Inspection on 29/09/08 for Ancaster Court

This inspection was carried out on 29th September 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ancaster Court 02/10/07

Ancaster Court 01/08/06

Ancaster Court 24/08/05

Ancaster Court 08/04/05

Ancaster Court 17/11/04

Ancaster Court 01/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 04/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ancaster Court 24 Hastings Road Bexhill On Sea East Sussex TN40 2HH     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Deborah Calveley     Date: 2 9 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Ancaster Court 24 Hastings Road Bexhill On Sea East Sussex TN40 2HH 01424-213532 01424221925 sowerbya@bupa.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Alison Sowerby Type of registration: Number of places registered: BUPA Care Homes (CFC Homes) Ltd care home 51 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The home may from time to time accommodate service users under the age of sixtyfive on admission The maximum number of service users that can be accommodated is fifty-one (51) Up to twelve service users who have nursing needs may be admitted with the condition dementia Date of last inspection Brief description of the care home Ancaster Court has 51 registered beds that can be used to provide nursing care and admits people who are privately funded and those who are funded by Social Services. A secure unit on the second floor now provides separate accommodation for 12 of the 51 residents, requiring general nursing and dementia care. Ancaster Court is owned and managed by BUPA Care Homes Ltd. The bedrooms are found on three floors and Care Homes for Older People Page 4 of 30 0 0 Over 65 12 51 Brief description of the care home an 8-person passenger lift accesses all accommodation used by residents. Four of the bedrooms are registered for double occupation, but only one of these is now used for shared occupancy. 16 bedrooms have en-suite facilities. Ancaster Court is a Victorian building that has been converted and adapted to its present use. It is located in a residential area approximately half a mile from Bexhill town centre, seafront and mainline train station. The home has a garden to the rear of the property. There is parking to the front of the home for approximately 15 vehicles. The current range of activities includes bingo, quizzes, poetry club and PAT the dog visits. Holy Communion services take place on a monthly basis. A copy of the latest inspection report is kept in the ground floor lounge. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Ancaster Court will be referred to as residents This was a key inspection that included an unannounced visit to the home and follow up contact with residents representatives and visiting health and social care professionals. This unannounced inspection was carried out over 7 hours on the 29 September 2008. There were 45 residents living in the home on the day of which five were case tracked Care Homes for Older People Page 6 of 30 and spoken with. During the tour of the premises eight other residents both male and female were also spoken with. The purpose of the inspection was to check that the requirements of previous inspections had been met and inspect all other key standards. A tour of the premises was undertaken and a range of documentation was viewed including the Service Users Guide, Statement of Purpose, care plans, medication records, and recruitment files. Four members of care staff activity co-ordinators and the maintenance person were spoken with in addition to discussion with the Manager and Head of Care. Telephone contact was made with visiting professionals following the visit and their views and comments are incorporated into the report along with the information received verbally during the site visit has been incorporated into this report. An Annual Quality Assurance Assessment was received from the Manager completed in full prior to this key inspection. What the care home does well: What has improved since the last inspection? Since the last inspection the homes recruitment practices have improved and full employment histories have been obtained for all staff employed to work at the care home and it was confirmed that employment gaps are investigated. The commission are now informed of all accidents injuries and incidents of illness or communicable disease affecting the welfare of residents. Care Homes for Older People Page 8 of 30 The home now record clearly when action restricting a residents freedom of movement for their safety has been done. This includes input from the resident and advocates. Pressure relief equipment was found to be in correct working order. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides prospective residents and relatives with a good level of information about the home, its facilities, services and the costs involved. The admission procedures allow for the needs of prospective residents to be assessed by a competent person before admission although people are not assured in writing that their needs will be met. Evidence: There is a Statement of Purpose and Service Users Guide in place which contains information about the home and the services it provides. Copies of these were available on request it would benefit visitors and prospective residents if these were more readily available. The Statement of Purpose was up to date and contained in essence the information required, however it refers throughout to the Organisational polices for more information. This then becomes time consuming for the reader if they have to then approach the home for a copy of the specific policy og interest. This has Care Homes for Older People Page 11 of 30 Evidence: been discussed in full with