Inspection on 24/07/07 for Ann Slade Care Home, The

This inspection was carried out on 24th July 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

Ann Slade Care Home, The 19/01/10

Ann Slade Care Home, The 22/10/09

Ann Slade Care Home, The 29/07/09

Ann Slade Care Home, The 19/06/06

Ann Slade Care Home, The 30/01/06

Ann Slade Care Home, The 14/09/05

Ann Slade Care Home, The 05/01/05

Ann Slade Care Home, The 09/03/04

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 HOMES FOR OLDER PEOPLE Ann Slade Care Home, The 5 Mornington Road Southport Merseyside PR9 0TS Lead Inspector Mrs Margaret Van Schaick Unannounced Inspection 24th July 2007 08:35 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 Ann Slade Care Home, The DS0000005316.V340465.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. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ann Slade Care Home, The Address 5 Mornington Road Southport Merseyside PR9 0TS 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) 01704 535875 01704 512917 Brooklyn Home Limited Mr Korwin-Granford Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 24 OP To admit one male service user under the age of 65 years Date of last inspection 19th June 2006 Brief Description of the Service: Ann Slade is a residential care home that specialises in the care of older people. The home is registered for 24 service users and is owned and managed by Mr Korwin-Granford who has many years experience in the care of older persons. Ann Slade is located within a suburb of Southport and is close to all local amenities. The home presents an older type property, which has been converted into a care home with the accommodation being provided over three floors all served by a passenger lift. The communal space within the home consists of one dining room 2 lounge areas and a small smokers lounge. All communal space is provided on the ground floor. The home has 22 single and one double bedroom all having en suite facility. The home provides limited car parking to the front of the premises. The home provides ramped access to all entrance and exit areas and has aids and adaptations in place to meet all assessed need. The weekly rates range from £356-£395. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day and lasted approximately 9.5 hours. 24 residents were accommodated at the time of the inspection. A partial tour of the premises took place including public areas. A number of residents were spoken with and three interviewed on a one to one basis. Three relatives, two staff and one visiting health professional were interviewed. Discussion took place with the cook, the registered provider/manager and deputy manager. The interviewees gave the inspector their views on how the service was run. Three residents were also case tracked as part of the inspection (when the inspector examines the assessment process, care plan and other care documentation in detail with regard to the three residents during their stay and gains their views of the service). All the key standards were inspected. Satisfaction forms “Have your say about….” Were distributed to a number of residents, their relatives and health professionals prior to the inspection and some of their views are included in this report. Two complaints were raised to the Commission since the last inspection. They are referred to in this report. What the service does well: All prospective residents are met and assessed prior to admission to the service. Relatives interviewed stated, “Jenny visited mum at the hospital to assess her”, the social worker sent us a list of homes and we visited a lot, when we came here, we liked the feel of it, no smells, the staff were welcoming, when I popped in I thought it was homely” Residents care needs are generally well met and professional intervention is provided for residents where required. Health professional visits are recorded, the reason for the visit and dated, which is good practice. Specialist intervention and support is sought and provided for residents who need it. This is documented in care files. Relatives interviewed stated, “I’m quite impressed and she is 98 very happy here and is as happy here as she is going to be in a home” and “mum is now walking with her three wheeler since she came in her mobility is better”. Residents discharged from hospital have their medication checked by the service pharmacist and further advice is sought when needed. This ensures any new prescribed medication is confirmed. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 6 A daily audit is carried out for medication such as night sedation. This is good practice. A daily pattern of living is recorded and includes residents’ morning, afternoon and evening routines. This is good practice as it evidences the individual residents preferences. Residents interviewed stated, “You go to bed when you want to, I go at 7. 