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Inspection on 17/06/08 for Aberdeen House Residential Home

Also see our care home review for Aberdeen House Residential Home for more information

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There was again evidence of promoting the welfare of residents in terms of good relationships between staff and residents with staff listening and consulting with residents. Residents said that the care provided by staff was very friendly and respectful. Staff get to know residents life history through a ``Getting to know you`` life history form, developed by management. The District Nurse was very positive about the professionalism of the staff in attending to residents health needs. Residents are consulted about life at the home with informal conversations to meet their choices. Facilities used by residents are comfortable and homely. Staff are encouraged to have training to equip them to meet residents needs and have supervision to support them in their jobs. Residents and staff thought that the Registered Manager was doing a very good job in that she was friendly and efficient. Management use a Quality Assurance system to check that services to residents are of high quality.

What has improved since the last inspection?

The Registered Manager has ensured that an enhanced Criminal Records Bureau disclosure or a Protection of Vulnerable Adults first check is obtained prior to staff commencing employment, there is a policy in place for staff to always knock on doors before entering to respect residents rights to privacy. The Registered Provider has reviewed staffing levels again so that a staff member starts earlier to provide more early morning support. Preferences for times residents wish to go to bed are now recorded so that staff respect residents lifestyle choices. The Registered Manager has introduced Residents and Staff Meetings to gain views as to the running of the service and suggestions for improvement, and quality assurance results as to the services the home provides are published to give this information to all stakeholders. The Registered Provider has fitted radiator covers to most radiators to provide further protection to residents from burns injuries.

CARE HOMES FOR OLDER PEOPLE Aberdeen House Residential Home 20 Stockerston Road Uppingham Rutland LE15 9UD Lead Inspector Keith Charlton Unannounced Inspection 17th June 2008 09:30 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 Aberdeen House Residential Home DS0000006456.V366498.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. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aberdeen House Residential Home Address 20 Stockerston Road Uppingham Rutland LE15 9UD 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) 01572 823308 F/P 01572 823308 Mrs Linda-Jane Thornalley Mrs Joanne Chapman Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18), Physical disability over 65 years of age (1) of places Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditions of registration. Date of last inspection 17th July 2006 Brief Description of the Service: Aberdeen House is an 18-bedded residential care home for older people. The home, which is a converted farmhouse, is situated in Uppingham, close to the centre of this rural village. Residents rooms are located on two floors with a shaft lift and a stair lift providing access to upstairs facilities. Residents have access to a communal lounge / dining room, a conservatory and a quiet lounge. There is a well-maintained patio garden outside. The weekly fee is from £390 - £490, which was provided by the Registered Manager on the week of the inspection. There are additional costs for hairdressing, toiletries, transport, chiropody and dry cleaning. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for residents and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting three residents and tracking the care they received through looking at their records, discussion, where possible, with them, visitors and care staff and observation of care practices. This was an unannounced Inspection. The Registered Manager was present and helped in carrying out the inspection. Planning for the Inspection included looking at notifications of significant events sent to the Commission for Social Care Inspection and the issues contained in the previous two Inspection Reports. There have not been any complaints made to the Commission for Social Care Inspection about the service since the last full inspection. The Inspection took place between 9.30 and 15.50 and included a selected tour of the building, inspection of records and indirect observation of care practices. The Inspector spoke with six residents, three members of staff, the District Nurse, one relative and the Registered Manager. Surveys have been sent out to interested parties – residents, staff and residents representatives and have been received from three residents, four relatives, one health care professional and five staff. Their comments are reflected in this report. All surveys were positive regarding the standard of care supplied to residents. A resident was helped to complete the surveys by the home’s staff. In order that this process is more independent in future it is recommended that if residents need assistance to do this that an outside advocate is used instead. What the service does well: There was again evidence of promoting the welfare of residents in terms of good relationships between staff and residents with staff listening and consulting with residents. Residents said that the care provided by staff was very friendly and respectful. Staff get to know residents life history through a ‘’Getting to know you’’ life history form, developed by management. