Inspection on 11/03/08 for Arthur Clarke

This inspection was carried out on 11th March 2008.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Arthur Clarke 01/12/06

Arthur Clarke 24/11/05

Arthur Clarke 29/04/05

Arthur Clarke 19/10/04

Arthur Clarke 04/05/04

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Arthur Clarke 1 Albert Road Caversham Reading Berkshire RG4 7AN Lead Inspector Ruth Lough Unannounced Inspection 11th March 2008 10:45 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 Arthur Clarke DS0000039521.V359137.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. Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Arthur Clarke Address 1 Albert Road Caversham Reading Berkshire RG4 7AN 0118 9015359 0118 9015360 tracy.newport@reading.gov.uk www.reading.gov.uk Reading Borough Council 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) Vacant post Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28), Physical disability (2) of places Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No service users to be admitted under 55 years of age. Service users category PD to be respite care only. Date of last inspection 1st December 2006 Brief Description of the Service: Arthur Clark is a moderate sized residential care home for service users over the age of 65(OP) and up to 2 service users with a physical disability aged 5565 years of age. The home has 22 beds for long-term residency and 6 beds for respite and emergency short-term placements. Reading Borough Council runs the home. A day centre for the elderly, which is also the responsibility of Reading Borough Council, is linked to the home and shares the catering and staff facilities. Residents can only be admitted to the home through a Social Services referral process. The fee for this service is £440.95 per week. Items not covered by the fees include chiropody, hairdressing, and aromatherapy. Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that people who use the service experience good quality outcomes. This was an unannounced planned key inspection process. The inspection process included information submitted to the commission in the Annual Quality Assurance Assessment, self-assessment document completed by the manager prior to a one-day visit to the service. Relatives, staff and health and social professionals were also given the opportunity to comment about the service through surveys returned to commission. Twentyfive were returned in total. The inspector also spoke to service users, staff, and relatives during the visit to the service. A previous requirement in regard to the content of the Statement of Purpose had not been met fully. This did not impinge in the general outcomes for the people living there as service users and relatives confirmed that they had been consulted with and had access to information should they wish for it. What the service does well: What has improved since the last inspection? They have employed a specific member of staff to develop and improve the activities on offer to people living in the home. Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 6 The medication practices have been reviewed and updated to ensure that safe practices are carried out. 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. Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Standard 6 is not applicable. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The information given in the Statement of Purpose does not give the required information to prospective users of the service. Service users needs are assessed before they are admitted to the home. EVIDENCE: The Statement of Purpose was reviewed to see what information prospective service users and their families are provided with, before they make the decision to use the service. During the last inspection process it was identified that some of the information was not up to date or was missing. The document provided by the manager during the day visit to the service did not give sufficient information about the service establishment or about the registered provider. Greater information about the facilities at the home should Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 9 be included such as the size and number of rooms available and the reader should be informed about the registered provider, Reading Borough Council. The layout of the document could be improved to user friendly and should include the contact details of the home. Service users can only be referred to the home through the local authority’s Community Care Team and only after a full social services full care needs assessment has been carried out. From discussion with senior staff and the manager it was also apparent that the home carry out an independent assessment visit to the prospective service user as to ensure that they will be able to support them. The care records for one recent admission, during the last two weeks, was reviewed to see what information the home was provided with and what processes they carried out. A relative of this individual also provided further information about the whole process and what support the home gave to the individual and the family. The records showed that information had been supplied by the discharge planning service of the local hospital and a care manager who carried out a full assessment of need. The care staff of the home had included additional personal information, such as relatives and supporters contact details to these. What was evident from discussions with care staff, reviewing the care planning records and observing the needs of one service user that some of the information regarding their health needs was omitted from the recorded information provided by the hospital on discharge. Staff were in the process of securing the necessary information and support from the individual’s GP during the day of the visit. The relative who spoke with the inspector did confirm that time was taken to explain the process to them and their relative before admission and although there was an opportunity to visit the home this was declined because of prior knowledge of the home and the health needs of the person concerned. One relative commented in a returned survey that they thought they were not provided with sufficient information about the home before their relative was admitted to the home. Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9, and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service can be assured their needs will be met and that safe medication practices are now carried out. EVIDENCE: The service user plans for three residents were reviewed as to assess that staff are given sufficient information and guidance to meet the needs of the individual and ensure that there is continuity of care. The service users records selected included one person who had been admitted during the last few weeks, and two people who had been living in the home for some time. The records reviewed supported that the care needs were divided up into topics such as personal care, mobility, and communication with a varying degree of detail to provide instruction to meet the persons identified needs. They also note down any specific dietary or continence needs and there are good records to show that each person is supported to obtain regular consultation/ treatment for dental, hearing, chiropody, and eyesight care. Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 11 For one person a risk assessment process had been carried out for the use of specialist treatment/care should the need arise. However, insufficient information was in place to enable the staff to support the individual. This was also reflected in the medication administration records. The staff had already identified this was of concern (see Choice of Home) and were in the process of seeking healthcare support to be able to meet his needs. Through discussion with a service user and their relative, information was given about a recent change in their health needs that they were worried about. This was with particular reference to the divan bed in the service users room that may not necessarily meet their needs, maintain their safety, and put care staff at risk when supporting them. The senior staff confirmed that the family had already made them aware of the concerns and that they were in the process of reviewing the current facilities. However, the care planning records for this individual did not reflect the medical condition or recent changes for this person sufficiently or give staff guidance of how staff are to monitor or support them should it occur again. The records seen did show that senior staff review the care planning frequently and amend where necessary. A more formal process is a six monthly review of the whole care plan is undertaken with the service user and their relative should they wish to be involved. Some work has been carried out to record the individual’s life history and personal preferences to assist staff to have a better understanding of the person concerned. However, the quality of those seen very variable, with one giving a good picture of the personality, interests and family background and another being very brief. For the person recently admitted to the home this had not been completed as yet. Staff are recording in detail in the daily records, well. Senior staff note down in a separate document any significant event or contact with professionals relevant to the care of the individual. The homes medication practices were reviewed to see what training staff are provided with and if there are safe handling processes in place to protect the service users living in the home. During the last inspection process a recommendation was made about some of the recording and storage practices for medication in the home. On a review of the current records available during the day and the storage facilities these appear to have been acted upon, with accurate recording and safe storage practices carried out. What was identified was there were a small number of residents who have medication that should be stored and managed under the regulations for controlled medications. The home has the facilities that comply to the recent changes in the guidance given for drug administration given by the commission to meet with the Controlled Drugs Regulations that were amended Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 12 in 2007. However, the record book for this had loose pages and therefore information could be lost or recorded inaccurately. Since the last inspection process the service has informed the commission through regulation 37 notifications of two incidents of serious medication administration errors that occurred. The senior staff provide information that incidents were investigated by the home and suitable action taken to ensure there were no further occurrences. This was done through a retraining programme and individual monitoring of staff. Staff confirmed that there had been no further episodes of poor practice since then. Residents and the relatives who spoke to the inspector during the day were very complimentary about the staff. They expressed great confidence in them in regard to understanding their needs and supporting them to get health and medical support. Relatives were pleased that staff were swift to contact them with any concerns with health or the well being of their relative and that they were always very responsive to any worries they expressed. However, comments in the returned service users surveys did show there were mixed feelings about whether they obtained the support they thought they should have. Two residents said that they felt they did not get the help they needed, and one added, “ Have to do it all myself.” Another said there were not enough staff. One resident wrote, “They do it so well I don’t want to go home.” In answer to the question, ‘Do the staff listen and act on what you say?’ One service user said, “Turn their back on you and walk away.” Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14, and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service are able to have the lifestyle of their choice matching their preferences and needs. EVIDENCE: All the people who live in the home that spoke to the inspector during the day visit stated that they liked living in the home. Some also said that they were able to carry on with their interests where able and enjoyed joining in with the activities in the home. The three selected care planning records were reviewed to see how the staff establishes the individuals interests, choices and wishes of how they wish to live. The records showed that religious and ethnicity needs are noted and if there are any particular language or communication difficulties of the person concerned. The manager did provide information in the Annual Quality Assurance Assessment that the people currently living in the home were of the Christian faith and that they were provided with regular visits from and contact Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 14 with the local churches, should they wish. They also stated that they were able to resource support for other faiths if required from the local community. From information given by staff and that what was included in the Annual Quality Assurance Assessment document there is a regular programme of activities. The programme includes the weekly events such as the hairdresser, games, and gentle exercise plus periodical visiting musical entertainment and trips out. Where possible they join in the activities in the adjoining day centre that gives the