Inspection on 15/11/06 for Minster Lodge Residential Care Home

This inspection was carried out on 15th November 2006.

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

Other inspections for this house

Minster Lodge Residential Care... 22/05/07

Minster Lodge Residential Care... 25/04/06

Minster Lodge Residential Care... 08/03/06

Minster Lodge Residential Care... 22/06/05

Minster Lodge Residential Care... 21/09/04

Minster Lodge Residential Care... 20/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Minster Lodge Residential Care Home Minster Lodge 6 Westminster Road Earlsdon Coventry CV1 3GA Lead Inspector Kevin Ward Key Unannounced Inspection 15th November 2006 08:05 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 Minster Lodge Residential Care Home DS0000050158.V319659.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. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Minster Lodge Residential Care Home Address Minster Lodge 6 Westminster Road Earlsdon Coventry CV1 3GA 02476 552585 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) R M Health Ltd Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th April 2006 Brief Description of the Service: Minster Lodge is situated close to Coventry City Centre and can be reached easily using public transport. The home is situated over two floors and can care for 27 older people who are frail. There is one shared room and the remaining rooms are single occupancy, two of the bedrooms have en-suite toilet facilities. Communal toilets and bathrooms are available close to the lounge and dining areas and also near to those bedrooms without an ensuite facility. There is a back garden, which is secure with paved areas and this can be accessed from the dining room. The home does not have its own parking facilities and parking is prohibited on the road. There is a Pay & Display car park close to the home. The current fees at Minster Lodge range between £326 and £340 per week. This does not include personal items, such as toiletries, hairdressing, private chiropody or newspapers. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and focused on assessing the home’s performance against key inspection Standards and looking at the progress the home is making to meet requirements from the last inspection, which took place, 25/4/06. The inspection involved looking at a range of information, including the service history for the home, such as notifications made by the home to the Commission for Social Care Inspection, monitoring reports carried out by the home and information provided by the manager as part of the inspection. 20 service users were living in the home at the time of this inspection. The inspection included talking with service users, staff and the manager at the home. The inspection also included case tracking three people’s care. This involves looking at their care plans and checking how their care is met in practice. Other records were also seen, such as care plans, staff files and fire safety records. The inspector also spoke with a community nurse manager and with a relative visiting the home on the day of the site visit. What the service does well: Staff were friendly to people and were seen to follow up their requests for support in a caring manner. Comments by the people at the home indicate that they find staff to be respectful and helpful. Personal care tasks were carried out behind closed doors indicating that staff pay suitable regard to people’s privacy. A catholic priest visits the home so that people can take communion. The manager said that appropriate arrangements would be made for people from other religious backgrounds in the event that they were referred to the home. The home has a walk in shower facilities and a shaft lift to enable people to move between the floors in the home. There has been one complaint to the Commission for Social Care Inspection that was not upheld. Comments by the people living at the home confirm that they have been encouraged to raise any personal concerns they may have with the manager. Staff are provided with a suitable range of training to equip them to work at the home, including Health and Safety related courses as well as care courses and National Vocational Qualifications. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The home has failed to correctly assess a person’s needs prior to her recent short stay. It is important that people’s needs are properly assessed before they move in and to make sure that the correct information is available to staff so that they can meet people’s needs effectively. Overall the care plans and risk assessments have improved, however there are still shortfalls in some instances e.g. there is a need to ensure that one person is weighed regularly and that suitable records are maintained. The manager undertook to refer this person to a nutritionalist for advice. The manager also agreed to increase the details in some risk assessments to ensure that staff have more in depth strategies to respond to the challenges presented by people with mental health needs. Since the site visit the manager has sent written confirmation of an updated risk assessment that was deemed a high priority. A timetable of activities has been devised since the last inspection but this only provides a narrow range of social opportunities for people. The hall carpet is stained near the dining area and need to be properly cleaned or replaced. A bedroom carpet was also brought to the attention of the Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 7 manager to replace, as it is smells unpleasant. Two dining tables were unsteady and wobble about which is annoying when people are eating and could cause spillages. “Door guards” (devices to hold doors open) are fitted to a number of doors in the home. The manager has agreed to seek written confirmation from the fire officer that these devices are acceptable to use in the home. 