the organisation. It was confirmed whilst talking to residents that the contract arrangements were clear and understood. There is a copy of the terms and conditions of residency included in the homes information documents. A review of the care documentation confirmed that pre-admission assessments are completed by the manager or the head of care. The last four admissions to the home were identified and the records relating to the admission procedures followed were reviewed. This confirmed that pre admission assessments are completed and provide a clear assessment of prospective residents care needs. These are completed by the manager or the head of care and discussion with the manager confirmed that these are used to ensure new admissions to the home are appropriate and that the home have the staff equipment and environment to meet their care needs. Prospective residents are seen either in their home or hospital before admission and the input from relatives and other professionals is used whenever possible. It was however noted that the home does not confirm having regard to the assessment that the home can meet the assessed needs of the prospective resident This was discussed with the manager who was advised that this should be completed in writing in accordance with the required documentation. The manager was able to verbally demonstrate her knowledge and awareness of the different specialities required in the home and ensures that the carers employed have attended relevant courses to deal with the needs of the elderly and also specialised courses for certain diseases. Trial visits to the home can be arranged. The manager confirmed that self-funding residents are invited to a trial period to ensure suitability of the home, this is clearly stated in the Statement of Purpose and in the statement of terms and conditions. Intermediate or rehabilitative care is not provided at Ancaster Court. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans provide a gooe framework for the delivery of care which give clear guidance to care staff on all the care needs of the people living in the home. Medication practices in the home at this time do not promote and protect the health needs of residents. On the whole the privacy and dignity of residents are promoted. Evidence: The care documentation pertaining to five residents was reviewed in depth as part of the inspection process At the last key inspection a new care planning system had been introduced, this inspection evidenced that thev staff were working well with this format. The care plans were found to have a comprehensive assessment format which guide staff to produce a care plan for the identified need. The majority of residents were found to have care plans specific to their needs and evidenced regular review. There was also evidence of regular consultation with residents and their relatives. Risk assessments for health needs are included in the care planning format used by Care Homes for Older People Page 13 of 30 Evidence: the home and all risk assessments were found to be completed, however from viewing the weight records and identifying weight loss it was found that these need to be followed through with an appropriate plan of action and cross referenced with the care plan. This was discussed in full with the head of care and manager. The moving and handling assessments are brief and need to include full guidance for staff regarding the hoist to be used and the sling size. Staff spoken with confirmed that they received a full report on each resident daily Residents spoken with were satisfied with the care provided at the home one saying that the home, I am ok, they look after me well, I think its good here, they give me every thing I need. There is a clinical room on each floor and there are suitable storage facilities for medication, stocks of medicines, dressings and items that require being kept in a fridge. Temperatures of the room and fridge are recorded daily. From direct observation the morning medications were administered safely and were in line with the homes policies and procedures. The systems for recording and checking controlled drugs were found to be thorough. The Medication Administration Charts (MAR) were viewed, gaps were identified and these need to be followed up by the senior staff. There were medicines for a number of residents out of stock for up to four days and this should not occur if the staff are monitoring the medications appropriately and this does impact on the positive health outcomes of the residents. The MAR sheets identify residents are refusing their medication however there are no records kept of dates and reasons for non administration and no link to the care plan or a referral to the G.P to ask for a medication review. As discussed during the inspection this needs to be introduced to provide vital information for the G.P and for audit purposes. The comparison signatures of staff able to administer medication were available for two of the three floors but were old and not current these need to be updated. Other shortfalls included, handwritten entries of medications need to be signed or dated, medications that have been discontinued need to be signed and dated and include whom ordered the change and the identity photographs of residents need to be updated regularly. Staff were seen to be respectful and considerate to all residents whilst attending to their needs. Each of the residents were addressed by their preferred term and dressed appropriately in well-laundered clothing, one resident said I appreciate the staff ensuring that I am clean, tidy and thank them for ensuring that I am cared for. Care Homes for Older People Page 14 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lifestyle experienced