Care Home: Somerset Villa Care Home

What the care home does well The home has a good pre-admission assessment process in place. This means that people know the home understands their needs and can meet them. New staff are employed using a thorough recruitment process. This helps to reduce the risk of abuse to residents. The process follows good practice guidelines. On appointment, staff receive good and timely training to help them provide the care needed by people living at the home. The home is well-maintained and all health & safety issues are kept up to date and under review. This helps to ensure that people live in an environment that is safe. What has improved since the last inspection? New care plans have been put in place. Staff are still getting used to the new formats. The care plans give good information about all the aspects of the person`s care. There are some elements that need to be developed further but this is in hand. A new medication system has been introduced. The system is well known and provided by an experienced chemist. As it had only been introduced two days before inspection, it was not possible to do a full inspection. However, the evidence seen showed that staff have a good understanding of the procedures and are implementing them well. The new medication system will help to ensure medicines are safely stored and administered. There is continuing improvement to the environment. Where areas have been completed, the outcome is good. Redecoration and refurbishment is to a good standard. This programme will continue for the foreseeable future. CARE HOMES FOR OLDER PEOPLE Somerset Villa Care Home 19 Austin Street Hunstanton Norfolk PE36 6AJ Lead Inspector Mrs Geraldine Allen Unannounced Inspection 11th December 2007 09:20 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 Somerset Villa Care Home DS0000067349.V356448.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. Somerset Villa Care Home DS0000067349.V356448.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Somerset Villa Care Home Address 19 Austin Street Hunstanton Norfolk PE36 6AJ 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) 01485 533081 denisepriaulx@hotmail.co.uk Reminiscence Care Homes Limited Manager post vacant Care Home 16 Category(ies) of Dementia - over 65 years of age (16) registration, with number of places Somerset Villa Care Home DS0000067349.V356448.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 12th March 2007 Brief Description of the Service: Somerset Villa is a care home providing personal care and accommodation for 16 older people who have dementia. The home was acquired and has been owned by Reminiscence Care Homes Limited since 31st August 2006. The home is located in the seaside town of Hunstanton, close to shops, pubs and other local amenities. The building is a converted house, providing domestic style accommodation over 2 floors. There are 4 shared occupancy bedrooms and 2 of the single bedrooms have en-suite facilities. All communal space is located on the ground floor. Somerset Villa Care Home DS0000067349.V356448.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on Tuesday 11th December 2007, commencing at 09:20. There were fifteen people living at the home on the day of inspection. Information has been obtained from various sources. Before the inspection took place, Mrs Priaulx completed and returned an Annual Quality Assurance Assessment (AQAA). This document is completed each year and provides detailed information about the service and how it is performing. We also sent out our own questionnaires to residents and relatives. These gave good information about people’s views of the service. On the day of inspection, various records were looked at, residents and staff were spoken to and practice was observed. Also, a tour of the premises was undertaken with Mrs Priaulx. On the whole, people have made good comments about the home. These include, ‘It’s nice that they have someone coming in to entertain them and that they get taken out sometimes’, ‘I am pleased with everything they do for me. I have no complaints’, and ‘During my visits the care staff appear perfectly competent’. People were not so happy about the laundry services and one person said, ‘I’m not always happy with the laundry care’. A total of four good practice recommendations have been made. What the service does well: What has improved since the last inspection? Somerset Villa Care Home DS0000067349.V356448.R01.S.doc Version 5.2 Page 6 New care plans have been put in place. Staff are still getting used to the new formats. The care plans give good information about all the aspects of the person’s care. There are some elements that need to be developed further but this is in hand. A new medication system has been introduced. The system is well known and provided by an experienced chemist. As it had only been introduced two days before inspection, it was not possible to do a full inspection. However, the evidence seen showed that staff have a good understanding of the procedures and are implementing them well. The new medication system will help to ensure medicines are safely stored and administered. There is continuing improvement to the environment. Where areas have been completed, the outcome is good. Redecoration and refurbishment is to a good standard. This programme will continue for the foreseeable future. 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. Somerset Villa Care Home DS0000067349.V356448.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 Somerset Villa Care Home DS0000067349.V356448.