Inspection on 21/05/08 for Castlemaine Care Home

This is the latest available inspection report for this service, carried out on 21st May 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Castlemaine Care Home 4 Avondale Road St Leonards on Sea East Sussex TN38 0SA Lead Inspector June Davies Unannounced Inspection 21st May 2008 10:15 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 Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Castlemaine Care Home Address 4 Avondale Road St Leonards on Sea East Sussex TN38 0SA 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 422226 01424 460028 Alpha Care Castlemaine Ltd Mrs Lynda Patricia Whitfield Care Home 42 Category(ies) of Dementia (0) registration, with number of places Castlemaine Care Home DS0000070629.V363540.R01.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 42. Date of last inspection New Service. Brief Description of the Service: Castlemaine Care Home is situated in a quiet residential road in St Leonards-on-Sea. A large car park is provided at the front of the home, and there is a secure well tended garden area to the rear of the home, where residents can walk and sit in safety. The home is registered for 42 older people over the age of 65 years who have a dementia type illness. All bedrooms in the home are single rooms many with their own en-suite bathrooms. Communal bathrooms and toilets are provided on all floors, all have specialist equipment to meet the assessed needs of the residents living in the home. Bedrooms are situated over the first and second floor of the home and are served by a shaft lift. The communal dining rooms and lounges are situated on the ground floor, and look out over the attractive rear garden. The décor, furniture and fittings in the home are of a good quality, and regular maintenance is carried out. The fees charged by the home range from £415.00 to £460.00 per week. Castlemaine Care Home DS0000070629.V363540.R01.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 star. This means the people who use this service experience good quality outcomes. This was the first key unannounced inspection since the new registered provider took over Castlemaine Care Home in November 2007. This key inspection took place on 21st May 2008 over a period of 7 hours. During this time the inspector spoke with the Registered Provider, the Registered Manager, the Administrator, the cook and one member of senior care staff. An audit of medication was carried out as well as a tour of communal areas of the home, the garden and some of the bedrooms. The inspector also viewed all the documentation relating to the key standards inspected. What the service does well: The statement of purpose and service user guide gives prospective residents good information on which to base their choice of moving into the home. The manager carries out thorough pre-admission assessments prior to the resident moving into the home. Care plans are initially based on the information gained during pre-admission assessment and enlarged upon once the resident moves into the home. Where possible and taking into account the level of dementia residents are able to make choice in regard to their daily living routines. The registered manager has developed a good range of activities for the residents in the home. Residents are able to maintain contact with their own religious preferences. Relatives are being encouraged in being more pro-active in the quality of the standard of care offered by the home. The meals offered in the home provide residents with a varied, nutritious and balanced diet. Two residents spoken to said that they like the food provided by the home and had no complaints. Castlemaine Care Home provides its residents with a homely and attractive place to live. Decoration, furniture and fittings in the care home are of a good standard. The registered manager has worked hard to improve the quality of care offered to the residents, and recognises where improvements need to be made. She dedicates a lot of her own time into the home, its staff and updating records. Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The care plan needs to be drawn up with the involvement of the resident and or their relative/representative, and signed by them to confirm that they agree to their plan of care. Staff need to recognise that residents are all individuals, with their own personalities, likes and dislikes, and levels of disability, therefore daily reports should be written for individuals and not generically. Personal hygiene tasks carried out for each individual resident should be listed to ensure that personal hygiene issues are not overlooked. Resident live in a comfortable and attractive home, but there are some issues that need addressing to ensure that residents are safe at all times or at least the risk is reduced to a minimum. En-suites attached to bedrooms should have a call bell, so that residents can call for assistance at any time. Radiators in en-suites should be covered, so if a resident falls they are not at risk of burning themselves on the radiator. En-suites that have baths in them should be risk assessed to ensure accidents are reduced to a minimum. The registered manager must ensure that Protection of Children and Vulnerable Adults UKCC register is checked prior to confirming the appointment of a new member of staff. A CRB check should also be received prior to a new member of staff taking up employment. This may not always be possible due to a delay in CRB checks being issued, and on these occasions, new staff who have been POVA first checked can be deployed to work in the home under supervision of a senior member of staff. While some staff have completed their mandatory in recent months, there are many staff who have not received mandatory training especially in health and safety issues, this leaves both residents and staff at risk of harm. This is a home registered as a dementia care home and therefore the staff should have the knowledge and skills to meet these residents needs. Please contact the provider for advice of actions taken in response to this Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 7 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. Castlemaine Care Home DS0000070629.V363540.R01.