Inspection on 15/06/05 for Farnham Common House

This inspection was carried out on 15th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

Other inspections for this house

Farnham Common House 05/06/07

Farnham Common House 03/05/06

Farnham Common House 14/11/05

Farnham Common House 23/05/05

Farnham Common House 30/09/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Farnham Common House Beaconsfield Road Farnham Common Slough, Bucks SL2 3HU Lead Inspector Mike Murphy Announced 15 June 05 at 9:30 am 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 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. Farnham Common House Version 1.10 Page 3 SERVICE INFORMATION Name of service Farnham Common House Address Beaconsfield Road, Farnham Common, Slough, Bucks SL2 3HU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01753 644282 01753 644282 The Fremantle Trust Yvonne Peace CRH 50 Category(ies) of Old Age (OP), Dementia over 65 years of age registration, with number (DE(E) of places Farnham Common House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Farnham Common House opened in May 2004. It is a care home providing personal care and accommodation for 50 older people. The development is the result of a partnership between The Fremantle Trust, Beacon Housing Association and Buckinghamshire County Council. The service is run by The Fremantle Trust.The home is located in Farnham Common, Buckinghamshire, on the A355 road and is conveniently located for buses between Beaconsfield and Slough (hourly service) and about half a mile from shops and other amenities of Farnham Common. The home is divided into four houses – two of ten places and two of fifteen places. One house on the ground floor is dedicated to the care of people with dementia.The home is purpose built and provides a good quality, well equipped and spacious environment for service users. All bedrooms are single and all have en-suite facilities comprising wc, sink and shower. The home is set in compact pleasant grounds. There is usually sufficient parking for staff and visitors cars. Farnham Common House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over two days. On the first day by two inspectors and on the second by one. This was an announced inspection. A particular feature on this occasion were the comments which inspectors received from relatives of residents in the home – through comment cards, correspondence, telephone conversations and personal interviews during the course of the inspection. These helped create a fuller picture of the service. The methodology for the inspection included interviews with managers, residents, relatives and staff. It also involved examination of resident and staff records, perusal of relevant policies, walking around the home and consideration of pre-inspection information forwarded by the registered manager. The inspectors discussed the main themes with the registered manager at the end of the first day and the beginning of the second day (The manager was involved in a meeting at the time the inspection concluded on the second day). The home, which opened about fourteen months before this inspection, provides a good quality environment for older people with a wide range of needs. Standards of care are variable. Residents and relatives reported good work. People communicated a strong wish to establish a good home. At the same time, however, evidence of shortfalls were noted while examining records, when walking around the home, in written comments to the Commission in advance of the inspection, and in conversation with relatives. Managers need to address these. Throughout the inspection managers and staff freely provided their time and whatever information was requested. Residents and relatives made time to give accounts of their experiences. The inspectors are grateful to all who contributed. What the service does well: Involves residents and families in the running of the home. The home seeks the views of residents and their relatives through regular meetings. Provide care for older people with complex problems. The home provides residential care for people with a wide range of abilities and with problems of varying complexity. Gives residents choice. There is a residents committee which is consulted on a range of matters. Farnham Common House Version 1.10 Page 6 Good quality environment. The environment is of a good standard. Residents rooms are a good size and all are en-suite. There is sufficient communal space. Managers are helpful in solving problems. The manager is responsive to complaints and comments from residents and relatives. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Farnham Common House Version 1.10 Page 7 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 Standards Statutory Requirements Identified During the Inspection Farnham Common House Version 1.10 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 3 The home has an up to date statement of purpose which provides current and prospective residents, families and prospective referrers with essential information on the home and the service it offers. The structure of assessment processes, both on referral and on admission, are comprehensive and thorough. However, weaknesses in their implementation may lead to assessed needs not being recorded or to needs not being fully met. EVIDENCE: The statement of purpose was revised in April 2005. The statement of purpose includes all of the information required under Regulation 4 (1)(c). The home accepts referrals from Buckinghamshire and Milton Keynes social services under a block contract arrangement and direct referrals from people who are in a position to fund themselves. In both cases the prospective resident is assessed by the manager or deputy manager using the home’s own assessment methods. Further assessments are conducted on admission and as required during the course of a resident’s stay in the home. The forms which structure the process and in which information