Inspection on 19/11/07 for Attwoods Residential Care Home

This inspection was carried out on 19th November 2007.

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

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

Other inspections for this house

Attwoods Residential Care Home 25/11/09

Attwoods Residential Care Home 09/02/09

Attwoods Residential Care Home 19/08/08

Attwoods Residential Care Home 18/04/08

Attwoods Residential Care Home 26/02/07

Attwoods Residential Care Home 12/09/06

Attwoods Residential Care Home 14/11/05

Similar services:

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Attwoods Residential Care Home 46 Northgate Cottingham East Yorkshire HU16 4EZ Lead Inspector Key Unannounced Inspection 19th November 2007 09:00 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 Attwoods Residential Care Home DS0000064183.V348369.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. Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Attwoods Residential Care Home Address 46 Northgate Cottingham East Yorkshire HU16 4EZ 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) 01482 841133 Mr Ateeq Rehman vacant post Care Home 19 Category(ies) of Dementia - over 65 years of age (19), Old age, registration, with number not falling within any other category (19) of places Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th July 2007 Brief Description of the Service: Attwoods is a care home providing personal care and accommodation. It is registered for older people and also for older people with dementia. The home is situated in Cottingham within easy reach of the village centre and local amenities; a bus stop is outside the door and the railway station is nearby. The home is a large detached house arranged on two floors. Three bedrooms are on the ground floor and all other bedrooms, which are located on the first floor, can be accessed by the stairs or stair lift. There are six double and seven single bedrooms, however, some of the double rooms are used as singles. There are two lounges and a dining room on the ground floor; the kitchen is located directly off the dining room. A paved courtyard and flowerbeds are situated to the rear of the building which has full access for wheelchair users and all other residents; there is also limited car parking in this area. The current scale of charges for the home is £292 -339 per week with additional charges for private chiropody (£10.00), hairdresser (£15.00 perm, £6.50 wash and set and £5.00 trim), magazines and newspapers at cost. Toiletries are provided by the resident or their family although the home does keep a small stock. Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since the last key inspection of the home on 26th February 2007, including information gathered during a site visit to the home. This unannounced site visit was undertaken by one inspector over one day, starting at 9.00 am and ending at 4.00 pm. On the day of the site visit the inspector spoke with several residents, a relative, two members of staff and the manager. Inspection of the premises and close examination of a range of documentation, including four care plans were also undertaken. The acting manager submitted information about the service in advance of the site visit by completing and returning a pre-inspection questionnaire. Survey forms were sent out prior to the inspection, two were returned by health and social service professionals and four by relatives. Further questionnaires were completed by residents and staff at the time of the site visit. Comments included “the care service has improved since the change of owners”, “adequate without being outstanding”, “staff are friendly and kind to residents” and “more visits out of the home”. It needs to be recognised in reading this report there have been no consistent management arrangements for this home for two years and the current acting manager has only been in post for three months. What the service does well: What has improved since the last inspection? The home has been redecorated outside and the hall, stairways, two lounges, dining room and all but four bedrooms have been completed internally. Work has been completed in upgrading fire protection and electrical wiring in the home. Temperature control valves have been fitted to all but two wash hand basins (due to being situated too close to the wall) and baths used by the residents. A local authority quality development scheme officer is working with the home towards attaining an award for quality monitoring. Improvements Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 6 have been made in staff attitudes, particularly in being more welcoming towards visitors to the home, and in the home’s documentation systems. Staff training has improved since the last inspection and is ongoing; all staff are currently taking a medicine administration course which will be completed in December 2007 and during the year staff have had training in back care and nutrition with further training for updating mandatory subjects scheduled for the New Year. An “employee of the month” scheme has been introduced, which boosts staff morale and job satisfaction; a certificate is displayed in the dining room. The acting manager now oversees the purchase of food to provide a better variety and quality of what is available. What they could do better: Following requirements made at previous inspections, minimal improvements have been made in the medication systems within the home and several issues remain outstanding which may mean residents are not safeguarded in this respect. Whilst improvements have been made to activities taking place inside the home, further thought needs to be given to visits outside the home. Although the acting manager stated none of the residents are interested in going to church, there should be a process of consultation to ensure religious needs are being individually met and opportunities for religious observance are provided if required. Residents’ case records and documentation needs to be further improved along with ensuring risk assessments are undertaken, that they are regularly reviewed and an action plan is produced to address any identified risks; photographs are not available of each resident in their case record and medication record which