by residents at this time match their expectations, choice and preferences. Meals remain good in respect of both quality and variety that meets the majority of residents tastes and choice Evidence: There are two activity co-ordinators in the home, which provide the activities to all the people who live in the home. One specific co-ordinator takes the responsibility of the dementia unit whilst the other works with the rest of the home. The dementia unit was colourful and thought had gone into the provision of mobiles and wall coverings in individual rooms to catch the interest of those confined to bed. The main activities in the dementia unit are one to one sessions and therapy sessions. During the site visit two residents were receiving a massage from an outside therapist which is paid for privately. The activity programme for the home is displayed in the main communal areas and in individual rooms. It evidenced a weekly programme and included information regarding the two weekly visits from Dixie the PAT dog, the mobile library visits and Care Homes for Older People Page 15 of 30 Evidence: details of the hairdresser. The programme displayed that on Monday a musical story would be told, Tuesday a pub lunch followed by an afternoon film session, Wednesday would be a visiting production, Thursday was bingo day and Friday was an arts and crafts session. from talking to the residents, it would be beneficial for something to be arranged at weekends as they are sometimes very long. Residents spoken with confirmed that they could choose to attend activities if they wish to and were also encouraged to go out with friends and families. The homes flexible routines enable residents to choose how to spend their time. The care plans include a life cycle chart which is a valuable document and invites a person centred approach to meeting individual social needs. However not all were completed and the activity notes on all residents were acknowledged by the activity co-ordinators as not being current and up to date. These need to be developed and kept up to date to monitor and evidence that the social needs of all the people are being met. Holy Communion services are organised at the home on a monthly basis and lay people from other religious denominations visit residents at the home as required Residents are facilitated to maintain their independence for as long as they are able There are no restrictions on visiting times as long as consideration is shown to all the residents. Two visitors commented staff are always welcoming and make time to chat to us, the home is busy but my relative enjoys living here. There are communal areas throughout the home that are available to residents and their visitors for private meetings if required. Many of the residents have individualised their bedroom with items from home and residents and relatives spoken with confirmed that they are encouraged to make it homely. It was observed during the inspection that the routines at the home are flexible and residents spoken with confirmed that they were consulted about all aspects of their lives. The home has an advocacy policy in place and the information regarding this is available to all residents The Annual Quality Assurance Assessment completed by the manager in June 2008 stated A full and varied menu is available in the home, these have been developed to allow for residents choices and preferences. The Bupa Menu Master helps ensure every menu within the business is customer led and nutritionally balanced. The Nite Bite menu allows our residents to choose to eat when they feel like it providing healthy choices at any time through the night. This was evidenced during the site visit. Care Homes for Older People Page 16 of 30 Evidence: There was varied feedback regarding the consistent quality of food and this was fed back to the manager. One resident said that a noticable change in the the quality of the food in the past few weeks. It was noted that a few residents did not eat all their meal and this needs to be recorded and an alternative offered. There is no daily record kept of residents food consumption. The home staff use a nutritional assessment tool to identify any residents with special dietary needs including monthly weights, however as previously mentioned an action plan needs to be in place for those whom have been identified as at nutritional risk. The dining area was pleasantly furnished and staff were observed assisting residents discretely ensuring their dignity was upheld. Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Practice in the home ensures that complaints are responded to, with residents and representatives being confident that they are listened to. Practice in the home ensures that adult protection issues are responded to when identified. Evidence: The complaint policy and procedure is clear and uncomplicated and a copy of this is readily available in the home and the Service Users Guide. A system of recording complaints was demonstrated during the site visit to the home. The home has received four complaints since the last inspection, and they were responded to within the stated timescales. Relatives and residents spoken with confirmed that they were confident that any complaints or concerns that they had would be listened to and responded to effectively. The home has relevant guidelines on the protection of vulnerable adults and staff have received appropriate training. The management team has a clear understanding of adult protection guidelines and are aware of how to initiate an investigation if required. There have been two safeguarding referrals which have been investigated by the home and social services were satisfied with the action taken. Care Homes for Older People Page 18 of 