CARE HOMES FOR OLDER PEOPLE
Alma Rest Home Alma Residential Home 19-23 Alma Road Sheerness Kent ME12 2NZ Lead Inspector
Graham Cummings Unannounced Inspection 10th February 2006 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 Alma Rest Home DS0000023899.V281586.R01.S.doc Version 5.1 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. Alma Rest Home DS0000023899.V281586.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Alma Rest Home Address Alma Residential Home 19-23 Alma Road Sheerness Kent ME12 2NZ 01795 665051 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) Mr Patrick Nicholas Pinagapany Care Home 20 Category(ies) of Dementia (20) registration, with number of places Alma Rest Home DS0000023899.V281586.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service user whose DOB is 15/5/1920 room 8 will be OP until they leave then will revert to DE. 20th September 2005 Date of last inspection Brief Description of the Service: The Home provides residential care for older people, all but one of whom have dementia. Recent alterations to the Home now mean that all service users have their own rooms, many of which are en-suite. The Home is on several floors and there is a lift access to all levels. The Home has a large lounge area in which there is plenty of space to wonder if that is what the service user want to do. The dining areas are also part of this space. There is also a conservatory and small courtyard garden where service users can relax or entertain family and friends. The Home is situated near the sea front in Sheerness, and is close to shops and many other amenities. Sheerness has a railway station and the Home is near a bus route. Alma Rest Home DS0000023899.V281586.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Graham Cummings carried out the Unannounced Inspection on the 10th of February 2006. The Inspector met with Cath Harrison the Deputy Manager. Entrance to the home had been temporarily changed as the main entrance hall was in the process of being re-plastered and decorated, this was well signposted for visitors. The entrance hall is also to have a new carpet. The Inspector went through the Requirements and Recommendations made at the last review and was informed that both Requirements had been implemented and the 2 Recommendations have been addressed. The Inspector looked at the medication and found that there were omissions in the recording of medication dispensed on the Medication Administration Record. The Inspector discussed the recording and dealings of Residents personal finances. At present the two of the homes Residents are in hospital and meetings are to be held to discuss whether they return to Alma Rest Home or move onto a nursing home. What the service does well: What has improved since the last inspection?
A staff supervision system is now in place and working well with staff supervised on an 8 weekly basis with full staff meetings held every 6 weeks. All staff working in the home have now got their Criminal Records Bureau checks on file. The Complaints procedure was on display by the entrance hall at the last inspection but comments received showed that relatives and people visiting were not aware of it, it has now been copied onto coloured paper and placed by the visitors signing in book to highlight its presence and availability. Adult Protection training has been arranged for the 7th March when 15 staff will attend. The homes entrance hall is in the process of being redecorated and carpeted. Alma Rest Home DS0000023899.V281586.R01.S.doc Version 5.1 Page 6 What they could do better: 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. Alma Rest Home DS0000023899.V281586.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alma Rest Home DS0000023899.V281586.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5,6 Prospective residents have the information they require to make an informed choice about where to live. Residents moving into the home have their needs assessed. Prospective Residents, relatives and friends have an opportunity to visit the home. The home does not cater for Intermediate Care. EVIDENCE: During the Inspection a prospective resident and their family visited for a look around the home, the Inspector was informed that the family had received a copy of the homes Statement of Purpose and Service User Guide prior to the visit. The home carries out a full needs assessment of an individual prior to any placement taking place. The home does not take referrals for Intermediate care. Alma Rest Home DS0000023899.V281586.R01.S.doc Version 5.1 Page 9 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): 8,9, Residents health care needs are met but there is a shortfall in the recording of the Medication Administration. EVIDENCE: The Inspector looked at the recording of medication and was concerned to find that in the last 2 weeks of Medicine Administration Records that there were 7 occasions where no entries had been recorded covering different Residents. The Deputy Manager and the Inspector checked against the staff on duty for the specific dates and found that 5 of them were the same member of staff. The Deputy Manager assured the Inspector that the member of staff would be spoken to and resent on a Medication Administration course, the