could lead to incidents of mistaken identity. A recommendation made at the last inspection that all concerns, no matter how trivial, along with complaints should be recorded as well as the action taken and outcome of the investigation has not been implemented; two complaints currently being investigated had not been recorded. An audit, with a view to replacing carpets and bed headboards throughout the home would add to the improvements already made; the manager is devising a programme for redecoration and refurbishment of the home which should mean maintenance and upkeep of the home is achieved in a planned way. The appointment of a cleaner, including hours to cover weekends, would be beneficial to the home and release carers to spend more time with the residents. An acting manager is in charge of the home, supported by a deputy. The acting manager is also covering two shifts as a carer leaving only 28 hours a week in her role as acting manager which does not leave enough time to get to grips with the job and undertake all the improvements necessary for the medication systems, staff supervisions, documentation, risk assessments, review and implementation of policies and procedures etc. The registered provider is visiting the home at least monthly according to staff but reports of the visits are outstanding since 22nd May. A permanent registered manager with the qualifications, skills and experience needed to run a care home would further improve the quality of care and services provided and by fostering an atmosphere of openness and respect residents, family and staff will feel valued and also feel their opinions matter. Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 7 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. Attwoods Residential Care Home DS0000064183.V348369.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 Attwoods Residential Care Home DS0000064183.V348369.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): 3 and 6 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service and their representatives have the information needed to make an informed choice about where to live and be assured the home can meet their individual assessed needs. EVIDENCE: Examination took place of case records for three residents admitted since the last inspection. Evidence was seen in only one file that a pre-admission assessment had been undertaken and written confirmation provided that the home could meet the assessed needs. However, the acting manager has only been appointed in recent months and she confirmed that all prospective residents are visited either in their own home or hospital to assess their needs and ensure these can be met by the home. The assessment does not include oral health and foot-care and the acting manager was advised it would be good practice for these areas to be included. Contracts were seen to have been Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 10 issued and signed by the resident or their relative and the acting manager; the acting manager confirmed all residents have a contract in place. The home’s statement of purpose has not been amended to reflect the home’s arrangements following the guidance regarding smoking. The home is not registered to undertake intermediate care. Attwoods Residential Care Home DS0000064183.V348369.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): 7,8,9 & 10 People who use this service experience poor quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents health and personal and care needs are set out in an individual plan of care. However, the home’s policies and procedures for dealing with medicines and the lack of risk assessments may mean the residents are not safeguarded. EVIDENCE: The home uses very detailed and comprehensive care plans which include assessments covering mental health, physical health, moving and handling, behaviour, pressure areas, nutritional screening and risk of falls. Four care plans were examined and good daily notes indicate the care provided. The local authority quality development scheme officer is currently working with the home to ensure these records are being kept in an orderly way. Both the care plans and the medication records do not have photographs of the residents which would help reduce the risk of incidents involving mistaken identity. Risk assessments do not include the action to be taken to manage the risk and one examined, dated July 2006, had no evidence of being reviewed or Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 12 updated to reflect the changing needs of the resident. There was no evidence of risk assessments having been undertaken for two residents whose beds have been fitted with bed rails and the acting manager was not sure whether she had seen a copy of the recent Health and Safety Guidance; a copy was provided by the inspector for reference. Only one of the four case files seen included a copy of the needs assessment. The acting manager confirmed arrangements are in place to access health service support, usually through the general practitioner. A district nurse was attending one resident at the time of this visit and chiropody, dental, optical services are all accessed either through the NHS or privately. The home has been loaned a special hospital style bed and lifting equipment for one resident, arranged through the district nurse, and is an indication of residents health care needs being met. At the time of this visit, residents had not had the annual flu injection and the acting manager stated she was to chase these up with the general practitioner. A pharmacy inspection was undertaken by the Commission for Social Care Inspection on 20/7/07 which resulted in six requirements and one recommendation being made; at the time of this inspection four have not met the timescale and remain outstanding. All the staff undertaking the administration of medication are currently attending training by Hull College and this will be completed during December. Four residents medications and records were examined. A requirement made following the pharmacy visit was for any prescriptions transcribed onto the medicine administration records be signed and dated by the author and by a witness. There were a number of omissions in the signing and dating of these transcriptions