Care Home: Tregenna House

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What the care home does well The home provides a comfortable warm, environment that is well maintained and safe for residents, staff and visitors. There is an ongoing programme of redecoration and refurbishment. There is a garden area that is enclosed and safe for residents to enjoy outside activities. All prospective residents are assessed prior to admission to ensure that the home can meet their needs. From the assessment written care plans are compiled and relevant risk assessments are undertaken. The plans are reviewed on a monthly basis and this is recorded. Daily records are maintained by the nurses and care staff. There are safe systems in place for the use of medicines and only qualified nurses administer the medicines. There is an activities coordinator employed who organises activities and entertainment. Residents regularly go out into the community with her or other members of staff. Appropriate records are maintained for each resident. Recruitment procedures are robust and the checks required by law are undertaken. There is a relaxed, open style of management and staff and residents told us the home is very well run. The Manager said she has a fantastic team of staff. The management have worked hard to ensure that improvements have been made and there are further plans for improvement in place. What the care home could do better: Pre-assessment documentation should be dated and signed by the person undertaking the assessment. The records should detail who was involved in the process. The care plans should cover all of the persons needs. They should fully inform and direct care staff on the care to be provided. Random inspection report Care homes for older people Name: Address: Tregenna House Pendarves Road Camborne Cornwall TR14 7QG one star adequate service 24/07/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Diana Penrose Date: 0 1 0 6 2 0 1 0 Information about the care home Name of care home: Address: Tregenna House Pendarves Road Camborne Cornwall TR14 7QG 01209713040 01209715356 enquiries@tregennahousenursinghome.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Amanda Johnstone Type of registration: Number of places registered: Conditions of registration: Category(ies) : Trecare Group Limited care home 48 Number of places (if applicable): Under 65 Over 65 0 0 dementia mental disorder, excluding learning disability or dementia Conditions of registration: 48 48 The maximum number of service users who can be accommodated is 48 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Dementia (Code DE) Mental Disorder (Code MD) to a maximum of 48 Date of last inspection Brief description of the care home Tregenna House is a large two storey Victorian property with modern extensions. 2 4 0 7 2 0 0 9 Care Homes for Older People Page 2 of 9 Brief description of the care home The building is situated in large grounds close to the town of Camborne with parking to the front of the home. The enclosed garden to the rear has been developed and is very much appreciated by residents and staff. There is another large area of garden at the side of the home which is to be levelled and made safer for residents. The home provides nursing care for up to forty-eight elderly people with a mental disorder or dementia and accommodation is over two floors. The ground floor has a large lounge and dining area, next to the main kitchen. Accommodation is provided in a single storey extension. There is a wing dedicated to men who receive rehabilitation and activities that may enable them to return to the local community. There are lounge and dining facilities in this wing and a small kitchen where residents can prepare and cook meals. Above the male facility is a large room that is used for activities and staff training. The first floor, Bluebell Wing, provides accommodation for residents with more limited mobility. There are two lounges upstairs with dining facilities incorporated. There is a kitchenette for making snacks and drinks. Information about the home is available in the form of a residents guide, which can be supplied to enquirers on request. A copy of most recent inspection report is available in the home. Fees range from 500 to 2,014 pounds per week, this includes payments for special needs. This information was supplied to the Commission by the manager during this inspection. Additional charges are made in respect of private healthcare provision, hairdressing and personal items such as newspapers, confectionary and toiletries. Care Homes for Older People Page 3 of 9 What we found: A Compliance Inspector visited Tregenna Nursing Home on 01 June 2010 and spent four hours at the home. In accordance with the amendments to the Care Standards Act inspection programme this was a random inspection and an unannounced visit. The purpose of the inspection was to ensure that residents needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus was on the inspection of certain standards and reviewing compliance with the requirement notified at the last inspection. On the day of inspection 41 people were living in the home. The Inspector met with staff, the manager and the General Manager to gain their views on the services offered by the home. Records, policies and procedures were examined and the Inspector toured the building. This report summarises the findings of this inspection. We received a completed Annual Quality Assurance Assessment (AQAA) from the Manager, 5 surveys completed by people using the service and 9 from staff, prior to this inspection; this information has been used to inform this inspection. The home has made significant improvements since the last inspection and the AQAA states their plans for the coming year. No requirements have been notified following this inspection and none are outstanding from previous inspections. We looked at the care files and medication records for the two most recent admissions to the home. Pre-admission assessment information was seen for both people that included information from outside agencies where appropriate. The assessment records were not dated or signed and there was no information on who was involved in the assessment process. One file contained care plans written by staff at Tregenna, these did not cover all areas of need and some were more detailed to direct staff than others. Social needs were not included. This