Inspection on 24/09/07 for Amadeus

This inspection was carried out on 24th September 2007.

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

Amadeus 12/09/06

Amadeus 21/03/06

Amadeus 25/10/05

Amadeus 18/03/05

Amadeus 21/09/04

Amadeus 11/12/03

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Amadeus Hampden Grove Patricroft Eccles Gtr Manchester M30 0QU Lead Inspector Kath Oldham Unannounced Inspection 24th September 2007 08:45 24/09/07 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 Amadeus DS0000041691.V347725.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. Amadeus DS0000041691.V347725.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Amadeus Address Hampden Grove Patricroft Eccles Gtr Manchester M30 0QU 0161 787 8638 0161 707 1014 amadeuscarehome@hotmail.com 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 Bradley Scott Jones Mr Russell Scott Jones Mrs Kathryn Trenor Hewitt Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability (1) of places Amadeus DS0000041691.V347725.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That the home only operates within its registered category and numbers. That care staffing levels do not fall below the minimum staffing levels specified in the Residential Forum Guidance for Staffing in Care Homes for Older People. That dependency levels of service users are assessed on a continuous basis and staffing levels adjusted where appropriate to ensure continued compliance with the Residential Forum Guidance for staffing in Care Homes for Older People. That a maximum of 21 older people be accommodated in 15 single rooms and 3 double bedrooms. One named service user is accommodated who is below 65 years of age. If this person no longer requires the service, the category will revert back to older people (OP). 12th September 2006 4. 5. Date of last inspection Brief Description of the Service: Amadeus is a private residential care home providing accommodation for 21 older people, requiring personal care only. The home is registered in the name of Mr Bradley Jones and Mr Russell Jones. The home is a detached property, set out on one level, located on a quiet grove, close to Eccles shopping centre and market and accessible to bus routes located on Liverpool Road. There are 15 single bedrooms and three double bedrooms. Communal space comprises of a large lounge and dining room in the centre of the building. There is a smaller conservatory style seating area to the front entrance. The fees for staying at the home range from £317.92 to £426.71 per week. This includes accommodation and care. Additional charges are made for toiletries, newspapers and hairdressing. Amadeus DS0000041691.V347725.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced, which means Amadeus was not told we would be visiting, and took place on 24th September 2007, commencing at 8:45am. The inspection of Amadeus included a look at all available information received by the Commission for Social Care Inspection (CSCI) about the service since the last inspection. This included Amadeus filling in a questionnaire about the home, which gave information about service users, the staff and the building. Amadeus was inspected against key standards that cover the support provided, daily routines and lifestyle, choices, complaints, comfort, how staff are employed and trained, and how the service is managed. Comment cards were sent prior to the inspection for distribution to people staying at Amadeus. The views expressed in returned comment cards and those given directly to the inspector are included in this report. We got our information at the visit by observing care practices, talking with people staying at Amadeus and talking with the manager and staff. A tour of Amadeus was also undertaken and a sample of care, employment and health and safety records seen. The main focus of the inspection was to understand how Amadeus was meeting the needs of service users and how well the staff were themselves supported to make sure that they had the skills, training and supervision needed to meet the needs of service users. The care service provided to two service users was looked at in detail to help form an opinion of the quality of the care provided. A brief explanation of the inspection process was provided to the manager at the beginning of the visit and time was spent at the end of the visit to provide verbal feedback to the manager. What the service does well: The manager carries out a pre-admission assessment before people come to live at Amadeus. This is good, as service users are able to ask questions in their own environment before going to Amadeus for a visit. Amadeus DS0000041691.V347725.R01.S.doc Version 5.2 Page 6 Service users are able to bring furniture and other personal possessions to Amadeus to make their rooms homely. The staffing team has, in the main, stayed the same over the last 12 months which ensures service users receive a service from staff who know them well. Service users said they liked the staff. Staff continue to develop their skills and knowledge through attending training and seminars which enhances the service they offer at Amadeus. An activities co-ordinator works during the week and provides service users with an opportunity to take part in occupation or stimulation. Service users were complimentary about the skills of the activities co-ordinator. Amadeus is a friendly, homely place and service users seemed happy and relaxed. The manager