Care Home: Three Corners Nursing Home

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What the care home does well People who use the service and their relatives have the information they need to decide whether Three Corners is the right home for them to move into. The admission procedure shows that staff make sure they can meet the persons needs. People receive a good standard of personal and nursing care. One person said " They really are great, nothing is too much trouble". Communication with health care professionals in the community is good. The care people receive is good and provided in a safe and respectful way. Medicines are generally well managed at the home by the nursing staff. Staff at the home ensure people see the doctor or other health care professionals when they need to. The care planning systems and documentation at the home are good and means that staff know how to care for someone in a safe and consistent way that meets their individual needs and preferences. People have access to a good programme of activities and are able to maintain contact with their family and friends. People enjoy the activities at the home. People tell us that the food is good at the home and any issues regarding dietary requirements, preferences or weight issues are sensitively managed. People who use the service and their relatives can be confident that their complaints and concerns will be listened to and acted on. People are safe at the home. Staff have had training to recognise signs of abuse and know how to report any suspicions or poor practice. Three Corners is a safe and pleasant place to live and work. The manager and her staff group have the experience to care for people who require nursing and personal care. The home is well managed Vicky Bundy, the manager. What has improved since the last inspection? The home has worked really hard to improve the standards since the last inspection and the results are such that they should be very proud of what the have achieved. The sytems in place for recruitment of new staff and how monies are checked are robust. Care plans are written well and contain all the relevant information needed to provide good care. What the care home could do better: No requirements were made at this inspection. Key inspection report Care homes for older people Name: Address: Three Corners Nursing Home 3 Greenway Road Churston Ferrers Brixham Devon TQ5 0LW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Caroline Rowland-Lapwood     Date: 0 7 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Three Corners Nursing Home 3 Greenway Road Churston Ferrers Brixham Devon TQ5 0LW 01803842349 01803846079 info@threecornersch.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Golfhill Ltd Name of registered manager (if applicable) Mrs Victoria Jennifer Bundy Type of registration: Number of places registered: care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 46. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Physical disability (Code PD) Date of last inspection Brief description of the care home Three Corners Nursing Home is a 46-bedded care home providing personal and nursing care to older people who may have dementia type illnesses and physical illnesses. The home is located on the edge of a village of Galmpton close to the seaside towns of Care Homes for Older People Page 4 of 27 Over 65 46 0 0 46 0 2 0 4 2 0 0 9 Brief description of the care home Brixham and Paignton. There is a car park in front of the home and access to the front of the home is through a modern porch. The accommodation is arranged over a two floors which can be accessed via stairs or passenger lift. Each room has a nurse call system and is equipped with furniture and adaptions for the needs of each person. A variety of equipment and adaptations are provided to meet the needs of people with access problems. There is at least one registered nurse on duty at all times supported by a team of care staff. Information about the home such as statement of purpose is given to each person at the home and also can be located within the entrance hall. The current fees range from five hundred to six hundred and fifty pounds per week. This price varies according to nursing needs and does not include costs of hairdressing, chiropody, personal items and newspapers. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key unannounced inspection consisted of a visit to the home on 7th April 2010. One inspector performed this inspection. During this time we spoke to the manager, the administartion staff, the Registered Nurses and some other members of care and ancillary staff on duty. We case tracked three people who use the service. Case tracking means we looked in detail at the care three people receive. We spoke to staff about their care, looked at records that related to them and made observations if they were unable to speak to us. We looked at three staff recruitment records, induction and training records and policies and procedures. We did this because we wanted to understand how well the systems work and what this means for people who use the service. Care Homes for Older People Page 6 of 27 All this information helps us to develop a picture of how the home is managed and what it is like to live at Three Corners Nursing Home. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Care Homes for Older People Page 8 of 27 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides good information to people, which enable them to make a choice about whether the home will suit their needs. Good systems are in place to ensure that peoples needs are assessed and can be met prior to moving into the home. Evidence: There is a guide to the home, the statement of purpose, which gives people an idea of what to expect prior to admission, this is reviewed regularly the last review taking place at the end of 2009. People returning CQC surveys told us they had received enough information about this home before they moved in, helping to ensure it was the right place for them.The Annual Quality Assurance Assessment provided by the home told us the homes website is updated regularly, to allow everyone to have as much information about us before they visit. They welcome prospective residents and their families to visit at anytime, with or without an appointment. They also encourage short stays, including respite, as a possible prelude to a longer or permanent stay. Care Homes for Older People Page 11 of 27 Evidence: People spoken with during this visit told us they were happy living at the home, one said, Its really good, I am more than happy. The home uses an assessment as a way of getting information about peoples needs and preferences before they move to the home. This helps to ensure that individual needs can be met. We looked at three assessments, all gave good information about peoples abilities, needs, usual routines and preferences to enable staff to plan and deliver care appropriately. Social care professionals told us in surveys that assessment arrangements always or usually ensure that accurate information is gathered and that the right service is planned and given. The home provides care for those people requiring intermediate care, these people are mainly admitted via from the local Care Trust, the staff assist in enabling many of these patients to return home. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a good care planning system, which provides the staff team with the information needed to enable them to support people in a way they prefer. Peoples health needs are well met and the management of medication is good. People feel they are treated with respect and that their privacy is upheld by caring staff. Evidence: People responding to CQC surveys told us they always received the care and support needed. One wrote, They take really good care of me. During our visit people told us they were happy with the care they received, comments included, The staff are lovely, they work so hard and Everyone is helpful, no problems. Each person has a plan of care, these detail his or her individual care needs, wishes and preferences. Staff were aware of peoples needs and could describe the care delivered.Care plans are available to all families and other professionals, with the permission of the resident. Care plans are reviewed and revised regularly. Care Homes for Older People Page 13 of 27 Evidence: Risk assessments were in place and generally reflected behavior or situations, which may cause harm to people, for example poor mobility, falls, aggression and the use of equipment. Moving and handling assessments and plans, skin care and continence assessments were in place and generally provided staff with the instructions needed to deliver care. Staff were observed to assist people with manual handling needs in a competent and sensitive manner, using the correct equipment and giving gentle instructions and reassurance to people as needed. Staff were given information at shift handovers about some peoples particular needs any changes to their needs, who was to be offered a bath, or needed encouragement with drinks or food. Staff surveys showed they were always given up to date information about peoples needs. Peoples personal care was well attended to; people were smartly dressed, and well groomed. Everyone spoken to advised that they rose and retired at a time of their own choice. People told us their medical needs were always met; Health professionals responding with CQC surveys told us the home always or usually sought advice and acted on advice. Health professionals felt that peoples health care needs were always met. Their comments included; They offer a flexible service and are not shy to look after people with complex needs and The manager always takes time to discuss clients with me (GP), I find all the staff and the owner always courteous. Records show that people have access to a variety of health professionals including GP, district nurses, optician and other specialists and out patient clinics. We looked at the way the home stores and administers medicines. Medicines at the home are managed safely. Medicines are stored and disposed of safely. The fridge used to store medicines is lockable and temperatures of the fridge are kept. Other storage was satisfactory, including the arrangements for storing of controlled medicines. Daily records were complete.People that wish to self medicate are assessed and a risk assessment undertaken as to their ability to manage this, a lockable facility is available in the bedrooms in which to lock medication away.We saw one person who looked after their own medication, his bedroom door was open and his medication was left out on the side this included some controlled drugs. We discussed this with the manager who agreed that the person should lock their bedroom door to make this area safe and free from risk to others. Care Homes for Older People Page 14 of 27 Evidence: During our visit staff were seen and heard to be polite and friendly when delivering care or assisting people with their daily activities. Staff were heard to address people in a respectful manner and their approach was pleasant and caring with good humour. The service is efficient when caring for people who are terminally ill or dying. The wishes of individuals about dying and terminal care, and the arrangements they want after death are discussed and recorded.The home works closely with external professionals and specialists for advice and support to help the person their family. Care Homes for Older People Page 15 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Three Corners are encouraged and enabled to take part in activities of their choice outside the home. This means their personal preferences and choices are promoted and facilitated by the staff team where possible. Meals are well balanced and nutritious; choices are available to all. Evidence: The home uses external activities organisers who come in on a regular basis to bring a range of interests to the people living at the home,including music, crafts, animal therapy, quizzes and poetry. They also have carers who have dedicated hours for activities and spend time with the people on social activities. The home encourages families to visit and be involved whenever possible. Peoples religious beliefs are respected and people are enabled to visit their place of worship or else religious representatives are welcomed as visitors. There is an open visiting policy and family and friends are encouraged to spend time with people and to take meals with them in the home. On the day of the inspection lots of people were visiting and there was a lovely atmosphere within the home, one visitor said They always make me welcome, they are very nice. Care Homes for Older People Page 16 of 27 Evidence: When asked about food peoples responses included, We get so much but its lovely, The food is very good, usually and Its usually pretty good. All spoken with said that they were given sufficient to eat and mentioned the availability of evening drinks and snacks. Food is bought fresh, fruit and vegetables are always available, people said they were always offered an alternative if the meal was not to their liking. On the day of the inspection one of the meal choices was a fresh salad which looked very appetising and which people spoken with after said was very nice. The cook told us that individual likes and dislikes are catered for and special diets such as diabetic diet and a vegetarian diet are provided. The kitchen was clean and well organised. Care Homes for Older People Page 17 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their complaints will be listened to and staff understand the principles of adult protection, which helps to protect people from abuse. Evidence: All people responding with CQC surveys knew how to make a complaint and knew who to speak with should they have any concerns. People felt Mrs Bundy was approachable and would listen to them and always act on what they say. Relatives were also aware of how to make a complaint and told us that concerns were responded to. Outside professionals were confident that complaints or concerns were responded to appropriately. The Commission has received three complaints about this service since the last inspection, this was investigated by the home in a professional and timely way and was found to be unsubstantiated. Training records showed that staff receive adult protection training to ensure they are aware of the issues and know who to raise any concerns with. People spoken with confirmed that they were happy living at the home and all said they felt safe. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy a good standard of accommodation that is attractive, clean, homely and well maintained. Evidence: Three Corners Nursing Home is a large house set on a hill in a residential area of Galmpton, close to the seaside towns of Paignton and Brixham. The house has been recently extended to provide a newer purpose built unit including bedrooms and large bright communal lounge/dining area. All areas of the home are accessible by people who use the service. The older part of the home has been adapted with grab rails, ramps and passenger lifts for those with mobility problems. The lounge and dining room on the ground floor are bright and well equipped. Various seating areas are arranged to provide private space and communal areas. Large financial investment has taken place at the home. Many areas of the home have been re decorated, new carpets and flooring have been provided and items of furniture have been replaced. Many beds have been replaced for fully adjustable beds for people who require nursing care. The arrangements for the maintenance of the home are good. The home was clean, tidy and free from offensive odours on the day of inspection. Care Homes for Older People Page 19 of 27 Evidence: People are mainly provided with their own single bedroom with some double rooms now being made into single accommodation. A small number of rooms are left for people who chose to share, these have screening curtains. Rooms contained items, furniture, photos and small ornaments that people had bought to the home to personalise them. Many rooms have new and fully adjustable beds which are appropriate for people who need nursing care. A small number of people have bed rails that are only used after a risk assessment is done and the outcome agreed with the person in the room and their relative. Bed rails that had been fitted to beds were being used after a detailed risk assessment. Staff use protective equipment when providing personal and nursing care. Gloves, aprons and hand washing are available for staff use and staff talked with confirmed that they have had infection control training. The home has its own laundry that is large and well equipped with industrial type washing machines with sluicing cycles and large dryers. The laundry has washable walls and impermeable floors. There are dedicated staff who operate the service. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are sufficient to ensure that peoples needs are met in a timely way. Experienced and friendly staff support people well.People are protected by the recruitment practice followed at the home. Evidence: People living at the home told us in their surveys that staff were either always or usually available when they needed them. Staff we spoke with on the day said that generally there were enough staff on duty. Some comments made on the day include, The girls are great, so kind and All the staff are good. People who we spoke to during the inspection all told us that staff responded to requests for help and that the bell was answered fairly promptly. Staff has had up to date training in mandatory areas such as Moving & Handling, Protection of Vulnerable Adults, Fire and First Aid. Moving & Handling training is provided in house by a person trained to do so. Dementia training for staff is planned for the future. They have completed the Government initiative for Infection Control, Essential Steps being one of the first 10 homes in Torbay to complete this. They are also taking part in part in the pilot for end of life training. This will help many of our staff to have a greater understanding of the dying process. We looked at the homes recruitment procedures for three new staff. Three files were Care Homes for Older People Page 21 of 27 Evidence: complete containing references, police checks, application form, proof of ID and former employment details etc. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, with good systems in place to ensure that peoples views are sought and acted upon. Health and safety within the home is promoted meaning people live in a safe environment. Evidence: Three Corners have an experienced first level nurse as a registered manager. Together with the Provider and office manager they are available to the staff, the people living at the home and visitors. Staff told us leadership was very good at the home and they felt supported and were able to see their manager when necessary.One member of staff said Vicky is very good, she is a help to us and always listens. Financial viability was not inspected in detail on this occasion, however the building work and re refurbishment is a sign that the providers are keen to improve the home. Care Homes for Older People Page 23 of 27 Evidence: The home appeared to be a safe place to live and work. No risks to health and safety were identified. Maintenance records and training records showed that staff mandatory training was either up to date or booked. People at the home are encouraged to manage their own finances where possible or encourage family members or power of attorneys to hold this responsibility. Some people have a small amount of cash held at the home for services such as hairdressing, chiropody and other services. On inspection balances were found to be correct. The manager told us quality assurance occurred in various ways at the home. Surveys are sent out to people who have an interest in the service and the results collated to monitor trends. Complaints are also treated as a way of improving the service and the daily presence of the manager is useful in picking up issues before they become a complaint. Staff said the Providers visit the home on a regular basis and are always looking at how the service is running. The manager said she has a good relationship with the provider and feels supported when making decisions. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 Constant monitoring is needed in respect of the storage of medication used by those people that self medicate; this will keep everyone safe from harm. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. 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