residents the opportunity to meet some friends and acquaintances that live in the surrounding local area. A small number of the residents are still able to arrange their own activities where they use the local ‘Redibus’ service to the town centre. The manager did also state in the Annual Assessment that they thought that the activities organiser, who is employed for three days per week, had improved the lives of the residents over the last twelve months. This was by developing what is on offer and by encouraging them to join in the service user meetings where they can comment on what is provided. Service users comments in the surveys returned to the commission showed that there were a small number of people who did not feel that they wished to join in with the activities going on in the home. Comments were: “I would rather sit on my own,” and, “There is not a lot going on here.” Two others were more positive about the activities provided. One said, “Always look forward to it.” Individuals participation in activities and interests is recorded in the care plan records and staff also note the persons enjoyment and involvement in the daily records. Relatives who spoke to the inspector stated that they felt welcomed and included in the activities and daily routines going on in the home. The home provides the residents with a four weekly rotational menu plan that is changed on a seasonal basis. The cook gave information that the menu plan is developed from the residents meetings, discussion with individuals, and observation of how the residents appear to enjoy what is on offer. Personal choices and dietary needs are recorded both for planning and in daily records in the kitchen for the catering staff to monitor that they are meeting individual’s needs. The records show that the staff are flexible to changes in the planned meals and can offer alternatives should the need arise. Care staff are able to provide snacks and hot drinks between meals should a resident be hungry or miss a main mealtime. Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 15 Residents are encouraged to eat at the dining tables for all their meals but staff are flexible should they choose not to. There are three areas that are used for mealtimes, part of the lounge by the kitchen, the rear conservatory, and a sitting room. In the survey the majority of the service users stated they enjoyed the food provided with comments added, “ Wonderful, the food is lovely,” and “Very good.” Staff have encouraged meal times to be social occasions by the presentation of the dining tables and providing the menu for the day on each table for service users to read. An observation of the midday meal during the day of the inspection showed that residents enjoyed the occasion, conversation, and the meals provided. A member of staff commented, “Arthur Clark home is comfortable and warm and the staff are friendly. The residents have told me they are happy with the meals. Fresh fruit is offered with their 11:00 am drinks. They are offered activities three days a week, which most of the residents join in.” Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. That service users are concerns are listened to and acted upon. The home has strategies in place to ensure that the people who use the service are safeguarded from possible harm. EVIDENCE: The majority of the residents who took part in the survey from the commission said they usually know who to speak to if they are unhappy. Comments were, “ I’m very happy here so I can’t see that happening!” and “ I have never been unhappy.” However, four said they did not know how to make a complaint. This information was passed back to the manager after the inspection visit had been carried out. The service provides the residents with a copy of the complaints procedure in the Service User Guide. Copies of the process are also put on display in the home. Residents and relatives who spoke to the inspector confirmed that they knew who to speak to if they had any concerns. They also stated that if they had had concerns in the past their experience was positive as staff responded quickly and appropriately. Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 17 The manager provided information that there had been twenty complaints made during the last twelve months but it was unclear from the information given in the Annual Assessment document if these were not upheld or fully resolved. Therefore the records for the complaints management were reviewed as to assess if the record keeping gives a clearer picture of the management of complaints or concerns. The home record all comments, concerns, or complaints in a logbook where the detail is noted and the action or response is recorded. What was not apparent was the timescales of the whole process or that the concern was fully resolved. For the two last entries insufficient information was recorded to show that the situation had been acted upon and that the complainants were happy with the response. The manager provides information about complaints and concerns to the registered provider on a monthly basis who monitors the overall complaints for all the services they provide. A recommendation was made to look at improving how they record concerns or complaints as to ensure confidentiality and monitor timescales. They could also develop the process to indicate trends of concerns for quality assurance processes within the home. The complaints seen were a mixture of minor concerns and those that required further investigation including lost valuables and relationships with staff. It was unclear if the home use the compliments given by service users or visitors to the home in their quality assurance monitoring processes as they do not record or monitor these when received. Staff usually tend to put these on display in the entrance hall. The home has the necessary information and training is provided to staff for the protection and safeguarding of the service users from possible abuse. Staff are given training within their induction programme and the topic is periodically reviewed when there is a change in the local authority policy and procedure. Retraining is not provided routinely or included in the mandatory training programme. For the long serving staff this topic may not be revisited for a considerable length of time as evidence seen in training records showed this could be over four or more years. However, staff do have access to support within the providers organisation if they have concerns or require support. The commission has not been in receipt of any concerns or complaints about the home since the last inspection process. Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. These judgements have been made using available evidence including a visit to this service. The home meets the needs of the people living there and provides a homely comfortable environment. Greater care should be taken to ensure that there are good infection control processes in place to protect both the residents and the staff from risk. EVIDENCE: The home is partially purpose built as it was developed as a large extension to the mature pre- existing building that used as a day centre for the local community. The two services have been provided with separate entrances and grounds but share the services of the catering department that is based in Arthur Clark. Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 19 The home is on two levels with the majority of the bedrooms on the upper floor and the four communal spaces, laundry and administration offices on the ground floor. The home is provided with a passenger lift to the upper floor and there are assisted bathrooms and toilets on both levels. None of the bedrooms have en suite facilities and the size of individual rooms vary. There are four of the smaller bedrooms that are used for the respite services they offer. Additionally to this there is one specific room with a ceiling hoist fitted that is dedicated to be available for emergency admission from the community to use for a more physically dependent service. The home has added security measures in place such as entry cameras and key codes to main doors. An observation of the facilities and environment of the home highlighted that generally it is kept clean, tidy and in good repair. The communal lounges and corridors appear friendly and welcoming and it was evident that individuals were supported to personalise their rooms. Care should be taken in some areas to ensure that infection control is maintained. Staff have been leaving personal toiletries, towels and furniture with permeable coverings in the bathrooms and toilets that could compromise the control of cross infection. There are two sluice rooms, one on each floor of the home for the emptying and cleaning of commodes. Both only provide a facility to flush the contents away and rinse the commode pans. They do not have the ability to cleanse or disinfect these items in accordance to the guidance given by the Department of Health, Control of infection for Care Homes. The manager was advised to look at how they can improve the current facilities to meet these guidelines. Both sluice rooms appear to be used as a storage area for the domestics cleaning tools and equipment and a number of partially used personal toiletries, and some disposable goods are also stored there. A recommendation was made to improve the management of these areas to aid the domestic staff to keep clean and reduce the possibility of infection spreading. Previous concerns about the laundry service have improved. The employment of a specific member of staff for this task has eliminated deficits previous highlighted. Residents appear to be happy with the quality of the service now given. An observation of the condition of the residents clothing during the day indicated that they are washed and care for appropriately. Service users commented in the survey that generally they thought the home was kept clean and fresh. Other comments were: Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 20 “Beautiful and clean.” “Very clean.” “Even the cat has to wash her feet!” Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, and 30. Quality in this outcome area is good. These judgements have been made using available evidence including a visit to this service. The needs of the people living in the home are not compromised by the shortfall in employing permanent staff to work in the home. The staff are provided with training to ensure that they have the skills and competencies to meet service users needs. EVIDENCE: Residents and relatives commented during the day that they thought there were enough staff on duty at all times of the day. Residents did also say that they usually responded quickly when asking help or assistance at any point during the day or night. Both groups said they thought the staff friendly, cheerful, and helpful. One service user stated in the survey that there were never enough staff to provide support and added, “ Can sit for half an hour and no one will come around.” Through discussion with the senior staff it was identified that they continued to use some agency staff to meet any problems with staffing sickness, annual leave, and vacant posts. The majority of the time they have regular staff supplied by agencies, who know the residents and the home well. Occasionally, Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 22 this is not possible and new staff are introduced to the home usually with the support of regular staff. From the four staff surveys returned to the commission, one thought there are usually enough staff and three said there were sometimes enough staff. Comments from staff were: “Residents bring up in residents meetings that they have to wait a long time to go to the toilet and to go to bed at night.” “At the moment there is not enough staff, more permanent staff are needed.” “To have more care staff” “ Staffing is a huge problem. We often use agency staff who do not work a full shift leaving us very short at certain times of day.” Information supplied in the Annual Assessment document shows that a high number of staff have left the service including five full time and three part time care staff. Of this, there is less than 25 of the whole team of the staff have attained a qualification in care, NVQ level 2 or above. This is below the anticipated level and the management team have already recognised this and another two permanent staff have registered to commence training. The recruitment and employment records of two members of staff were reviewed to see what the recruitment practices are and what support and training is given to staff. One person had been working in the home for over three years; the other had been employed in 2007. The records for both employees that are stored in the home was disorganised and were not stored with good principles of separating information. The records for supervision, induction, and contractual information were also kept in this file and it was difficult to establish that all the relevant information had been obtained. All the records were loose documents in no particular order. The provider carries out the main recruitment process and passes copies of the key documents to the home for inspection and management purposes. This being so it may be that the information supplied to the home from the provider is incomplete. The records showed that the applicant is required to complete an application form, provide proof of identity and two referees. For one employee, a copy of only one half of the application form had been provided with accompanying references. The other, employed in 2007, did have a full copy of the application form but this did not ask for their full work history and on closer examination did not explain any gaps between posts. A copy of the interview process with this applicant was supplied but this did not explore this topic any further. Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 23 The providers human resources department informs the home via email that the Criminal Records Bureau check and health screening has been completed. These were in place for both employees. A photocopy of the photo from the passport or photo driving licence card is the only photographic evidence of the employee concerned in the home. Those seen were not of a good quality and it was difficult to see if it was a true likeness. Training records for each member of staff is kept separate from the employment records. The records reviewed showed that the most recent employee had had the necessary induction training and was now on a programme of training for the key topics for health and safety and safe working practices. For the other member of staff there was some evidence that some of the mandatory topics for training were being revisited and that they had had further training in the past for caring for people with Dementia. Information provided by senior staff and the manager highlighted that staff have not been in receipt recently of any training in regard to any specialist needs of the individuals. However, there is a planned training for staff to support a resident with respiratory problems and the use of specialist equipment. From records seen there is a regular programme of supervision and appraisal that is carried out. However, one staff member stated in the survey that they sometimes have supervision with an added comment; “I have had two supervisions in the last year.” Three of the staff stated that they usually have the right support from the management team to carry out their role. Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the people living there. EVIDENCE: One relative wrote about the home and the support provided, “ I have not seen my mother so content for many years. The home has made an enormous difference to her.” One relative wrote in response to the question about what the home does well: “Overall the quality of care provided is very good. The staff have an attitude of care to be commended, and the catering staff are sympathetic to the residents wishes.” Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 25 A new manager has been appointed to the role in October 2007 and she is currently in the process of an application to the commission for the registered manager position for the home. She provided information that she is a Registered Mental Health Nurse (RMN) with previous experience as a Registered Manager and has undertaken the Certificate in Health and Social Care Management. She is supported by a small team of senior staff that now includes a deputy manager who has been promoted and transferred from another of the provider’s services. The manager confirmed that there were a number of activities in place to monitor the performance of the home for quality assurance purposes. These include monthly provider visits, staff meetings and the supervision and appraisal of staff. To ensure that service users and their relatives are consulted about the home there are residents meetings, reviews of care and an annual survey carried out by the provider. The manager was unable to provide a copy of the last quality assurance survey carried out for the home. However, the other records were open to examination. The residents and those relatives who spoke to the inspector stated that they thought they were kept informed of changes and asked their opinion of what was going on in the home. The home does manage small amounts of personal money on service users behalf if the do not have a representative to do so. A member of the administration team is responsible for this task and ensures that the records are up to date, audited and that all monies are correct. The provider regularly implements a thorough check on a periodical basis. Any service users valuables taken into safekeeping is receipted and personal property is logged when the individual is admitted to the home. The home has a number of policies, procedures, and systems in place for protecting the health and safety of the residents and staff. There are a number of routine checks carried out including those for the facilities of the home such as heating, water, and safety equipment. Regular checks have been carried out by the Environmental Health Department, with the last check for the catering service resulted them in being rewarded a ‘Five star’ rating. The training records show that the staff team are provided with the necessary health and safety training they require, including safe moving and handling and fire safety. Staff commented on what they thought the home did well: “The service offers excellent care.” “The home has a friendly atmosphere and relatives often comment on this.” Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4 Requirement Update the home’s Statement of Purpose to include all the information required by the Regulations. Requirement not met previously 31/01/07 Timescale for action 30/04/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP8 Good Practice Recommendations The staff could improve how they record the service users health and medical conditions to ensure that they have sufficient information for care planning and to identify any training that staff may need to meet them. The home should replace the Controlled Drugs register as to ensure that information is not lost. That the manager looks at how they can improve how the record concerns or complaints as to ensure confidentiality and monitor the process of investigating timescales. The manager should review the processes for the cleaning and disinfection of commode pans as to ensure that they DS0000039521.V359137.R01.S.doc Version 5.2 Page 28 2. 3. 4. OP9 OP16 OP26 Arthur Clarke 5. OP26 6. OP29 follow the DOH guidelines for Control of Infection in Care Homes. The manager and senior staff should ensure that greater care is taken by all staff to reduce the risk of cross infection by the storage of personal toiletries in the communal bathroom and equipment in the sluice rooms. That greater care is taken to manage the documentary evidence of the recruitment and employment of staff to ensure that the information is available and open to inspection. Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Arthur Clarke DS0000039521.V359137.R01.S.doc Version 5.2 Page 30 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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