Care Home: Portland House

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What the care home does well People living at the home feel that they are well cared for and are able to express and make choices to suit their needs. Staff is supportive of the people living at Portland House. A mini bus is provided for regular trips out. What has improved since the last inspection? A new conservatory has been built but is not yet completed. This will provide another public area for the people living at the home to use. A new care plan system is being introduced to assist the care staff to record the care they give more effectively. What the care home could do better: A new medicine cabinet must be provided to house controlled drugs in accordance with a change in law. All care homes, whether providing nursing or personal care, must now keep controlled drugs (CD) in a controlled drugs cupboard. CARE HOMES FOR OLDER PEOPLE Portland House Portland Road Kirby Muxloe Leicestershire LE9 2EH Lead Inspector Lesley Allison-White Unannounced Inspection 23rd July 2008 09:00 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 Portland House DS0000061981.V368909.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. Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Portland House Address Portland Road Kirby Muxloe Leicestershire LE9 2EH 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) 0116 2393056 0116 2393056 K.Roundtoit@aol.com Ms Karen Stevenson Mrs Teresa Poynton Ms Karen Stevenson Care Home 19 Category(ies) of Dementia - over 65 years of age (7), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (7), Old age, not falling within any other category (19) Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service User Numbers No person falling within categories MD (E) or DE (E) may be admitted to the home when seven persons in total of these categories/combined categories are already accommodated in the home. 22nd September 2006 Date of last inspection Brief Description of the Service: Portland House is a long established home in the village of Kirby Muxloe and is situated in a quiet residential part of the village. The rooms in this home are a mixture of double and single occupancy and many have a pleasant view over the gardens. The home is generally well decorated and comfortably furnished. The gardens form an attractive area for people living there if they wish to sit outside. There are a variety of lounges and service users can choose to sit in whichever one they choose. A new conservatory is also being built (2008). The Statement of Purpose, Service Users Guide & Inspection Report is available at the entrance to the home (these provide information on how the home is organised and what services they provide). A current Employers Liability certificate of insurance is displayed in the hallway also. At the time of the inspection, fees ranged from £1,645.00 to £1,839.00 per calendar month. There are additional costs for individual expenditure such as hairdressing and private chiropody. Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. There were eighteen people living at the home on the day of inspection plus one person in hospital. The inspection took six and a half hours to complete. Preparation included examining inspection records, looking at the service history and the annual quality assurance assessment (AQAA). The annual quality assurance assessment is in two parts. The first part is a self assessment and is how providers let us know how well their service is performing and achieving outcomes for the people using their service. The second part is a data collection form that asks providers to give us some detailed, factual information about their service. This aided the inspection process by providing background information. A discussion was held with four people who live at Portland House. One person had some memory problems. The primary method of inspection used was “case tracking”. This involved speaking with or observing the people who use the service provided, looking at three peoples care plans and making observations. Care plans are records about the care or support provided for an individual. All the required key standards were inspected during this visit. Requirements were made at this inspection. The Registered Manager assisted during the inspection. What the service does well: What has improved since the last inspection? Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 6 A new conservatory has been built but is not yet completed. This will provide another public area for the people living at the home to use. A new care plan system is being introduced to assist the care staff to record the care they give more effectively. 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. Portland House DS0000061981.V368909.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 Portland House DS0000061981.V368909.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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission process is good and the pre-admission process ensures that the needs of the people living at this home will be met. EVIDENCE: Three people living at the care home were case tracked. One of them was fairly new. This person explained that although the assessment process is very vague to them they remember being made to feel very welcome by both staff and other people at the care home. The other person said that they had an assessment done by the previous owners whilst in hospital to ensure that their needs could be fully met. The care needs of all three people included their pre assessment details. Assessments also include the Mental Capacity Act 2005, which includes the individual’s ability to consent to treatment and financial affairs. It is recognised by the Registered Manager that this is changeable and care plans are updated accordingly. Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 9 A copy of the Service User Guide and Statement of Purpose (information about the services the home offers) is available on request and a copy is kept in the entrance hallway. Both are clear and well written. Information about payment and contract agreements are stated. This service has links with a local advocacy services and is available on request. A trial period of up to one month forms part of the assessment process when deciding if this home is right for the prospective person. Currently a budgerigar also lives at the home. The home does not offer intermediate care facilities. Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 10 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. This judgement has been made using available evidence including a visit to this service. People living at the home have individual care plans that give a comprehensive overview of their general health and acts as an indicator to their changing needs. EVIDENCE: The three people case tracked had assessments for care and social needs in place and an evaluation of the care given had also taken place. Involvement of specialist support such as the District Nurses or Chiropodist visits were also evident. The General Practitioner (GP) visits Portland House when someone is unwell. The Registered Manager said that the relationship with the local medical, nursing and support services was very good and that people living at the home were not kept waiting for extra care support. Comments from individuals living at Portland House included ‘If I need help I just ring a bell, the staff couldn’t be better. ‘I can ask for pain killers when I need them.’ ‘The District Nurses visits to do my dressings’. Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 11 ‘There are two male carers that work here it is nice to have male staff.’ There was evidence of one of the individuals being involved in their care planning and information relating to the Mental Capacity Act 2005 for when they choose to refuse treatments or see specialists. The care plan is regularly updated and the necessary action taken to respond to any changes. People living at the home are involved in their care planning wherever possible. This includes the choices that they make affecting their lifestyle. The Registered Manager is aware of current policy issues relating to the care of older adults and has been transferring this information into the care planning processes at the home. A new care planning system has recently been brought in. Care plans are being up graded as the information is transferred to the new paper work. The Registered Manager said that this should make specific areas of care clearer and easier for staff to use. Relative and visitors comments include ‘We visit regularly during the week and have been visiting for some years now.’ ‘It is difficult to have a conversation with my relative now but we are always made to feel welcome when we visit.’ ‘In the afternoon my parent is offered bed rest. The bed clothes are always clean. Care here, no problems.’ ‘If I had a problem with my parent’s care I would go to the manager. I have never had cause to worry about my parent’s care at this care home.’ Medications of the three case tracked people at the home were checked. Staff works to an efficient medication policy. One controlled drugs medication was checked. Staff at the home follow good practice guidelines and included all the measures needed to ensure the safety of medicines. (Controlled drugs fall under the Misuse of Drugs Act 1971 which aims at checking the unlawful use of the drugs liable to produce dependence or cause harm if misused). In this way peoples’ medicines are safeguarded. Due to changes in the law requirements will be made, as care homes without nursing must also have controlled drugs cupboards that meet the latest legislative requirements. Eye medication must be correctly stored in a non food fridge that can meet the requirements of the safe storage of medicines at all times. Currently eye medications at Portland House are stored in a lockable box in an unlocked food fridge. There is no one on night duty that can give medications and the on call person from the home would go in to do this if it was required. People who spoke with the inspector said that the staff was friendly, polite and courteous to them at all times. Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 12 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 excellent. This judgement has been made using available evidence including a visit to this service. Routines are flexible and individuals are encouraged to make choices in important areas of their lives. EVIDENCE: People living at the home said there were a number of activities – games, music, and staff making time to talk with them. A mini cruise is planned for this July and a number of people will be going on it. Individual records confirmed participation in activities or not as preferred. ‘Quite a few activities take place here. I do not join in with them, as I like my own room, television and radio although I do not use them much these days. I like to have a nap in the afternoon on my bed, the staff help me to do this when I ring for them.’ ‘There is a tuck shop here where biscuits and toiletries can be bought.’ ‘Staff ask you what you want for tea time every day’ (this was also heard later by the inspector). ‘I mainly watch TV. Newspapers are here for you to read. I read the headlines mostly.’ Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 13 People living at the home said that their visitors were made welcome by staff and their relatives took them out. Visitors were seen visiting friends and relatives during the day. ‘My visitors are made to feel welcome and always get offered a cup of tea.’ ‘Family can visit when they want to, no problems.’ A hair dressing service was visting on the day of inspection and individulas were seen going indepedendtly or assisted to go to the hairdresser by the staff. Some people said that they went out in the local community. Individuals who spoke to the inspector were able to describe the choices that they made including when they went to bed or got up. If they wanted to take part in a group activity or if they wanted to see a GP or attend a hospital appointment. In this way individuals exercised their rights and made choices. Maintaining independence and enabling individuals to make their own decisions about how they wish to live is important within the home. A meal at lunch- time was seen it looked pleasant. A menu was placed on the dining tables of those people who could read it. Condiments of salt and pepper were also placed on the tables or individual trays of those people who could use them safely. At a residents meeting food at breakfast time was mentioned. Following the meeting a new breakfast menu was served. People living at Portland House all said they enjoyed the food and they had alternatives to all meals. ‘The food here is very good and you get a choice of food for breakfast, dinner and at tea time.’ On inspection two individuals were seated in armchairs and encouraged to start feeding themselves. Aprons were placed on them to protect their clothes, side guards on the plates and staff available to assist and prompt whenever required. In this way the two people ate unrushed and participated in the mealtime and maintained a degree of self independence. Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 14 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. This judgement has been made using available evidence including a visit to this service. There are policies and procedures for dealing with complaints and protection thereby giving protection to the people living at Portland House. EVIDENCE: The Commission of Social Care Inspection has received no complaints about Portland House since the last inspection. People who spoke with the inspector explained what they would know what to do if they had a problem and knew that the Registered Manager would address them. There are policies in place for dealing with complaints and protection. The complaints book was checked and satisfactory. The complaints procedure is included in the Service User Guide and Statement of Purpose. Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 15 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. This judgement has been made using available evidence including a visit to this service. People living at Portland House are provided with a safe, hygienic and comfortable environment. EVIDENCE: The inspector saw two bedrooms they were clean, uncluttered and tidy. Some bedrooms had toilet and face basin facilities in them. The corridors were welllit, clean uncluttered areas. People who lived at the home said that they liked their bedrooms and they could bring in small items of their own furniture. Facilities were found to be clean and odour free. Comments from people living at the home ‘This is a very quiet home and I like it like this.’ ‘My room kept tidy every lunchtime by the domestic staff when I am out for lunch.’ ‘I like my bed room as I can watch people going by down the lane.’ Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 16 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. This judgement has been made using available evidence including a visit to this service. People living at the home are well supported by the culture and life style within the home and feel safe with the staff that supports them. EVIDENCE: The recruitment records of two members of staff were inspected and were satisfactory. Staff receives regular training and are part of an ongoing training programme. Over half the staff has a National Vocational Qualification (NVQ) level 2 in care or above. Staff receives induction when they start working at the home. People at Portland House who spoke with the inspector said that they felt the staff were well trained and felt that they were able to provide for their needs. The staff rota indicated that people who lived at this home had their needs met by the flexibility of the staff. Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 17 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. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the people who live there. EVIDENCE: Quality Assurance surveys were seen at inspection. Surveys from the health care professionals included ‘Staff are always helpful. Residents are well cared for and treated with respect. Privacy when attending to anyone living at the home is always offered.’ They thought the home was well maintained; people living the home looked well presented and had their health needs met. Staff was polite and helpful. Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 18 There is also a quality survey supplied to people living at the home and their relatives, to determine how the service is operating. Relatives’ comments about the home included ‘I would like things to remain as they are, good regular staff run by good management. Portland House is by far top of its class in the residential home bracket’. The Registered Manager keeps small amounts of individuals monies - records are detailed with running balances, two signatures per transaction and receipts kept. Records and money checked was correct. The Registered Manager explained that all statutory requirements under Health and Safety are met. Records were available for inspection. Fire drills and checks form part of the normal weekly and monthly routines at Portland House care home. A boiler inspected by plumbers earlier in the year needs replacing. The Registered Manager said that it would be done this year. Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 19 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 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 Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 20 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 OP9 Regulation 13 (2) Requirement In 2007 the law changed. All care homes, whether providing nursing or personal care, must now keep controlled drugs (CD) in a controlled drugs cupboard. In brief, the requirements for CD storage are: • • • Timescale for action 31/10/08 metal cupboard of specified gauge specified double locking mechanism fixed to a solid wall or a wall that has a steel plate mounted behind it fixed with either Rawl or Rag bolts. 31/10/08 2. OP9 Regulation 13 (2) 1. In accordance with the Care Homes Regulations 2001 Act. The registered person must make arrangements for the safe administration of medicines prescribed for the people they care for. This includes eye medications. DS0000061981.V368909.R01.S.doc Portland House Version 5.2 Page 21 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 Portland House DS0000061981.V368909.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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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