Inspection on 08/08/08 for Britannia House

This is the latest available inspection report for this service, carried out on 8th August 2008.

CSCI found this care home to be providing an Good service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Britannia House 14/06/06

Britannia House 08/11/05

Britannia House 07/06/05

Britannia House 08/12/04

Britannia House 28/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 20/03/2009.

CARE HOMES FOR OLDER PEOPLE Britannia House 7-11 Jameson Road Bexhill-on-sea East Sussex TN40 1EG Lead Inspector June Davies Unannounced Inspection 8th August 2008 09:30 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 Britannia House DS0000021401.V369472.R02.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. Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Britannia House Address 7-11 Jameson Road Bexhill-on-sea East Sussex TN40 1EG 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) 01424 217419 Britannia Care Homes Ltd Dianne Thelma Westray Care Home 21 Category(ies) of Dementia (0) registration, with number of places Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Dementia (DE) The maximum number of service users to be accommodated is 21. Date of last inspection 13th September 2007 Brief Description of the Service: Britannia House registered to accommodate 21 older people with a dementia type illness. The property is an adapted building situated a short level walk from Bexhill town centre with its shops and access to bus and rail routes. Accommodation is provided on three floors with a shaft lift and a stair lift fitted to assist those who may have problems managing stairs. Bedroom accommodation consists of 3 double and 15 single rooms. The registered providers are Britannia Care Homes Ltd who also owns another three homes in the area. The home makes CSCI reports available to prospective residents and/or their relatives/representatives upon request. The fee charged as of August 2008 is £418.00 to £440.00 per week. Additional charges are made for chiropody, hairdressing, newspapers and magazines and dry cleaning. Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This unannounced key inspection took place on the 8th August 2008 over a period of 8 hours. During this time the inspector talked to the registered provider, the registered manager, two members of staff and residents. A tour of premises took place together with observation of staff respecting residents’ rights to privacy and dignity, and a medication audit. The inspector took a lunchtime meal with the residents. Documents relating to the key standards inspected were also viewed. Information from the AQAA (Annual Quality Assurance Assessment) has also been taken into consideration. What the service does well: Britannia House is a well presented homely place for the residents to live in. All prospective residents are pre-assessed before coming to live in the home to ensure that staff have the skills and knowledge to meet the residents needs, further information is also obtained from external health care professionals and when appropriate the resident’s local authority care manager. Care plans are comprehensively written, with good risk assessments and regular reviews. Relatives and other professionals are invited to the review of the care plan. Staff respects the residents’ rights to privacy and dignity at all times by ensuring that personal hygiene is carried out behind closed doors, and that residents’ are discreetly assisted with eating at mealtimes. Staff have good knowledge of protection of vulnerable adult issues, and would not hesitate to report any form of abuse. Recruitment procedures are stringent and staff are never employed to work in the home until all appropriate checks are carried out. The majority of staff have received mandatory training in health and safety issues and dementia care as well as job related training. Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 6 Since the registered manager took over the management of the home nearly one year ago she has worked hard to ensure that all paperwork has been updated, and to ensure that residents receive a good standard of care. Health and safety practices in the home are good, with all appliances used in the home having up to date maintenance certificates. The home is regularly risk assessed for fire safety and health and safety. What has improved since the last inspection? What they could do better: Personal hygiene tasks carried out for residents must be recorded to ensure that all hygiene needs are being met e.g. bathing, washing, shaving, hair washing, cleaning teeth and dentures, nail care and that tissue viability is checked. All residents must be weighed on a regular basis to ensure their nutritional needs are being met and any concerns are reported immediately to the resident’s general practitioner. Where residents are unable to use stand on scales; sit on scales must be provided. All visits to and from health care and social care professionals must be recorded in the residents’ care plans. All liquid medication and eye drops/ointments should be dated on the day of opening on the bottle to ensure that these medications do not go out of date. The rear garden area of the home needs to be made safer to ensure that residents can access the garden at any time and not be at risk. Recruitment application forms should require a full employment history, and any gaps in employment should have a written explanation. Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 7 The registered manager must ensure that those staff who have not completed all the mandatory training do so as soon as possible and new staff must complete their mandatory training within the first six months of their employment. While both the registered provider and registered manager have done all they can to ensure that the building is safe and an agreement has been reached with one resident who smokes with consent from the resident’s daughter, that the resident retains her cigarettes, but that the lighter is kept in the office. The resident then asks a member of staff for her lighter when she wants to smoke out in the summerhouse. The inspector noted there was a strong cigarette smell in this resident’s bedroom, and both the provider and manager are in the process of investigating this and will inform the inspector of their investigation outcomes and the actions they will be taking. 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. Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 8 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 Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 9 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): Standards 3 and 6 People using this service experience Good quality outcomes in this area. Residents move into the home knowing that their needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector viewed four pre-admission assessments and found them to be very comprehensive in the quality of information gained, to ensure that Britannia House is able to meet the residents’ needs prior to moving into the home. These pre-admission assessments had information regarding all aspects of care required including physical, mental and social care. Where relevant the registered manager also obtains from the local authority care manager a plan of care and pre-admission assessment. In some cases the Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 10 registered manager had obtained further information from other multidisciplinary agencies. The home does not offer intermediate care. Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 11 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): Standards 7, 8, 9 and 10 People receiving this service experience Good quality outcomes in this area. The care planning system while providing good information needs some attention to ensure that appropriate records are kept to show that all the residents assessed needs are being met. The medication at this home is well managed promoting good health. Personal support in this home is offered in such a way as to promote and protect residents’ privacy and dignity and independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans viewed showed detailed information in regard to the residents care needs. Risk assessments had been carried out relating to falling and Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 12 mobility, appetite, medication, tissue viability, toileting, personal hygiene, communication, aggression, activities, environment and night care, all were well written. It was also noted in two care plans that thorough risk assessments had been carried out where cot sides were used and in one care plan where the resident needed to be transferred by hoist. Residents and or their relatives/representatives had signed up to the residents care plan. All care plans have been reviewed on a regular basis. When care plans are reviewed the registered manager tries to ensure that all relevant health care professionals, relatives/representatives are invited to the review. While care plans were basically well written, there were some areas for improvement in regard to the personal hygiene tasks carried out for each resident and the checking of tissue viability. The inspector observed that staff do refer concerns regarding tissue viability to the district nurses, as some of the residents had been provided with pressure relieving equipment. There are a number of residents in the home who require continence aids, but visits by the continence nurse had not been recorded in the plan of care. Again in regard to psychological needs the registered manager was able to tell the inspector that she is able to access community psychiatric nurses as and when required, but again this information is not written into the plan of care. Not all the residents are weighed on a regular basis, mainly due to their mental and physical condition they are unable to balance on standing scales. This issue was discussed with the registered manager and provider, in relation to sit on scales being provided, to ensure that residents can have their nutrition assessed on a regular basis. There was evidence in at least three of the care plans to show that these residents had regular access to the general practitioner. It was noted however that visits from other health care professionals (chiropodists, dentists etc.) were not recorded in the care plan although some care plans showed that the resident had received a recent visit from their optician. The registered manager must be careful not to keep bathing books etc with collective residents names as this is in contravention of the Data Protection Act 1998. Requirements are being made in relation to personal hygiene tasks, weighing of residents, and recording of visits from external health and social care professionals. The medication policy and procedure is up to date and contains relevant information in regard to the receipt, storage, administration, recording and return of medication as well as the administration of PRN (when necessary) pain relief. From looking at the current monthly administration records for residents the inspector found that all medication is signed off appropriately, this was also the case in the controlled drugs book. The medication trolley and cupboard are kept in a clean and tidy condition. Only staff trained in medication are allowed to administer the residents’ medication. It was noted Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 13 however that eye drops and liquid medication was not dated on the bottle on the day of opening. From a tour of the home and observing staff, the inspector found that staff treat residents with respect and observe the residents’ rights to their privacy and dignity being upheld. Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 14 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): Standards 12, 13, 14 and 15. People using this service experience Good quality outcomes in this area. Residents are supplied with a variety of activities both internal and external to meet their interests and social needs. The residents in the home are given the opportunity to make choices in relation to their everyday life. The meals in the home are good offering both choice and variety and catering for specialised diets as required. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A variety of activities are offered by the home for the residents, to include board games, memory books and discussion, reminiscence, and music. One of the care staff is the activities co-ordinator when on duty. This member of staff Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 15 told the inspector that she is always looking for new ideas for activities suitable for the client group. An activities book is kept with separate entries for each resident, there is a small introduction about the resident together with their likes and dislikes, and then a record is kept of all the activities they join in with. As well as the activities offered internally by the home, the residents have a variety of entertainment available to them from external visitors, such as Pata-Dog, Pat-a-Rabbit, Music and Health; Motivation Therapy; a Violin player; an entertainer who plays the organ; and the land army girls. Some residents retain the religious beliefs and the local church visits regularly to give Communion. Visitors are welcome into the home at any time, and are always made welcome by the staff. None of the residents’ in Britannia House have the capacity due to their dementia to manage their own financial affairs, and arrangements have been made for either relatives or representatives to do this for them. From a tour of the home the inspector noted that all residents are able to bring small items into the home with them. All residents can have access to their own personal records if they wish to. The inspector viewed a four-week rotating menu for lunch and teatime meals and the two week rotating breakfast menu. These menus showed that residents’ are offered a variety of wholesome and nutritious food. Residents also have choice of sandwiches made on a daily basis to eat with their suppertime drink. Two residents’ told the inspector that they were not offered a choice of lunchtime menu on the day of this key inspection. Discussion took place with both the registered manager and provider at ways of providing the dementia care residents a choice of menu they could relate to, such as pictorial menus for each day. Some residents need supervision and staff assistance with eating and this is done in a respectful and discreet manner. On the day of the visit the lunch time menu was fish and chips and peas or baked cod with mashed potatoes and peas, with a choice of cheesecake, or pineapple for sweet. The inspector joined the residents for lunch and found the meal to be well presented and appetising. The cook confirmed that she is able to meet the dietary requirements of residents in the home, at present only diabetic diets are catered for. Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 16 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): Standards 16 and 18 People using this service experience Good quality outcomes in this area. The complaints process in the home is good, with residents and relatives being made aware of the complaints procedure and knowing that any concerns will be responded to. Staff have a good knowledge and understanding of adult protection issues, which helps to protect residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints policy and procedure is up to date and displayed in a prominent place within the home. Relatives/representatives for all new service users are given the complaints policy and procedure within the service user guide for the home. Since the last inspection the home has received three complaints, which have all been properly investigated and replies given to the complainants. Copies of complaints, investigations and replies are all kept within the complaints file. Both the registered manager and provider stated that they see complaints as positive in that when there is something wrong in the home, if they are not informed about it they cannot put it right and Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 17 improve the service they give. One resident said that they would know how to complain if necessary. The safeguarding vulnerable adults policy and procedure is up to date. Nine of the ten staff employed by the home have received protection of vulnerable adults training. All staff are POVA (protection of vulnerable adults) register and CRB (criminal records bureau) checked prior to taking up employment in the home. There have been no adult protection issues since the last key inspection. The home does not have a copy of the Sussex Multi-Agency Policy and Procedures for Safeguarding Vulnerable Adults, but the registered manager will contact the local social service department to obtain a copy. Two members of staff stated that they had received training in the protection of vulnerable adults and they would know how to whistle blow should they need to. Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 18 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): Standards 19 and 26 People receiving this service experience Good quality outcomes in this area. The standard of the environment within this home is good providing residents with an attractive and homely place to live. Further attention needs to be made to infection control within the home, to ensure that residents are not placed at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Generally Britannia House provides a comfortable homely environment for its residents to live in. The back garden of the home has a well-maintained lawn with wooden garden furniture and flowerbeds; there are apple and pear trees, Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 19 a small green house where tomatoes are grown and a summerhouse where both residents and staff can smoke. It was noted however the some of the concrete paths are in need of attention, and there are some concrete slaps which are uneven. The garden is secure, but residents would not be able to use this area unescorted, as there is a danger that they could fall. The home is in good decorative order internally and is fitted throughout with domestic style furniture. All bedrooms have en suite facilities, and two en suites have a shower. There are sufficient communal bathrooms and toilets throughout the home. The kitchen was clean, well ordered and decorated, with fridge and freezers being temperature checked on a daily basis. The laundry room has two industrial washing machines with clinical sluicing facility, and one tumble drier. It was noted that in some communal toilets and in the laundry, liquid soap and paper hand towels were not provided. 63 of staff have received infection control training. In some bedrooms and an inner hallway there were offensive odours. The registered manager said that she realised there was a problem and through discussion it was suggested, provided the residents and relatives permissions were sought that it would be permissible to replace carpets with non slip attractive vinyl flooring, therefore reducing the risk of infection and the odours in the home. A requirement is being made that offensive odours in the home must be addressed. Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 20 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): Standards 27, 28, 29 and 30 People using this service experience Good quality outcomes in this area. Staff morale is high resulting in an enthusiastic workforce that works positively with resident to improve their whole quality of life. The standard of recruitment practices is good ensuring that staff are appropriately vetted to ensure that residents are not placed at risk. There are good induction processes within the home, and staff are multi skilled ensuring a good level of quality care and support. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the present time the registered manager employs 10 care staff with 1 on maternity leave. When other care staff are required they are deployed to work in Britannia House from other homes in the group. An extra member of care staff has been employed to work between 6:00 hours and 8:00 hours to relieve a very busy period in the morning. This frees care staff up later in the morning to spend more time with residents when they are up. It also meets the assessed needs of residents by allowing them to get up when they want to. Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 21 On the day of this inspection three care staff were on duty throughout the day and this agreed with the staff duty rota for that day. Four care staff have obtained their NVQ in Social Care while another five staff are working towards this qualification. The housekeeper and cook are also working towards their NVQ qualifications. The inspector viewed personnel files for three members of staff and found that all had completed an application form, but it was noted that this application form does not require a full employment history. This was pointed out to the registered manager and provider who will ensure that the format of this form is updated to require a full employment history. The staff personnel files viewed showed that these staff had at least two written references, a POVA (protection of vulnerable adults) register and CRB (criminal records bureau) check. On each file there were at least two forms of identification. From viewing the staff training matrix and conversation with two members of staff the inspector found that the home has worked hard to ensure that the majority of its staff have completed mandatory training. At the present time 72 of staff have undertaken moving and handling training, 81 have received Fire Safety training, 100 of staff have first aid training, 81 of staff have food hygiene training, 63 of staff have infection control training, 81 have protection of vulnerable adults training, 100 of staff have received medication training, and 81 of staff have dementia care training. Staff have also undertaken courses in diabetes, epilepsy, The Mental Capacity Act, risk assessment, health and safety, challenging behaviour, communication skills and caring for the bereaved. Further training is also booked throughout the year. There was evidence in staff personnel files that all new staff now undergo skills for care induction. Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 22 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): Standards 31, 33, 35, 36 and 38 People using this service experience Good quality outcomes in this area. The registered provider and manager have a good understanding of what needs to improve in the home. Planning is in place and sets out how this improvement will be resourced and managed. The quality assurance system is well developed with one further improvement to be made to ensure that the home provides a high quality of care to its residents. Health and safety in the home takes high priority, to ensure that residents and staff live and work in a safe environment. This judgement has been made using available evidence including a visit to this service. Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 23 EVIDENCE: The registered manager has previous experience of managing dementia care homes; she has an NVQ level 3 and is currently working towards her Registered Managers Award, which she hopes to complete in December 2008. There was evidence that the registered manager also updates her knowledge and skills and certificates show that she has completed courses in Stress Management, Time Management, Team Leader Skills, Care Planning, Managing Change and Supervision and Appraisal. The deputy manager has also completed similar courses. The management ethos in the home is open door and residents, relatives and staff are able to speak with the registered manager and registered provider throughout the day. This management practice is reflected in the happy and informal atmosphere in the home. The registered manager has worked hard at developing a good quality assurance system. Questionnaires are available from residents, relatives and representatives. There is an annual development plan for 2008/2009. The manager ensures that she carries out a monthly health and safety and fire risk assessment of the home. Systems used in the home are quality monitored by the manager each month. Regular monthly managers meeting are held, between managers from all homes in the group, and there are regular staff meetings. The inspector was able to view the annual summaries for questionnaires sent out in 2007 and 2006. The registered provider now employs a consultant who carries out an unannounced Regulation 26 visits to the home, and then produces a thorough report of her findings. There is just one further improvement that the registered manager needs to make to this system and that is to ensure that questionnaires are completed from all professionals who visit the home (stakeholder surveys). The home does not manager any of the personal allowances for residents, where a resident says they would like to buy something, this is done on their behalf with monies from petty cash, a receipt is obtained and relatives or representatives are billed monthly. From viewing the staff personnel files and the supervision matrix and talking to a member of staff, it is evident that the registered manager carries out staff supervision and annual appraisals. As mentioned previous many of the staff have undertaken or updated their mandatory training, there are a few gaps, and the registered manager is aware of this, and has booked further training for this year. Staff said that they are given plenty of training, as well as work related training. Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 24 Health and safety practices in the home are good. All appliances used in the home have an up to date maintenance certificate. Fire safety and hot water temperature checks are carried out regularly. All windows throughout the home have window-opening restrictors in place. The premises are secure and there are number locks on all external doors. A Legionella water check was carried out on 11/01/08. Electric circuit testing is due this year and has been booked. As mentioned under Environment in this report further improvements need to be made in the back garden to ensure that resident have free access and are not placed at risk. All residents are risk assessed in regard to the environment. The registered provider and registered manager are investigating a cigarette odour on one of the resident’s bedrooms, and will keep the inspector informed of outcomes. Where a resident has an accident, a member of staff completes the Health and Safety Executive Accident book appropriately. Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 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 Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP8 Regulation 12(1) 17(1a) Schedule 3 (3)(m) Requirement The registered person must ensure the following:That a record is kept of all personal hygiene tasks carried out for each resident. That all residents are weighed on a regular basis, and that any unexplained weight loss or gain is acted upon. That a record is kept of all visits from external health and social care specialists. 2. OP26 16(2)(k) The registered person must ensure that the environment is kept free from offensive odours at all times. 06/10/08 Timescale for action 06/10/08 Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 27 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. 2. 3. 4. Refer to Standard OP9 OP19 OP29 OP30 Good Practice Recommendations It is good practice that all liquid medication and eye drops/ointments are dated on the bottle/tube on the day of opening. Residents should have free safe access to the garden in the home. The registered provider manager to update the application form to ensure that a full employment history is obtained prior to staff being employed in the home. The registered manager to ensure that all present staff receive mandatory training and new staff receive mandatory training within the first six months of their employment. The registered manager must continue to investigate the cigarette smoke odour in one of the bedrooms. 5. OP38 Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. Extracts may not be used or reproduced without the express permission of CSCI Britannia House DS0000021401.V369472.R02.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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