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 Castlemaine Care Home DS0000070629.V363540.R01.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 1 and 3 People using this service experience good quality outcomes in this area The homes Statement of Purpose and Service User Guide are excellent and prospective residents and or their relatives/representatives with the information they need to make a decision about moving into the home. Residents move into the home knowing that their needs can be met and that their independence will be maximised and promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose and Service User Guide has been reviewed and now contains detailed information at required by National Minimum Standard 1. Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 10 Prospective residents are also sent a brochure of the home when the first initial enquiry is made. The registered manager has developed a good pre-admission assessment tool. This pre-admission assessment covers all areas of health; physical and social care needs, with tick boxes and spaces underneath each section for comments. Where a prospective resident is to be funded by a Local Authority the registered manager ensure that she obtains a care manager assessment and plan of care. These assessments are then used by the registered manager to ensure that the staff have the skills and knowledge to meet the needs of the prospective resident this information is also used to start the care plan. Three pre-admission assessments were viewed together with care manager assessments and plans of care, all contained detailed information. The home does not offer intermediate care. Castlemaine Care Home DS0000070629.V363540.R01.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 using this service experience good quality outcomes in this area. The care planning system is consistent and adequately provides staff with the information they need to satisfactorily meet the residents’ needs; further improvements need to be made to daily reporting to reflect that residents’ are treated as individuals. The health needs of resident’s are well met, but these need to recorded appropriately to show when visits have been made by external health care professionals. The systems for medication administration are good with clear and comprehensive arrangements in place to ensure the residents’ needs are met. Personal care is offered in a way to protect residents’ privacy and dignity and promote independence. This judgement has been made using available evidence including a visit to this service. Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 12 EVIDENCE: Three care plans viewed showed good directions for staff as to the care needs of each individual resident and these needs were based upon the preadmission assessments carried out the registered manager and care manager. Risk assessments were available in all the care plans for mobility and tissue viability. All three care plans showed that they have been reviewed on a monthly basis. There was no evidence in these care plans to show that the residents’ and or their relatives/representatives had signed up to their plan of care. While care plans stated clearly the health needs of the residents, it was not clear via the daily reports written by care staff if daily personal hygiene tasks had been carried out in regard to oral care, shaving, bathing, washing, nail care and hair care. From viewing the daily reports in all three care plans there was no evidence that residents are treated as individuals with differing personalities and care needs. Where residents are at risk from developing pressure areas, the registered manager or a senior member of care staff ensures that the district nurse carries out a professional assessment, and appropriate pressure relieving equipment is provided. Where the district nurse provides pressure-relieving mattresses, these residents have a turning chart and are turned at regular intervals. There was evidence within the professional visits page of the care plan that the registered manager seeks the advice of the continence nurse, and that appropriate continence aids are provided following an assessment visit. None of the residents in the home at the present time receive regular visits from the psychiatric consult or a community psychiatric nurse. The manager stated that should the home have concerns regarding a resident’s mental health, she would request a referral to the psychiatric department via the resident’s general practitioner. Part of the activities programme is music to movement and residents are able to choose if they wish to participate in this activity. All care plans showed that residents’ are weighed on a regular monthly basis, and any concerns are reported to the resident’s general practitioner. While there was some recording of professional visits these were not consistent, and it was difficult to ascertain, if residents receive regular visits from the chiropodist, dentist, dental technician, optician or other therapeutic services. Through discussion with the registered manager she stated that residents’ do have access to health care professionals but this is not always recorded on the care plan, and that she would speak to staff about the importance of recording information onto the care plan. The manager is also going to develop a personal hygiene matrix; so that staff can clearly indicate what personal care tasks they have carried out for each individual resident and to ensure that the residents’ personal hygiene needs have been met. Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 13 An audit of medication processes was carried out and the inspector found that the receipt, storage, administration and return of medication had some failures but were generally good. The home has up to date recently reviewed policies and procedures in place to cover administration of medication, self-medication, receipt of medication, and controlled drugs. All Monthly Administration Records were accurately completed. The registered manager has recently completed medication profile sheets, which will act as dividers between each resident’s Monthly Administration Record. It is noted however that when new prescriptions are issued by the general practitioner, during the cycle of the blister packs this medication while being entered onto the record does not always state the quantity of medication received, the date it was received or the initials of the person receiving the medication into the home. Eye drops were dated on day of opening on the box and not on the bottle, this was discussed with the manager and she will now ensure that the bottle is dated on day of opening. The controlled drugs register is up to date and two medication trained members of staff sign the administration of controlled drugs. All unused medication is returned to the pharmacist on a monthly basis, unless the resident has passed away and then it is retained for a longer length of time. The medication fridge was clean and well ordered, with regular daily temperature checks being recorded. The inspector did note that the medication room does not have a regular temperature check, and this was discussed with the registered manager who will ensure that a thermometer is supplied and that staff will take medication room temperatures on a daily basis. Castlemaine Care Home DS0000070629.V363540.R01.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 the service experience good quality outcomes in this area. Residents’ are able to choose what activities they participate in. Links with the community are good, and residents’ religious beliefs are respected. The meals in this home are good offering both choice and variety and catering for special diets. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents’ are able to make choices in regards to their daily and social lives as far as their levels of dementia will allow them to do so. The home offers a variety of activities as well as one to one interaction between residents’ and staff. Activities on offer at the present time consist of – music to movement, simple baking, puzzles, card picture games, art and design. Both the Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 15 registered provider and registered manager stated they are in the process of developing further activities, within the home. Residents’ are able to choose if they wish to be involved with activities or not. One resident said, “I enjoy some of the activities, and I like to join in with those. When the weather is nice we go out into the garden and I enjoy that.” Another resident said “Sometimes I join in it depends what it is.” Many of the residents enjoy going into the garden when the weather is nice. Families take individual residents out of the home sometimes for a meal or a ride in the car. One resident goes to a local club. The registered manager has ensured that residents’ religious wishes are met; a Catholic priest visits some of the Roman Catholic residents from time to time. The Church of England vicar gives communion to one resident. The Roman Catholic Nun’s visit the home weekly and talk to all the residents. The registered provider described how they have recently had a relatives party, and that many of the relatives came to this. Another Summer Party is being arranged in June, for residents and their relatives. The registered provider would like to set up a Relative Support Group in the home. The home has an open visiting policy and visitors are made welcome at any time. None of the residents are able to manage their own financial affairs due to their levels of dementia, and arrangements have been made for relatives or solicitors to manage the residents’ personal finances. At the present time none of the residents has an advocate. From a tour of the home the inspector observed that each resident has been able to bring personal items into the home from their own home, this included pictures, ornaments, photographs and furniture. The four-week rotating menu offers resident a varied, nutritious and wholesome diet. Some discussion took place with the registered manager regarding residents remembering or recognising what food choices they have made and the possibility of using laminated pictures of food on offer on the menus. The cook on duty on the day of this inspection talked of the different diet on offer in the home and that at the present time they cater for vegetarians and diabetics but other diets can be catered for as and when required. The cook described how several of the residents have their food liquidised and that she ensures each item is liquidised separately to ensure it is served in an attractive and appetising manner. The inspector observed residents enjoying their lunch and noted that staff sat with those residents who needed help with feeding and that interaction was good, it was noted however that while liquidised meals are served in an attractive and appetising way, staff Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 16 immediately stir all the food together. Two residents spoken to said, “The food here is very nice, I have plenty to eat.” “The food is good old fashioned cooking, which I enjoy.” Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 17 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 home has a satisfactory complaints system with some evidence that residents’ feel that their views are listened to and acted on. Staff have knowledge and understanding of Adult protection issues, which protects residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints policy and procedure is prominently displayed within the home. There has been one complaint made to the home, paperwork is available to show that this complaint has been investigated appropriately and that a reply of outcomes had been made to the complainant, this information is accessible via the complaints file. Only one resident was able to give information regarding making a complaint and they said, “If I was displeased with something I would tell one of the girls, and I would expect them to look into it and put it right.” The home has policies and procedures in place for Safeguarding Vulnerable Adults as well as the Sussex Multi-Agency Policy and Procedures for Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 18 Safeguarding Vulnerable Adults. Staff training in Safeguarding Vulnerable Adults is ongoing and at the present time 59 of staff have received this training. There have been no Safeguarding Vulnerable Adults issues since the new registered provider took over the home in November 2007. Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 19 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, 20, 21, 22, 23, 24, 25 and 26 People who use this service experience good quality outcomes in this area. The decoration and furnishing in the home are good providing residents with an attractive and homely place to live. Improvements to the call bell system and the provision of radiator covers in en-suite facilities will provide a safer environment for the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well decorated and furnished and provides a comfortable and homely atmosphere for the residents. All bedrooms are well maintained, and furniture is of good quality. The registered manager has concerns regarding Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 20 the slight odours in three of the bedrooms, in one bedroom a vinyl floor has been fitted with permission from relatives, and this has alleviated the odour from this room. In other rooms while the carpets are regularly shampooed the odour remains, but the relatives still wish the home to retain carpets in these bedrooms. The remaining bedrooms and communal rooms in the home have a high standard of cleanliness and there are no odours. Where there are en-suites attached to bedrooms the registered manager must risk assess these en-suites that have baths in them. None of the en-suite facilities throughout the home have their radiators covered or call bells in place, should a resident fall they are at risk of burning themselves on the radiator and not being able to call for help. The back garden of the home is safe and secure for residents to use, as and when they wish to. From the patio door in the lounge there is a ramp down onto a lawn area, where well-maintained chairs and seats are provided, the garden has many trees and shrubs. The laundry room is clean and fitted with industrial washing machines with sluicing facilities and industrial tumble driers. The staff have protective clothing in the form of aprons and disposable gloves for use when carrying out personal hygiene tasks. Only one member of staff has infection control training but a further ten staff are due to be trained in infection control on the 12th June 2008. Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 21 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 adequate quality outcomes in this area. Staff are employed in sufficient number to meet the needs of the residents. Some staff have achieved their qualification in care, and others are working towards this giving the skills and knowledge to provide a good standard of care to the residents. Staff recruitment practices must improve to ensure that residents are not placed at risk of abuse. Staff training, needs to improve to ensure that residents and staff are not placed at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The duty rota, talking to one staff member and two residents, it is confirmed that there are sufficient staff on duty at all times to ensure that the care needs of the residents are met. Staff have time to spend interacting with the residents, and mealtimes are unhurried. Ancillary staff are employed in Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 22 sufficient numbers to ensure that residents are offered three meals a day, that the home is kept to a good standard of cleanliness, that residents regularly have their clothes laundered, that regular maintenance is carried and the garden is well tended and safe for residents to use. 33 of care staff have obtained their NVQ qualification and a further 8 staff are in the process of completing their NVQ, once these 8 staff have completed their NVQ, 68 of staff will have this qualification. Four staff personnel files were viewed by the inspector, it was noted that the application form for employment in the home did not require a full employment history, this was immediately remedied by the home administrator and all future employees will be required to provide a full employment history with a full written explanation of any gaps in employment. At the present time there is no evidence within the home that the registered manager obtains a POVA first check prior to employing a new member of staff, there was evidence that a CRB checks had been applied for, but these are taking time to come through and sometimes the home is not able to wait to employ a new member of staff. The registered provider, the registered manager and home administrator all confirmed that POVA first checks are done on prospective new staff, but these are e-mailed through, and they do not print them out. One file showed that the POVA first check was received one month after a carer had taken up employment. There was evidence of identification on all files, together with two written references and a student permit for one overseas carer, who is undertaking her NVQ qualification. All files contained statements of terms and conditions of employment. The inspector viewed the staff training matrix and found that many of the staff have not received or updated their mandatory training, at the present time the training levels of care staff completing mandatory training are – Moving and Handling 45 ; Food Hygiene40 ; First Aid 27 ; Infection Control 1 ; POVA 59 ; Medication 54 . Under the previous provider staff had started to do Dementia Care training, but did not complete this, an in depth course has been arranged by the registered manager with the Alzheimer’s Society starting on 12th June 2008. All staff receive initial introductory induction and the ‘Skills for Care’ induction has also recently been introduced. Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 23 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 who use this service experience good quality outcomes in this area. The registered manager has a good understanding of the areas in which the home needs to improve. Planning is in place and sets out how this improvement will be resourced and managed. Quality assurance systems have been developed and further development is taking place to ensure that residents’ receive good quality of care. Residents’ personal allowances are well managed and kept safely and securely in the home. Staff receive regular recorded formal supervisions, to ensure that each member of staff can meet the assessed needs of the residents in the home. Health and safety issues within the home are regularly monitored to ensure that residents and staff live and work in a safe environment. Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 24 This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has many years experience of working in the home as deputy manager, she has also worked for the Alzheimer’s Society, and has achieved her NVQ level 4 and Registered Managers Award. Since being registered the manager has worked hard to improve the systems used in the home, and is still updating and improving. The manager is aware of what she wants to improve on, and is working towards this. Two residents spoke highly of the manager stating that she was kind, and thoughtful, and nothing was too much trouble. There are clear lines of accountability through the management structure. The manager is in the process of developing a good quality assurance system this includes surveying relatives, and recorded monitoring of systems used in the home, further developments are to survey visiting professionals, extend monitoring systems to include medication, and daily reports. The registered provider carried out Regulation 26 visits to the home, but does not leave a copy of his findings with the registered manager. At the end of the year the manager aims to produce a report of her findings, and set out the practices that need improving in 2009. Relatives bring in personal allowance money for their residents, these monies are then entered onto an account sheet for each resident, receipts are kept of any expenditure made on the residents behalf or at their request and entered onto the account sheet. In some cases relatives/representatives prefer the home to make purchase on the residents behalf, receipts are kept entered onto an account sheet, and the relatives are billed at the end of each month for the purchases made. All monies kept in the home are safe and secure and accounts are kept separately. All staff receive 6 formal recorded supervisions per year and covers the philosophy of the home, the quality of care offered to residents, where further training is required and how this is going to be met. The registered manager also holds staff meetings and regularly talks to staff about issues that concern them. Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 25 As mentioned previously under staffing in this report not all staff have received their mandatory training. Some further mandatory training courses have been booked, and further training will be available throughout the year. All equipment used in the home has up to date maintenance certificates. A regular recorded health and safety check is carried out. Fire call points and emergency lighting are checked regularly. Staff receive regular fire drills. The maintenance person also checks and records all hot water outlets to ensure that they are delivering hot water at around 43ºC. The registered manager has ensured that the home has up to date health and safety policies and procedures in place. All windows throughout the home are fitted with window opening restrictors. All accidents are recorded appropriately onto accident forms, and a monthly check is kept of falls. Where residents are experiencing regular falls this is risk assessed and where there are concerns for the residents safety, further investigation takes place, with a possible referral to the residents general practitioner. Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 26 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 2 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(2)(a) (b)(c)(d) Requirement The registered manager shall ensure that care plans are drawn up with involvement of the resident and or his relative/representative and signed by them. That daily records are kept to reflect each resident’s choices, personality and wishes. Daily records are a good source of evidence to show that care is being provided, as detailed in the care plan, however the term ‘All care given’ is not helpful or adequate. Daily records when well written, help ensure a consistent approach and good quality of care for service users, and this information is then used when care plan reviews take place. The registered provider must ensure that all rooms that residents use regularly are fitted with a call bell to ensure that resident can call staff for assistance. This must included en-suite bathrooms/toilets. The registered provider must DS0000070629.V363540.R01.S.doc Timescale for action 09/07/08 2. OP22 23(2)(n) 11/08/08 3. OP25 13 (4)(a) 11/08/08 Page 28 Castlemaine Care Home Version 5.2 (c) 4. OP29 19(4)(c) Schedule 2 5. OP30 12(1)(a) (b) 13(4)(c) 18(1)(a) (c) ensure that radiators are covered throughout the home this includes en-suite bathrooms/toilets. The registered manager must ensure that satisfactory checks of the Protection of Children and Vulnerable Adults UKCC register are carried out prior to new staff being confirmed in post. The registered manager must ensure that all staff complete mandatory training within the first six months of their employment, and that current staff have completed all mandatory training by the end of this year. 09/07/08 09/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations It is recommended that the registered manager ensures that all medication received into the home is properly recorded onto the Monthly Administration Record, by recording the amount of medication received the date on which it was received and the initials of the person receiving and recording the medication onto the MAR sheet. That a daily temperature log is kept of the medication room to ensure that medication is stored at the correct temperature. It is recommended and good practice that liquidised meals are kept attractive whilst feeding them to the residents. 2. OP15 Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 29 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 Castlemaine Care Home DS0000070629.V363540.R01.S.doc Version 5.2 Page 30 - 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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