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 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions to the home are not made until a full needs assessment has been undertaken. The assessment is undertaken by an experienced member of staff and involves the individual and their relatives or representative. This service does not provide intermediate care. EVIDENCE: Two care plans were looked at and these demonstrated that all people have a full assessment of their needs before moving into the home. Assessments and information from other agencies were also seen within the files. The assessments included all issues relating to health, personal, emotional and physical care needs. This means that people can be confident the staff understand their needs and know how they can be met. Somerset Villa Care Home DS0000067349.V356448.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 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The delivery of personal care is individual and flexible. People have access to healthcare services and staff respond appropriately to the individual needs of people using the service. The service has efficient medication policies and procedures that staff follow. Medication records are fully completed. Staff have completed an appropriate medication course. The records seen ensured that confidentiality was protected. People were treated with respect and their privacy protected. EVIDENCE: The home is using a new care planning system and has been gradually transferring records over. Two care plans were looked at in detail and both were completed, with assessments in place. The new format had not been in place long enough to evidence regular monthly reviews although Mrs Priaulx confirmed this took place. Somerset Villa Care Home DS0000067349.V356448.R01.S.doc Version 5.2 Page 10 Neither care plan had a life history in place at the time of inspection, although the home has requested information from the families. Once in place, the individuals life history will provide valuable information to staff. The daily records were well completed and gave good information about daily living. Staff need to ensure that all elements of the care plan are completed so that a full picture of the care provided is given. It is expected that this will happen as staff become more familiar with the new documents. Overall, improvements have been made to the care planning process and documentation and the requirement made at the last inspection has been met. The care plans contained good evidence that people receive the appropriate support from healthcare professionals when they need it. All interventions were clearly recorded and it was possible to follow visits and treatments. This is helpful as it makes health information easy to retrieve. The arrangements for medication were discussed with Mrs Priaulx. The home changed over to a new system on 10/12/07 and therefore had only been in operation for two days. Mrs Priaulx said there had been some minor teething problems and these were being resolved during the inspection. The administration record charts for two people were looked at. These had been completed properly although there was an error on one of them and this was being dealt with. People said that staff treated them well. Interaction between staff and residents was observed and was respectful. Personal care was provided in private. Somerset Villa Care Home DS0000067349.V356448.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 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People said they were able to choose how they spend their day and others were observed in activities that were meaningful to them. Staff were seen offering choices to people and respecting any preferences expressed. Visitors are welcomed at the home at any time and there is good contact with the local community. People enjoy a varied and nutritious diet that offers choices at each mealtime. EVIDENCE: Staff said that there are activities in the home on most afternoons. There is a weekly music session, plus daily hand massage/manicure, foot spa etc. Staff take residents out for a walk when the weather allows and they also go out to shows. Some residents go out to the hairdresser and one resident likes to go shopping to the local store. A Community dog regularly visits the home and both Catholic and Church of England communion services are held monthly. One of the owners brings their dog to the home each day and this is clearly enjoyed by some residents. Somerset Villa Care Home DS0000067349.V356448.R01.S.doc Version 5.2 Page 12 One resident said she enjoys sitting in the conservatory with the dog and goes outside to have a cigarette. Mrs Priaulx said that covered arrangements for smoking were offered to the resident but she declined them, preferring to sit outside in the courtyard. During the afternoon, staff were attending a training session in the dining room. Time was taken to sit with residents during this time and six were spoken with. Observations of activity and interaction also took place throughout the day. Residents were engaged in various activities, including a memory game with cards, knitting and watching television. Two residents were in the conservatory and the remaining residents were in the lounge or their own rooms. Good interactions were seen between residents and staff. Conversation was appropriate and respectful. There was evidence that residents were able to make choices about their daily living that were respected and supported by staff. For example, residents were seen arriving for breakfast when they