Inspection on 20/02/07 for Andrew Smith House

This inspection was carried out on 20th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Andrew Smith House 09/10/07

Andrew Smith House 06/03/06

Andrew Smith House 19/07/05

Andrew Smith House 24/10/04

Andrew Smith House 19/05/04

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 HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Andrew Smith House Marsden Hall Road North Nelson Lancashire BB8 8JN Lead Inspector Mrs Marie Matthews Key Unannounced Inspection 20th February 2007 10:00 X10029.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 Andrew Smith House DS0000022506.V323285.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 and Care Homes for Adults 18 – 65*. 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. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Andrew Smith House Address Marsden Hall Road North Nelson Lancashire BB8 8JN 01282 613585 01282 611630 julie.gaskell@btconnect.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) Stocks Hall Care Homes Limited Mrs Julie Elizabeth Gaskell Care Home 60 Category(ies) of Dementia (12), Dementia - over 65 years of age registration, with number (12), Old age, not falling within any other of places category (40), Physical disability (20) Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 60 service users to include: A maximum of 40 service users in the category of OP (older people) A maximum of 20 service users in the category of PD (physical disability under 65 years of age). A maximum of 12 service users in the category of either DE (Dementia) or DE(E) (Dementia over 65 years of age) Date of last inspection 6th March 2006 Brief Description of the Service: Andrew Smith Care Home in Nelson is part of a group of homes owned by Stocks Hall Care Homes. It is a two-storey property with a lift to all floors and wheelchair access to all parts of the home. The home has extended and upgraded the facilities and is registered to provide both nursing and personal care for up to sixty people in four separate units. The home provides a twelve-bed dementia unit, eight-bed younger disabled unit, seven-bed rehabilitation unit and a thirty-three bedded unit for older people. The home is located in Nelson across from a school and is close to the local park, community centre and shops. There is a bus service nearby and the home has a small car park. The outside of the home has patios and grassed areas that are accessible to the residents and their visitors. The home has a number of lounges and dining areas on both floors. There is a small conservatory at the side of the home and the entrance area is also a popular place for sitting and meeting visitors. The home offers single rooms some of which are en-suite; throughout the home are toilets, bathrooms and showers all of which have adaptations to assist the residents. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 5 Information about the services that the home offers is provided in the form of a service user guide and is available, with a summary of the most recent inspection report, to existing and prospective residents and their relatives. The fees range from £324.50 to £700.00. Additional charges are made for hairdressing, personal toiletries, podiatrist, massage, newspapers and some outings. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The key unannounced inspection was conducted at Andrew Smith House on 20th February 2007. The inspection involved looking at records, talking to the registered manager, care staff and ancilliary staff, three visitors and six residents in detail, a tour of the premises and generally looking at what was happening in the home. The registered manager provided written information about the home prior to the inspection. Seven visitors and three residents completed survey forms to assist with the inspection. This inspection looked at things that should have been done since the last visit and a number of areas that affect resident’s lives. There were fifty-one residents living in the home on the day of the inspection. What the service does well: People were given enough information about the home to help them to make the right decisions about whether it would meet their needs. The home made sure they were able to meet people’s needs before they were admitted to the home. All residents had a care plan that contained useful information about how their needs were to be met. Residents confirmed that they were given choices in many aspects including meals, routines, bedtimes and activities. The home employed two activity coordinators to work with residents in groups and on a one to one basis; records showed there had been a range of varied activities and entertainments that were suitable and appropriate for the individuals in the home. Most visitors had commented that they were welcomed into the home. One visitor said staff were ‘always friendly and would make you a cup of tea’. Records showed the home had followed a safe recruitment procedure that would protect residents. The home provided staff with a range of suitable training to support them in their role, to increase their knowledge and skills and to help them to meet the needs of the residents in their care. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 7 Residents were offered a choice of nutritious meals that met their needs and preferences. Resident comments included ‘the food is very good’, ‘there is always plenty to eat and its ever so good’, ‘they will make you something else if you don’t like the menu’. The complaints procedure was clear and had been included in the service user guide. People were aware of whom to complain to and felt their concerns would be dealt with appropriately. The adult protection procedures were clear and detailed the action to be taken by staff if a suspicion or allegation of abuse was reported; this made sure that residents were protected from harm. Residents lived in a safe, comfortable and well-maintained environment that met their individual needs and expectations. Aids and adaptations were provided to assist with mobility and to promote independence. All areas of the home were clean, well decorated and bright. Gardens were attractive, well maintained and accessible to residents and their visitors. Residents said they were able to watch local wildlife from their