and staff know everyone well and treat everyone as individuals, with different preferences and needs. The staff spoken with were particularly pleased with the training offered. Training consisted of induction; pressure area care; loss grief and bereavement; first aid, safeguarding adults and medication. National Vocational Qualifications were ongoing. What has improved since the last inspection? The activities co-ordinator should consider making a photographic file of activities available to service users living at Amadeus and displaying the daily activity in photographic form as well as in print. Since the recommendation in the last inspection, an alternative choice of meal is offered at the main meal of the day. The development of the recruitment procedures are now followed fully before new staff are employed at Amadeus. This provides a safeguard to service users and also staff employed at Amadeus. A social history has been obtained from service users and/or their family and recorded on file. This information provides staff with additional knowledge about service users’ previous lifestyles and gives them an idea of their past experiences. Amadeus has recently been awarded the Investors in People Award. Amadeus DS0000041691.V347725.R01.S.doc Version 5.2 Page 7 Amadeus has developed quality assurance systems to obtain the views of people who use the service and their relatives, friends and any visiting professionals. This has provided an opportunity for Amadeus to look further at the service they provide and continue to develop. What they could do better: The statement of purpose and service user guide need to be reviewed and revised to make sure that the information is up to date and accurate, and truly reflects the service provided at Amadeus. This needs to be given to service users so they have the information they need about Amadeus. When reviewing service users’ care needs, Amadeus needs to ensure the changes to care are indicated in the care plan, so staff have a clear record of the service users’ care needs and don’t have to read through the review. A record needs to be made in the care plan of the assessed needs of service users at night, so it is clear what staff need to do and when they need to do this during the night. The home needs to make sure service users are weighed monthly, or more frequently if the care plans dictate this and that the weights are recorded within service users’ care files. This will help Amadeus keep an eye on service users’ weights and identify easily if they are losing or gaining weight. There are some areas of best practice developments that need to be made to the medication process, which will further safeguard service users. A lockable refrigerator in which to store medication needs to be obtained to ensure medication is maintained safely and securely. Service users should be provided with opportunities to maintain their independence at mealtimes by the provision of individual teapots so they can help themselves to hot drinks when this is possible and safe to do so. The menu needs to indicate all the meals of the day and the choices available. Service users would benefit by being given an opportunity to view the menu of the day as a reminder of the meals available. A record of food served to service users should be maintained so that if anyone needed to look at the record could judge if the diet was sufficient for the individual in terms of nutrition, for example. Amadeus DS0000041691.V347725.R01.S.doc Version 5.2 Page 8 The presentation of the soft diets need to be reviewed and revised, so that the meal looks appetising and is identifiable, which would promote the dignity of service users. The development of the recording of complaints and comments made would assist Amadeus to monitor the quality of the service provided at the home. To enable service users to call for support or staff assistance, the call bell system needs to be extended to include the lounge and dining room. 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. Amadeus DS0000041691.V347725.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 Amadeus DS0000041691.V347725.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 3 (Standard 6 not applicable) Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users are provided with information that helps them to decide if Amadeus is the right place for them. EVIDENCE: The statement of purpose and service user guide need to be reviewed and updated, so service users have up to date information which is accurate. The manager said that when this revision has been undertaken, the amended document will be given to all service users. Once revised, a copy needs to be sent to the Commission to be placed on file. Amadeus DS0000041691.V347725.R01.S.doc Version 5.2 Page 11 The information provided prior to the inspection stated that prospective service users are always assessed before Amadeus would offer a placement. This usually involves visiting them in their current setting, which could be home, hospital or intermediate care settings. During the visit Amadeus indicated they would request information from current service providers also families, if acting as advocate, and the service user themselves. Amadeus feels this allows them to build a picture of the service user and whether or not they, as a care provider, can meet their needs. Prospective service users were described in the information provided to the Commission for Social Care Inspection (CSCI) to be always asked if they would like to spend some time at Amadeus before they make a decision to move in. A service user said that they came to visit the home before making a decision as to whether to stay at Amadeus. Information provided by Amadeus indicated service users’ families or advocates have access to all relevant paperwork they need in order to make an informed choice before accepting a placement. Amadeus states prospective service users are not admitted until they have received the relevant documentation from social services, as well as discharge summary from the current provider. All service users at Amadeus have individual files in which all the required documentation is kept. Two service user comment cards indicated that they had received enough information about Amadeus before making a decision to move in. Amadeus does not provide an intermediate care service. Amadeus DS0000041691.V347725.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. 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 care planning documentation was sufficient to demonstrate personal and health care needs of service users. Personal support is offered in such a way as to promote and protect people’s privacy and dignity. Medication procedures need further development to reflect best practice. EVIDENCE: Examination of two care files identified that care plans were in place and that these had been reviewed at a minimum of monthly. The detail in the review was not always transferred into the care plan, so staff would have to look at the review form and the care plan to see what care needs the service user had. This could lead to service users not getting the care they need. There were entries in the care plans which were described to be no longer needed, which had not been amended. Amadeus DS0000041691.V347725.R01.S.doc Version 5.2 Page 13 The daily and night-time reports indicated the support service users have received. Consideration should be given to include in the daily reports the activity service users have taken part in and the impact that has had on their day. There is a separate record kept by the activities co-ordinator of the activities arranged at the home and the names of service users who have taken part in the activity. It was not clear on the records viewed the purpose of night-time checks. There was no indication in the care plan of what these were for. The daily/ nightly reports seen for service users who had these checks indicated that service users “appeared to be asleep”. Risk assessments were in place which identify when people are at risk of falling and what action is taken to minimise that risk. A record is maintained on individual service users’ files of visits by or to the doctors, nurse support and chiropody and optical tests. This record enables, at a glance, to see what health care needs have been provided. Service users are assessed to identify those who are at risk of developing pressure sores. District Nurses provide support and advice on the treatment and routines to be undertaken by the staff team. Without exception, service users said they felt they were well treated and respected. Staff were observed to be courteous and patient with them and respected their individuality and privacy. A format is in place to record the weight of service users. This was not recorded as routinely undertaken for one service user, so Amadeus cannot be sure if service users are maintaining or losing weight. In the second care file examined, the weights were recorded as being undertaken. The record was not transferred onto the service user’s individual paperwork, so you could not easily see if this service user was losing or gaining weight. This needs to be arranged and service users weighed and the detail recorded routinely. Examination of the medication administration records identified that they had been completed properly with, in the main, no unexplained omissions in the routine of recording medication administration. Staff were observed recording within the medication administration records to detail the non-admission of medication at the end of the round, as opposed to when the service user declined it. Medication records should be signed at the same time as medication is administered or declined to each individual to ensure inaccuracies are not made. Amadeus DS0000041691.V347725.R01.S.doc Version 5.2 Page 14 There were some handwritten entries of prescribed medication in the record that need to be signed by a second member of staff to ensure the entry is copied correctly from the prescription. Current practice could result in people living at Amadeus getting the wrong dosage of medication. The date of opening of some medication, which has a limited shelf life, was not indicated. This needs to be in place to ensure the medication is suitable to be administered. Photographs to assist in the identification of service users were not on all the medication administration records, as is best practice. A controlled drugs book is in place to record when service users are prescribed this type of medication. On the site visit no service users were prescribed controlled drugs. Advice was given to the manager on viewing the past entries within the controlled drugs book to make sure that a record is made of what has happened to these drugs when a service user no longer needs them or they have left the home. Medication that requires refrigeration is kept in the refrigerator in the kitchen. The fridge does not have a lock fitted. All medication should be kept securely. A number of service users have a variable dose of medication. The actual number of tablets administered was not included in the record, which means an accurate record of medication administered to service users is not kept. Service users are consulted about their last wishes and feelings, which are recorded on file. Amadeus ensures, as far as possible, that individual requests are followed through in the event of death. Amadeus DS0000041691.V347725.