is recorded are comprehensive. Farnham Common House Version 1.10 Page 9 Examination of records revealed an uneven picture with many weaknesses in practice – omissions in drawing up a plan of care for all problems identified at assessment, an apparent failure to conduct a full assessment within a reasonable timescale in one emergency admission, the use of imprecise medical terminology in one admission (which had, however, been accurately copied from hospital discharge information), and, in many cases failure to maintain continuity between assessment, the formulation of a care plan and records of care delivered. For example, in some care plans items identified as a problem at assessment did not lead to a plan of care. Conversely, in one case, items ticked as a problem for the person on the assessment checklist (‘communication’, ‘continence’, ‘food & drink’) were stated not to be a problem on the care plan (it was recorded that the person was able to communicate, was fully continent and was able to make own choices from the menu and had no problems in feeding’). With regard to timing it was noted that a person admitted in an emergency had not had an assessment, had not been seen by a GP within 48 hours of admission but did have a good plan of care with very useful information. Farnham Common House Version 1.10 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 All residents have a plan of care. The quality of care plans varied and a number lacked information to ensure consistency in fully meeting individual needs. This may lead to uneven standards in the provision of care. In the majority of records examined entries in the daily record were limited to the provision of physical care provided. This fails to provide a full account of the range of activities undertaken by residents over the course of a day, fails to record psychological and social aspects of residents lives, and fails to record the range of care provided by staff. This leads to gaps in significant information on individual residents and has an adverse effect on the quality of care over time. The home is reviewing its approach to care planning and associated documentation and is aiming to develop ‘person centred care planning’ (PCP). This is a welcome development since a key aim of PCP is to ensure that the residents past and present experience is central to the plan of care and a review of documentation should address the weaknesses of the present system. The home’s systems for the storage and administration of medicines are generally sound. Some omissions in recording the administration (or nonadministration) of medicines were noted. Such weaknesses increase the Farnham Common House Version 1.10 Page 11 potential for errors and indicate a need for ongoing staff training and supervision and closer monitoring by managers. EVIDENCE: A care plan is in place for each resident. The format consists of an assessment of needs, a care plan to meet identified needs, risk assessments, a night care plan, a record of care provided and a record of reviews and changes to the plan of care. Standards of practice remain uneven. A number of care plans contained relevant and detailed information which support good quality care. Practice varied however and inspectors were informed that in many cases information provided to staff by residents and relatives had not been recorded in the care plan. These included dietary preferences in the evening, nightime routines and individual bathing preferences. Such omissions lead to gaps in staff knowledge of individual needs and preferences, frustration on the part of those who have contributed to such plans and a reduction in the overall quality of care. With regard to a lack of continuity in the system of assessment, care planning and recording care given we found that daily entries in many records contained few or no references to the assessment or care plan. Residents were regularly weighed but weights had been recorded in imperial and metric. This complicates comparison between weights at different points in time. The manager said that weights are now to be recorded in metric only and that a conversion chart will be available to compare weights if required. Risk assessments are included in care plan files. The use of ‘Tippex’ was noted on some care plans. This practice must cease. Errors should have a single black line drawn across them and be dated and signed. In one case needs related to diabetes were not recorded in the care plan. Care plans are regularly reviewed. However, some residents and relatives said that matters agreed at review were not always recorded in the updated plan of care. Daily entries are brief and tend to focus on physical care and fail to communicate a rounded view of a resident’s day. The inspectors received an account in which it is claimed that an entry in a care plan was an exaggeration of an event which the observer felt was due to a failure to understand distress expressed through non verbal behaviours. There were examples of good care plans, based on good assessments and in which the daily entries had more detail of the resident’s day. The inspectors received reports of good care and observed good work by staff. However, this was not reflected in daily records. At the time of this inspection the overall standard of care planning remains uneven. This uneven picture was confirmed by others who communicated their views – both critical and complimentary. Farnham Common House Version 1.10 Page 12 Assessment and care planning processes and documentation are under review and the home is likely to adopt a ‘person centred care’ approach to care planning. Since the last announced inspection in December 2004 the registered manager has implemented additional training in assessment and care planning and intends to maintain this for the foreseeable future. The annual Fremantle internal quality audit of care homes includes a review of care plans and this could usefully be supplemented by periodic audit of a sample