Care Home: Tremanse Care Home

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What the care home does well We found that there were clear assessments of people`s needs before they moved to Tremanse. This information would potentially provide the basis for developing care plans. One person told us that staff treated him with respect. The eight people who responded to the survey said that they were generally able to spend their time as they chose, and that staff always or usually treated them well. The areas of the home that we saw were clean and tidy, and there were no offensive odours. We checked the hot water in the bath on the ground floor, and found that it was of approprite temperature. We were told by one of the people who lives at the home that the food is good. We saw the menu on the day of the inspection and was shown how each person is given a choice of meals. We found that medication was generally well managed though there were areas where improvements are required. We also found that there were generally good processes in place to ensure that only people suited to the work are recruited. There was evidence that staff were receiving training, although training in relation to mental health had yet to start. The Registered Manager, Pam Davey, told us that Policies and Procedures were in the process of being revised. We looked at one document during this visit and found that further revisions were needed. What the care home could do better: We found that whilst each person had a care plan these documents lacked detail and did not cover some aspects of the care or support offered or needed. The care plans were brief and focused on "issues", therefore if something was not considered an issue, then it was included. We discussed with the Manager the need to included information about each person needs in relation to support, for example with domestic tasks. Given that many of the people living at Tremanse will move to more independant accommodation, it is appropriate that such areas are considered. We noted that one person`s behaviour had changed over the previous two weeks, however there was no information as to how this was to be managed, and the care plan had not been updated.We found that there were no self medication risk assessments in place, and where individuals did manage their own medication, there was no record of stock kept in the medicines cupboard or when it was given to the individual. We tried to look at the accident book, however only the cover of the accident book could be found, the stubbs of the accidents sheets were missing. This therefore made it difficult to audit accidents. As has already been noted the recruitment process was generally in good order, however there was no record or risk assessment to show how decisions are made where an indivdiual has a criminal record or where there are other concerns. We asked to see a copy of the Legionella Risk Assessment but was told that this had not been completed. A Fire Risk Assessment had been reviewed. Random inspection report Care homes for adults (18-65 years) Name: Address: Tremanse Care Home Fore Street Bodmin Cornwall PL31 2HR one star adequate service 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: Helen Tworkowski Date: 1 7 0 5 2 0 1 0 Information about the care home Name of care home: Address: Tremanse Care Home Fore Street Bodmin Cornwall PL31 2HR 0120874717 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Pamela May Davey Type of registration: Number of places registered: Conditions of registration: Category(ies) : Vivacare Limited care home 17 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Conditions of registration: 17 The maximum number of service users who can be accommodated is: 17 The registered person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Mental Disorder, excluding learning disability or dementia - Code MD, maximum number of places: 17 Date of last inspection Brief description of the care home Tremanse is a large older style house situated in the centre of Bodmin. Whilst within walking distance of the town, the access to the home is up a steep hill for vehicles or through the garden for pedestrians, so that anyone with reduced mobility might have difficulties. There are bedrooms on three floors. The communal rooms on the ground Care Homes for Adults (18-65 years) Page 2 of 9 Brief description of the care home floor comprise of a large sitting room, conservatory and dining room. The kitchen and utility areas are also on the ground floor. The garden in the front of the home has a level patio area, furnished with tables and chairs for people to use in fine weather. The company that owns the home also own a second, unregistered property behind Tremanse. There is limited car parking at the rear of the property. At the time of the previous Key Inspection in July 2009 the fees range between GBP331 and GBP560, any additional information on charges are to be obtained from the Registered Provider.The Service User Guide and Statement of Purpose, that provides information about the home, are available in the care home office. Care Homes for Adults (18-65 years) Page 3 of 9 What we found: This inspection was an unannounced Random Inspection that was carried out on 17th May 2010, between 9.10am and 1.00pm. As a Random Inspection we did not look at all of the key areas of the service, and therefore this report cannot change the current rating of the service. As part of this visit we looked at the care provided to two people who had recently moved to the home, we met with them, talked with a member of staff about the care, and looked at the records. We also looked at the way two staff who have recently started work, were recruited. Finally we looked at the outstanding requirements from the previous inspection. We had received an Annual Quality Assurance Assessment (AQAA) from the Registered Manager, before this inspection. We also received surveys back from some of the staff and people who live at Tremanse. What the care home does well: What they could do better: We found that whilst each person had a care plan these documents lacked detail and did not cover some aspects of the care or support offered or needed. The care plans were brief and focused on issues, therefore if something was not considered an issue, then it was included. We discussed with the Manager the need to included information about each person needs in relation to support, for example with domestic tasks. Given that many of the people living at Tremanse will move to more independant accommodation, it is appropriate that such areas are considered. We noted that one persons behaviour had changed over the previous two weeks, however there was no information as to how this was to be managed, and the care plan had not been updated. Care Homes for Adults (18-65 years) Page 4 of 9 We found that there were no self medication risk assessments in place, and where individuals did manage their own medication, there was no record of stock kept in the medicines cupboard or when it was given to the individual. We tried to look at the accident book, however only the cover of the accident book could be found, the stubbs of the accidents sheets were missing. This therefore made it difficult to audit accidents. As has already been noted the recruitment process was generally in good order, however there was no record or risk assessment to show how decisions are made where an indivdiual has a criminal record or where there are other concerns. We asked to see a copy of the Legionella Risk Assessment but was told that this had not been completed. A Fire Risk Assessment had been reviewed. 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 Adults (18-65 years) Page 5 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 Adults (18-65 years) Page 6 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 1 6 15 Each person who lives at 01/08/2010 Tremanse must have a detailed care plan that where appropriate specifies goals, for example in relation to learning new skills or moving towards independence. People need to know the level of support offered. This requirement was made at the last Key Inspection and was not met. 2 8 42 Risk assessments must be 01/08/2010 carried out in relation to environmental risks including those posed by Legionella. The accommodation provided must be safe. A similar requirement was made at the last inspection and has not been met. 3 20 13 Risk assessments must be 01/07/2010 completed in relation to people self medicating. There must be a readily auditable Page 7 of 9 Care Homes for Adults (18-65 years) 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 account of all medication held. People need to know that they will get the support they need to manage their own medication. A similar requirment was made at the last key inspection and has not been met. 4 35 18 Care staff must have 01/08/2010 received training where appropriate to ensure that they have the skills and competences to carry out their role. Where appropriate, training in relation to mental health, movng and handling and manging aggression must be provided. This is to ensure that staff have the skills to carry out their role. This requirment, made at the last two inspections has been partially met. 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 Care Homes for Adults (18-65 years) 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 Adults (18-65 years) 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. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 noncommercial 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. 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