Deputy Manager also said that they would be checking the administration records daily from now on to ensure that all records were fully completed. All of the Residents were registered with a local G.P and the home has started to take Residents to appointments whenever possible instead of the doctor being asked to visit. None of the present Residents are able to self medicate. Alma Rest Home DS0000023899.V281586.R01.S.doc Version 5.1 Page 10 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): 13,15 Residents maintain contact with family and friends. Residents receive a nutritious and wholesome diet. EVIDENCE: Residents are encouraged to maintain contact with friends and families, the Residents are supported where necessary in writing letters and making telephone calls to relatives and friends. There have been no changes in the delivery of nutritious and wholesome diets to the Residents. Alma Rest Home DS0000023899.V281586.R01.S.doc Version 5.1 Page 11 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): 16,18 Resident and relatives have their complaints listened to. Residents are protected from abuse. EVIDENCE: The Inspector at the last inspection noted that the complaints procedure was on display on the front door notice board and that a Service User Guide was available in each of the Residents rooms giving them access about who to complain to should they need to, however, the Inspector received 5 responses to the relatives and visitors comment cards, 2 of these indicated that they were not aware of the homes complaints procedures. The Manager has now had the Complaints policy and procedures printed on coloured paper and placed it next to the visitors signing in book and pointing it out to visitors when they sign in. The home has had no complaints since the last inspection. Adult Protection training has been booked for the 7th March and 15 staff will be attending. The home has checked through their Adult Protection policies and procedures to ensure they are consistent with the Kent protocols on Adult Protection. Residents finances are kept locked in a safe in separate named wallets, there is an individual ledger sheet for each Resident, when money is withdrawn this is carried out by 2 staff, one being a senior, the transaction is recorded on the ledger sheet and signed by the 2 staff and wherever appropriate the Resident themselves. Alma Rest Home DS0000023899.V281586.R01.S.doc Version 5.1 Page 12 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): 19,26 Residents live in a safe well maintained environment. The home is clean. EVIDENCE: On the day of the Inspection work was being carried out in the main entrance and hallway. The walls were being re-plastered and a second entrance and exit door were being used at the opposite end of the building. When the work is completed a new carpet is to be laid. The home was clean and tidy and there were no offensive odours. Alma Rest Home DS0000023899.V281586.R01.S.doc Version 5.1 Page 13 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): 27,29 Residents needs are met by the number and skill mix of staff. Residents are protected by the homes recruitment policy. EVIDENCE: The home now has a full compliment of staff that have access to training courses and are supervised 8 weekly. The home follows the process of advertising in the local press, sending out application forms, interview and a shadowed introduction visit, get references and CRB, if employed the person attends 4 introductory workshops that cover the induction process and they are shadowed whilst working until the Management and individual are confident to work as a member of the staff team. The Manager makes random telephone checks to referee’s to ensure the information given is legitimate. Alma Rest Home DS0000023899.V281586.R01.S.doc Version 5.1 Page 14 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): 31,33,34,36,38 The home is managed by a person fit to be in charge of the home. The home is run in the best interests of the children. Residents are safeguarded by the homes financial procedures. Staff are appropriately supervised. EVIDENCE: The Inspector was satisfied that the home is run by a Manager that is fit to be in charge and of good character and that the service was run in the best interests of the Residents. The Inspector was satisfied that the Residents finances were protected by the procedures and practice of the home. The home has now implemented a program of supervision that means that all staff now have formal supervision at 8 weekly intervals. The Inspector had no concerns for the protection of Residents health, welfare or safety. Alma Rest Home DS0000023899.V281586.R01.S.doc Version 5.1 Page 15 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 3 X 3 X 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 X 3 X 3 Alma Rest Home DS0000023899.V281586.R01.S.doc Version 5.1 Page 16 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 OP9 Regulation 13(2) Requirement Timescale for action The Registered person shall make arrangements for the 01/04/06 recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Alma Rest Home DS0000023899.V281586.R01.S.doc Version 5.1 Page 17 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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