of care plans conducted by the home managers and senior care workers. The subject could also be constructively addressed in staff meetings and individual staff supervision. The home should continue its efforts to engage residents in the process, and where appropriate, and in the context of the Fremantle Trust confidentiality policy, their families (particularly in House 1 where the residents are more frail). All residents are registered with a GP and the home has regular contact with community health services - district nurses in particular. No resident had pressure sores. Toileting programmes were in place where indicated. One inspector was informed of a situation in which a resident required medical intervention for constipation and of another in which the management of laxative medication had caused distress to the resident. A range of activities are on offer to residents and the home has a small enclosed garden. Over the two days of this inspection some residents went for a walk in the local area. Residents generally expressed satisfaction with the service. They appreciated the size of the bedrooms and the en-suite facilities. Staff were described as caring and attentive and residents seemed confident that their health needs would be attended to promptly. Food was reported to be good. They had company if they wanted it but could be alone if they wished. They felt settled and supported in the home. Feedback from relatives was mixed. They appreciated the quality of the environment but expressed criticism of the uneven standards of care. Some felt that some elements of the culture within the home was not receptive to criticism. To a certain extent these comments were countered by an acknowledgement of the positive aspects of life in the home, of the qualities of some staff, of the response of the manager to complaints and of the home’s potential. None expressed a wish for their relative (the resident) to be moved elsewhere. There was a genuine wish for more constructive engagement between staff, relatives and residents. The home’s procedures for the storage and administration of medicines were examined. A number of irregularities were found in Medicines Administration Records (‘MAR sheets’). Gaps in recording were not explained and the use of codes was inconsistent - for example, when using a code such as ‘F’ (‘other’ (reason for not administering the medicine)) no explanation was recorded. Farnham Common House Version 1.10 Page 13 In one record it was noted that staff had written over an earlier entry. A practice which must cease. Staff make hand written entries on the MAR sheets. This is permitted when transcribing from a prescription but such entries must be signed and dated by two staff. Where a course of antibiotics is finished, as a matter of good practice, staff should sign to confirm that the prescribed course has been completed. A number of medicines are treated as controlled drugs and a register maintained. This is good practice. A sample of entries were checked and these tallied with the stock of medication held in the home that day. However, staff were also recording this medication on MAR sheets and this information did not tally with the controlled drug register. Staff must be supported by training. Skills levels should be monitored by occasional checks of competence. Records of such checks should be maintained for inspection purposes. MAR sheets must be audited periodically and any variance in practice be addressed through staff meetings, supervision and other management processes. Farnham Common House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 The home offers a varied range of activities for residents and involves residents in planning these. These have physical, psychological and social benefits for residents. Residents expressed satisfaction with the food and there are sufficient staff to provide support to residents who require assistance at mealtimes. Residents general nutritional needs are met. EVIDENCE: The home is a modern, large and airy building comprised of four ‘houses’ on two floors. There is a lounge in each house plus a large communal lounge on the ground floor and a smaller communal lounge on the first floor. Residents are encouraged to participate in social activities. An activity programme was displayed in each house. A part-time leisure co-ordinator had recently been appointed. The leisure co-ordinator works 20 hours a week and care staff are expected to continue activities at other times. The home has a residents committee which is chaired by a resident. A variety of activities are planned including those aimed at ‘mental stimulation’, reminiscence, outings and encouraging social interaction. Activities include quizzes, word games, discussions, bingo, craft activities, paintings and outings to places of interest. Farnham Common House Version 1.10 Page 15 Houses seem well equipped with tv, dvd/video, music centres, games, books and magazines. Visiting is open. A church service is held once a month and residents would be supported in attending a local service if desired. Residents expressed satisfaction with the food. Breakfast can include a traditional cooked breakfast if desired as well as cereals and toast. Lunch is the main meal of the day and consists of a choice of main course served with potatoes and vegetables and a choice of dessert. The evening meal served around 6.00 pm (5.00 pm in House 1) is a lighter meal which usually consists of soup, sandwiches and cake. On the first day of the inspection lunch (a mild chicken curry served with rice and vegetables) was taken with residents. The residents were happy with the quality and quantity of the lunch and drinks (fruit squash and water) were available as needed. Staffing in house 1 has been adjusted in order to provide additional support to residents requiring assistance with eating. Farnham Common House Version 1.10 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17 18 The home has an effective complaints