Inspection on 18/02/09 for Silver Springs
Also see our care home review for Silver Springs for more information
This is the latest available inspection report for this service, carried out on 18th February 2009.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Not yet rated. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.
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.
What follows are excerpts from this inspection report. For more information read the full report on the next tab.
What the care home does well
We observed good interaction between care staff and residents during the visit and residents appeared happy and busy. Residents had a craft session provided by a member of staff who is employed to provide activities and outings and we spoke briefly with one resident at this time although this person had limited communication abilities. We spoke with several members of care staff at the home and these care workers said that they were aware of the Complaints and Whistle Blowing policies at the home. The care staff told us that the care provided was person centred and that residents were encouraged to make choices about how they spend their days. The residents we spoke with were unable to give clear answers to our questions but we observed that interaction between residents and care staff appeared good. We checked the recruitment record of a care worker who had recently started work at the home. We saw evidence that appropriate employment checks were in place before the care worker started work.
What the care home could do better:
We identified several areas where improvements are needed in the home and the manager confirmed that action is being or will be taken to ensure changes are made. During the inspection the manager informed us that she had reviewed the needs of one resident and had informed the placing authority that the home could no longer meet this resident`s needs. The manager said a planned move would be taking place for this resident. As a result of issues raised with the manager by reviewing officers maintenance work was underway at the home on the day of the inspection. Appropriate adaptations had been made to a lock on the front door. A double locking device had been removed and the door was now alarmed. This means that able residents are now able to open the door when they wish but the alarm will alert staff that the door is open so that care staff can be sure all residents remain safe if they wish to go out. A reviewing officer had also found that the ground floor bathroom was very cold on the day of their visit. As a result of this we saw an additional radiator being installed on the day of our visit. We saw a copy of the staff duty roster for the week during the inspection. This showed that, from Monday to Friday there were four care staff on duty in the morning, three in the afternoon and two at night. The roster showed fewer staff were on duty at the weekend but the Proprietor said that the roster was not finished and that more staff would be on duty and their names would be added. The manager`s name was not on the roster but the Proprietor said that the manager was "supernumery" to the staffing numbers. The manager was not on duty when the inspection started but arrived later in the morning. The Proprietor was reminded that the weekly staff roster must accurately detail the names of all staff who work at the home and must be kept as a legal document. We were provided with the staff training matrix during the visit. This showed that staff training courses have been booked throughout the year and these covered all appropriate subjects. However the details also showed that most of the staff were currently not up to date with essential training and this could mean that care staff were not adequately trained at present to meet all residents` needs. Regular training must be provided for all care staff and the manager confirmed that this would continue to be done. During the Serious Concerns meeting, officers who had recently visited the home felt that the home`s Policies and Procedures were not up to date and that the system for handling residents` personal allowances was not appropriate. It was aslo noted during the meeting that the manager had not sent information to the Commission and to the relevant Local Authorities about issues and accidents which had taken place at the home. This action is required under the Care Homes Regulations and by the terms of the Local Authority contracts. During the inspection the manager demonstrated a recently introduced system which will ensure that all accidents, incidents and appropriate issues are reported to the Commission and to the Local Authority. Each resident`s care plan now has blank notification forms included in the file with instructions to staff how to complete and where to send the forms. The manager said that the procedure has been explained to all staff members and one care worker confirmed they were aware of the procedure. The manager is changing the system for dealing with residents` finances. All residents have accounts with a building society and previously money was drawn out from these accounts and kept in a joint fund in the home. In the new system the residents will collect their money from the building society and will keep their own personal allowances in the safe provided in each bedroom. All residents have their own cash book and we tracked the money of one resident during the inspection. The cash counted tallied with the records shown in the individual`s cash book and building society book. The manager is currently acting as a trustee for three residents but confirmed that she will be ending this responsibility and has asked the relevant social workers to make alternative arrangements for the residents concerned. We checked the system for administering medication. The system was basically sound but the manager must provide a medication fridge for the home and purchase a record book for controlled drugs, in line with current legislation. The manager confirmed these items would be provided as soon as possible. We checked the home`s written Medication Policy and found this was inadequate and out of date. The manager said that this and other written policies in the home were being reviewed and updated at this time. During the visit we saw one bedroom door held open with a door wedge. We reminded the Proprietor that this device would compromise the fire safety system and could put residents at risk of harm. The Proprietor removed the wedge and confirmed th