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. Minster Lodge Residential Care Home DS0000050158.V319659.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 Minster Lodge Residential Care Home DS0000050158.V319659.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): 2 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users needs are not always fully assessed before moving into the home. EVIDENCE: The assessment of a service user, recently admitted on a short stay basis was checked for information. The file contained evidence of a basic assessment carried out by the home. This information was limited and did not include all the information necessary to manage the person’s care fully. The manager explained that the social workers assessment had not been sent as promised as the social worker had been off sick and the placement was urgently required by the hospital. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall there have been improvements in care planning. The rating for this group of Standards has been compromised by some ongoing There is scope for improving the consistency of recording to improve health monitoring and for increasing levels of information in some risk assessments, to ensure that people’s needs are properly monitored and met. The medication procedures need to be clarified with staff to ensure safe practice. EVIDENCE: New care plans have been devised and implemented this year. Overall these documents represent a marked improvement in the way the home plans people’s needs. Similarly there have been improvements in the home’s risk assessments. The new care plans cover a good range of common needs, e.g. physical, emotional, dietary, (including likes and dislikes), communication, mobility, history of falls, continence and sleeping. Moving and handling and skin care risk assessments were also seen in people’s files. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 11 Most of the care plans and risk assessments that were seen had been reviewed and dated. These documents were seen to contain some helpful advice and information to assist staff in providing care to people. One person’s risk assessment had not been reviewed and amended to take account of the fact that her mobility needs had changed and that she now used a wheelchair. One person is said to often reject staff input to help him manage certain health needs. The manager agreed to meet with relevant professionals, such as social worker and nurses to agree an acceptable strategy for intervening with this person so that this person’s needs are not neglected and so that relevant parties share the risk management responsibility with the home. The home is now retaining better records of people’s personal care, which are a helpful means of monitoring the care provided to people although some gaps in recording were noticed in some cases. Records are being kept of a person’s dietary intake, in keeping with his care planned needs but the home has not kept an adequate record of this person’s weight which is necessary to monitor his good health and well-being. The manager agreed to contact the GP again to refer this person for a dietician assessment. Since the last key inspection the manager has issued identity cards for two people who venture out alone, containing the contact details of the home so that the people concerned are able to make contact with staff if they need to do so. Discussion took place regarding the need to develop the risk assessment of a person who likes to go out alone for a drink so that staff know how to respond in the event that he does not return within a reasonable timescale. Since the inspection visit the manager reports that she has reviewed the risk assessment with the involvement of the social worker. The home provides support to several people with mental health needs and some behaviour challenges. The manager reports that staff have been provided with training to assist staff in these matters. The manger was advised of the need to consider the risks to other service users in the home when accepting referrals for people with behaviour challenges and to seek multidisciplinary advice to inform risk assessments where it is necessary. Whilst overall the risk assessments have generally improved, the manager was advised to add more specific advice in certain cases, e.g. the amount of time people may remain unsupervised. Entries in peoples’ health notes indicate that the home has supported people to gain access to local health services for advice and check ups, such as GP, dentist, optician and chiropody. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 12 Comments by the people living at the home indicated that they feel well supported by they staff at the home and find them to be kind and helpful. All personal care tasks took place behind closed doors, indicating that staff show an appropriate regard for people’s right to privacy and dignity. A visiting relative spoke positively about the care and support provided to her mother and said that she was appropriately consulted and kept informed of changes in her care. The home’s medication practices were reviewed at a random inspection, 8/8/06 and were found to have improved markedly. Better recording systems are now in place to account for medication as it arrives in the home and audits are carried out to check that the correct number of tablets are given out by staff. Suitable measures are in place for the storage and recording of controlled drugs. Two people’s medication was counted and tallied correctly with the controlled drugs record. A member of staff was seen signing for medication before it had been given to people and explained that had misunderstood the procedure. The manager undertook to review the procedure with all staff to ensure that they understand the need to sign the record after medication has been given. The manager said that this would also be included as an extra question in the home’s new medication competency assessment. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 13 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): 12,13,14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a limited range of activities for people to make their days more meaningful. People are consulted about their food so that they receive the meals they enjoy. EVIDENCE: When asked what they do during the day, people were able to identify a limited range of activities. One person said that occasional bingo sessions take place and another person said that he likes to complete quiz books to fill his time. Four people’s recent activity records were seen. This also indicates that time spent in activities is quite limited. The manager said that many of the people living at the home are not keen to take part in activities. Since the last inspection the activities co-ordinator has left the home and this role has past to staff. An examination of the activities timetable (coupled with entries in people’s activities records) shows that there is a limited range of activities on offer. The manager reports that there have been no visiting entertainers and there have been no outings other than occasional shopping trips. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 14 A representative of the catholic church visits the home to provide holy communion where people want this service and the manager said that efforts would be made to support people of other religions to access appropriate places of worship should this become necessary. As previously noted a visiting relative spoke positively about the staff of the home and confirmed that she is welcome to visit when she wishes to do so. Comments by other people confirmed that relatives are allowed to visit the home on a flexible basis. Comments by the people that live at the home indicate that staff respond appropriately and promptly to their requests for care and support. People confirmed that they are able to contact night staff in the event that they require any assistance. Since the last key inspection the manager has surveyed people views regarding the night care support to ensure that this remains satisfactory. Comments by people confirmed that their views are sought regarding the menus in the home and to check their mealtime preferences for the next day. A member of staff was seen to do this on the day of the inspection visit. People were seen to rise at their own pace and to choose their breakfast. People were seen to eat a wholesome roast dinner and people commented positively on the meals provided by the home. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 15 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): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall suitable procedures are in place and staff are being provided with training so that the home can respond appropriately to complaints and ensure people are protected from abuse. The rating for this group of Standards is compromised by the fact that two people’s financial records are not held at the home, as required. EVIDENCE: The manager stated that there have been no complaints direct to the home since the last inspection, 25/4/06. Concerns regarding one person’s care have been raised with the Commission for Social Care Inspection. The concerns were investigated but were not upheld. Comments by people living at the home confirmed that they had been told how to complain. Most people spoken to said that they would complain directly to the manager if necessary and some also said that they would be happy to raise their concerns with staff. A visitor commented that she is kept well informed and updated in events relating to the care of her relative, at the home and confirmed that she had been informed how to complain. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 16 Comments made by staff confirmed that the home is providing them with distance learning training to equip staff to recognise and respond to suspicions of abuse. A copy of the staff training materials being used were seen at the last key inspection and contain good levels of information on this subject. Comments by staff confirmed that they had seen the abuse reporting procedures and whistleblowing procedures as part of NVQ training courses. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 17 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): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is further scope for improvements in the home so that people live in a comfortable clean environment. EVIDENCE: Positive work has taken place to complete a number of outstanding requirements for items of equipment and improvements to the environment e.g. new light shades to improve the lighting, replacement pillows, towels and flannels, replacement flooring in bathroom and shower room, painted bedroom ceilings with water stains, replaced some old wooden exterior windows, replaced broken furniture in the bedrooms and purchased an air purifier. A new carpet has been purchased for the lounge, which makes a significant improvement. Good work has also taken place to improve the seating arrangements in the lounge to create several groups of sitting areas so that people have more options to group with people they wish to. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 18 A number of maintenance issues were identified at this inspection that need to be addressed. The décor in the downstairs hallway and the dining area is looking grubby in places. The manager said that plans were already in place for the hallway to be decorated imminently. The hall carpet by the entrance to the dining room was badly stained where food had been trodden in. This carpet is old and manager said that this carpet is cleaned frequently but it is a recurring problem. Seven bedrooms were checked. Two carpets were stained and one carpet had an unpleasant odour and needs to be replaced. The wallpaper in this bedroom is also stained in parts where pictures have been removed that belonged to the previous occupant. People’s bedrooms looked comfortable and there is ample evidence to demonstrate that people are supported to personal these areas and equip these areas to their own liking. Two dining tables were seen to be wobbly. One person commented, “this always happens”, referring to the fact that the table wobbles about as he tries to eat. The home has two “walk-in” shower rooms with grab rails to provide easier access to people with mobility issues. There are also bathrooms with grab rails and lifting equipment to help people use the baths safely. The corridors in the home are narrow and do not provide ideal wheelchair access. A shaft lift is in place to enable people to travel between floors safely. At the time of the inspection visit one bathroom was out of order due to a plumbing blockage. Since then the manager has reported that this has been fixed. Staff were seen to make appropriate use of protective gloves and aprons and the manager said that staff have been trained in proper hand washing techniques as part of the home’s infection control procedures. A cleaning schedule is in place for the cleaning staff and the manager produced records to demonstrate that cleaning in the home is being monitored. Comments by staff confirmed that suitable measures are in place for the safe handling of soiled laundry. The laundry room is situated safely away from the kitchen so there is no need for staff to take any laundry through food preparation areas. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 19 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): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are suitably vetted and trained to work with older people. Staffing availability is tight during the afternoons, providing limited scope for activities and outings. EVIDENCE: Since the last inspection the home has employed a second team leader to provide extra management cover at the home. One team leader has recently left and the owner said that a new person has been appointed and will start imminently, as soon as the correct employment checks have been completed. The home continues to provide 3 care staff on duty throughout the day and evening, in addition to two part time cooks, 2 part time cleaners and a handyman and a laundry person. The manager reported that the home had 7 service user vacancies and had retained the same staffing hours with the exception that the part time activities co-ordinator was not being re-advertised. Staff confirmed that one member of care staff cooks the tea each afternoon, which leaves two staff caring for people for part of the time, which can include two staff assisting people to bath. On some occasions the tea is prepared in advance by the cooks for staff to serve to people at teatime. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 20 Staff said that in the event that they hit a busy period attending to people’s personal care needs the member of staff preparing tea comes out of the kitchen to spend time with people in the main lounge. They said that this member of staff does not carry out any personal care tasks, as this would compromise food hygiene practices. Comments by the people living at the home confirmed that they do not have to wait for prolonged periods to have their care needs met. However as previously mentioned there is little evidence of stimulating activities and entertainments at the home. Two staff files were examined and found to contain evidence of employment references and Criminal Record Bureau Checks, confirming that staff are being vetted to ensure they are safe to work at the home. Comments by staff confirmed that they are being provided with access to a range of training opportunities. This includes Health and Safety related courses, such as first aid, food hygiene, moving and handling, fire safety, prevention of abuse, Control of Hazardous Household Substances and medication training, in addition to care courses and National Vocational Qualification (NVQ’s) training. To date 6 care staff are reported to have completed NVQ 2/3 training courses and 2 are currently in the process of completing NVQ level 2 (out of a total of 14 care staff). The manager also reports that since the last inspection a number of care courses have been provided o equip staff to meet the specific needs of people at the home, e.g. Most staff have attended alcohol awareness training, 8 staff have been provided with mental health / dementia care training and 6 staff have attended risk assessment training. The manager said she intends to increase the number of staff trained in first aid, although that there is always a trained first aider on duty during the day and night. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 21 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): 31,33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people living at the home are being given opportunities to comment on the quality of the service they receive. The rating for this group of Standards is compromised by shortfalls in storing people’s financial records and the need for the manager to be registered. EVIDENCE: The manager has many years experience of working in social care settings and holds the Registered Manager’s Award and other relevant qualifications for her role. The manager said that she does not currently hold the NVQ 4 in Care and will be applying for this training. The manager stated that she has applied to be registered with the Commission for Social Care Inspection. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 22 The Commission has not received the application pack and the manager has been advised of the need to send in a new application. The manager explained that since the last inspection action has been taken to improve the quality assurance measures in the home, including sending relatives satisfaction surveys to complete. This was verified by a sample examination of the questionnaires. Good work has also taken place to survey the views of people at the home regarding their satisfaction with care they receive at night, the outcome of which was favourable. The manager has also expanded her monitoring audits, which were seen to include laundry, cleaning and a thorough medication audit. The Registered Provider also carries out regular monitoring checks at the home. Records are in place for recording people’s personal expenditure and for retaining receipts. The manager also said that the owner’s accountants carry out periodic audits of the home’s finances including people’s personal monies. At the last key inspection two people’s financial records were not at the home as the owner was holding them and a requirement was made for the records to be held at the home. This requirement has not been met and the records are still not held at the home. The owner explained that both people have been referred for an independent appointee at age concern and were awaiting a service. The owner agreed to ensure that the records are retained at the home in future. An examination of the fire safety records confirmed that fire alarms and emergency lighting is being routinely tested to ensure this equipment is in safe working order. A log is retained of hot water temperatures in the home. Entries in the log indicate that how water is being kept at a safe and comfortable temperature for the people living in the home. There are a number of “door guards” in the home (devices used for keeping doors ajar). The manager stated that these devices have been seen by the fire officer and have been assessed as an acceptable measure. The manager agreed to approach the fire officer to seek written confirmation of this fact. As previously noted, staff training records confirm that staff have been provided with access to health and safety related courses, including fire safety awareness training. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 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. 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 1 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 x x x x x x 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 2 x x 2 Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 24 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 13 (1) (b) Requirement Review the risk assessments/care plans of people with challenging behaviour / mental health needs to ensure contain appropriate strategies for responding to people’s current needs. Involve social workers in agreeing strategies where necessary to support shared decision making and accountability (e.g. where people refuse healthcare support). Refer the person with weight loss (discussed at the inspection) to the nutritionalist for advice. Take action to ensure that all staff responsible for giving out medication understand the correct recording procedure. Increase the range of social activities and outings available to residents. In particular the manager must ensure that those residents without relatives are given the opportunity to go on outings and have fun. Ongoing from 19/12/05. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 25 Timescale for action 07/12/06 2 3 OP8 OP9 13 (1) (b) 13 (2) 07/12/06 14/12/06 4 OP12 16(2)(m) (n) 31/12/06 5 OP18 17 (2) Sched 4, 8&9 6 OP19 23 (1)(c) (d) 7 OP26 23 (d) 8 OP27 18 9 10 OP31 OP31 9 9 11 OP38 23(4)(c) (d) The Registered Provider must ensure that all financial records belonging to 2 service users, for whom they are managing finances, are retained at the home until such a time that Age Concern agree to act as appointee for the people concerned. (Outstanding from the last inspection, 15/05/06 The Registered provider is required to make plans to decorate the downstairs hallway and dining area, stabilise the dining room tables to stop them wobbling and replace bedroom carpet. The Registered provider is required to clean / replace the hall carpet and other bedroom carpets that are stained, as discussed with the manager. The registered provider and manager must ensure that there are sufficient staff on duty to carry out all the necessary tasks and provide time for activities. In particular adequate staff cover must be provided during the afternoons when care staff prepare tea. Ongoing from 19/12/05 The manager must apply to register with the Commission for Social Care Inspection. The manager must apply to complete a relevant care qualification, such as NVQ 4 in Care. Seek written confirmation from the fire officer for the use of the existing fire door guards in the home. 14/12/06 14/12/06 07/12/06 14/12/06 31/12/06 31/01/07 14/12/06 Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 26 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 OP7 Good Practice Recommendations Continue to monitor the use of the new daily records to ensure they are filled in routinely everyday by staff at the home. Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Minster Lodge Residential Care Home DS0000050158.V319659.R01.S.doc Version 5.2 Page 28 - 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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