system and the manager responds promptly to complaints received. The system supports an open culture towards complaints and to the organisation learning from the feedback received. Procedures for the protection of vulnerable adults are thorough and are supported through staff training. Good systems appear to be in place for the management of residents monies. The home’s systems reduce the chances of abuse occurring and ensure a prompt and effective response from managers to reports of abuse. EVIDENCE: The home is required to conform to Fremantle Trust policy on complaints using ‘Fremantle Feedback’. Feedback forms are available in the reception area. A record of complaints is maintained. The record of complaints and compliments received since the last announced inspection was examined. The manager responds promptly to complaints. The system appears thorough and maintains a summary record of complaints and compliments and associated correspondence. The statement of purpose states that ‘The record is analysed annually by the Director of Care and findings made available across the organisation. The record is also inspected during the monthly service manager’s visit and during the Regulation 26 visit’. The complaints section of the statement of purpose correctly states that ‘Concerns may also be raised with the Commission for Social Care Inspection…’. This is a good system which supports an open and healthy culture towards complaints. However, some respondents indicated that some elements of the culture would appear to be less receptive to criticism. This may inhibit individuals from expressing an opinion and requires investigation by the registered manager. Farnham Common House Version 1.10 Page 17 The manager said that residents are registered on the electoral register and that in the recent 2005 general election around 10 residents expressed a wish to vote and that eight had used a postal vote and two went to a local polling station. One relative had not seen voting cards while visiting a resident in the period leading up to the election. The home is subject to The Fremantle Trust policy and practice on vulnerable adults. The subject is included in staff induction, in the training programme for the year and is included as one of the subjects which will continue to be provided according to the ‘Workforce Development Plan’. The home responded promptly to one allegation received since the last inspection and the matter was concluded appropriately. The staff records relating to this event were examined and a number of questions were raised with regard to the detail of procedure and it was agreed that this matter would be taken up further with the Service Manager. In terms of protection, however, managers acted promptly and effectively and the safety of the resident was maintained from the moment the matter was brought to their attention. Residents monies are managed in line with the Fremantle Trust’ policies and procedures. A safe is available for retaining small amounts cash where required. Farnham Common House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The home is a new building which provides a good standard of accommodation. The home provides a safe and pleasant environment for residents. Since opening the home has received a poor standard of service from the organisations responsible for maintenance. This has led to a failure to respond promptly to repairs and this has caused residents and staff inconvenience and discomfort. EVIDENCE: The home is conveniently located in Farnham Common on the main A355 road midway between Beaconsfield and Slough. The home is a new building which opened in May 2004. There is sufficient car parking and dropping off space at the front. A small garden runs to the side and rear of the building. Entry is controlled by staff. The accommodation is located in four ‘houses’ – two on the ground floor and two on the first floor. Entry to two of the houses is controlled through coded locks. It is a relatively spacious, light and airy building which provides a good standard of accommodation. All rooms are of a good size and have en-suite accommodation. Each house has a common room and a small kitchen and dining area. There is a shared common room on each floor – that Farnham Common House Version 1.10 Page 19 on the ground floor also being used for meetings and larger social events. There are sufficient additional WCs for the use of staff and visitors. Bathrooms are well equipped. Throughout the course of this inspection the home was clean and tidy. Residents expressed appreciation of the quality of the facilities. The first year of operation has not been without problems. Problems are to be expected in a new building and are usually rectified during the ‘snagging’ phase soon after handover. The building is owned by a Housing Association which is responsible for its maintenance. In terms of timing, the handover of the building and the development of the service by the Fremantle Trust coincided with the takeover of Beacon Housing Association (the initial owners of the building) by London and Quadrant Housing Association (the owners at the time of this inspection). This fact may or may not have contributed to a succession of problems which have occurred since opening and which have caused residents, staff and relatives inconvenience, discomfort and intense frustration. The Housing Association has failed to act either promptly or effectively to reports, requests and representations from staff and managers of the Fremantle Trust, with the result that problems have either not been addressed at all or have been ineffectively dealt with, sometimes by a succession of maintenance staff, who on occasions have given conflicting opinions on the nature of, or the solution to, the problem under consideration. Given the nature of the work of the home it has received an inexcusably poor level of service since opening. Matters appeared to have come to a head around the time of this inspection and the