wished. The radio was playing in the background and there was plenty of conversation between residents. Breakfast was prepared freshly according to their choice, which was established on their arrival in the dining room. All the food provided at lunchtime was freshly prepared at the home using fresh ingredients. Food was served ready plated. Fluids were available and encouraged throughout the meal. Lunchtime arrangements were observed. Most residents ate their main meal in the dining room and four residents had their meal in the lounge. Two of these residents required assistance from staff. One member of staff was seen sitting and talking quietly throughout the meal. She was encouraging the resident and this was clearly a pleasurable experience for the resident. As a result, the resident ate and drank well. Unfortunately the experience for the other resident was not so good as the member of staff left her on several occasions to help other residents. The carer also mashed the components of the meal together meaning that the resident would not be able to tell what she was eating. The carer appeared distracted, looking around at other residents and trying to feed the resident faster than she wanted. There was little engagement and the carer appeared to be playing with the food. Staff need to ensure they give residents individual and uninterrupted help at mealtimes. This will ensure that all people can enjoy their meals. Somerset Villa Care Home DS0000067349.V356448.R01.S.doc Version 5.2 Page 13 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 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is clearly written and easy to understand. The complaints procedure is displayed in the home. The service has policies and procedures in place about safeguarding adults. Staff receive training about safeguarding adults. EVIDENCE: The home’s complaints procedure was displayed in the entrance hall. Mrs Priaulx has not directly received any complaints. However, allegations have been received by the Commission and the Adult Protection Unit from anonymous sources and have been discussed with Mrs Priaulx. At the time of inspection, two such allegations had been investigated and found to be unsubstantiated. A further allegation had been received and was also not substantiated. Mrs Priaulx has given full assistance and provided requested information throughout. Mrs Priaulx provided copies of the safeguarding training, last completed in June 2007 when 6 staff attended. She said she was arranging the next training session with the training provider who was doing training on the afternoon of the inspection. The training provider was spoken to and he confirmed that Mrs Priaulx keeps in touch with him and he provides safeguarding training to the staff. Somerset Villa Care Home DS0000067349.V356448.R01.S.doc Version 5.2 Page 14 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, 25 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is well maintained. The physical environment meets the needs of the people using the service. The home is pleasant and safe. The service providers have started a redecoration and refurbishment programme that is improving the environment. The lighting in the home needs to be improved so that it is more domestic and provides adequate lighting levels. The home was clean, tidy and there were no unpleasant odours. EVIDENCE: A tour of the premises took place with Mrs Priaulx. Those bedrooms that have now been redecorated have been refurbished with matching furniture including new beds. The rooms were bright and clean. Somerset Villa Care Home DS0000067349.V356448.R01.S.doc Version 5.2 Page 15 Quite a few of the bedrooms have strip lights that are harsh. The lighting in the main lounge was low as only 1 of 3 bulbs in the main light fitment were on. There was also a strip light in the dining room. The need to provide more domestic but equally effective lighting throughout the home was agreed with Mrs Priaulx. There were no lingering odours and all beds were being aired at the time the tour took place. Mrs Priaulx said all floors other than those with carpets are bleach cleaned daily. The laundry room was locked with a key pad. All laundry is done on site by night staff. Good hygiene control was in place. A sluice is located on the 1st floor. The lift was checked and had a smooth, easy to use operation. One of the ground floor bedrooms is due to have en-suite facilities fitted. Mrs Priaulx also said that the improvement plans include refurbishment of the ground floor bathroom and the installation of a shower room also on the ground floor. This work is due to start very soon. New fire doors have been fitted and all radiators have covers fitted. The requirement set at the last inspection regarding flooring has been met. Somerset Villa Care Home DS0000067349.V356448.