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. 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. The day-to-day routine was relaxed and informal and met service users’ needs. Mealtimes were well managed and satisfied the expectations of service users’. EVIDENCE: The home has an activities co-ordinator five days each week. The information provided to CSCI before the inspection indicated, “Amadeus have an excellent activity programme this includes healthy hips and hearts, back massage, dominoes, baking afternoons, reminiscence, drawing and colouring, local tea dances, museum trips, music work shops, religious services, as well as lunch at local pubs”. A comment card said that there are sometimes activities arranged by the home that they can take part in. Another said there are usually activities arranged by the home that they can take part in. A record is maintained of the activities available and the activities co-ordinator details the names of service users who have taken part in activity. One service user said they are kept busy and the activity co-ordinator is really nice. Amadeus DS0000041691.V347725.R01.S.doc Version 5.2 Page 16 A recommendation was made on the last inspection to consider making a photographic file of activities available to service users living at Amadeus and displaying the daily activity in photographic form as well as in print. Photographs were shown to the inspector of service users taking part in past activities. The manager said it was the plan to display the photographs and also to have the activity of the day displayed in a prominent area of the home, used by service users. Amadeus has recently appointed a new cook, having had a vacancy for a considerable amount of time. A four-week menu is in place that details the meals to be served each day. There was an alternative to the main meal but this wasn’t indicated on the menu. The four-week menu was on the wall in the corridor. The size of print may make it difficult for service users to read. Teatime meals were not detailed on the menu. A board outside the kitchen indicated the main meal of the day and the alternative to the meal. Consideration should be given to displaying the menu somewhere different to the corridor wall. Service users spoken with on the inspection were not aware of what was for lunch. A menu, perhaps on the table, would provide service users with an opportunity to see what the meal is. Service users were seen to have a choice at lunchtime. Comments regarding the meals were, in the main, positive. Some service users have soft diets due to their health or abilities. appearance of the meal wasn’t particularly appetising. The An individual record needs to be maintained of the food served to service users so that a judgement can be made whether the diet is satisfactory in terms of nutrition. People living at the home were able to receive visitors at any reasonable time. Amadeus DS0000041691.V347725.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. Service users are confident that complaints are dealt with appropriately and are protected from abuse or exploitation through policies and procedures. EVIDENCE: A complaints procedure is in place, which details the action the home will take in response to any complaints or comments. Of the comment cards returned, service users or their relatives said they were aware of or had received information about Amadeus’ complaints procedure. People living at the home indicated that they were aware of who to complain to and had not had reason to complain. The Commission for Social Care Inspection has not received any complaints. The complaints book did not detail any recent complaints or comments, which did not validate the procedures in place. Amadeus DS0000041691.V347725.R01.S.doc Version 5.2 Page 18 A copy of Salford’s All Agency Safeguarding Adults Policy and Procedure was available. The manager has obtained a copy of this so that she can respond quickly and efficiently, as required by the local safeguarding adults policy, to any suspicions or allegations of abuse. Staff have attended safeguarding adults training in the definitions of abuse and how to identify abuse. This training should ensure staff are able to recognise potential abuse. In the past, service user meetings have been arranged monthly, which provides service users with an opportunity to discuss areas of development. These need to be rearranged periodically. Amadeus DS0000041691.V347725.