Inspection on 25/07/06 for Aspen Court Care Home

This inspection was carried out on 25th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Aspen Court Care Home 20/09/07

Aspen Court Care Home 14/06/07

Aspen Court Care Home 31/05/06

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

CARE HOMES FOR OLDER PEOPLE Aspen Court Care Home Hope Corner Lane Taunton Somerset TA2 7PB Lead Inspector Caroline Baker Key Unannounced Inspection 25th July 2006 09:25 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 Aspen Court Care Home DS0000066159.V305367.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. Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aspen Court Care Home Address Hope Corner Lane Taunton Somerset TA2 7PB 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) 01823 346000 01823 346001 N Notaro Homes Limited Post Vacant Care Home 27 Category(ies) of Dementia - over 65 years of age (27) registration, with number of places Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To accommodate up to 27 service users in category DE (E) who require nursing care. Including 3 service users from the age of 55 years. The manager to have supernumerary of at least 25 hours a week. Date of last inspection Brief Description of the Service: Aspen Court is a purpose built care home found on the same site as its sister home Cedar Lodge. The home is registered with the Commission for Social Care (CSCI) to provide nursing care for up to 27 persons over the age of 65 years with a dementia with the conditions listed above. All private rooms are single with en-suite facilities. There are communal areas and a secure garden for resident use. The current scale of charges range from £537 - £637 per week. Hairdressing, private chiropody, dental care, optical treatment, clothing, toiletries and newspapers are not included. Since February 2006 part of the 42 bed premise was registered separately the ‘Roma Unit’ - to accommodate up to 15 younger adults. Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key Inspection was unannounced and took place over one day and was conducted by three inspectors, including the CSCI Pharmacist Inspector, which amounted to 20.5 inspector hours. This inspection took place to follow up concerns raised at the last Key Inspection undertaken in May 2006 when 22 requirements and 2 recommendations were identified. The CSCI met with the registered provider on 27 June 2006 and received a comprehensive improvement plan. Since the last inspection a new manager had been employed. The new manager, staff and residents welcomed the inspectors. There were 22 residents living at the home at the time of this inspection. A tour of the premises took place where a selection of bedrooms and all communal areas were seen. The inspectors consulted with at least ten service users, two visitors and three staff during the inspection. The manager and regional manager were available throughout the inspection. During the inspection the inspectors observed interactions between staff and residents. A vast improvement was identified overall at the home at the time of this inspection. Many requirements had been dealt with and outcomes for residents were good overall. Unfortunately medication systems and care planning remained poor, which affects the overall assessment as this puts residents at a potential risk of harm. What the service does well: Prospective residents and their representatives are able to visit the home before making a decision to move into the home and residents benefit from being assessed by the home before admission to see if it can meet their needs. Residents are able to have visitors at any time and keep links with the local community. Visitors seen during the inspection were satisfied with the provision of care at the home. Comments received from residents during the inspection included: ‘I like living here’, ‘the food is good’, and ‘the staff are kind and helpful’. Residents spoken to were aware of the complaints procedure and felt able to raise concerns if they had any. Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 6 The building and gardens are well maintained. The environment is designed with dementia care needs in mind with contrasting colours and signage. Residents’ benefit from having good sized light and airy single rooms, which suit their needs, and being able to bring personal items in to the home to personalise their rooms. What has improved since the last inspection? All residents seen looked well cared for and well attired. The homes Statement of Purpose and Service User Guide were being updated and should be ready by 1st August 2006, enabling prospective residents and/or their families to make an informed choice as to whether they would want to move in to the care home. Residents’ contracts were being updated and should be ready by 1st August 2006, which will enable residents to have the information they need in regard to the terms and conditions of their stay. Residents now benefit from care staff at the home having training to ensure they have the appropriate skills and training to meet their specialist needs. Residents now benefit from staff beginning to understand their past life histories and social care needs so that social interaction as well as task orientated interactions can take place on a regular basis throughout a residents day. Also regular activity has been implemented with the input from staff and the activities co-ordinator. Residents now benefit from action being taken when loss of weight is identified and nutritional assessments being completed and care plans adjusted. Residents now benefit from staff being made aware of the policies of the home in particular the death and dying policy and the Whistleblowing policy. Also the policy manual at the home had been updated and completed to ensure it was individualised to the home. Residents now benefit from a choice of dining area and tables being laid up to help maintain their dignity. Residents now benefit from being given a choice of meal at lunchtime to include desserts. Residents now benefit and are at less risk of harm as recruitment procedures have improved, and the home had arranged for staff to receive training in abuse and know the local adult protection policies, which explain steps to take should they suspect any form of abuse. Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 7 Residents now benefit from staff being supervised to ensure their competencies. Staff spoken to felt the leadership at the home was much improved and staff morale was good. 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. Aspen Court Care Home DS0000066159.V305367.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 Aspen Court Care Home DS0000066159.V305367.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4. NMS 6 does not apply to this service. Quality in this outcome group was good. Residents benefit from the home undertaking pre-admission assessments to ensure it can meet individual service users needs. Residents’ benefit from staff understanding dementia care and challenging behaviour through the training provided and competencies of trained staff. EVIDENCE: Standards 1 and 2 have not been assessed at this inspection as the home was in the process of updating the Statement of Purpose and resident contracts and had until 1st August 2008 to do so in line with the requirement made at the last inspection. The home has agreed to send the updated copy of the Statement of Purpose to the CSCI on completion. Resident contracts will be assessed at the next inspection. Evidence was found in the four individual care plans sampled of pre-admission assessments being carried out prior to admission to the home. Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 10 Prospective residents and their representatives are able to visit the home prior to admission to allow them an informed choice. Two visitors spoken to confirmed this. Staff training records and care staff spoken evidenced that training to meet the specialist needs of the current resident group has now been implemented as required at the last inspection. Registered Nurses trained in mental health (RMN’s) are employed at the home. Aspen Court Care Home DS0000066159.V305367.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7; 8; 9; 10 and 11. Quality in this outcome group was poor. Each resident had an individual plan of care. Residents would benefit if these were individualised and person centred. One sampled had evidence of input from the resident and/or their representative. Medication administration, storage and recording practise put residents at a potential risk of harm. Staff showed respect towards residents and allowed their privacy and dignity to be maintained in regard to personal care. The home had policies and procedures, which inform staff how they should handle dying and death, had been relayed to staff. The wishes of residents about arrangements after death were recorded. EVIDENCE: Two of the inspectors sampled four individual resident care plans and met the individuals as part of the case tracking process. Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 12 Overall care plans specified clear actions for care staff to take to enable them to deliver the care required, however they were not individual to the resident and therefore were not person centred, for example all four individuals should be receiving music and art therapy as well as occupational therapy according to the care plans and one had someone else’s name on their care plan. Generic care needs plans had been used, which was concerning when each individual resident has different types of specialist need. One sampled had been reviewed with input from the resident and/or their representative. Three of the care plans contained a completed social care profile and evidence was seen that the home, through the activities co-ordinator, has taken social care seriously since the last inspection. Nutritional Assessments had been completed for the individuals’ case tracked and appropriate action had been taken to ensure supplement drinks were prescribed where an assessed need had been identified. As discussed care plans should reflect the type of supplement drink prescribed in line with the Medication Administration Records (MAR), for example one admission sheet stated ‘fortisips’ were given when clearly the individual was prescribed ‘ensure’. The four care records sampled stated that the individual residents must have 2-3 litres of fluid per day. Fluid intake and output charts had been recorded for many residents however some were only partially totalled therefore it was difficult to determine whether adequate fluids had been given in line with their care plans. One individual had been prescribed ‘thick and easy’ according to their MAR sheet, however their individual care plan did not state whether it should be added to drinks or not. The same individual ‘s care plan stated that medication should be of a soluble liquid type and they had been prescribed tablets. One individual MAR sheet reflected that nursing staff were recording the individuals pulse daily, however the care plan nor the MAR sheet reflected actions to be taken in line with GP instructions. Specialist care needs plans, for example diabetes, did not reflect clear actions to take or current best practice. As discussed a diabetes specialist