30 Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst Ancaster Court provides a comfortable and generally safe environment for those living in the home and visiting, there is a need for a plan of renewal and redecoration throughout. Residents are enabled and encouraged to personalise their room, and rooms are homely and reflect the residents personalities and interests. Evidence: Ancaster Court is a Victorian building that has been converted and adapted to its present use. It is located in a residential area approximately half a mile from Bexhill town centre, seafront and mainline train station. The home has a garden to the rear of the property and a new sensory garden. The inspection included a tour of the home, which identified that the ground and first floor of the home is in need of redecoration and continued maintenance work as the home looks tired and dull. There is a need for a refurbishment plan, which will improve the outcomes for the people living in the home and those visiting. This was identified at the last inspection and therefore remains outstanding. Areas identified included wall paper hanging off, damaged paintwork, and stained flooring. The dementia unit on the second floor was found well maintained and decorated to a good standard. Care Homes for Older People Page 20 of 30 Evidence: The communal areas in the home are comfortably furnished, however the conservatory is out of use at the present time which impacts on the space available for residents and visitors. There are adequate communal bathrooms and shower rooms in the home with specialist equipment, which enables frail residents and those with a physical disability to enjoy the facilities available. However the bathrooms are not attractive and inviting and are in need of redecorating. They are also used as storage areas for zimmer frames, wheelchairs and hoists. This was discussed in full. Specialised equipment to encourage independence is provided e.g. handrails in bathrooms, hoists, wheelchairs and lifts to all areas of the home. Call bells are provided in all areas. It was noted that the ground and first floor corridors do not all have handrails to promote peoples independence. The home has a range of pressure relief and preventative equipment for people who have tissue damage or those who have been assessed as being at risk to tissue damage. Call bells are provided in all areas. The lighting in the home is of domestic quality and there are above bed lights as well as the main ceiling lights. Water temperatures are controlled and monitored monthly and a record kept. Random temperatures were taken and were of the recommended level. There are systems in place for monitoring safety issues such as fire checks, fire drills, PAT testing, electrical tests and gas and boiler checks and all the rooms are routinely checked for safety and maintenance issues. The records in the home confirmed they were up to date. The tour of the home confirmed that doors were found inappropriately wedged open and held open by various objects which place people at risk and advice is to be sought by the fire authority. Polices and procedures for infection control are in place and are updated regularly. It was noted that equipment used by residents were dirty and this included wheelchairs and hoists. A cleaning schedule needs to be developed to ensure that these are routinely cleaned. Good practice by staff was observed during the day and there were gloves and aprons freely available in the home. Sluice and laundry areas were found clean and safe, but some equipment was found rusty and in need of replacing as they are an infection risk. The home provides a good laundry service and the laundry area was clean and well organised Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are robust recruitment practices in place to protect residents, and staff training ensures that the staff are aware of their roles and competent to meet the needs of the people living in the home. Evidence: The staffing rota was viewed and the staffing levels were seen to be sufficient to meet the needs of the residents at this time. It was confirmed by the manager that there is flexibility of the staffing levels and they are adjusted according to the changing needs of the residents. Care staff spoken with said that the levels of staff on duty were sufficient to give the care required; they also said that the trained staff always helped out when needed. overall the comments from the residents were positive in respect of the staffing levels, though one resident said the staff are always rushing and dont have time to talk another said that more staff would be appreciated. A selection of staff recruitment files were viewed and demonstrate that a robust recruitment process has been maintained to protect residents and contained all the relevant information required. There was evidence of health questionnaires, Criminal Record Bureau checks, two references, a resume of previous employment and work permits where necessary. All the paperwork is kept within a locked room. The induction programme is now in place and has been introduced for all staff. Files seen Care Homes for Older People Page 22 of 30 Evidence: confirmed this. Staff spoken with said that training opportunities at the home are good and they are well supported by the senior staff and the manager. Staff and the training list seen confirmed that compulsory training such as manual handling, adult protection, first aid and fire safety are being undertaken on a regular basis. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The overall management of this home is good with effective systems to ensure the home is run in the best interests of the residents and in the main promotes their health, safety and welfare. Evidence: The home manager is a level 1 registered nurse and has been the home manager of Ancaster Court for approximately 7 years and has successfully attained the Registered Managers Award. She has the necessary experience and knowledge to manage the home effectively. However there are some repeated requirements that have not been actioned since the last key inspection and this reflects negatively on the overall management of the home. The staff spoken with said that they felt supported by the management structure of the home. Residents were aware of whom the manager is and of her role in the home. Care Homes for Older People Page 24 of 30 Evidence: The quality assurance systems in the home include questionnaires sent out to residents and relatives following admission to the home. The formal quality assurance and quality monitoring systems has enabled the management to objectively evaluate the service and ensure it is run in the residents best interests. The quality assurance results are audited and action taken to address any suggestions of improvement and the results are then published to the residents. The home maintains personal monies for some residents. Records of transactions are kept. Receipts are obtained for services provided or items obtained on behalf of residents. Monies are held in a separate interest bearing account. BUPA has devised a system to distribute interest proportionately. The home sometimes retains small items of importance on behalf of residents and records of the arrangement are kept. Staff supervision was discussed and staff supervision has been commenced. Staff spoken with confirmed that they receive supervision. It was discvussed that all staff employed need to have formal supervision including the activity co-ordinators. All staff receive the mandatory training in moving and handling, health and safety and fire safety and there is evidence of a rolling plan of training that ensures that all staff are competent to perform their role in the home. The manager confirmed that all staff are appropriately supervised until they have received the necessary training and induction. The home need to ensure that the risk assessment of the environment is developed which includes the regular inspection of all parts of the building to which residents have access ensuring that any unnecessary risks are identified and so far as possible eliminated. This pertains to the use of portable equipment, radiator guards being unsafe, a television on the floor in the communal lounge and the use of wedges and inappropriate objects to keep doors open. Care Homes for Older People Page 25 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action 1 9 13(2) Full details of dose changes to the prescribers directions must be clearly recorded on the medication administration record chart. 15/10/2007 2 19 23(4) That approved measures are 31/10/2007 taken to ensure the protection of all residents in the case of fire. All areas used by residents must be kept in a good decorative state 31/10/2007 3 19 23(2) Care Homes for Older People Page 26 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 That registered person 14/12/2008 confirms in writing that having regard to the assessment made on any prospective service user that the home can meet those needs To ensure the service user is confident that their needs can be met by the home. 2 9 13 That the registered person ensures that there are competent and safe arrangements for the accurate recording of medicine administration and ordering and supply of medicines To protect and promote the service users health needs. 12/12/2008 3 12 16 That the registered person 12/12/2008 ensures that all service users have a social care plan that is designed to meet their interests and preferences. Care Homes for Older People Page 27 of 30 That service users isolated in their bedrooms have a plan of care to ensure that they receive interaction and stimulation. That service users social and welfare needs are met. 4 15 16 That the registered person ensures that a formal monitoring of service users appetites and amount consumed is kept. That service users appetites are monitored and identified when at risk. 5 19 23 That the registered person ensures that all areas of the home are kept in good decorative order. That a refurbishment plan is in place with realistic timescales. To meet the homes Statement of Purpose. 6 25 23 That the registered person ensures that advice is sought from the fire authority in respect of the use of objects and door wedges being used to keep doors open. To ensure the service users safety is promoted and protected. 7 26 12 That the registered person 12/12/2008 ensures that The standard of cleaning throughout the home must improve to 12/12/2008 12/12/2008 12/12/2008 Care Homes for Older People Page 28 of 30 minimise cross infection risks. This pertains to hoists, equipment and wheelchairs. To protect the service users. 8 38 13 That the registered person ensures that a risk assessment of the environment is undertaken which includes the regular inspection of all parts of the building to which residents have access ensuring that any unnecessary risks are identified and so far as possible eliminated. That advice is sought regarding the use of objects to keep doors open. To ensure that the residents safet and welfare is protected. 12/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 8 8 That the weights recorded are linked to the residents nutritional risk assessment and care plan. That the equipment used for the safe moving and handling of the service users is described in the risk assessment. Care Homes for Older People Page 29 of 30 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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