windows. Residents were happy with their rooms and had been able to bring in their own belongings to make it more homely. One resident said the home is ‘always clean’ another said ‘I like my room it is nice’. The home had sought the views and opinions of residents and their families to ensure their needs and expectations were being met. What has improved since the last inspection? What they could do better: Residents individual care plans did not always include clear information about what action staff needed to take to make sure all aspects of resident’s needs would be met. The care plans did not always show that residents and their relatives had been involved in discussions about care needs although some relatives said they had been consulted and ‘kept informed’ about changes to care. The home needed to improve some aspects of medication management and to ensure residents had the correct medication at the right time to help maintain their health. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 8 Most residents were provided with call leads for when they needed assistance; these had been removed on one of the units for appropriate reasons but had not been assessed to determine why. The laundry areas were organised although a new washing machine and dryer had been requested as staff were finding it difficult to maintain a good service and prompt return of resident’s laundry. These had been requested and the registered manager was waiting for authorisation. Residents and relatives had raised a number of concerns regarding insufficient staffing levels on the EMD unit particularly at peak times of the day. Comments included ‘staffing is not good sometimes’, ‘need extra staff at mealtimes and when people need changing’, ‘the staff cope very well. I feel at meal times they could do with an extra hand to help’. Concerns about staffing levels on the EMD unit were discussed with the registered manager who advised that measures were in place to ensure resident’s needs would be met. The home needed to ensure that improved safeguards were in place to protect the financial interest of the residents and to provide safe guidance for staff. 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. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. People were given detailed information about services to enable them to make the right decisions about whether the home would meet their needs. Detailed assessments were always completed prior to admission to ensure the home could meet resident’s needs. EVIDENCE: Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 11 The service user guide contained information about services offered by the home; copies of the guide were around the home and had been given to residents and their relatives prior to their admission to the home. Residents said they had been given enough information before admission to the home. Detailed information about what care residents would need was collected before admission to the home; this was to make sure their needs could be met. The home had assured residents and their families, in writing, that their needs would be met. Staff had received appropriate training to help them to meet the needs of the residents in their care. The home had a separate unit for people who needed some therapy before going home. The unit had specialised facilities and equipment and suitably qualified staff to help residents to increase their independence and to return home safely. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The care plans did not always detail action to be taken to meet residents needs and did not always show that residents and their relatives were involved in decisions about care. Medication policies and procedures provided safe guidance for staff although staff had not always followed guidance and this could put residents at risk. Residents privacy was respected and staff responded positively to residents and their visitors. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 13 EVIDENCE: Three individual care plans were looked at. The care plans had been developed using the initial assessment information and had been regularly reviewed and updated to reflect any changes to care. The care plans did not always include detailed information about what action staff needed to take to make sure all aspects of resident’s needs would be met. The care plans did not consistently show that residents and their relatives had been involved in discussions about care needs although some relatives said they had been consulted and ‘kept informed’ about changes to care. A range of risk assessments relating to health and general risks were in place for the majority of residents but were incomplete on one of the units. Risks in relation to the use of bed rails to prevent falls had not been properly assessed and consent from residents and relatives had not been documented. There were no risk assessments to support non-provision of call leads on the EMD unit. The medication policies and procedures had been reviewed to provide staff with safe guidance. Records were completed and showed that generally medications were managed safely. However records showed that two residents had not had medication given as prescribed and this could put their health at risk. Handwritten prescriptions needed to be witnessed to ensure accuracy and medications given ‘as needed’ should be supported by clear guidance to support staff and to ensure medication was given appropriately. There needed to be a list of staff signatures to identify those staff who were responsible for the administration of medication. The home needed to obtain written permission form residents to manage their medicines. Storage areas were clean and medications were stored securely and at the right temperatures. Staff confirmed they had received training that supported them with the safe management of medication. Staff were able to describe how they would respect residents choices, privacy and dignity and said these issues were covered as part of their ongoing training. One visitor confirmed that the doctor had seen her relative in the privacy of his own room. Staff were seen responding to residents and visitors in a friendly and supportive way. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. The home offered a range of suitable age related activities that met individual needs and expectations. Residents were provided with a choice of wholesome and nutritious meals that met their dietary requirements. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 15 EVIDENCE: Residents confirmed that they were given choices in many aspects including meals, bedtimes and activities; one member of staff said choices and preferences would be written in each residents care plan. The home employed two activity co-ordinators to work with residents in groups and on a one to one basis. Records showed there had been a range of varied activities and entertainments that were suitable and appropriate for the residents in the home. Staff were advised to include detailed information about the past history and preferences of residents to assist them to meet their social needs (see standard 7). The home had its own transport that was used to take residents on shopping trips, visits to a local activity centre, excursions and appointments. One resident said there was ‘plenty to do’ but preferred to stay in her room and this was respected. Another resident said she had ‘made some good friends’ during her stay at the home. Most visitors had commented that they were welcomed into the home. One visitor said staff were ‘always friendly and would make you a cup of tea’. Another visitor felt she was not made to feel welcome by all staff. Some visitors said they were kept up to date with any changes to their relatives care others said they had to ask if they needed information. There were information leaflets and posters about local community services and informing residents how to access independent advocates for advice. Menus showed residents were offered a choice of nutritious meals that met their needs and preferences. The cook had information about special diets and likes and dislikes to ensure she was able to offer a suitable meal to all residents. The meals were cooked in a central kitchen then transported to each unit in ‘hot trolleys’ where meals were eaten in pleasant surroundings. Records were sampled and found to be in order. All units had a small kitchen where visitors and residents could make a drink and a snack if they wished. Resident comments included ‘the food is very good’, ‘there is always plenty to eat and its ever so good’, ‘they will make you something else if you don’t like the menu’. Staff were seen giving sensitive support to residents who needed assistance. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. People had access to a robust complaints procedure and were protected from harm by the home’s procedures and staff awareness. EVIDENCE: A record of complaints and concerns had been maintained; the records showed the home had acknowledged, investigated and responded to people appropriately. The procedure was clear and had been included in the service user guide. Seven visitors and six residents were aware of whom to complain to and felt they would be dealt with appropriately. One visitor and one resident were not clear whom to approach with a complaint. The adult protection procedures provided clear and detailed the action to be taken if a suspicion or allegation of abuse was reported. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 17 The home had a financial policy but this did not clearly support and protect staff that were managing residents finances (see standard 35). Records and staff confirmed they had attended training to help them to recognise and respond appropriately to suspicions of abuse to ensure residents were protected. There was a procedure to support staff with any verbal or physical aggression from residents. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents lived in a safe, comfortable and well-maintained environment that met their individual needs and expectations. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 19 EVIDENCE: The home was safe and well maintained and had been designed to meet resident’s individual needs. Aids and adaptations were provided to meet resident’s needs and to assist with mobility and to promote independence. All areas of the home were clean, well decorated, bright and comfortable. A programme of maintenance and renewal was produced that showed future planned improvements to the home. Gardens were well maintained and accessible to residents and their visitors. Residents were able to watch local wildlife from their windows. Residents were happy with their rooms. One resident said the home is ‘always clean’ another said ‘I like my room it is nice’. Bedrooms were bright and clean and personal items were in place to enhance the homely feel. All rooms had lockable storage and locks to the door and risk assessments were in place to support non-provision of keys and minimum furnishings. All rooms were single occupancy. Resident were provided with call leads for when they needed assistance; these had been removed on one of the units for appropriate reasons but had not been risk assessed (see standard 8). Other than two rooms all areas were fresh smelling. The laundry areas were organised although a new washing machine and dryer had been requested as staff were finding it difficult to maintain a good service and prompt return of resident’s laundry. These had been requested and the registered manager was waiting for authorisation. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home protected residents with a robust recruitment procedure and staff were competent, supervised and had appropriate skills and knowledge to meet residents needs. Staffing numbers were generally sufficient to meet resident’s needs although this needed to be kept under review at peak times on one of the units. EVIDENCE: Some residents and relatives had raised a number of concerns regarding insufficient staffing levels particularly at peak times of the day. Comments included ‘staffing is not good sometimes’, ‘need extra staff at mealtimes and Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 21 when people need changing’, ‘the staff cope very well. I feel at meal times they could do with an extra hand to help’. It was noted on the EMD unit that there were short periods when only one staff covered the unit. Staff were spoken to and the reasons for this was to collect the meal trolley from the kitchen; visitors said if both staff had to attend to a resident this left no one around