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 6 The District Nurse was very positive about the professionalism of the staff in attending to residents health needs. Residents are consulted about life at the home with informal conversations to meet their choices. Facilities used by residents are comfortable and homely. Staff are encouraged to have training to equip them to meet residents needs and have supervision to support them in their jobs. Residents and staff thought that the Registered Manager was doing a very good job in that she was friendly and efficient. Management use a Quality Assurance system to check that services to residents are of high quality. What has improved since the last inspection? What they could do better: Residents welfare could be more effectively met by staff ensuring that: Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 7 All aspects of care – e.g. dates of medical checks, are in Care Plans to assist staff to meet all residents needs. Referral to Medical Services needs to be made to ensure that proper treatment for residents is obtained if they have an accident. Activities could be further extended as per residents preferences to provide more stimulation for them. The home has more signs to assist residents with dementia – e.g. photos of residents on their bedroom doors, and memory boxes with treasured items for individual residents to provide prompts and stimulation to make everyday living clearer for them, particularly for residents with dementia. Two choices are offered for lunch every day, as per the National Minimum Standard, so that more meal choice is seen to be available to residents. Another medication cupboard needs to be obtained to strengthen medication security. There were some comments regarding how busy staff were, especially when there are only two care staff on duty in the afternoon, so an increase in staffing would mean swifter care and increased supervision to be able to care for residents with increased care needs – e.g. with dementia or confusion/ residents who wander/were at risk of falls. The Complaints Procedure needs to be clearer for residents and their representatives so that any complaint is dealt with fully. The staff training programme is generally comprehensive though would aid staff understanding if training on all residents conditions – parkinsons disease, diabetes, strokes etc – were added to the programme. Monies records need to be kept up to date to ensure that residents monies are accountable and properly protected. Fire systems need to be strengthened by ensuring fire doors not on approved systems are kept shut and that staff are aware of the full fire procedure. 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. Aberdeen House Residential Home DS0000006456.V366498.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 Aberdeen House Residential Home DS0000006456.V366498.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): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assessed before admission so that staff are able to meet their needs. EVIDENCE: Residents said that someone from the home came to see them before admission to discuss their needs and they were encouraged to visit. An assessment was inspected and whilst it contained good detail of relevant information as to residents needs it did not include all aspects of medical checks – dates of dental, optical, hearing etc to ensure these are followed up in a timely manner so residents health needs are fully promoted, as per the National Minimum Standard. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 10 The Registered Provider said in the Annual Quality Assurance Assessment that assessments are carried out for all prospective residents as per the policy contained in information about the service, information about the home is also supplied in large print. Assessments were seen on file – this allows staff to be aware of a new resident’s needs. The service does not offer intermediate care. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The individual needs and choices of residents living in the home are generally well met. EVIDENCE: None of the residents spoken with said that they could recall having Care Plans. However a relative said she was aware her mother had a Care Plan and this could be seen if wanted. Residents need to be reminded they can see their Care Plans and discuss them if they wished to ensure that their needs are accurately recorded. There were a number of very positive statements from relatives in the surveys: ‘’I think its perfect for my mother’s needs’’. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 12 ‘’I feel extremely happy with the choice of care home. The staff are brilliant… I am so grateful that at this late stage in her life she is so well cared forWe have never had any concerns’’. ‘’The food is all home cooked….and presented with care and imagination’’. Care Plans seen by the inspector contained a good amount of information information as to the physical, social and medical needs of residents. Risk assessments were found to be a part of the plans so that staff know how to keep residents safe. Monthly reviews of residents needs were noted in Care Plans and were kept up to date. Residents said when they felt ill then staff would swiftly summon medical assistance – residents contacts with medical personnel were documented in their Care Plans. The District Nurse was spoken with and she was very positive that staff contacted her when needed and were professional if she asked that care needed to be carried out, and residents always looked to be well cared for. The survey from the health care professional also testified to the high standard of care being provided to residents: ’provides a homely environment, home cooked food, support, end of life care and reseached based knowledge in the provision of care’. Accident records were viewed which showed that medical services were properly referred to on most occasions when there had been a head injury. The Registered Manager said this would always be done in the future. The inspector observed that staff were friendly and respectful to residents and encouraged in a friendly manner at the residents pace. There were very positive comments about the staff from all parties spoken with. This was also reflected in the satisfaction expressed by residents in returned surveys. The visitor the inspector spoke with said she thought the staff were caring and friendly and did a good job. It was observed that one staff lifted a resident so did not use proper Moving and Handling techniques – the Registered Manager said this would not be repeated. It was also seen by the inspector that a resident was transferred to the toilet using a shower chair without foot supports thereby risking injury. The Registered Manager said that a Risk Assessment would be carried out and this practice stopped if there was a risk in practice. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 13 The Registered Manager confirmed that all staff issue medication undertaken medication training and this was recorded on staff records. Medication was observed to be properly issued to a resident. Medication record sheets were found to be largely without gaps. No residents asked wanted to self medicate and all appreciated the staff holding their tablets and giving them at prescribed times. Medication is kept securely in the medication cupboard and controlled medication kept more securely though a more robust cabinet is required for special medication. The Registered Manager said this would be swiftly orderd through the pharmacist. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents living at the home have opportunities for activities though this needs extending, and meals continue to be seen as very good. EVIDENCE: Residents again said that they were generally satisfied with the range of activities on offer though there were a few comments that there should be more activities. The inspector did not see any activities in the morning of the inspection apart from a resident listening to her talking book tapes and other residents watching the new, large size TV. The Activities Organiser came in the afternoon to provide activities. The Registered Manager said in the Annual Quality Assurance Assessment that more outings and activities were being planned this year and the minutes of the Residents Meetings supported this. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 15 An activity file is kept to show what is done though the Activities Organiser keeping a record of what she did for her two one hour sessions per week. Some residents said they liked being outside and enjoying the garden patio area, which they went when the weather was good. Staff said residents can go out if they wish and are able to and attend clubs though no one was currently able to do so at present, and staff can take residents out for a walk in the village if they want this. One resident said she is taken for a walk by the Age Concern volunteer and she appreciated this. Residents said that the regular communion is held in the home and different groups visit. Residents said that their visitors were made welcome by staff and this was supported by the visitor’s comments. There were a number of comments about the home getting another pet, e.g. a cat, as a number of residents would like this as they had them in their own homes and it gave them pleasure to help care for an animal. The Registered Manager said this would be discussed with residents. Residents said there were no rules, e.g. going to bed and getting up times, whether to stay in their rooms or go to the lounge etc., and staff respected this. The Registered Manager clarified that residents can keep alcohol in their rooms if they chose and there were no risks in them doing so. Staff said that it was important that residents were able to keep their independence so they could still do things for themselves. This was confirmed by comments made by residents. One resident was appreciative of the help the staff gave her to walk again. There was a comment in a survey that a resident would like to have more practice in walking – the Registered Manager needs to follow this up. Residents again said that they enjoyed the food. There was a comment in a resident’s survey that the food is: ‘’…thoughtful and well cooked…nicely presented’’. Although there was not a choice each day for the main meals residents knew they could ask for something else if they did not want the meal on offer. The cook explained that she was aware of residents preferences and residents could have a salad or omelette as an alternative if they wished. In order to meet the National Minimum Standard the home needs to offer a set choice each day, based on residents preferences. Food records showed there were a variety of vegetables offered. The cook said there is a weekly fruit supply though there was a low supply in the kitchen the Registered Manager said that residents kept it in their bedrooms. The food tasted was found to be of a very good standard with a two course meal offered with two fresh vegetables followed by a tasty rice pudding dessert. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 16 Residents are asked their opinion of the food at their meetings, which was recorded in the notes. This gives them the opportunity to comment and the management then can change the menu accordingly if needed. The inspector spoke to the cook and it was obvious that she takes pride in the food served. Staff were observed to assist a resident to eat in a friendly way at the resident’s pace. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents views are listened to and acted upon and they and their representatives can be confident their concerns will be properly attended to. The Complaints Procedure needs to be altered to make it easier to make a complaint. EVIDENCE: Residents and the relative spoken with thought that if there was a problem then they were confident the management would sort it out. The Annual Quality Assurance Assessment stated that an advocacy service is available to residents if they wished to have this support. A Complaints Book is kept. There have been a number of complaints in the past year though there was evidence of investigations of complaints on file that they had been properly followed up by management. The Complaints Procedure is generally satisfactory but does not give the complainant the opportunity to go to the lead Agency, the local Social Service Department, as per the National Minimum Standard. It also states that all complaints need to be made to the home first – the National Minimum Standard states complainants can choose to go to the lead agency first. