Inspection on 13/12/05 for 85 Heath Road

This inspection was carried out on 13th December 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

85 Heath Road 08/08/08

85 Heath Road 09/08/07

85 Heath Road 09/08/06

85 Heath Road 05/08/05

85 Heath Road 13/01/05

85 Heath Road 14/09/04

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE 85 Heath Road Barming Maidstone Kent ME16 9LD Lead Inspector Lynnette Gajjar Unannounced Inspection 13th December 2005 10:00 X10029.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 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 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 and Care Homes for Adults 18 – 65*. 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. 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 85 Heath Road Address Barming Maidstone Kent ME16 9LD 01622 729946 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) MCCH Society Limited Vacant Care Home 3 Category(ies) of Learning disability (2), Learning disability over registration, with number 65 years of age (1) of places 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care for one older person with learning disabilities is restricted to one person whose date of birth is 3 July 1929 5th August 2005 Date of last inspection Brief Description of the Service: 85 Heath Road is one of a group of small care homes managed by MCCH Society Ltd. The home provides care through encouraging independent living and support for 3 ladies with a Learning Disability, one of whom is over 65 years of age. The home does not provide 24 - hour care or nighttime sleep-in care staff. The home’s care staff work on a roster basis to cover identified key care time to the individual care plans. The home currently has 84 direct care hours over 7 days. The Service Users in this home are required to be semi independent and have daily programmes within the local community and day services in the area. 85 Heath Road is situated in Barming, with good local amenities near by. It is on a main bus route to Maidstone town centre. The house has two bedrooms, communal bathroom/toilet and small office/staff room on the first floor. The third bedroom with en-suite facility is situated on the ground floor, alongside the lounge, kitchen/dining area. The home has car parking to the side of the property (but further car parking available on the main road) with a ramped pathway entrance to the front door. There is a small garden to the rear of the property 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second in the year running from April 1st 2005 to March 31st 2006. The visit lasted from 10:00am until 12:45pm. The home currently has 3 residents who have lived together a number of years. The visit was spent talking directly with one service user, as the others were out bowling, the homes new manager and one staff member. The service user was welcoming and openly discussed how things had changed for them since the last visit. Due to planned activities with the service users outside the home this visit was finished after 2 ¾ hours. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of the service users in the report. Some judgements about quality of life and choices were taken from direct conversation with service users and observations followed by discussion with staff and evidencing records held at the home. A partial tour of the premises was undertaken, with time spent assessing various records held in the home. Further discussion took place with the service manager to clarify action taken by the organisation in relation to written records made by staff. The focus of this inspection was to assess the action taken following the last inspection and consequent adult protection alert that was raised. The commission acknowledges that the organisation has been working closely with the placing authority to review care needs and full staffing structures have been replaced. However service users expressed feeling a little more confident in their views being listened too but also felt it was too early to be fully confident in this process and changes that have occured. What the service does well: 85 Heath Road provides a welcoming, homely and bright environment. The homes ethos promotes individual independent living support, by care staff supporting them in daily living skills, personal care, activities, and accessing the local community. Service users are happy to have and enjoy the company/antics of their pet cat. Health professionals work closely with the staff team to monitor service users health care needs and staff support them to attend appointments. Continued good relationships and contact is maintained with service users and their family. 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: On going work to develop current and accurate risk assessments, guidelines of care and records will enhance the consistent support and care individuals require. Further development of records held in the home can be improved. Service users and staff would benefit from regular internal audits / monitoring by the manager of records held in the home. Through monthly regulation 26 visits, better monitoring and quality assurance of the service will be achieved. Following the changes in the management of the home, undertaking a formal quality assurance of the services provided to families, professionals and service users in the home will enable the new manager to assess the impact this may have had and appropriate action to take for future planning of the service. Service users and staff would feel more supported and secure by having a permanent manager in post. 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 7 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. 