was discussed with the manager who told us that the care planning system was under review as part of their work for the Gold Standards Framework and all of the activities of daily living would be included. The second person had been admitted from another home in the group only two days before this inspection and had care plans from that home; we were told that new plans would be written. We saw various risk assessments in the files and other information such as doctors visits and so on. We saw daily records that were recorded by nursing and care staff and these were informative. The manager showed us other care files that included more concise and detailed care plans and these did include social needs. The files were much more organised and the information included was an improvement on the last inspection. Surveys we received from residents were positive. When asked what the home does well comments included: Food is excellent, Their care for residents and families, They have been marvellous looking after my mother for the last 10 years and it has been really appreciated and still is, There are very dedicated staff who are excellent with the residents and it is their dedication that without a doubt helps families to cope with the fact that a member of family is in a care home. Other comments The home is well run and well staffed and The staff are all pleasant, helpful, sympathetic and courteous. When asked what they could do better comments included; They need more staff Care Homes for Older People Page 4 of 9 regardless of what government statistics say you need, The garden outside the day room could be made really attractive for the residents to sit in during the summer months. The front also needs a bit of tlc. A full time gardener is really needed, Parking is a problem, Ensure that all staff who come into contact with residents are fully trained in dementia care as well as general caring. The medication records for the two newest residents showed that the administration of medicines was up to date with no gaps in the records. Individualised care plans were seen for people prescribed medicines on an as required basis, and these were kept with the medicine charts. We were shown the system and storage arrangements for controlled drugs and this was appropriate. A nurse told us he is responsible for the medicines system in the home and he showed us the information he had been gathering in respect of residents allergies. The medicines room was very organised on this visit and fridge temperature recordings were seen. We were told that a new full time activities coordinator had been employed and some of her work was evident in the home. There were photographs of residents enjoying activities and some bedroom doors had pictures on them to enable residents to recognise their rooms. We saw the records maintained for each resident and these were detailed. One survey commented The occupational therapist is excellent and has really made a difference. The Inspector toured the building with the General Manager; the new extension was in use and much appreciated. We were told that a stair lift was to be installed to access the second floor of the extension. The new laundry was seen and it was much bigger than the previous facility with three washers and three driers now in use. We were told that upstairs, on Bluebell wing, a new bath was awaiting installation and the bathroom flooring had been ordered. The home was clean with no offensive odours and redecoration had taken place in some areas. New dining tables and chairs were seen and the cook told us that a new fridge and cooker had been provided in the kitchen. The enclosed garden was looking tidy with seating areas and colourful borders. We were told that the residents had been involved in planting the flowerbeds and that the area had been well utilised. We were told that work was to commence on the garden area outside the main lounge soon. We examined the personnel files for the three newest employees; they all contained the documents required by legislation and interview records were seen. One file held induction records; we were told that the other records were with the employees. Staff told us during this inspection that they enjoyed working in the home and that there were enough staff to meet the residents needs. The Manager said that more staff had been employed since the last inspection and less agency staff were employed. Staff surveys were generally positive, staffing levels, the way information is shared and having the knowledge and information to meet peoples needs were a little less positive, in that some people ticked usually rather than always. When asked what the home does well comments included; Trains its staff well, Delivers a high standard of care for individual residents, Staff work well as a team, Provides good information about residents to families, Activities within the home have increased, The home ensures that the residents have the best possible care in a loving and friendly home, Staff really do care about the wellbeing of their clients and Caring for people with difficult behaviours and Care Homes for Older People Page 5 of 9 complex needs. When asked what they could do better comments included, Offer better rates of pay, Staffing levels are poor at times due to staff sickness. More supervisions have been taking place so hopefully this will improve, To maintain a regular staff of our own instead of using agencies, Increase trained/untrained ratio and Improve needs led training with outside bodies. One further comment was, Tregenna is a well run home and the users and the staff are all cared for, it is a wonderful place to work. The accident reports were seen and were filed per residents name. We also saw a matrix which the manager said she finds useful for auditing purposes. The matrix was held on a computer at the head office and could be filtered to provide various aspects of the information. What the care home does well: 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 set out on page 2. Care Homes for Older People Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 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, 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 7 Care plans should be consistently detailed. To inform and direct staff on the care to be provided. Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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