housing association has now acknowledged the problems and given a commitment to the Chief Executive and Estates Manager of the Fremantle Trust that it will address all outstanding matters and immediately improve access by home managers to maintenance staff. The Commission will expect to see evidence of significant improvement at the next inspection. It is important to say that while the Fremantle Trust is the registered body responsible for conformance to the National Minimum Standards, the failure to fully meet this standard on this inspection is largely due to matters outside of its direct control. The home was generally clean and tidy. The exceptions were the area around the bird cage on the first floor and some residual odours in some rooms on the ground floor. Other odours were noted which were thought to be related to a continuing problem with the drains. The bird cage and its immediate area requires more frequent attention. The cleaning schedule for the rooms affected may need review. A dishwasher in one of the houses was due for repair. The ceiling in bedroom 10 had holes in the ceiling and the light fitting was not secured in place. Laundry facilities are well organised and of a good standard, however, the replacement of the present bins with pedal operated bins would aid the control of infection. There are sufficient handwashing facilities around the building. Infection control training is provided by the training department. Farnham Common House Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 Staffing levels appear satisfactory and staff benefit from the training, development and support policies of the Fremantle Trust. This contributes towards the provision of good quality care to residents by skilled staff who are supported in their work. Omissions to obtain pre-employment ‘POVA first’ checks were noted on examination of staff records. Failure to obtain such checks exposes residents to risk through the appointment of staff considered unsuitable to work with vulnerable adults. EVIDENCE: In its pre-inspection questionnaire the home has calculated that it provides 937 care hours against assessed needs of 819 hours (using the ‘Residential Forum’ staffing calculations taking account of residents dependency). 269 hours of ancillary staff time is provided in addition. These figures excludes the registered manager and administrator. There were no complaints of inadequate staffing and additional staff are available in House 1 at meal times. Some concerns about the lack of staff in some houses at handover times were expressed and were discussed with the manager. Changes are being made to minimise such occurrences. 5 staff have completed NVQ2 or above and a number of staff are attending the Fremantle NVQ training programme. Recruitment of staff is managed by the home supported by head office. Four staff files were examined. In two of the four examined a POVA first check did not appear to have been received before the employee started work. In two Farnham Common House Version 1.10 Page 21 files it was not possible to say whether open references had been verified by a manger. The Fremantle Trust maintains an ongoing training and NVQ programme which addresses a wide range of training needs. Since opening in May 2004 staff have attended induction training and foundation and update training in moving and handling, food hygiene, first aid, infection control, health and safety, and abuse. Other subjects covered during the course of the year have included medication, dementia care, difficult behaviour, POVA, person centred health care, diabetes, hazard analysis, care planning, care of the dying, and use of the glucose meter. The manager said that training in dementia was provided once a month in staff meetings. A copy of the ‘Workforce Development Plan’ drawn up by the training manager was submitted for information. This outlines the training needs of staff in support of the Fremantle Trust business plan. Farnham Common House Version 1.10 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Farnham Common House Version 1.10 Page 23 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x x x x x x x Farnham Common House Version 1.10 Page 24 No Are there any outstanding requirements from the last inspection? 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 3 Regulation 14 Requirement The registered manager is required to maintain a programme of staff training and supervision in the assessment of care needs. The registered manager is required to maintain a programme of staff training and supervision in care planning The registered manager is required ensure that staff comply fully with the homes procedure for the storage and administration of medicines The registered manager is required to ensure that standards of cleanliness are maintained to a high standard. The registered manager is required to replace the present waste bins in the laundry with pedal operated bins The registered manager is required to ensure that a POVA first check is obtained prior to staff working under supervision until an enhanced CRB certificate has been obtained and that copies of references are verified Timescale for action September 30 2005 2. 7 15 September 30 2005 June 16 2005 3. 9 13 (2) 4. 26 16 (2) (j) June 16 2005 July 31 2005 July 31 2005 5. 26 16 (2)(j) 6. 29 19 (4) (b) (i)(c) Farnham Common House Version 1.10 Page 25 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 13.5 Good Practice Recommendations It is recommended that the registered manager establish effective liaison with relatives in a form appropriate to the particular needs of relatives of residents with dementia. Farnham Common House Version 1.10 Page 26 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close, HP19 8JR 01296 737550 National Enquiry Line: 0845 015 0120 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 Farnham Common House Version 1.10 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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