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,6 Service users are feeling better about the care and support given by staff and felt more confident that their views will be listened too. EVIDENCE: Service users have lived at the home for a number of years. There are no plans for anyone to imminently ‘move on’. The organisation has a clear, detailed admission process including consultation and trial visits. Service users at the last inspection discussed concerns over lack of staff support and allocated time. From discussion today they felt happier and expressed how they felt they were listened to by the staff. Staffing hours have been reviewed as part of an assessment in collaboration with the placing authority. The service user discussed going out more and a planned shopping 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 10 trip today, but also evidenced where they had decided not to do an activity for a justified reason or personal choice. Through discussion with staff today, it was also identified that service users were requiring more support and guidance to undertake specific self-help and household tasks, often requiring staff to complete this for them. The statement of purpose remains an ongoing project for the new manager and is currently under review. The home does not offer intermediate care. 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10, A service user felt they are treated with genuine respect and dignity by care staff. Service users are beginning to feel confident in the staff care and support given through listening to their views and developing clearer care plans. EVIDENCE: Care staff support service users through the 84 care hours allocated in personal care, household chores, cooking meals, shopping and accessing local community and health care appointments. Daily planners detail regular 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 12 activities and support needs. Appointments with health professionals are well supported by staff with records kept of outcome. Service users are maturing (one is elderly with limited mobility). They are not as able to undertake daily task /cleaning activities often requiring staff to partake and completed the task. Through discussion with service users their understanding of the care hours allocation is limited. Their expectations and assessed preference is for staff with them until early evening. A service user today expressed how they were enjoying the company and conversations with current staff. The openness, familiarity and fondness towards each other were evident from direct observations made by the inspector. Records seen, are improving through reassessment and reviews of strengths and needs to develop more comprehensive risk assessments and guidelines of care to be given. It is acknowledge this is an evolving process and has still much to be achieved. Tracking of records over the past two months have shown improvement since the new manager has been in post with few gaps identified. Where gaps were identified this was to be addressed directly with staff concerned. Due to the adult protection alert full reviews and assessment have taken place with the placing authority. Records are stored securely and service users do not allow these to be share with others without their personal agreement. Content of some records evidenced did raise concern to the inspector as to appropriateness. This was subsequently discussed with the service manager, as to the action taken by the organisation to address staff training and supervision in record management. Medication has been reviewed with the GP and times altered for time of administration to allow staff support and supervision. MAR Records evidenced have improved with no gaps identified in the last three week. Gaps prior to this have been raised with the service coordinator. The current manager and staff expressed a clear understanding of the procedures and records to be maintained in the event of a missed medication or error. All medication is supplied in weekly Nomad system and stored securely. 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Service users feel their lifestyle has improved over the past few weeks. Staff are now beginning to understand and meet their individual expectations or needs. EVIDENCE: Service users are being encouraged to follow hobbies and interests of their own choosing and the staff developing an understanding of individual personal preferences. 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 14 Daily diaries reflect that a steady, though flexible routine occurs on a day - to -day basis and the service spoken with today did say they felt safer but didn’t feel totally safe. Outings happen daily both planned structured sessions at local day centres, adult education as wells as more leisure opportunities such as the local pub as a particular favourite and having ‘lunch out’. Watching personal videos, TV, colouring, looking through magazines and other in house activities continue to be offered and are clearly enjoyed. Two service users were attending bowling that morning and the other waiting for the inspection to end as going on their Christmas shop that afternoon. It was clear the service user preferred to go out when weather was not so cold and during the day, clearly expressing not liking going out at night but to stay at home and relax. Service users continue to have very regular contact with their direct and extended family through phone calls and letters, as well as friends visiting occasionally. Following the last inspection and adult protection alert staffing hours have been reviewed and staff work in the home between 8-6pm, enabling staff to support to prepare a variety of hot/cold meals three times a day. Concerns over food consumption have been closely assessed and stock of fresh foods of the service users choices has been encouraged. Personal stock of snacks is held in their rooms. The service user spoken with appeared happier having staff support for meals and indicated continued reliance on fellow peers in preparing of beverages during the evening through choice not because they were unable to make this them self. 