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 18 The Registered Manager said these issues would be followed up. The staff spoken with was aware of the procedure regarding of which Agencies to contact if the in house arrangement failed. The Registered Manager showed the inspector the Safeguarding procedure that staff have to use which contained the right information to help staff with the reporting of abuse. It was also recommended that a short procedural statement be drawn up and displayed to help staff to follow the procedure and so be able to fully protect residents welfare if the situation happens. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents see facilities as homely and comfortable. EVIDENCE: Residents all said that they liked their bedrooms and they could bring in their own things. These were observed to be personalised and homely by the inspector, with personal items of residents furniture, pictures, photographs etc. The lounge was comfortable and furnished in a homely fashion. The back garden area looked attractive and there were and chairs out so residents could sit there and appreciate the fresh air if they chose. . Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 20 There is currently no signing to the environment to assist with residents with dementia, e.g. photos on doors to make them more recognisable, same colour doors for bathrooms, notice of time, day, weather in the lounge etc. The Annual Quality Assurance Assessment referred to the need for signing so this is in hand as something that needs to be done. There was a menu displayed to show residents what was to be the main meal. Odour control was of a good standard, which residents positively commented on. One resident wanted to have another hook installed near her bed so that she could use the call bell when she was in bed. The Registered Manager said this would be followed up. Locks to some bathrooms were not working. The Registered Manager said these would be checked and fixed as needed, to ensure residents privacy and dignity. Most radiators now have covers fitted to them to ensure that residents cannot be burnt. Where there are no radiator covers these need to be Risk Assessed to ensure there is no risk to residents. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels need to be reviewed to ensure they fully meet residents needs. Recruitment procedures are in place to properly protect residents welfare. Staff training systems are in place to plan to equip staff to meet residents needs though more training on residents health conditions needs to be carried out. EVIDENCE: Generally residents thought there were enough staff though there were some comments that staff were very busy and where there are only two care staff on duty then it took some time to help residents on occasion. The staffing rota demonstrated that staffing has been increased since the last inspection as a staff member now comes on at 7.00am to ensure there are two staff available between 7.00 and 8.00am. There are three staff on duty with the Registered Manager until after lunch. This then drops down to two staff from 2.00 pm to 8.00pm (two staff from 11.00am at weekends), and one waking staff at night with an on call system. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 22 It was discussed with the Registered Manager that a staffing review needs to look at whether the current provision meets residents needs, e.g. more than two care staff on throughout the day, providing domestic cover seven days a week to help with care staff not being called upon to carry out domestic duties so they can concentrate on residents needs. There is a cook seven days a week so residents nutritional needs are covered. Two staff in returned surveys said there were staffing issues: ‘’Could do with more help night time…there’s only one night staff on at any one time’’. Another staff member said there were ‘’usually’’, i.e. not always, enough staff on duty. A night care worker with no previous paid care employment had been appointed to work on her own after a short time. The inspector recommended that a Risk Assessment be carried out to identify what duties the worker would need to cover and an assessment of how she would be able to perform these duties, to ensure that all residents needs and welfare are fully protected. Staff said there had been a lot training provided by the management of the home. Records seen by the inspector showed this. There was also evidence of induction training for new staff - the recognised Skills for Care induction pack was being used according to the Registered Manager and a new staff member. Specific training on residents conditions – e.g. stroke care, diabetes, parkinsons disease etc, is still needed. The Registered Manager said she would do this training in house. The Registered Manager was recommended to set up a Training Matrix to identify what training specific staff members need so this can be seen at a glance to make planning for this training needs easier to spot and organise. Staff said they were encouraged to undertake National Vocational Qualification level training. The Annual Quality Assurance Assessment stated that with staff completing the National Vocational Qualification level 2 then there will be 50 of staff with this qualification, which will then meet the National Minimum Standard. Recruitment records were inspected with Criminal Records Bureau /Protection of Vulnerable Adults checks and written references in place to ensure that residents are fully protected from potentially unsuitable staff and have a proper check of competency etc. The Registered Manager is to follow up that staff have identification as needed which is a further legal check to ensure that residents are protected. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management systems are in place to protect the health and safety of residents. EVIDENCE: The Registered Manager said she was a Registered Nurse with over twenty five years experience of the caring professions. Residents, the visitor and staff spoken to said that the home was well run and they could not think of many improvements that were needed, apart from increased staffing levels and activities. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 24 There was a very positive comment in a staff survey regarding the management of the home: ‘’The Manager and Assistant Manager are excellent, they don’t ask anyone to do anything they would not do themselves, they are very supportive, informative and kind, they make the home the safe and happy place it is for residents and staff’’. There was evidence on records that staff are supervised and supported. Staff also said this was the case both on the day and in the surveys returned from three staff members. It was recommended that there is more detail to supervision records to show what issues have been discussed, as per the National Minimum Standard, e.g. care issues, performance issues, training etc. There are also residents meetings to ensure that there is a forum to air views and preferences, put forward suggestions etc. The Registered Manager may wish to consider inviting residents representatives to the meetings to be able to effectively put forward residents views, subject to residents approval. A Staff Meeting has been held and was well recorded. It stated in the minutes that these will be at regular intervals in the future, which will provide more support for staff and ensure practice issues are regularly discussed. There are also management meetings, which are useful in reviewing the quality of services for residents. A Quality Assurance system was in place with completed surveys carried out for 2007. This is also due to take place in 2008, according to the Registered Manager. It is recommended that they are also given to other interested parties - e.g. GPs, Social Workers, District Nurses etc, and this would be followed up. The results are now included in the Statement of Purpose so that this information is available to residents and their representatives. It was recommended that an Action Plan is also included showing how the home has dealt with any issues that arise from the survey so that residents quality of life is shown to be promoted. The management also use a recognised audit tool – Quality Management System to assess all the home’s services to try to ensure they meet the National Minimum Standards. Residents monies records were found to be properly kept with running balances and two signatures had been recorded to show that transactions are witnessed with receipts available to prove that the home was keeping monies correctly. Fire Precautions: System testing was on the required monthly schedules for emergency lighting and weekly fire bell testing was also carried out. Fire drills are carried out on a regular basis of at least every three months. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 25 There was also a fire risk assessment on file, which helps to ensure that proper fire safety systems are in place to protect residents. A staff member was asked the fire procedure and was not fully aware of the whole procedure although the Registered Manager showed the inspector a very useful quiz on fire issues, which is used to train staff. Two fire doors were wedged open in the home, which does not fully protect residents in the event of fire. The Registered Manager said these issues would be followed up. There is a Health and Safety folder with Risk Assessments for safe working practices so residents can be properly protected from any potential dangers in the home. Regarding Health and Safety training all staff are expected to complete fire training, infection control training, moving and handling training, first aid and food hygiene training. The hot water temperature was measured at 44c, close to the National Minimum Standard of 43c. It was recommended that hot water temperatures are regularly tested and recorded so that it can be seen that residents are protected from scalding risks. Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 3 X 2 Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP8 Regulation 12 Requirement Residents health needs in respect of referral to Medical Services regarding potentially serious injuries and proper Moving and Handling must be met at all times. There needs to be a more robust storage system for certain medications. Timescale for action 17/07/08 2. OP9 13 17/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations There needs to be detail as to all medical checks for residents – e.g. dental and optical to ensure residents are given the opportunity to have these checks at the proper times. An Activities Programme based on residents preferences should be drawn up to cover all the week. DS0000006456.V366498.R01.S.doc Version 5.2 Page 28 2. OP12 Aberdeen House Residential Home 3. OP16 There needs to be a clear Complaints Procedure to ensure the complainant is given a choice as to how to complain and to the proper lead agency. That the Registered Manager and Registered Provider review the staffing levels to ensure that residents needs are covered at all times. Staff training on all relevant issues needs to be supplied. Health and safety systems in the home must fully protect residents from harm with regards to fire. 4. OP27 5. 6. OP30 OP38 Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Aberdeen House Residential Home DS0000006456.V366498.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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