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. The home was clean and tidy, bedrooms were personalised and all furnishings, fittings and equipment were in working order. EVIDENCE: Access to the house by response by staff to the front door. This ensures that no-one enters Amadeus without the knowledge of staff. A visitor’s book is placed in the hall and visitors to the home are encouraged to sign in and out. This is to ensure that in an emergency situation, everyone in the building is accounted for. Amadeus DS0000041691.V347725.R01.S.doc Version 5.2 Page 20 Amadeus is a single story building, therefore service users are able to walk around the building and return to their room if they wish without the use of stairs, which makes it easier for service users who have mobility difficulties or who use a wheelchair. There is limited outside garden space so service users do not have a pleasant garden area in which to sit out in the better weather. In the next 12 months, Amadeus is to build a sensory garden, which will encourage service users to use the garden. Ramped access is available to the outside, which enables those people in wheelchairs or with walking difficulties easy access. Service users have access to a large combined lounge and dining room. The chairs are arranged in the lounge in small clusters, in an effort to make the room look homely and comfortable. The lighting in the lounge is not particularly bright which may make it difficult for service users to read or take part in other activities. There is no call bell system in the lounge to enable service users to summon assistance. This has always been the case since registration. There is a small conservatory, which is the front entrance to the building. Service users were seen at different times of the day sitting in the conservatory. One service user said they sat in the conservatory, although it was sometimes a bit draughty, as they liked watching the comings of goings of visitors and staff. A number of service users’ rooms were seen, some had been personalised by the occupants, with many service users being quite self-contained in their own rooms. One service user said they had everything they needed in their bedroom and had brought things with them from home to make it more their own. All public areas seen were clean and tidy. Maintenance contracts are in place and the manager stated Amadeus meets the requirements of Health and Safety, Fire and Environmental Health regulations. A number of rooms are looking tired and would benefit from redecoration. Amadeus is to be extended in forthcoming months, which will enhance the facilities provided to service users. The manager was positive about the building plans and recognised the work that will be undertaken to enhance the facilities available to service users. Amadeus DS0000041691.V347725.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. Staff are competent and in sufficient numbers to meet the needs of service users. EVIDENCE: Staff personnel files were examined. All contained all the information and documents needed to ensure that the necessary checks had been made before they started work at the home. All new staff attend induction training to Skills for Care specification. This provides staff with a baseline for what is required when working with older people. Staff comment cards indicated that they had been given training relevant to their role which helped them understand and meet the individual needs of service users and that they are given training to keep up to date with new ways of working. A staff member added, “we are always being kept up to date with our training”. Staff also said there are always enough staff on duty to meet the individual needs of all the people who use the service. Amadeus DS0000041691.V347725.R01.S.doc Version 5.2 Page 22 The duty roster indicated the names of staff on duty. The roles of staff were not defined and the hours of specific staff were not indicated on the duty roster. 60 of staff at the home have a NVQ level 2 or above. Four staff are working towards NVQ qualifications. This ensures that staff have the skills required to care for older people. One service user said, “staff are kind and helpful, they have helped me settle in”. Another service user said, Amadeus is a lovely place to live, all the staff are pleasant and committed”. The staff had received training in core skills, such as adult protection, medication administration, moving and handling and health and safety. Amadeus DS0000041691.V347725.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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The management is approachable and there is a focus on meeting the needs of people living at the home. EVIDENCE: Staff comment cards received before the inspection indicated that the manager regularly meets with them to give support and discuss how they are working, and that the manager is “always there to discuss and support me with my working and to help with any help we need”. Amadeus DS0000041691.V347725.R01.S.doc Version 5.2 Page 24 Residents, relatives and staff said the manager was approachable and was often seen out and about around the home. One relative said, “You feel you can talk to her and she will listen”. Staff who were spoken with said that the manager was approachable and fair. The information provided to the Commission before the inspection indicated “Registered Manager achieved NVQ 4 and has had 23 years’ experience in the social care settings, the last six years at management level”. Amadeus has recently been awarded the Investors in People Award. Staff meetings are arranged which provides staff with an opportunity to influence how Amadeus is run and to contribute to the effectiveness of the home. Satisfaction surveys have been sent by Amadeus to service users, relatives, visiting GP’s and other professionals and district nurses. The feedback has been analysed and has assisted Amadeus to