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Service users are becoming more confident that their views will be listened to and action taken to address concerns they raise. Service users are vulnerable and continue to be at risk through their lack of understanding of confidence in personal safety and security of the home. EVIDENCE: Following the last inspection on 5th August 2005 an adult protection alert was raised following information shared with the inspector by the service users and direct observations made regarding the care and support being received. This adult protection continues to remain open as action is being taken by the organisation. Through discussion with a service user they expressed how they were beginning to feel more confident in the staff and that their views were being listened too. “It’s much better now”. Some records seen today raised concern to the relationship between staff and service users and being made to feel uncomfortable about some of the issues raised regarding their care and support. When asked if they feel safe in the home, they replied, “Yes, she’s good she is, listens and talks to me and so does (name of staff)”. There are clear 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 16 preferences for female staff on duty, with a definite relaxed and friendly atmosphere for both service users and staff today. This visit continued to reiterate the concern over service users safety and security when staff are not at the home. The understanding and lack of confidence to call staff through the piper lifeline or on call system. This was reinforced with the lights failing one evening and not being reported or picked up until staff arrived the next morning. Service users had not called for support or assistance but just took themselves off to bed. Giving further concern and reinforces their vulnerability when staff are not present to guide and support them. 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Service users live in a comfortable, nicely decorated home. Personal choice, lifestyle and safe access to the garden is restricted for elderly service users with limited mobility. EVIDENCE: The home is semi detached three-bedroom property. There is a ground floor bedroom has been adapted with an en-suite bathroom. All rooms are single 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 18 and are personalised by individuals. Two service users on the first floor have to share the bathroom, WC and washbasin. There is a ramped pathway leading the front door and secure gates and fencing installed to the side of the property. There is a slopped drive with parking for two cars. Access to the garden requires re-assessment to ensure safe use for service users. Service users have restricted mobility, additional lighting, highlighting, grab rails and pathways and seating would enable them freedom to access the garden, which at present has to be escorted. As the home is not staffed 24 hour this access is restricted to staff allocated time at the home. Cleanliness within the home has improved with staff encouraging service users to take part as best they can but acknowledging and being proactive, to often complete the task to a satisfactory standard. The laundry is sited in the kitchen and requires dirty laundry to be carried through the kitchen as access. Risk assessments are in place and washing is not put on while food is being prepared, cooked or eaten. 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29, A motivated and interested staff team are currently supporting service users. Service users feel much happier having female staff supporting them. EVIDENCE: The home is not staffed 24 hour a day. 84 direct care hours have been assessed and contracted by the local authority with 24-hour on-call support. The home has following the last inspection and adult protection investigation undergone a number of changes, as to how the home is staffed and the allocated rosters. This is only been in place 6 weeks and too early to assess the full impact it has had. However the service user at home was very clear that they were happier and enjoyed the company of the current staff team. There was a very different feel to the home and a less tense atmosphere. It is acknowledged that it will take time for the new staff to develop their personal relationships and full understanding of the service users personal and collective care needs. 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 20 The home has been appointed a new manager (37 hours) but who will be covering two small homes; with two care staff totalling 67 hours and a new staff member due to start once all recruitment checks have been completed. Hours are yet to be confirmed. All are females at the service users request. Rosters are planned to ensure the home is staffed within the 84 hours to offer key support between 8 and 6pm. This enables full support with personal care, preparing and cooking of meals as well as activities and medication monitoring. Staff felt their current assessments indicate that the ladies really don’t want staff around after 6pm and clearly are looking and prompting them to leave. However staff did express concern that the ladies are still reluctant to call for assistance during the evening and this is an area that requires more support to develop. Staff have undertaken core training required by the organisation and promoted to undertake NVQ 2 or above. 