30pm I get up for breakfast at 7am I like it in bed”, “I can go out when I wish, I go to the Red Cross shop around the corner”. Meals looked appetising and staff provided assistance to residents who needed it. The meals were not rushed. Ann Slade provides a clean, homely service for residents. The service is very keen for care staff to complete NVQ training and at present all staff but one has the qualification to Level 2 or 3, which ensures staff are trained to meet the needs of the residents. The NVQ training has exceeded this standard. A visiting health professional stated, “staff are welcoming, they carry out our instructions, I have no concerns, staff are always helpful”. The management consult with the residents, their families and staff regularly to gain their opinions on how the service is run. This process enables residents, their relatives and staff to feel valued and promotes an open atmosphere. What has improved since the last inspection? Care documentation has improved from the previous inspection therefore this ensures care records are clearer and easy for staff to follow. The maintenance of the service has improved to ensure residents live in a safe environment. Previous requirements have been addressed and improvements include roof repairs, new ceiling tiles, redecoration of a resident’s bedroom, replacing the carpet, replacing the en suite flooring, redecoration of the laundry and repair of laundry steps, refurbishing of the ground floor shower room and repair of the medi bath seal. One relative interviewed stated, “I’m quite impressed, it’s homely, clean and her bedroom is a joy all round I’m totally impressed”. All areas of the service were clean and hygienic with no odorous smells Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 8 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 Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 9 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All prospective residents are assessed prior to admission to the service. The service need to ensure sufficient detail is accessed prior to admission to ensure the care plan is effective. Op3 was assessed. OP6 is not applicable. EVIDENCE: Three residents were case tracked (this is when the inspector examines all care documentation in detail with regard to these three residents whilst receiving care at this service), for the process of inspection. All three residents had been assessed prior to admission. Assessment documentation evidences this. Through discussion with residents some confirmed they had met with Jenny (deputy manager) prior to admission. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 10 Relatives interviewed stated, “Jenny visited mum at the hospital to assess her”, the social worker sent us a list of homes and we visited a lot, when we came here, we liked the feel of it, no smells, the staff were welcoming, when I popped in I thought it was homely” and “I was aware of the weekly costs and costs of extras, like hairdressing, chiropody when we came”. The assessment process needs to be improved to ensure the date that the assessment is carried out is recorded and signed. The service has recorded where the assessment took place with regard to the most recent resident admitted to the service. This assessment was carried out in a local hospital. The deputy manager confirmed that most prospective residents were assessed at hospital. Most areas of care are assessed but insufficient information is collected to get a true picture of what some of the residents needs are. Areas that need clarifying prior to admission are previous and most recent healthcare needs, prescribed medications, last dental, optical, chiropodist, hearing and other appointments. More detail needs to be recorded with regard to some of the residents identified needs such as type of walking/mobility aids, type of spectacles worn. One of the residents has only a copy of their original assessment on file. The deputy manager was unsure of where the original was and thought it may be filed away. The service needs to keep the original assessment documentation at hand so that it can be looked at. The most recent assessment in June 2007 is better. There is evidence of additional information being recorded that is specific to the individual resident. This therefore will enable staff to better identify the individual residents needs and provide more accurate and up to date information so that care plans can effectively reflect each residents needs. Additional information gathered includes, short term memory loss, attends memory clinic, needs prompting for oral hygiene but it does not state if the resident has some/all of their own teeth/dentures worn or what the residents oral health is like. Some information from the most recent resident admitted has come from their family. This is good practice and the service is now thinking of reviewing their assessment documentation again to enable families to provide their input in a recorded format where it is needed. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is good. Residents care needs are generally well met and professional intervention is provided for residents where required. The service needs to monitor accidents to ensure residents are not placed at risk unnecessarily. This judgement has been made using available evidence including a visit to this service. OP7,8,9,10 were assessed. EVIDENCE: All three residents whose care and documentation were case tracked had care plans in place. All three care plans have been signed and dated by the individual residents. Some of the residents interviewed were familiar with their care plans with one resident interviewed stating, “I think I signed the care plan, not long after coming in”. The care plans identify and include areas such as personal hygiene, continence, sleep pattern (checks at night), communication, mental condition, mobility and any aids used, dietary intake, skin condition and any treatments/intervention and any wishes, e.g. size of meals, social needs, bereavement concerns, sight and hearing and oral care. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 12 The personal preferences of residents are recorded including how they prefer to spend their day. E.g. “…..although very independent is still offered assistance of the staff and …….likes to go to rest a lot on his bed”. A brief history of their previous lives/work and up to date family/friend contacts/personal information and religious needs are recorded. There is evidence of social work reviews of residents a few weeks after admission and during their stay in the service. The reviews evidence good progress of the residents. Residents care needs are reviewed monthly with dates and signatures recorded but not all the reviews evidence all the changes in the residents care. Comments canvassed from health professionals and others state, “from my observations, I feel that ….. personal care needs and welfare are satisfactorily met, there is nothing more ….wants the care home to do for them”. The documentation has improved from the previous inspection but sometimes dates are not included e.g. manual handling assessment undated and nutritional assessment undated so it is not known when these assessments were carried out. Health professional visits are recorded, reason for visit and dated, which is good practice. Specialist intervention is sought and provided for residents who need it. The district nurse visits the service regularly to dress one residents leg and give injections where prescribed. A physiotherapist has been providing treatment with mobility for another resident. The dentist, chiropodist and optician are frequent visitors to the service as evidenced in care documentation. Residents interviewed stated, “I have the Dr if needed, I had the chiropodist last week, the optician, yes and I saw the dentist last week and they (dentist) came again today, they have cleaned my dentures for me and now they are all white”. Accident records are completed for residents. One resident in particular has had several accidents recently and all at night. There is no audit of this or record of how to manage this increase in the falls. One fall has been identified in the care review but no further action has been taken. Risk assessments are in place for residents who have been identified as at risk of falling and the deputy advised that one resident had their bed rails removed because of the increased risk to the resident. The family of this resident have been consulted and it was agreed that it would be better for the resident to remove the bed rails. One resident has a history of self-neglect, refusing prescribed medication and personal care support. Their care plan identifies the management of this resident’s care needs following agreement with the resident. The most recent review is 1/7/07, which has been signed by the resident and dated. Detailed information is recorded with regard to this resident’s care needs with the personal preferences with regard to daily routine and living documented. Professional support is provided on a regular basis and this is documented. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 13 Families interviewed were complimentary about how staff cares for their relatives. One relative interviewed stated, “Mum has fallen out of bed a couple of times and we have always been informed. We discussed the care, we also filled in something a month ago, it might have been the care plan. Jenny went through all this when mum came in. They are very good at reminding the residents to go to the toilet and helping them. The GP visits when Mum is unwell. I don’t have to ask for a visit, they tell me if mum has been ill and about the GP being called. Other relatives interviewed stated, “I am happy with the way they are looking after her, they have had the Dr in to assess everything, they seem to be quite on the ball. I’m quite impressed and she is 98 very happy here and is as happy here as she is going to be in a home and “mum is now walking with her three wheeler since she came in her mobility is better”. Medication records are clear with a list of staff names and signatures/initials in place. Photos of residents are in place. The GP and practice manager carry out medication reviews with the most recent one being held in March 2007. Residents discharged from hospital have their medication checked by the service pharmacist and further advice is sought when needed. The service pharmacist visited in April 2007 to audit the medication but the service could not find the report to view. One of the residents self medicates and she has a risk assessment in place. The service does not audit this resident’s medication as the resident concerned liaises with their GP for monthly prescriptions. The resident has a lockable facility in their bedroom. A daily audit is carried out for medication such as night sedation. This is good practice. Mar sheets evidence medication is checked in with a date and signature in place. One resident prescribed an anti coagulant (blood thinning drug) has blood tests regularly to ensure the correct dose of medication is prescribed. The mar sheet evidences the dose differs each week and the record shows lines are drawn through the changed prescription to identify this. The deputy has been advised that the service need to cease this practice and record the different doses on separate boxes so that there is no chance of error. Medicine fridge temperatures are recorded daily. Stock cupboards for storage of medication were tidy. A locked trolley for residents’ medication is secured in the locked medication store. The service needs to return prescribed bath treatments for one of the residents’ as the resident no longer requires it. An audit of some of the residents’ medication was carried out during this visit and found to be correct. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 14 Residents interviewed confirmed that staff are courteous in their manner and respectful. One resident interviewed stated, staff always knock, they do with everybody, there is always someone with you when you have a bath always a lady” and “I always have someone to help me with my weekly bath, a lady, the lady helps me with the toilet too”. Ann Slade Care Home, The DS0000005316.V340465.