nurse should be involved in care planning and competencies of trained staff should be assessed without delay given the instability found in an individuals blood monitoring record. Care plans sampled stated that continence assessments were to be carried out and there was no recorded evidence of this. It was difficult to determine whether residents’ continence needs were taken into consideration as the generic care plans indicated that residents were incontinent 24 hours per day. Following a discussion the manager agreed to monitor toileting routines and look at individual residents continence needs to ensure they were being met. It was found that not all medication was being stored securely. During the inspection the medication fridge was found to be unlocked with the keys in the lock. The temperature of this fridge was being recorded although no action Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 13 was being detailed to maintain the medicines within the manufacturers stated range. The inspector locked the fridge during the inspection. Hand written entries made on the MAR charts were not always clear in their direction or made in accordance with current guidelines. Examples of this included the handwriting of insulin dosages and also dose changes occurring during the period of the MAR chart. Although there were some records of receipt of medication into the care home these did not appear to be complete and were not easily audited. Some records were made on the MAR charts; others in a dedicated receipts book and others appeared to be absent. For those service users prescribed medication to be administered “when required” although in some instances clear directions are in the care plan, no record was found in the daily log to indicate that these had been followed. Evidence was seen through direct observation that staff treated residents kindly and with respect. Service users spoken to indicated that staff were always respectful towards them. One dignity issue was identified in regard to administration of insulin to one individual in the dining room. This was brought to the attention of the manager who took action immediately. All residents seen at inspection looked well cared for and were well attired. Male residents were clean-shaven. Recorded evidence was seen that staff had read the homes policies and procedures, which included handling death and dying. Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12; 13 and 15 Quality in this outcome group was good. Residents were benefiting from individualised social care. Individual residents social care profiles were being completed. Staff interaction with residents was less task orientated. Residents are able to maintain links with their families and friends. Menus were available and appeared nutritious with a specified choice. Residents were given a choice at the time of the lunchtime meal. The dining area used was a pleasant environment to eat a meal. EVIDENCE: Since the last inspection the home has vastly improved individual residents social care. Each individual resident seen had a box of memorabilia. Activity records were available of all activities undertaken with individuals, which include newspaper reading, artwork, planting, trips to town and the park and one to one sessions with individuals unable to join in. The manager agreed to exploring ways of identifying residents rooms for them by having door individualised plaques/pictures on the doors in consultation with the residents and their relatives as part of a social activity. The activity co-ordinator was not available at this inspection. Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 15 Visitors were seen at the home and told inspectors that they felt the care provision was satisfactory. Since the last inspection the new manager has ensured that all communal areas are available for use. The dining room being used at the last inspection had been utilised as an activity and social care area, and up to six residents can have their meals there if they choose to. During this inspection two residents chose to have their meals there. Other residents chose to remain in their rooms for lunch. One of the upstairs lounges had been converted into a dining area, which was a more congenial setting for residents. Tables were laid to a good standard and fresh fruit was available. Residents have a view of the garden form this dining area. Inspectors observed the lunchtime meal. Residents were given a choice of the main meal and a choice of dessert. Staff were seen interacting kindly and chatting to residents when serving the meals. The atmosphere had improved since the last inspection. As discussed it was disappointing to see the tea made and arriving before the lunchtime meal was served. The manager acknowledged that there were still improvements to make around meal times. Residents consulted with and able told inspectors that they enjoyed the meals at the home. Aspen Court Care Home DS0000066159.V305367.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality for this outcome group was good. Residents and visitors to the home have the information to enable them to make a complaint or raise concerns. Arrangements for protecting residents from harm or abuse were good. EVIDENCE: The home has a complaints procedure, which can be seen on request. The home has not received any complaints since the last inspection. The CSCI have not received any complaints about the home since the last inspection. Residents and visitors spoken to knew who to raise concerns with. The home has a Whistleblowing policy. The homes Whistleblowing policy has been completed and updated as required at the last inspection. Staff will receive formal abuse awareness training in September 2006 from the local POVA lead. This will give staff a better understanding of the local policies and steps to take should they suspect abuse. Four staff recruitment files sampled evidenced that the home had obtained a POVAFirst checks before staff commenced employment to protect residents from any risk of harm. Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19; 20 and 26 Quality in this outcome group was good. The homes provision of a safe environment for residents was adequate. Residents are able to individualise their private rooms. Residents were able to choose where they had lunch and/or socialised; however the dining room downstairs was not used at lunchtime. Residents are able to have access to a secure garden. EVIDENCE: Aspen Court has 27 single rooms with en-suite shower facilities. There are two dining areas and two sitting rooms it is split into 2 units. There is a secure garden available for residents. The home and garden is well maintained and complies with the local fire service. There are adequate parking facilities outside the home. The home was purpose built and completed in November 2005. Residents were able to access the garden if they chose to. Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 18 At least seven individual residents bedrooms were assessed as part of the case tracking process and through a tour of the premise. Residents spoken to liked their rooms and many contained personal items including pictures and photographs. Dining and lounge areas had changed – see ‘Daily Life and Social Activities’. Hot water temperatures were tested regularly and records maintained. There were no malodours in the home. At least six of the rooms seen and the main corridors had stains on the carpets and this was brought to the attention of the manager. The home was short of domestic staff at the time of this inspection. Infection control systems and equipment were in place and staff asked understood the importance of infection control and what actions to take. As discussed the storage of disposable gloves must be risk assessed, and they should not be accessible to residents given their specialist needs. The home has two laundries, both shared facilities. One, which is outside, is shared with Cedar lodge and one inside (solely for personal items the CSCI were told on registration), which is now shared with the Roma Unit. The manager told inspectors that the bulk of the laundry is undertaken in the inside laundry and stopped in the evening when the ‘Roma’ unit takes over. The home is awaiting two more washing machines for the larger outside laundry. The manager told inspectors that when the machines arrive the bulk of laundry would be undertaken in the outside laundry. This will be followed up at the next inspection. Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27; 28; 29 and 30. Quality for this outcome group was good. Residents’ benefit from adequate numbers of staff, to meet their individual needs. The service is developing the staff team to ensure residents are in safe hands. Staff training needs have been identified and implementation of training for individual staff had taken place. Residents were protected by robust recruitment procedures. EVIDENCE: At the time of this inspection there were 22 residents living at the home. The new manager was on duty in a management role. There was an Enrolled Mental Nurse (EMN) on duty and in charge of the shift from 8-8pm. There were four care staff on duty during the morning. Minimum staffing levels were being met at this time. Duty rotas seen evidenced consistency of staffing levels; which is an improvement since the last inspection. Agency staff had been used to cover any shortfalls. There are 11 care staff employed at the home. 27 have gained an NVQ in care. This should be 50 in line with NMS. The manager is exploring training providers to supply NVQ training in care. This will be followed up at the next inspection. Staff have now received in-house training in Dementia Awareness and Challenging Behaviour. Records seen and speaking to staff evidenced that Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 20 all staff had received mandatory training and induction over a 2-3 day period. According to records seen Palliative Care training is arranged for 8th August 2006. The manager has undertaken Venepuncture training on 18th July 2006. The manager is also exploring training courses for staff at the local college to include: Team Leading, Infection Control, Medication training, a certificate in Dementia Care and Care Planning and documentation. A poster is set up for staff to put their names on if they are interested in any of the training available. Individual staff training needs had been identified and recorded. This is a vast improvement since the last inspection and evidences a commitment from the manager to ensure staff are competent to undertake the jobs they are employed for and to meet the residents individual needs. Four staff recruitment files were examined which evidenced good recruitment practises. Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31; 32; 33; 36; 37 and 38. Quality for this outcome group was good. Residents are benefiting from an experienced, knowledgeable newly appointed manager. Staff morale had improved. The manager had begun to implement a person centred approach to meeting the social care needs of the residents therefore enabling equality and diversity. The manager had begun to implement the systems to monitor compliance with the homes plans, policies and procedures. Service users are protected by the health and safety checks in place. EVIDENCE: Since the last inspection the home has employed a new manager Mrs Lyn Tudge. She had only been in post for 8 weeks at the time of this inspection. Since taking up the post of manager at the home it was evident that Mrs Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 22 Tudge has worked very hard to move the home forward and ensure improvements are made. Staff and residents told inspectors that they like the manager and have seen improvements since she had been in post. Mrs Tudge has vast experience in care and a good knowledge of evidenced based person centred care. She acknowledged that there are still improvements to make around care planning and medication systems at the home and the inspectors were satisfied that she would take appropriate action to continue with moving the home forward in the best interests of the residents. The CSCI await an application to register the manager. The manager had supervised 16 staff on a one to one basis since the last inspection, and records were seen to evidence this. Quality monitoring systems and policies were in place, however quality monitoring had not yet commenced to ensure the home was being run in the best interests of its residents. A Policies and Procedures Manual is in place at the home. Recorded evidence was seen that staff had been made aware of the policy folder. As required policies and procedures were completed and personalised to Aspen Court. All health and safety checks were in place and up to date. Fire Risk Assessments for the building were not seen at this or the last inspection and will be followed up. Accidents records were maintained. Staff accidents were recorded. According to staff spoken to and staff training records all staff had received mandatory training including manual handling. Fire awareness training had been provided for 16 day staff, night staff were due to receive fire awareness training. Food Hygiene training had been provided and further updates in manual handling had been provided. Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 23 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 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X x X X X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X X 3 3 3 Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 24 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(1) (2) 5(1) (2) Requirement The registered person must reassess and produce an up-todate Statement of Purpose and Service User Guide with particular regard to current fee charges and menus, to allow for prospective residents and /or their representatives to have an informed choice. A copy must be sent to the CSCI. Not assessed at this inspection. Timescale for action 01/08/06 2. OP2 5(1)b The registered person must ensure that all residents are provided with a statement of terms and conditions and/or a contract if funded privately. Not assessed at this inspection. 01/08/06 3. OP7 15(1) The registered person must ensure that care plans in consultation with residents and/or their representatives are individualised, person centred and reflect current care needs. 30/08/06 Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 25 4. OP8 12(1) The registered person must ensure that any monitoring charts used as part of an assessed need are completed in regard to fluid intake and output and that care plans identify and reflect actions to be taken in regard to health and specialised care in consultation with a specialist nurse. 30/08/06 5. OP9 13(2) The registered person shall make 11/08/06 arrangements for the safe keeping of medicines received into the care home. This relates to the need to ensure that all medication is stored securely and within the temperature range as specified by the manufacturer. The registered person shall make 30/08/06 arrangements for the recording of all medicines received into the care home. This relates to the need to ensure a record is made of the receipt of all medicines into the care home. The registered person shall make 30/08/06 arrangements for the safe administration of medicines in the care home. This relates to the need to ensure that that all medication is administered only according to the directions of the prescriber and that clear guidance is incorporated into care plans about the administration of “when required” medication. The registered person must ensure that stains identified on carpets are removed. 01/09/06 6. OP9 13(2) 7. OP9 13(2) 8 OP26 13(3) (4)c Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 26 9 OP28 18(1)a c{i} The registered person must ensure training is implemented to ensure a minimum of 50 trained members of care staff (NVQ level 2 or equivalent) is achieved excluding registered nurses. 15/09/06 10 OP33 12(1) The registered person must start 24(1)(2) the development of quality (3) assurance and monitoring systems (this will be an incremental development monitored at future inspections). 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations The life histories of all residents should be available in their individual plans of care. This will allow all staff to begin to understand the individual social care needs of the service users. It is recommended that when an entry is hand written onto the Medicines Administration Record chart that this is signed and dated by the person making the entry and it is then checked and countersigned by a second person. It is recommended that the competence of all staff administering medication be regularly assessed, and this assessment be recorded as part of the supervision process. 2 OP9 3 OP9 Aspen Court Care Home DS0000066159.V305367.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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