedrooms near this area. The providers must write to the registration authority with the reasons why this has been done. Clearance reports must be obtained from all the statutory bodies. The providers will have to consider the implications of this should they wish to sell in the future. Polventon is kept very clean and hygienic. All laundry is laundered on the premises with the washing machines having a sluice facility. Protective clothing, and anti-bacterial soap and disposable paper towels are provided for the staff. “The Company have said in their AQAA that their plans for improvement in the next twelve months are”: “Replace more windows. Incorporate office within the home. Carry on redecorating program and up grading furniture Decommission current office to create more parking spaces.” Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 21 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): Standards 27,28,29 and 30 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing arrangements ensure that sufficient numbers of staff are on duty and deployed in a manner that promotes the health, safety and wellbeing of service users. Staff are employed on the basis of fair, safe and effective recruitment policies and practices to ensure that they are suitable to work with vulnerable service users. Service users are in safe hands and the number of staff with NVQ level 2 or above exceeds the 50 ratio. EVIDENCE: Polventon enjoys a very stable group of staff who have worked at the home for many years. Staff morale was high. There is a clear, written recruitment policy and recruitment documents provide evidence that this is adhered to in practice. There is a comprehensive policy to ensure that staff are recruited on the basis of equal opportunities. Interview records are retained and there is evidence that staff have undergone necessary checks to determine their suitability to work with vulnerable older people. Records of staff attendance at training courses are maintained on their files. All new staff undergoes detailed induction training. Discussion took place with the manager on implementing the industry standard for induction training “Skills Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 22 For Care Induction”. The benefits of this training are that staff can transfer elements of completed induction to provide evidence for NVQ training. Courses are conducted in house and through local colleges and independent training providers. The manager also organises in-house training courses for staff and often cascades the knowledge gained to all levels of staff “” The Company have said in their AQAA that their plans for improvement in the next twelve months are: “To continue to work with staff to gain more qualifications.” Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 23 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): Standards 31,32,33,35,36 and 38 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and organised for the benefit of the service users. Service users and their representatives are encouraged to contribute and comment on the manner the home is run on a regular basis. This provides service users with the opportunity to improve the services and facilities provided. Staff are well managed and supported in their duties by a competent manager who is adept at fostering an atmosphere of openness and respect, in which service users, family, friends and staff all feel valued and that their opinions matter. EVIDENCE: Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 24 The manager has many years experience of management, nursing and care. The manager updates her training to maintain her (pin number). There are clear lines of accountability within the home and with any external management. We are always impressed with her professionalism and full cooperation when we visit the home. The service users speak highly of her and the manner in which she conducts herself. The evidence supplied and observations and conversations with service users, staff and relatives evidence that the high standards set by the manager are being met. The manager creates an open, positive and inclusive atmosphere. Polventon is registered as a company with the provider registered as the responsible individual.The provider visits the home every week and it is acknowledged the input they make in the smooth running of the home. The Care Homes Regulations 2001 require the Responsible Individual for the company to submit a monthly report (Regulation 26) on the conduct of the home to the Commission and to each director responsible for the organisation. The manager, registered provider and maintenance man work together to ensure that the environment is kept safe for service users and staff. There are records of fire alarm and equipment tests and checks on a regular basis, and fire evacuations. The home’s fire safety risk assessment is complete. There are clear records of staff training in health and safety, including fire safety. A range of policies and procedures have been established to promote safe working practices at the home. Staff at the home are clearly aware of the importance of providing care in a suitable manner that safeguards and promotes the welfare and well being of the service users. All staff receive bimonthly supervision which is recorded in their individual file. The equipment and services provided, to the home are regularly serviced, maintained as evidenced from the reports and records made available for the inspection. The manager should put in place strategies for overseeing the accident book. The evidence recorded in the accident book referred to “swollen head” “falls”for example but there was no follow up recorded by management in the accident book or daily record. The manager agreed to rectify this immediately. The yearly quality assurance exercise has been completed for the home in September 2007. The results of the survey have been made available to current and prospective service users. A professional said “Care of the patients at Polventon is excellent and caring. Staff are very approachable and easy to communicate with”. Another person who visits the home to provide a service said “ I have been visiting the home for 12 years and have always found the staff more than caring to the rersidents”. Service users comments said that they were “very happy” “totally satisfied overall”. “everything most satisfactory and absolute perfection”. The Company have said in their AQAA that their plans for improvement in the next twelve months are: Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 25 “Investors in People. No significant changes required but we evolve our systems in accordance with changing needs.” Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 26 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 3 X 2 X X 2 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 3 3 X X 3 X 3 Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 27 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 OP24 Regulation 23(2)(j) Requirement The registered providers must write to regularise the situation regarding the bathroom with the registration authority, and seek statutory clearances from all the statutory bodies to ensure that it complies fully with the requirements of their department. The Responsible Individual for the company must submit a monthly Regulation 26 report to the Commission and directors of the company on the conduct of the home. Timescale for action 30/07/08 2 OP32 26(2)(j) 30/03/08 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 OP3 Good Practice Recommendations The registered person should develop the assessments and provide more detailed information that informs and directs the staff. DS0000066615.V349878.R01.S.doc Version 5.2 Page 28 Polventon House 2. OP18 3. 4 5 OP24 OP28 OP38 The registered person should update the policy and procedure on safeguarding Adults and it is recommended that the manager attend the local multi agency training and obtain a copy of the Cornwall Multi-Agency Code of Practice on the Protection of Vulnerable Adults. The registered person should give consideration to replacing the bolts on doors with suitable locks that can be overridden by the staff in an emergency. The registered person should implement the Skills For Induction training for all new staff. The registered person should put in place strategies to record what action has been taken as a result of accident reporting. Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. Extracts may not be used or reproduced without the express permission of CSCI Polventon House DS0000066615.V349878.R01.S.doc Version 5.2 Page 30 - 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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