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): Quality in this outcome area is good. Residents are generally able to live their lives as they wish to with restrictions in place only where it has been agreed that it is for the safety and benefit of the resident. This judgement has been made using available evidence including a visit to this service. Op12,13,14,15 were assessed. EVIDENCE: Residents are asked about how they wish to spend their time and their preferred activities and routines on admission to the service. This is documented on residents care files such as, “prefers to watch television after breakfast in lounge, reads her book pm she likes to retire at 7.30pm, preferred activities singing and quizzes, likes to go out to local shops, prefers own company”. A daily pattern of living is recorded and includes residents’ morning, afternoon and evening routines. This is good practice. Residents interviewed stated, “You go to bed when you want to but not too early, I go at 7. 30pm I get up for breakfast at 7am I like it in bed no, it’s not too early”, “night staff come to check you at night, no problems, I wake around 6.30am, l like that, to waken early, I go to bed late but I am resting all day so I don’t need much sleep” and “I can go out when I wish, I go to the red cross shop around the corner”. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 16 The activities provided for the residents are varied, advertised and discussed at residents meetings. Activities include quizzes, keep fit, organist, sing a longs, bingo and beauty. In addition to the general organised activities some of the residents play cards and watch videos. Poor weather has restricted residents outings therefore planned visits to the Botanic Gardens and Hesketh Park have been delayed. Residents interviewed stated, “musical people come in we have recitals, play bingo, I join in”, “you can please yourself, I don’t join in the exercises, I like to chat to the other residents after lunch and then I go to my room and watch television, I watch it in my room at night”, “I’m very happy here”. Relatives interviewed stated, “she is doing exercises, quizzes, the organist, its there if she wants it, she gets up and goes to bed when she wants, whatever pleases her. The stimulation she gets here is a 100 times better than she had at home” and “I’ve seen the exercise class but mum likes her own company but she is given the opportunity to participate”. Health professionals and others canvassed for their views stated, “staff have encouraged ….. to take part in organised outings and they have declined, however I feel that if someone was available to spend more time with the residents socially and creatively it would benefit them”. One resident interviewed stated, “I’m not really happy here but everyone is quite nice, staff are really quite nice, I have a flat in …., which I want to go back to”. Another resident interviewed stated, “I like it but I’d sooner be at home, they (staff) treat you nicely”. One relative interviewed stated, “she (Mum) loves it, I think she is cared for well, she loves it, she keeps herself to herself, they (service) don’t get in touch but there has been no need to, mum has her hair done and she has seen the GP and the chiropodist”. Residents are encouraged to maintain relationships with family and friends. There are no restrictions with visiting. Residents interviewed stated, “my family come alternate days and I have 2 grandchildren that visit too”. Religious needs are identified in care documentation. Every 4 weeks a Church of England service is held and communion is offered in the small lounge. The Roman Catholic Church also provides Holy Communion every week on a one to one with residents. Two of the residents go out to church each Sunday. Families interviewed confirmed that their relative had choices and one relative interviewed stated, “they only had two rooms and we chose the smaller one but on the understanding that when another room became vacant we would be offered it. Mum did get the other room. She chose it out of 2 that were empty. She is settled there now”. Residents interviewed with regard to meals served stated, “the food is good, it’s okay they change the menu, the food is served hot, not really home baking”, “I have breakfast in my bedroom, it’s served at a small table. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 17 Relatives interviewed stated, “she loves the food it’s been fantastic, she had lost weight, she had meals on wheels at home but they were left, she was not eating anything at home”, “the food always looks nice, I have no complaints, they give an alternative” and “staff come around with juice (for the residents), especially when it’s warm, I have been offered drinks and meals on occasions. The inspector was able to have a brief discussion with the cook. The cook advised that she had no problems with food supplies to the service. She has always been able to provide foods that residents like. The food stored was viewed and is of good quality and in plentiful supply. Menus are on a four weekly rota. A record is kept of residents’ names and their daily choice of meals is recorded. Residents are asked in the morning what they would like for lunch and after lunch asked what they would like for tea. The daily menu is displayed on the dining room notice board. There is a residents’ dining room and two additional smaller dining areas are in use