further develop the service it provides. Health and safety procedures presented as being effectively implemented. A selection of records relating to the maintenance of equipment and the fire detection systems was looked at. These were appropriately maintained. Staff confirmed they were provided with protective equipment, including disposable gloves and aprons, to minimise the risk of cross-infection. Annual appraisals take place and were recorded on the staff files seen. There were no records of staff meeting with their line manager to discuss their career development, training and the philosophy of the home. The manager said these meetings do take place but were not recorded. Staff should meet with their line manager at a minimum of six times a year to discuss these areas of development and this meeting needs to be recorded. Small amounts of money were held for people living at the home to purchase small items. Systems were in place to ensure the safe handling and storage of service users’ monies. The receipts were not all kept together, so it would be difficult to undertake an audit of these records. Consideration needs to be made of the process to ensure all receipts for whatever the purchase are retained centrally and are numbered to aid identification. In addition, when service users take out money they do not sign the record to say they have withdrawn the monies. Service users’ signatures as confirmation of withdrawal of their monies would safeguard service users and staff. Amadeus DS0000041691.V347725.R01.S.doc Version 5.2 Page 25 Weekly checks had been made of the building and equipment in respect of fire prevention and health and safety. Records showed that fire drills had been held. The manager said all staff had taken part in fire drill practice or training. A record is maintained of all accidents, incidents and occurrences experienced by service users. The details of some of these accidents were kept within the accident book, which does not meet Data Protection legislation. The system needs to be revised. The manager is made aware of accidents and said that care plans and risk assessments are reviewed or revised as a consequence to service users having falls, accidents or incidents. An analysis is not undertaken which may inform Amadeus if there are any patterns to accidents which could further develop routines or practice to reduce risk to service users. Amadeus DS0000041691.V347725.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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Amadeus DS0000041691.V347725.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 OP1 Regulation 4 &5 Requirement The statement of purpose and service user guide must be reviewed and updated to ensure that all information is up to date and accurate. Timescale for action 31/10/07 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 When reviewing service users’ care needs, ensure the changes to care are indicated in the care plan. Record in the care plan when a service user is assessed as having night-time care needs and the support and regularity needed. Arrange for service users to be weighed monthly, or more frequently if the care plans dictate this. Record service users weights within their care records. Ensure that on occasions where a variable dose of medication is prescribed, for example, one or two tablets to be taken, an accurate record is made of the actual dosage of each medication administered. DS0000041691.V347725.R01.S.doc Version 5.2 Page 28 2 3 OP8 OP9 Amadeus RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 4 5 6 7 8 Refer to Standard OP9 OP9 OP9 OP9 OP12 Good Practice Recommendations To promote best practice and to aid in identification, a photograph of service users needs to be with their medication administration record. Ensure the controlled drugs book indicates what has happened to the controlled drugs when they are no longer required or the service user has left the home. Obtain a lockable refrigerator in which to store medication, which needs refrigeration. To decrease the possibility of mistakes being made, ensure staff record service users’ refusal or decline of medication as it happens and not at the end of the medication round. Detail within the daily reports the activities service users have taken part in and the impact that has had on their day so a whole picture of their care and support is recorded individually Produce a four-week menu, which indicates all the meals of the day and the choices available. Maintain a record of the food served to service users so that a judgement can be made whether the diet is satisfactory in terms of nutrition and review the way soft diets are served. Record all comments and complaints made to Amadeus. Provide a call bell system within the lounge and dining room. Duty rosters should include details of the roles and hours that staff are employed. Maintain all receipts for purchases made on behalf of service users together so an audit can easily be made of these. Arrangements should be put in place for all staff to receive supervision at a minimum of six times each year which needs to be recorded. 9 10 OP15 OP15 11 12 13 14 15 OP16 OP19 OP27 OP35 OP36 Amadeus DS0000041691.V347725.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Manchester Local Office 11th Floor, West Point 501 Chester Road Old Trafford Manchester M16 9HU 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. 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