Inspection on 01/06/06 for Adamscourt Residential Care Home

This inspection was carried out on 1st June 2006.

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

Adamscourt Residential Care Home 14/04/08

Adamscourt Residential Care Home 06/12/05

Adamscourt Residential Care Home 30/06/05

Adamscourt Residential Care Home 27/01/05

Adamscourt Residential Care Home 13/09/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Adamscourt Residential Care Home 7 Talbot Avenue Talbot Woods Bournemouth Dorset BH3 7HP Lead Inspector Debra Jones Unannounced Inspection 1st June 2006 09:40 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 Adamscourt Residential Care Home DS0000043290.V298468.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. Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Adamscourt Residential Care Home Address 7 Talbot Avenue Talbot Woods Bournemouth Dorset BH3 7HP 01202 529855 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) eileencockwell@ntlworld.co.uk Mrs S Burden Mrs Eileen Cockwell Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That only mobile residents be accommodated on the second floor. Date of last inspection 6th December 2005 Brief Description of the Service: Adamscourt is registered as a care home for older people and is currently registered to accommodate up to 25. The home is located in the Talbot Woods area of Bournemouth. Accommodation is provided mainly on 2 floors, there is a passenger lift. There are 3 bedrooms on the 2nd floor, which are accessed via a flight of stairs. 18 of the rooms have en-suite facilities and 4 bedrooms are registered as doubles. The mature garden has some seating for residents. There are two communal lounges and seating in the small conservatory. The dining room is adjacent to the smaller of the two lounges. There is a small area for car parking at the front of the home. The home is situated on a main road into Bournemouth and close to public transport links into the neighbouring town of Poole. Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 6 hours on 1st June 2006 and was the home’s key inspection for the year. The 3 recommendations made at the last inspection were followed up to see how the home was progressing. The Inspector looked around some of the building and a number of records were inspected. The Proprietor, manager, staff and 6 of the residents were spoken to. During the visit residents were very positive about the home and the care that they received there. Comments included:‘You could not wish for a nicer place to live.’ ‘Better than being at home’ ‘I would not want to live anywhere else.’ ‘All the staff are marvellous.’ Prior to the inspection the home gave out comment cards on behalf of the Commission to people living in, and interested in the service so that they could give feedback about their experience of the home. Twenty cards were returned from residents, 10 from residents, 3 from care managers, 4 from health and care professionals and 1 from a GP surgery. Comments included :‘everyone is very happy and helpful’ (a resident) ‘as a new client I have been made to feel welcome’ (a resident) ‘On the whole I am happy with everything at Adamscourt, certainly the day staff are all very kind and friendly and Eileen the manager is always accessible to talk to when she is on duty.’ (a relative) ‘Mrs Burden and her team are very caring and always inform me if my aunt has any problems. Our family are grateful for the kindness and good sense of humour which makes Adamscourt rather special. A super home.’ (a relative) ‘My mother has only just become a resident at Adamscourt. Before placing her there I looked at a number of homes and was impressed by the homely feel of Adamscourt. It is clean with no unpleasant odours unlike many I visited. The rooms are a good size and everything seems to be done to meet mum’s needs as she has severe mobility disabilities.’ (a relative) ‘The resident involved, my aunt, has always been very pleased with her room, the food, helpful and friendly staff and the way in which she is being looked Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 6 after. She has said this quite frequently, without prompting from anyone.’ (a relative) ‘Staff very helpful and caring in all everything excellent.’ (a relative) ‘My aunt has been cared for very well by the home these past 5 years. In April she broke her ankle and tibia – the care and support Adamscourt and all the staff have given my aunt has been exceptional. I commend this home highly as I have been in others seeing relatives / friends, which are nowhere near as good as Adamscourt. Thoughtful considerate and caring. Our family are all happy with the care.’ (a relative) ‘A rest home providing excellent care for their clients. They liaise appropriately with us to ensure the best care possible is provided. Staff are helpful and friendly. It is a pleasure to work with them.’ (a district nurse) ‘always able to speak to the manager or owner. Service users are always treated with respect and dignity and are treated as individuals.’ ( a care manager) All relatives, care managers and the said that they were satisfied with the overall care provided to residents within the home. What the service does well: Adamscourt provides a well managed service for older people in a welldecorated and comfortably furnished home. The home has an easy, relaxed atmosphere. Pre-admissions assessments are completed on all prospective residents, which means the home will know whether or not their needs can be met before someone moves in. All prospective residents and their relatives are given the opportunity to visit the home before any decision is made about moving there. Each resident has a care plan, which outlines their care needs and how this needs to be provided. Having care plans in place ensures that staff have all the information they need to fully meet residents’ care needs. Daily notes are kept about what care is given to the individual residents along with other things that happen at the home. Residents health needs are well met by the home working with community health professionals. Medication is generally well handled at the home promoting the health and well being of residents. Residents confirm that they are well cared for and treated with respect and dignity. Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 7 Residents are free to, and encouraged to spend their days as they choose. Current residents who have expressed a view have said that they are happy with what is on offer at the home. Residents are able to see visitors when they wish and make decisions about how they spend their days within the constraints of a residential care home setting and their own abilities. Meals are wholesome and varied and planned around the likes and dislikes of residents. The complaints procedure reassures residents that their views are important to the home and that any complaints they, or their supporters raise will be properly investigated. The adult protection policy demonstrates the home’s commitment to providing a safe environment for residents that is free from abuse. Sufficient care staff are employed to meet the current needs of residents. Staff have access to the basic training that they need to do their jobs well. The home respects residents’ rights to look after their own finances and is not involved in their financial affairs. The home works hard to provide a safe environment for residents. The home regularly checks and gets their fire equipment checked and staff are trained in how to deal with any fires that might break out. Accident records are kept and regularly analysed to see if there are any steps that can be taken to reduce the risk of accidents happening again. What has improved since the last inspection? What they could do better: Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 8 Prospective residents would benefit from having the outcome of their pre admission assessment in writing e.g. being given written assurance that the home can meet their needs. The home should tighten up their medication administration system through self auditing e.g. looking at what medicines they have in the home and what is recorded as being there. To help this staff should write on bottles / boxes of tablets when they are brought into use, and or mark the medication administration charts with this information. Where staff are having to make entries on or changes to the medicines that are to be administered to residents they should always get a second person to check what they are doing and sign to confirm this check. It would be good if the home could get their pharmacist to always note on medication administration records whether someone has a known allergy or not. It would be good if the home arranged for the premises to be assessed by a suitably qualified person such as an occupational therapist to ensure that the home is providing all the appropriate environmental adaptations to meet residents’ needs. Staff and residents would potentially benefit from more care staff having qualifications in care. When new staff start are recruited to the home they should not start working there until the home has had confirmation that they are not on the protection of vulnerable adults (POVA) list which would prevent them from working with older people in a care setting. It would be good if the home updated their recruitment policy to state how they go about recruiting staff including the POVA check / Criminal Record Bureau check; recruiting and employing staff from abroad; employing students. 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. Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 9 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 Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. (Standard 6 does not apply to this home.) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home carries out pre-admission assessments to ensure that no one is offered a place at the home whose needs can’t be met. Prospective residents and their supporters are able to visit the home before making a decision about whether it is right for them or not. EVIDENCE: The care files for 2 residents’ demonstrated pre-admission assessments were completed before they moved into the home. Both residents had been visited by the home to carry out the assessment. The manager said that when they visited prospective residents they took a brochure about the home with them. Prospective residents are able to come to the home for afternoon tea visits before they make a decision about moving there. Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 11 The home does not inform prospective residents in writing what the outcome of their pre admission assessment has been e.g. that their needs can or cannot be met at the home. All 20 residents who returned comment cards said that they had enough information before they moved in to the home so they could decide if it was the right place for them. Nineteen said that they had received a contract with the other saying ‘it is in the pipeline.’ Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual plans of care show what the person’s health, personal and social care needs are and how they will be met whilst living in the home. The health needs of the residents are well met with evidence of good support from community health professionals. The medication at this home is generally well managed promoting the good health and well being of residents. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: Three care files were reviewed at the inspection visit. Residents have individual plans of care which detail their care needs. These are backed up by more detailed information in rooms as to the daily care tasks that staff need to perform. Plans are reviewed regularly. Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 13 There were up to date risk assessments on all files reviewed. Daily notes support and evidence the delivery of care to residents. When asked ‘do you get the care and support you need?’ 18 of the 20 residents who returned comment cards replied ‘always’ and the other two ‘usually’. Of the ten relatives who responded to comment cards eight said that they were informed of important matters in respect of their relatives and consulted about their care. One commented ‘I am aged 86 and I do not visit my sister. This residence writes to me from time to time to give information about her.’ The three care managers who returned comment cards said that there was a plan for every person placed in the home and that the plan was being followed and reviewed regularly. Residents have their health needs met by community professionals e.g. GPs, district nurses, chiropodists, opticians and dentists. Residents confirmed that they only had to ask if they needed a doctor and the home would call for one. One resident talked of the treatment she was receiving currently and another about a hospital appointment she had later in the week. A range of equipment is evident in the home including bathing equipment, raised toilet seats, zimmer frames and wheelchairs. Seventeen residents who returned comment cards said that they ‘always’ received the medical support they needed and 3 said they ‘usually’ did. The three care managers that returned cards said that they felt that the home was understanding of the needs of their clients. The GP surgery that returned a comment card to the Commission said that the home communicated clearly, worked in partnership with them and that staff demonstrated a clear understanding of the care needs of residents. They also said that the home took appropriate decisions when they could no longer manage the care needs of residents. Only staff who have been trained in handling medication safely dispense medicines to residents. At the time of the inspection no residents were managing their own medication. Medicines are appropriately stored / locked away. Most medicines are dispensed from a monitored dosage system filled by a local pharmacy. Samples of medication administered from boxes and bottles were checked. Not all medicines are to be dispensed daily and the number of tablets that should be in the home was not immediately obvious. Evidence of the home undertaking their own medication audits was not available. Where there were handwritten changes to / entries on the medication administration records these were not signed by two people to show that they had been checked with the direction of the GP. A system for returning medicines not used by residents is in place. Whilst some details of a residents’ medicine sensitivity was printed on the medication administration records (MAR) by the pharmacist where ‘none were known’ this was not being routinely noted. Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 14 Residents spoken to confirmed that they had confidence in the medication administration at the home and that they got their medicines when they were supposed to. ‘There’s no mucking about!.’ The GP surgery that returned a comment card to the Commission prior to the inspection said that in their opinion the residents’ medication was appropriately managed in the home. Several residents spoken to say that they felt their privacy was respected and staff knocked on their bedroom doors before entering. Residents said that staff were very good and treated them well. Most residents have their own rooms. Where residents share rooms their privacy is not compromised as screens are provided. Staff are introduced to the principles of privacy and dignity as part of their induction. A commitment to respecting these important aspects of care is stated in the home’s statement of purpose/ service user guide. The GP confirmed that they were able to see their patients in private. Nine relatives and the three care managers who returned comment cards also said that they were able to visit people in private Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ lives are enriched by the social opportunities afforded by their visitors, activities at the home and the choices they are able to exercise day to day. The meals in this home are wholesome and varied and are served in a pleasant environment. EVIDENCE: Adamscourt is run in a manner that supports residents to live their lives as they choose. There are organised activities every day and entertainers visit. Amongst other things residents can play skittles and basketball, bingo and do quizzes. Music and movement sessions are about to be increased from monthly to two weekly at the request of residents. Clergy visit to meet the spiritual needs of some people living there. The hairdresser visits weekly. On the day of the inspection visit the library service visited and this is clearly a popular and valuable service that residents enjoy. Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 16 Photographs displayed in the hallway show residents having fun on Christmas day and going out for a meal. Last year residents went to see the local red arrows display and at this visit talked of how they were looking forward to going again this year. The Inspector asked some residents in the lounge about how they like to spend their days. They talked of the activities they joined in with but said they did not have to join in if they did not want. Another resident talked of how she enjoyed doing her knitting and reading romances. Those able to talk about their experience said they were unable to think of any other things the home could organise for them to do and were happy with what went on there. Of the twenty residents who returned comment cards 13 said that they it was ‘always’ the case that there are activities arranged by the home that they can take part in; six said that this was true ‘usually’, and one said ‘never’. The visitors’ book confirmed the number and range of visitors to the home. Residents talked of their families and how they enjoyed their visits. One resident talked of how it had been her birthday the day before. The home had celebrated her day and her family had visited bearing gifts. All ten relatives who returned comment cards to the Commission said that they felt welcome in the home. Most residents at this home are well able to make their choices and opinions known to staff. They are very much in control of how they live their lives at the home and most have the support of families or supporters / solicitors to help them with their affairs. Residents spoken to said that they are able to maintain the routines that they prefer such as when they go to bed and when they get up. They can spend the day where they like, in the lounges, dining area, conservatory their rooms or the seating areas on each floor. Touring the premises evidenced the fact that residents are able to bring their own possessions, including furniture, into the home. In respect of ‘choice’ the Proprietor said ‘it’s their lives, their home.’ The lunch on the day of the visit was salad with a choice of meats, served with mashed potato. Pear, apple and blackberry tart with custard was for afters. Home made cakes accompanied afternoon tea. Food records show that there is a variety of food on offer and residents are able to make choices and have their preferences accommodated. Residents have the opportunity to influence the menus through the regular resident meetings. They have recently expressed a desire to eat baked potatoes and toad in the hole. Residents said that they thought the food was good. Residents can choose where they have their meals. There is a separate dining room. Prior to the inspection 20 comment cards were received by the Commission from residents. Eighteen of the twenty said that they ‘always’ liked the food and the others that they liked the food ‘sometimes.’ Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 17 All staff involved in the preparation of food have up to date food hygiene certification. The manager said that staff would be going on training about nutrition this year to broaden their knowledge. Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The procedure in place reassures potential complainants that they will be listened to, taken seriously and their complaints acted upon. The home has policies, procedures and staff have training in abuse awareness in order to protect residents. EVIDENCE: There have been no complaints to the home or the Commission since the last inspection. The home has a straightforward complaints procedure in place. Residents confirmed at the inspection visit that they would know who to speak to if they were unhappy with anything in the home and would have confidence in them sorting things out for them. The comment cards sent to residents asked the question ‘Do you know who to speak to when you are not happy?’ Twenty residents sent back cards. Nineteen residents answered ‘always’ to this question and one said ‘usually’. In respect of knowing how to make a complaint fourteen said ‘always’ and six said ‘usually’. Seven of the ten relatives who returned comment cards said that they were aware of complaints procedure. All said that they had never had to make a complaint. Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 19 The manager, who is a qualified trainer, provides adult protection training to staff at the home. There have been no allegations of abuse. The home has a policy and procedure in respect of adult protection based on the Department of Health guidance ‘No Secrets.’ There is currently no reference to the Protection of Vulnerable Adults list in this policy or of how staff are checked prior to employment and may be referred to the list should their employment be terminated due to abusive practice. It is suggested that this is addressed when the policy is next reviewed. Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Ongoing attention to the daily maintenance of the home ensures the comfortable and safe environment for the residents living there and anyone visiting. The home is kept clean and hygienic and smells fresh, providing a pleasant environment for residents to live in. EVIDENCE: The home is homely, comfortable and well maintained. Communal space is available on all floors with the main lounges being on the ground floor. There is a separate dining area and a conservatory. Residents have access to all parts of the communal areas of the home. Grab rails and other aids including hoists, assisted bath seats and raised toilet seats are there to assist residents. The home has also installed a new emergency call system throughout the home since the last inspection. Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 21 Bedrooms are personalised to the resident and it was clear that people are able to bring items into the home. The home has recently had the garden landscaped. On the day of the inspection visit the grounds were tidy and clearly well cared for. Attractive seating areas are available in the gardens to the front and rear of the home for residents and their visitors to enjoy. The building complies with the requirements of the fire service and environmental health. The home has not yet had an assessment by a qualified person such as an occupational therapist; however the manager and proprietor confirmed that all residents who have been identified as needing assistance have had individual assessments. The home was clean and fragrant on the day of the inspection visit. All twenty residents that returned comment cards said that the home is ‘always’ fresh and clean. The laundry area is sited away from food storage and preparation areas. Residents spoken to on the day of the inspection visit said that the home looked after their clothes well and did the laundry well. Those spoken to said that they did not have any problems with clothes going missing and have confidence in the home’s laundry system ‘mine are all labelled.’ Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 22 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 at least once during a 12 month period. 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. Sufficient care staff are employed and deployed to meet the care needs of residents. Whilst staff have the essential training they need to do their jobs both staff and residents would benefit from more staff having NVQ level 2 in care. A recruitment system is in place but not all appropriate checks are being carried prior to employment, potentially leaving residents at risk from unsuitable staff working at the home. EVIDENCE: The staffing roster includes the full names and work titles of all staff. The roster shows who is on duty and when, along with who is in charge at any time. The level of staff cover at the home remains that same as at previous inspections. There are 3 carers on duty between 8am and 2pm, 2 between 2pm and 8pm and one between 3.30pm and 7pm. Two care staff are on duty at night. The manager, the cook and the housekeeper work along side the care staff. The manager confirmed that she was available should she be needed when she was not on duty but had confidence that the staff complement was adequate to meet the current level of need of the residents. Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 23 Residents on the day of the inspection visit said that there were enough staff and their ‘attendance’ ( to residents) was good. Of the ten relatives who returned comment cards to the Commission 7 said that in their opinion sufficient numbers of staff are on duty. Residents were asked are the staff available when you need them? Nineteen out of the 20 who responded said ‘always’ and the other ‘usually’. The three care managers who returned cards said that there was always a senior member of staff on duty to speak to. The manager said that out of the thirteen care staff fully employed at the home three members of staff have completed their NVQ 2 in care. Two other members of staff are working towards this qualification. Two staff are from overseas and obtained professional qualifications in care in their country of origin. The manager is still trying to establish whether or not their qualifications are equivalent to NVQ level 2 in care in this country. Two other members of staff are very new to the home and are about to start their formal induction. They will be following the latest induction programme developed by Skills for Care. Staff records were examined for the two members of staff who have started working at the home since the last inspection. These contained appropriate information such as an application form with work history, two references and proof of identification. The manager said that the home has applied for POVA 1st checks for these staff while they are waiting for the full CRB disclosure to arrive. However the result of the POVA 1st check had not been received and these staff are working at the home. The recruitment does not cover the need to have POVA 1st checks before staff can begin working at the home or detail the process that the home has to go through to employ staff from abroad and the documentation that must be kept on file to prevent illegal working. The policy also does not cover the employment of students e.g. only being able to allow them to work for 20 hours a week in their term times. The manager said that she is currently constructing the training programme for the year. This will include mandatory training such as fire, moving and handling, food hygiene and medicines. More specialist training such as dementia and mental health awareness will be on offer. Staff involved in the preparation of food are being encouraged to attend nutrition courses. Staff files contain evidence of the training that staff have undertaken. Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 24 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager of the home understands the needs of the people living in the home and works hard to ensure that the home is well run. There are systems in place to ensure that the views of residents and other stakeholders are sought and acted upon to improve the quality of the home for the people who live there. The home is not involved in residents’ finances. Polices and practices promote the health, welfare and safety of the residents and staff at Adamscourt. Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 25 EVIDENCE: The manager is currently undertaking the Registered Managers Award. The manager has clear lines of accountability with the registered provider. Staff are supervised both formally and informally and have staff meetings to contribute to the running of the home. The manager has completed a report of the last resident and relatives survey showing a high level of satisfaction with the home. Residents have regular meetings where they are encouraged to give their views and suggest any changes they wish to see made. The manager also seeks out the views of those unable to attend the meetings. Residents spoken to at the home said that they feel they are listened to and gave some examples of changes that had been made following suggestions made at residents’ meetings. The registered manager does not get involved in the finances or act as appointee for any residents. Some residents have small sums of money held by the home for day to day expenditure. Where this is the case a record of balances and expenditure is kept, along with receipts. Records sampled accorded with monies held. The home documents all accidents. Accident records are analysed regularly and trends looked for to help prevent future accidents. It is suggested that a prompt is added to the accident form to remind those completing the form to note where the accident took place e.g. the bedroom / lounge. As stated above there is a rolling programme of staff training in respect of matters relating to health and safety e.g. moving and handling, first aid, food hygiene and infection control. The manager aims for staff to have fire refresher training monthly. Not all staff had had this training at this regularity. (This is above the standard desired by the Commission of day staff having training every 6 months and night staff every three months.) Fire fighting equipment is checked regularly by the home and by an external contractor. Appropriate records are kept. A file was see in which the manager keeps certificates of the maintenance of other equipment / facilities in the home e.g. hoists and the lift. Adamscourt Residential Care Home DS0000043290.V298468.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 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x 2 x x x 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Adamscourt Residential Care Home DS0000043290.V298468.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 OP3 Regulation 14 Requirement The registered person must confirm in writing to the service user that having regard to the pre admission assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of his health and welfare. CRB disclosures and POVA or POVA 1st checks must be obtained prior to any staff working at the home. (The recruitment procedure should be updated in this respect,) Timescale for action 01/07/06 2. OP29 19 01/07/06 Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 28 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 OP9 Good Practice Recommendations • To ensure a clear audit trail of medicines bottles / boxes should be marked with the date they are brought into use and / or medication administration records should have carry forward balances or be marked with the dates when medicines not in the monitored dosage system are brought into use. Where there are handwritten changes / entries to the medication records these should be countersigned by another competent person to show that the changes accord with the GP’s direction. A self-audit system for medicines should be introduced to regularly check medicines in the home against records kept and to ensure that any errors in balances are promptly investigated. All medication administration records should record if there are any allergies known or if there are not. • • • 2. 3. 4. OP22 OP28 OP29 The premises should be assessed by a qualified person such as an occupational therapist. 50 of staff should be trained to NVQ level 2. The recruitment policy should be updated with the procedures in place to recruit staff from abroad and in respect of students working at the home. Adamscourt Residential Care Home DS0000043290.V298468.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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. 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