in the lounges. The menu is varied with choices for main meals and puddings are lighter at present. Residents interviewed stated, “I had steak pie for lunch (menu confirms this) and I had bacon sandwiches for my tea”, “there is a choice at lunchtime and then they ask you what you want for tea, there are a few choices. The inspector viewed the evening meal being served to residents. Meals looked appetising and staff provided assistance to residents who needed it. The meals were not rushed. Clean cutlery, crockery, napkins and condiments were available. Tables were well presented and residents had suitable dining chairs. Residents were offered additional bread and cakes /pastries were provided –similar to the traditional high tea. Not all residents had the same meal served, as individual residents choices were evident. Supper is served later from 7pm. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Residents are generally well protected by the services policies and procedures but the service need to ensure that staff record all concerns/complaints and record their signatures when documenting this information. This judgement has been made using available evidence including a visit to this service. OP16,17,18 were assessed. EVIDENCE: The complaints record was viewed and this evidenced the complaints and concerns logged to date. All of the concerns/complaints logged have been investigated and the records show outcomes for the residents. Many of the issues raised are of a minor nature. The service has had two complaints raised that the Commission have been involved in. One complaint was fully investigated and resolved with full documentation relating to this sent in to the Commission by the provider of the service. The complaint was unfounded. The other complaint raised was regarding heating bedrooms and this was resolved the next day to the satisfaction of the complainant. The service do not have this second concern logged in the complaints/concerns record therefore this needs to be addressed. Complaints logged are dated but not always signed by the staff member. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 19 The complaints procedure is on display in the front hall. The procedure is not yet in large print or any other format. The service is looking at ways to improve this. To ensure residents are aware of the complaints process residents are reminded of it at each monthly residents meeting. No residents’ monies are kept. Residents interviewed stated, “yes, I am aware of the complaints procedure, you can make a complaint to senior staff, I have no worries here”. Relatives canvassed for their views commented, “I have never had any reason to raise concerns”. All of the residents use the posting vote system at election times. Sefton advocacy details contacts are on the office window. One of the residents who lack capacity has regular access to an advocacy service. This is recorded and documented in care files. Residents’ bedroom doors have locks but none of the residents have keys. The deputy manager stated, “no residents have asked for keys”. The service needs to ask residents if they wish to have a key to their bedrooms and where wished this should be accommodated. Where it is agreed that residents would be at risk of having this facility this needs to be documented. Residents’ have the use of lockable drawers in their bedrooms. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Ann Slade provides a clean, homely service for residents. The maintenance of the service has improved to ensure residents live in a safe environment. This judgement has been made using available evidence including a visit to this service. OP19,26 were assessed. EVIDENCE: The service provides a comfortable and homely environment for the residents. A tour of the public areas of the service including, sitting rooms, dining room, laundry, kitchen, storage, bathrooms and a few of the residents’ bedrooms took place. All areas of the service viewed were in a good state of décor. Residents’ sitting rooms, dining room, hallways and bedrooms were pleasantly decorated and furnished. Some of the residents have their own furniture in place. One of the residents interviewed stated, “I have a lovely room-I’ve brought some of my things, it’s homely” and another resident stated, “I like my bedroom, I’ve got most of my things in it”. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 21 A relative interviewed stated, “ I’m quite impressed, it’s homely, clean and her bedroom is a joy all round I’m totally impressed”. The maintenance of the service has improved over the last year as evidenced during the visit. Records show regular checks of the building with planned improvements carried out. The maintenance person is employed for 12 hours each week. The maintenance log was viewed and evidences the job to do, when done, ticked and signed dated All requirements from the previous inspection have been addressed. The roof has been repaired so there are no more leaks and ceiling tiles have been replaced. The ground floor shower room has been redecorated with tiles newly grouted and a new floor covering. The medi bath seal has been repaired also. The laundry room has been refurbished and looks clean, fresh and well organised. The steps have been repaired also. The laundry has two washers and one tumble drier and residents clothing has been laundered and transferred to residents’ rooms in their individual baskets. All areas of the service were clean and hygienic with no odorous smells. The ‘smelly’ area identified in the previous inspection report has had a new carpet, been redecorated and new flooring is in the en suite. The