to ensure the safety of other residents. Levels on this unit were discussed with the registered manager who said extra staff had been provided on six evenings and one morning each week, kitchen assistants would normally provide the meal trolley and staff from other units were available to assist when needed. The registered manager was advised to keep the staffing situation under review to ensure resident’s needs were met at all times. Comments from residents included ‘staff are very good’, ‘as far as nursing homes go its as good as you get’, ‘sometimes staff are a bit short so you have to wait but they do the best they can’, ‘the staff are nice and helpful’ and ‘they are conscientious’. One resident said ‘‘if you were the queen of England you couldn’t be looked after better’. More than half of staff had an appropriate qualification to help them to meet the needs of the residents in their care. The home provided a range of suitable training to support staff in their role and to increase their knowledge and skills. Three staff recruitment files were looked at. Records showed the home had followed a safe procedure that would protect residents. The registered manager said residents had been involved in the interview and selection of new staff. Records were clear and showed the interview process supported equal opportunities. Photos were not in place on all staff files as a means of identification. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) 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 adequate. This judgement has been made using available evidence including a visit to the service. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 23 The home had sought the views and opinions of residents and their families to ensure their needs and expectations were being met. The home needed to ensure that improved safeguards were in place to protect the financial interest of the residents and to provide safe guidance for staff. Health and safety of people was generally protected. EVIDENCE: The person in charge of the home and registered with the Commission for Social Care Inspection is Mrs Julie Gaskell. Mrs Gaskell has a wide range of experience, is a qualified nurse and has completed an appropriate management qualification to support her in her role. The home had regularly sought the views and opinions of residents and their families to ensure the home was meeting their needs and expectations. Survey information had been collated and action taken to improve any areas of concern. Audit systems had been introduced to monitor staff compliance with the home’s policies and procedures. The home managed some resident’s personal allowance. Records of three residents were looked at. A discrepancy was noted on one residents records; the matter was investigated and promptly rectified. The home needed to ensure that improved safeguards were in place to protect the financial interest of the residents and to provide safe guidance for staff. Records and discussions with staff confirmed that care staff received regular one to one support from senior staff to ensure they had the skills and knowledge to meet the needs of the residents in the home. Information was provided to support that systems were maintained and serviced to ensure that people’s health and safety was maintained. Staff were advised to report any incidents of aggression resulting in harm to ensure protection of staff and others and to determine adequate staffing. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 24 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 3 2 X 3 3 4 3 5 X 6 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 4 20 X 21 X 22 X 23 X 24 3 25 X 26 3 STAFFING Standard No Score 27 2 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 3 34 X 35 2 36 3 37 X 38 2 Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 25 YES Are there any outstanding requirements from the last inspection? 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 OP7 Regulation 14 Requirement Care plans must cover all aspects of their health, personal and social needs and indicate action to be taken by staff to meet these needs. Timescale of 24/04/06 not met. Residents and their family, friends or advocate must be involved in the development of the care plan and there must be evidence to support this. Timescale of 24/04/06 not met. The registered person must ensure that any risks to residents are fully assessed, including the use of bed rails, falls and non-provision of call leads; interventions must be documented in the care plan and kept under review. The registered person must ensure that medicines prescribed for residents are available in the home for administration at the appropriate times. The registered person must ensure staffing levels are kept DS0000022506.V323285.R01.S.doc Timescale for action 09/04/07 2. OP7 15 09/04/07 3. OP8 13 09/04/07 4. OP9 13 09/04/07 5. OP27 18 09/04/07 Page 26 Andrew Smith House Version 5.2 under review to ensure resident’s needs are met and people are safe. 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. 2. 3. Refer to Standard OP7 OP8 OP9 Good Practice Recommendations Care plans should include detailed information about residents social history and preferences. Permission for the use of bed rails should be obtained from the resident and or relative. The registered person should ensure criteria for the administration of when required and variable dose medication is clearly defined and recorded on all units. The registered person should ensure that transcribing is witnessed. There should be a list of signatures available of those staff who administer medication. Consent to manage and administer residents medication should be obtained from the resident (YA). A current photograph should be in place on staff files as a means of identification. The home should ensure systems are in place to regularly audit resident’s finances. Procedures should be sufficiently detailed to support staff with the safe management of resident’s finances. Staff should ensure any incidents of aggression/harm are reported appropriately. 4. 5. 6. 7. 8. OP9 OP9 YA20 OP29 OP35 9. OP38 Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. Andrew Smith House DS0000022506.V323285.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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