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 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are employed in sufficient numbers and with the relevant skills and experience to ensure the needs of residents are met. The home follows a recruitment procedure that is robust and helps to protect people who use the service. Staff receive training that is relevant to their role and there is a commitment to NVQ training for care staff. EVIDENCE: The staff rota for the week of inspection was provided. This showed, in addition to Mrs Priaulx and the deputy manager, a minimum of two care staff are employed between 07:30 and 20:30. One waking night staff is employed, with on-call provided by the service providers who live on site. In addition, kitchen staff are employed and the environment is maintained by the service providers, who undertake domestic and maintenance duties. Three staff files were looked at. These showed that good recruitment procedures are followed that help to protect residents. For example, all staff are subject to a Criminal Records Bureau check and must provide two written references before they can commence employment. Somerset Villa Care Home DS0000067349.V356448.R01.S.doc Version 5.2 Page 17 A copy of the training schedule was provided. This showed that staff receive regular training that includes induction, NVQ, safeguarding adults, moving & handling, food hygiene, infection control, medication, 1st aid, fire safety, care planning and dementia. Mrs Priaulx said that four staff have NVQ2 and two have NVQ3. One is studying NVQ2. Two staff are due to do Isle medication training shortly. The Chef is currently doing an apprenticeship at college. Three staff were spoken to in private. A recently recruited carer confirmed the recruitment process she had experienced. The carer demonstrated good knowledge of the needs of residents at the home. She also had good knowledge of safeguarding matters. The deputy manager was also spoken with. She confirmed that she is responsible for providing formal supervision to three staff. She also spoke about the new care plans being introduced and felt the process was going well. The chef said he was attending college one day per week and enjoys working at the home. He was knowledgeable about the diets provided. He attended food hygiene training during the afternoon. Somerset Villa Care Home DS0000067349.V356448.R01.S.doc Version 5.2 Page 18 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, 36 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Mrs Priaulx is well qualified and experienced to manage the home. The views of people who use and visit the service are sought and an improvement plan has been developed that reflects the views expressed. Good records are kept about resident’s money that is looked after by the service. Staff receive formal supervision that is recorded. The service is well-maintained and good health & safety practices are in place. Somerset Villa Care Home DS0000067349.V356448.R01.S.doc Version 5.2 Page 19 EVIDENCE: Mrs Priaulx has day-to-day responsibility for running the care side of the home and is well qualified to do so. She has completed NVQ4/Registered Managers Award and is a qualified nurse. She has now employed a deputy manager so that administrative tasks can be completed and monitoring take place in a timely way. There was evidence that this management structure is working well, with the implementation of staff supervision, monitoring of functions and new care plans having taken place since the last inspection. The requirement regarding supervision, set at the last inspection, was met. The service provider submitted an Annual Quality Assurance Assessment (AQAA). Part 1 was not completed using the correct format but the information was provided on separate sheets. This information is good but Mrs Priaulx is aware that the AQAA format must be used in future and she was advised to use the electronic version. Part 2 of the form was completed in full and gave good information. The home has a quality assurance system in place that is operated by Norfolk and Suffolk Care Support Ltd. A copy of the survey, the improvement plan and summary was provided to CSCI. The AQAA & Quality Assurance survey show that the home considers the views of all stakeholders and is implementing improvements that reflect these views. Resident’s personal allowances were checked. Only three people have their money looked after by the home. One was checked against the records and the amounts were correct. All transactions were fully recorded and receipts kept. Various health & safety records were looked at. The accident records were completed and up to date. Control Of Substances Hazardous to Health data sheets were in place with policy documents and guidelines. Fire records showed that all equipment is regularly serviced. All electrical installations were checked 05/01/07 and electrical tests (PAT) 02/11/07. The lift was last serviced 31/10/07 & the gas appliances 19/01/07. Somerset Villa Care Home DS0000067349.V356448.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 2 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 3 X 3 Somerset Villa Care Home DS0000067349.V356448.R01.S.doc Version 5.2 Page 21 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. 1. Refer to Standard OP7 Good Practice Recommendations Care plans need to include a life history of the resident and also information about significant events and anniversaries. This will help staff to understand the person and to help them maintain individual life preferences. Staff need to complete all the daily records contained in the new care plan formats. This will help them to monitor important health and care issues quickly and will also demonstrate that all care needs are being met. Staff need to make sure they sit with residents and assist them with their meals without interruption. This will improve the dining experience for the person. The lighting throughout the home needs to be reviewed and replaced with more domestic light fitments that provide good light levels. This will improve the environment and make it appear more homely. 2 OP7 3. 4. OP15 OP26 Somerset Villa Care Home DS0000067349.V356448.R01.S.doc Version 5.2 Page 22 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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