kitchen was well organised and clean on the day of inspection. Foods in the fridge were all covered and dated. The freezer, fridge and hot food temperatures are regularly recorded. The dry store is tidy and full of various foods with no opened packages. There is a separate facility for staff to wash their hands with hand towels and liquid soap. The floor is hygienic and easily cleaned. Tiles on all the walls are clean and in good condition. There are cleaning schedules for daily, weekly and monthly rotas in place. All areas and surfaces in the kitchen including equipment are clean. The gardener visits the service weekly twice a week when needed. The garden grounds are pleasant and contain suitable garden furniture for residents and their visitors. The inspector discussed the absence of a key for residents’ bedrooms previously in this report. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The service provides staff with a good training programme including the NVQ qualification, which ensures staff are trained to meet the needs of the residents. Further training for staff with regard to equality and diversity would benefit residents in the service. This judgement has been made using available evidence including a visit to this service. OP 27,28,29,30 were assessed. EVIDENCE: The staff rota evidences sufficient staff are on duty to meet the needs of the residents. The provider/manager and the deputy manager are also on call. The service has no laundry assistant. Care staff organise this. The service has a cleaning contract that provides cover over 5 days to maintain the cleanliness of the premises. A cook is employed throughout the week each day and care staff serves the prepared evening meal. The service is very keen for care staff to complete NVQ training and at present all but one staff has a qualification to Level 2 or 3. Qualifications are evidenced in staff files. One carer is now in the process of attaining Level 4. This standard is exceeded in this area. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 23 Two of the staff training records and staff files were case tracked. Both staff were interviewed also during the inspection visit. Training records evidence that all staff are up to date with all mandatory training including manual handling, fire training, health and safety, infection control, basic food hygiene and first aid. Other training attended includes care of the dying, pova, (Protection of Vulnerable adults), medication administration and abuse. There is no equality and diversity training in place. Staff training records did not evidence any training with regard to residents who have mental health needs. The cook has also attended intermediate food hygiene and manual hygiene and fire training were attended earlier this year. Staff files evidence that all pre employment checks were in place prior to employment. Interview notes are also recorded. Induction for staff is evidenced in training records and both staff were supervised in the first few weeks of employment as confirmed during staff interviews. Staff interviewed stated, “I do feel I get the right amount of training to do the job, “they are good for training” and “there are enough staff on duty for the work and when staff are off sick someone comes in who will be on call”. “We have an annual appraisal and 2 monthly supervisions, it’s good, I enjoy it”. “There are no problems with senior staff, I attend the staff meetings every month, an agenda is written up and you get a chance to air your views” and “the residents are definitely well cared for, the food is nice, no worries at all”. Relatives interviewed stated, “staff are great, no problems always polite to mum, they are the same when the managers are on holiday”, “staff are brilliant, I will give credit where it is due”, “It doesn’t matter what you ask the staff to do, they do it, they have their finger on it”, “they have got to know …… so quickly, when she has problems they deal with it, they couldn’t put her anywhere better, they have brought her alive, they have lifted a load of trouble of us”, “they are so friendly and nice”, “ It doesn’t matter who I speak to it’s seen to straight away, they keep me informed” and “they have given her a far, far higher quality of life”. Relatives and residents were mostly complimentary about the staff employed. Health professionals and others canvassed for their views stated, “I feel that some of the staff could be more patient and understanding” and “staff are welcoming, they carry out our instructions, I have no concerns, the staff are always helpful”. Residents interviewed stated, “most of the staff have been quite nice”, “staff are very nice to you”, “staff are very nice I can’t complain about the staff, I’m quite friendly with all of them they are respectful”, “staff are kind to other residents”, “there are some very kind nurses (carers) that mean well”, night staff check up on you, staff get drinks for us it’s not problem, staff are smashing, they are kind and helpful”. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 24 Contracts of employment are signed and dated. One staff interviewed stated, “during the induction we went through the fire procedures and exit tour of home and I worked with Andy during the day for two weeks, I have supervision monthly with Jenny” and “there is a handover in the mornings and evenings, some days are busier than others but we do have enough time”. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 25 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): Quality in this outcome area is good. The management consult with the residents, their families and staff regularly to gain their opinions on how the service is run. This process enables residents, their relatives and staff to feel valued and promotes an open atmosphere. This judgement has been made using available evidence including a visit to this service. OP 31,33,35,38 were assessed. EVIDENCE: The registered provider/manager has many years experience of managing Ann Slade. He has completed the Registered Managers Award (2005), and gained an NVQ Level 4 in care and management in 2006. Mr Korwin Granford has also kept up to date with mandatory training including basic food hygiene, first aid, fire training, health and safety and manual handling. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 26 Relatives interviewed confirmed that they were happy with how the service was managed and one stated, “the owner and deputy manager, we have no problems with, we sit and ‘natter’ to them I’m sure if I had a problem I would speak to them and it would be sorted”. Residents interviewed confirmed they had confidence in the manager and owner with one resident stating, “I might speak to Jenny or Edward if worried but …… is back so I’d speak to her”. One of the staff interviewed stated, “I have no problems with senior staff” Some of the residents the inspector met discussed how they were able to make any changes or suggestions either by speaking with the senior staff or participating in the residents monthly meetings. Not all of the residents go to the meetings. The last residents monthly meeting was held on 6th July 07. A list of residents who attended and senior staff present is on record. Items discussed included the poor weather meaning cancelling trips out, shopping trips to Asda to continue, food: residents are happy with current meals, further suggestions with some listed, no smoking designated smoking room as previously arranged. Previous residents meetings discussed the fire drill, new residents welcome and complaints. Staff meetings are held monthly with the last on 5th July 2007. Minutes read included, staff attended, staff bonus, no smoking, infection control, inspections, confidentiality and nutrition. The service has an external quality assurance and is due an assessment in August this year. The service carries out two residents/family surveys a year. The results of the March 2007 survey were positive. The service also has recent letters of thanks from grateful relatives complimenting the staff and care provided. These were viewed during the visit. The service has a valuables book. A lockable facility is available to store residents’ valuables. The service does not hold any residents’ monies. A general audit is carried out if the building and records evidence all checks are performed to ensure safety for residents and staff. Fire safety checks and training are up to date. The home insurance certificate is dated to 15/6/2008. Electrical appliances and portable appliances are in date to July 2007. Gas boilers in the roof space, kitchen and laundry have been serviced to date. The lift and hoists were last service in April 2007 but the certificate was not available to view therefore a copy is to be sent to the Commission. The most recent environmental health visit was 27/6/07. Some recommendations were made and these have been carried out. The service has been provided with the FSA (Food standards Agency) log and are now using it. COSHH (Control of Substances Harmful to Health) data is on file and stored in the locked cupboard upstairs on the first floor. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 27 Management is aware of Riddor (Reporting of Diseases and Dangerous Occurrences Register). Risk assessments are carried out for each room and documented. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 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 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 29 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. Standard Regulation Requirement Timescale for action 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. 4. 5. 6. 7. Refer to Standard OP3 OP7 OP8 OP8 OP9 OP9 OP9 Good Practice Recommendations It is recommended that assessments should be more detailed and includes the date the assessment is carried out and the staff members’ signature. It is recommended that monthly reviews of all the care plans should identify any changes in the residents needs. It is recommended that the service needs to monitor accidents to ensure residents are not placed at risk unnecessarily. It is recommended that manual handling and nutritional assessments should be dated. It is recommended that residents who are responsible for the ordering and administration of their own medicines should be monitored. It is recommended that any ‘old’ stock of medication should be returned to pharmacy. It is recommended that when the same medication (anti coagulants) is prescribed at different doses this should be DS0000005316.V340465.R01.S.doc Version 5.2 Page 30 Ann Slade Care Home, The 8. 9. 10. OP16 OP24 OP30 recorded in separate boxes on the Mar sheet. It is recommended that all complaints/concerns should be recorded and dated and the format be improved to ensure all residents understand the procedure. It is recommended that all residents should be provided with keys to their bedrooms unless their risk assessment suggests otherwise. It is recommended that the service should provide staff with equality and diversity training. Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Ann Slade Care Home, The DS0000005316.V340465.R01.S.doc Version 5.2 Page 32 - 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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