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,38 Service users and staff are benefitting from the stability and security of a permanent manager. A service user expressed feeling a little more confident with the new manager and that their views and care needs will be listened too. EVIDENCE: 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 22 Following 8 months of changing managers (3 in all). A new permanent manager has been transferred and been at the home since 29th October 2005. Due to the changes staff, senior carer and manager are currently building on relationships and maintaining good open dialogue with each other to maintain and develop the services provided. Application to register, as manager must be submitted to the commission immediately for processing. Regular team meetings and service user meetings are held to plan and discuss the running of the home. Christmas arrangements are high on the agenda at present. The commission has only received two regulation 26 visit report for May 2005 and following discussion after the last inspection new systems have been implemented and the first report was received from November 2005. The new manager is reviewing Environmental and fire risk assessments. Safety fire closures have been fitted the ground floor bedroom. Weekly walking routes records are undertaken it monitors and report maintenance and health and safety issues for action. Regular servicing of equipment in the home is undertaken as required. Incidents, which affect the well being of service users, have in the past not always been recorded, with what action was taken. The new manager has reviewed this and all staff today was aware of the procedures to follow and records to maintain. A formal auditing and tracking tool will assist the manager with monitoring incidences and accidents within the home and whether risk assessments and guidelines should be reviewed. A full review of personal finances for service users have taken place with agreement of the service user this being stored securely within the home with records of expenditure kept. Following the changes in the management of the home, undertaking a formal quality assurance of the services provided to families, professionals and service users in the home will enable the new manager to assess the impact this may have had and appropriate action to take for future planning of the service. 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 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 2 2 3 2 4 X 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 ENVIRONMENT Standard No Score 19 2 20 X 21 X 22 X 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 2 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No Score 31 2 32 2 33 2 34 X 35 X 36 X 37 X 38 2 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 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 OP4YA3 Regulation Requirement Timescale for action 31/03/06 12(1)(a)(b) The registered person shall ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users and to make proper provision for the care and supervision of service users. In that appropriate levels of competent staff are on duty to meet the contacted care needs of service users and proper formal provision to monitor and audit the quality of care by the registered person are implemented. A full review of care hours and needs assessments have taken place with the placing authority. New staff have been transferred to the home in the past few weeks. Whilst some improvements are acknowledged from this visit, it is too early in the changes to assess as met satisfactorily. 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 25 2 OP31YA33 18(1)(a) The registered person shall having regard to the size of the care home, the statement of purpose and number and needs of the service users ensure that at all times suitably qualified, competent and experienced staff are working at the home in such numbers as are appropriate for the health and welfare of service users. A full review of care hours and needs assessments have taken place with the placing authority. New staff have been transferred to the home in the past few weeks. Whilst some improvements are acknowledged from this visit, it is too early in the changes to assess as met satisfactorily. The registered person shall appoint a permanent manager to the home and ensure application for registration under the Care Standards Act 2000 is submitted to the commission for processing The registered person shall ensure that unnecessary risk to the health and safety of service users are identified and so far as possible eliminated. A full review of health and safety management systems have been introduced. New staff have been transferred to the home in the past few weeks. Whilst some improvements are acknowledged from this visit, it is too early in the changes to assess as met satisfactorily. 31/03/06 3 OP31YA37 8,9 31/01/06 4 OP38YA42 13(4)(c) 31/03/06 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 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. 2. 3. Refer to Standard YA1OP1 OP2YA5 OP7YA6 Good Practice Recommendations The current statement of purpose and service user guide is reviewed in line with current changes to staffing and management of the home. The current tenancy agreement is supported by a clear contract and agreement to the support and direct care being provided by MCCH. It is recommended that care plans continue to be reviewed and rewritten to reflect accurate information and guidelines of care and support required for individuals personal needs. It is strongly recommended that staff receive further training and guidance in accurate and appropriate record keeping. Daily records and diaries could improve with more detailed information of the support and care given, reflecting the care, independence and social support involved. It is strongly recommended that serious consideration be given to having a dishwasher to assist service users maintain independence whilst promoting safe hygiene practice in the kitchen. It is recommended that laundry facilities are located so that soiled clothing and linen are not carried through areas where food is stored, prepared, cooked or eaten. It is recommended that staff undertake further training in MCCH record and reporting procedures. It is strongly recommended the manager and staff team continue to explore alternative ways to enable service users to feel confident, involved and that their views are listened too, in respect to their personal care and the day to day routines in the home. It is strongly recommended that the manager introduce their own monitoring and auditing system to review records held at the home. 4 OP7YA6 5 OP26YA30 6 7 8 OP26YA30 YA41 OP32YA38 9 OP33YA39 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 85 Heath Road DS0000023800.V269921.R01.S.doc Version 5.0 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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