and particularly in one case where a full sheet had not been signed or dated by anyone. Some medications had been repeated and staff had opened all containers making the contents difficult to account for and in one case there was a discrepancy of twelve folic acid tablets. Daily temperatures of the Drug cupboard had evidence of being regularly recorded daily up to and including 4/11/07 but the acting manager explained that due to pressures of work this had lapsed. A book for medications returned to the pharmacist for disposal indicated appropriate records were being kept. Survey forms returned to the Commission from health and social care professionals, relatives and residents gave positive answers of “always/usually” to questions relating to the care provided. Residents spoken with were complementary about the staff and the care they receive and staff were observed to have a caring and relaxed approach when speaking to or assisting residents. Attwoods Residential Care Home DS0000064183.V348369.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 People using this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Some residents are consulted or listened to regarding the choice of recreational activities, but this process could be improved to meet individual expectations. EVIDENCE: Care staff provide some activities every day and a weekly activity programme is devised in conjunction with the residents. Survey forms completed by four residents said there are “always” or “usually” activities to take part in. A daily record is kept of the activities taking place and of those residents who took part; dominoes, music, watching DVD’s and sing-a-longs being some that were recorded. The acting manager stated an outside entertainer visits every two to three months which residents enjoy but there have been no organised trips out of the home during the summer months. One resident regularly takes himself into the village and three or four residents were accompanied to the village market which takes place weekly during the summer months. An invitation for residents, families and friends to attend a clothes party at the home was seen displayed in the hall Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 14 Church singers visited during October, and have been booked to visit again before Christmas. Representatives of the Methodist church visit two residents and bring the church magazine; according to the acting manager, residents are either unable to or are not interested in attending church but she agreed to review the arrangements for religious observance if this is what residents wish. Staff interviewed talked about Christmas arrangements including an entertainer visiting the home on 22/12/07, a Christmas party on 7/12/07, each resident receives a Christmas present from the home and residents relatives and friends are invited to Christmas Day lunch. Two key workers also agreed to discuss with residents their religious needs. Two survey forms returned by relatives said they were always kept up to date with important issues involving their family member, and two others said they were usually kept up to date. A telephone is available in the hall for residents to make and receive calls but it is difficult for these to be made privately. The manager stated she would look into obtaining a cordless telephone in the near future so calls can be taken confidentially. A record is being kept of all meals provided and at the time of this visit lunch of braising steak, mashed potatoes, swede, carrot, peas and cauliflower followed by bananas and custard, was observed to be plentiful, attractively presented and enjoyed by the residents. One resident was overheard talking to others about the food and how good it is. This was also confirmed in discussion with residents and from comments made in the survey forms; one responded “perfect”. The cook confirmed residents are informed of what is on the menu and are offered alternatives if required. One resident during the course of the tour of the building requested something to eat and chose to have an orange and a biscuit which the acting manager organised for him. The menu is usually displayed in the entrance to the home but on this visit was not seen. Fresh fruit is available in the dining room for residents to help themselves to; one resident was observed enjoying a banana with breakfast. There is a regular drinks round, drinks with meals and they are also available at any time on request. The acting manager is now responsible for shopping for food rather than buying in bulk. This way she is able to ensure there is plenty of variety in what is offered and also that produce is fresh. Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 15 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 17 People using this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents and their representatives are able to express their concerns. However, there is insufficient evidence these are listened to and acted upon. EVIDENCE: The home has a policy and procedure for making complaints and all residents have received a copy of the procedure; from speaking to residents and from the surveys returned it is evident residents and their relatives know how to raise concerns. However, although the home is recording on a weekly basis “no complaints”, issues have come to light which should have been recorded. One entry of concern recorded earlier in the year does not indicate what action had been taken or the outcome of the action and two recent complaints, currently being investigated by Social Services Care Management, had not been recorded either. The home has a policy and procedure for safeguarding vulnerable adults and staff interviewed understood the terms POVA and Whistleblowing. They were both aware of the home’s policy and procedure and said they had read the documents, however, safeguarding awareness training is outstanding. Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 16 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 People using the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The environment has been enhanced following a programme of redecoration inside and outside making the home a generally homely and comfortable place to live. EVIDENCE: The home is comfortable and provides a physical environment that meets the specific needs of the people who live there. There has been slippage in timescales for requirements made at previous inspections and maintenance tends to be reactive rather than proactive. The home has been awarded a grant by the local authority and the money has been used for redecoration inside and outside the home and for fire safety requirements to be met. The outside of the home has been repainted and all but four bedrooms and some toilets have been redecorated. The acting manager stated the toilet under the Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 17 stairs in the hallway, which has been used for storing Christmas decorations and pictures, is to be re-instated as a toilet for use by visitors to the home. Temperature controls are now in place to all hot water outlets in bathrooms, residents’ wash hand basins in their rooms (except two which are situated too close to the wall) and toilets. A new dryer has been purchased for the laundry. The acting manager stated arrangements are being made for adjustment to the fire doors into the living room and the kitchen to close the gap between the frame and the door to enable the cold smoke seals to work effectively but otherwise work has been completed in providing integrity of fire safety throughout the building in accordance with requirements made by the Fire Officer. The Food Safety Record implemented just before the last inspection in February has not been written up since August as the sheets have run out; the acting manager stated she would arrange for more sheets to be obtained and for the practice to be re-instated. Daily records are being kept of refrigerator and freezer temperatures and for cooked meat temperatures also to be recorded. A temporary repair has been made to the window in one bedroom and the acting manager stated work is in hand to complete the job. A floorboard outside room 9 needs securing. An audit of carpets throughout the building needs to take place to assess cleanliness and for a programme of replacement implemented where needed. Apart from one bedroom, which despite the best efforts of the staff had a slight odour, the home overall was generally free of any unpleasant odours. The home is currently without a cleaner and according to the provider, care staff are being given additional hours to undertake this work; a recommendation made at the last inspection for hours allocated to cleaning to be reviewed to cover weekends remains outstanding. Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 18 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 & 30 People using this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Sufficient care staff are employed on each shift to ensure the needs of the residents are being met. However the progress made in staff training needs to continue and recruitment procedures must ensure residents are protected. EVIDENCE: Fifteen residents were living in the home at the time of this visit supported by two care staff on duty on all shifts; the acting manager and/or deputy manager are also employed during the day Monday to Friday. The acting manager stated the home is currently advertising for a further 16 hour care assistant post as well as additional bank staff. Staff interviewed said they felt sufficient staff were on duty to meet the residents needs and confirmed they have time to spend with the resident. A previous manager of the home has been reemployed and is working in the home without a current Criminal Records Bureau (CRB) check or having the POVA First check; the personal file only had evidence of information relating to when she was manager of the home and did not include current references. (The day following the inspection, the acting manager stated that although the CRB application had been posted a week ago, this has not been received and the POVA First check cannot be made until the CRB application is received. A further application is being forwarded as soon as possible). Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 19 An employee of the month scheme was introduced during the summer months and a certificate is displayed in the dining room. Some improvement has been made in staff training but some mandatory training remains outstanding despite this being a concern at the previous inspection in February 2007. The acting manager stated only three members of staff have yet to train for a NVQ level II qualification. Twelve staff have, or are taking, NVQ level II, three staff have NVQ level III and one member of staff is currently working towards attaining level III. Staff interviewed had received moving and handling training but other mandatory training is still outstanding i.e. first aid, food hygiene, fire safety. All staff are currently undertaking medication training which is due to end during December and the acting manager and a senior carer/cook have attended a Nutrition course since the last inspection; when funding is available, other staff/cooks will attend this course. Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 20 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 People using this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The current management arrangements do not demonstrate the home is in charge of someone with the skills, knowledge and competence to manage the home which would benefit residents. EVIDENCE: The acting manager works 28 hours a week in this role and is supported by the previously registered manager who is now working as deputy; in addition she works two shifts as a carer and works flexibly to give cover at weekends. She confirmed she has a job description which gives clear lines of accountability to the provider; this document was not examined at this visit. Plans are being made to enrol for NVQ IV in care and management before the provider makes application for her registration with the Commission. Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 21 The acting manager is working with the local authority quality development scheme officer in developing survey forms to send out to residents and their relatives and updating policies and procedures; the smoking policy has not been updated in accordance with government guidance issued earlier in the year. Residents meetings are usually held monthly and although the inspector was informed staff meetings are also usually held monthly the minutes of the last meeting were dated 23/8/07. Staff supervision has recommenced recently and the acting manager stated this would be undertaken individually with each member of staff at least six times a year. Staff and the acting manager confirmed the provider makes regular visits to the home and is in telephone contact almost daily, particularly at weekends. However, the legal requirement for a report of the visit to be completed every month is outstanding, the last report being dated 22/5/07; this omission has been an area of concern at previous inspections and made a requirement. Accident reports were checked and found not to correspond with information received by the Commission. Several falls by residents were reported which resulted in a visit to the Accident and Emergency Department but had not been notified to the Commission. The home does not become involved in residents’ financial affairs but do keep small amounts of money on behalf of some residents. Two of these were checked and found to be correct with receipts kept. The acting manager was advised to issue a receipt when receiving and returning monies to and from relatives. Any valuables brought into the home are kept in a locked cabinet. Some maintenance certificates were checked i.e. Fire safety equipment was checked October 2007, the stairlift had a thorough examination 5/11.07 and certificates are in place for periodic inspection of the electrical installation. There was no evidence the bath hoist and two mobile hoists have had a thorough examination, the landlords gas safety certificate was dated 22/5/06 and therefore overdue and portable appliance tests are also now due. A health and safety notice is displayed in the hallway along with the Employers Public Liability Certificate which is current to September 2008. Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 22 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 2 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 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 2 17 X 18 3 3 x X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 X X 2 Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 23 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 OP3 Regulation 14 Requirement The registered person shall not provide accommodation to a resident unless, so far as it shall be practicable to do so, the needs of the resident have been assessed by a suitably qualified or suitably trained person. A photograph must be kept by the home of each resident and it would be good practice for the photograph to be kept with the care plan and medication administration record. (Outstanding requirement) Ensure risks to the health and safety of residents are identified, assessments made, with an action plan, and regularly reviewed and updated. The registered person must ensure that records of medications administered to residents are accurate and up to date. (Outstanding requirement) The registered person must ensure the medication policy and procedures are updated regularly so that staff are always working DS0000064183.V348369.R01.S.doc Timescale for action 19/11/07 2. OP7 17 (sch3) 30/12/07 3. OP7 13 30/12/07 4. OP9 13 19/11/07 5. OP9 13 30/12/07 Attwoods Residential Care Home Version 5.2 Page 24 6. OP9 13 7. OP9 13 8. OP9 13 9 OP19 23 10 OP19 16 11 OP30 18,23 to current good practice guidance (Outstanding requirement) The registered person must ensure handwritten entries on the MAR charts contain all essential information, are signed and dated by the author and checked and signed by a witness to reduce the risk of mistakes when copying information from the pharmacy label. (Outstanding requirement) The registered person must ensure medicines are stored securely at the temperature recommended by the manufacturer so they are safe to use. (Outstanding requirement) The registered person must ensure that controlled drugs are stored according to current guidance and regulations and that receipt, administration and disposal of controlled drugs are recorded in a controlled drugs register designed for the purpose. (Outstanding requirement) The registered person must take adequate precautions against the risk of fire and action the requirements of the Fire Authority in ensuring the gap between the frame and door of both the kitchen door and living room door are adjusted to enable the smoke seals to work effectively. Undertake an audit of floor coverings to assess cleanliness and to implement a programme for replacement where needed. The registered person must ensure persons employed in the care home receive training appropriate to the work they DS0000064183.V348369.R01.S.doc 19/11/07 19/11/07 30/12/07 30/12/07 30/09/08 28/02/08 Attwoods Residential Care Home Version 5.2 Page 25 12 OP33 26 13 OP38 38 14 OP38 23 perform. Training and updates were identified as outstanding in first aid, food hygiene and fire safety. (Outstanding requirement) The registered person must make unannounced visits to the care home at least once a month in accordance with this regulation and make a report. The registered person must notify to the Commission without delay and in writing any occurrence happening in the home in accordance with this regulation. Outstanding notifications of accidents involving serious injury must now be forwarded to the Commission. The registered person must provide evidence to the Commission the bath hoist and two mobile hoists have had a thorough examination and the home has a current landlord’s gas safety certificate. 19/11/07 30/11/07 30/12/07 Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 26 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. Refer to Standard OP1 OP12 Good Practice Recommendations The home’s statement of purpose, service user guide and smoking policy should be updated to reflect current government guidance regarding smoking. Arrangements for visits out of the home and for religious observance should be discussed with residents and/or their relatives and for action to be taken to meet any identified needs. It is good practice for residents to be offered the opportunity of having an annual flu injection and for arrangements to be made with the resident’s general practitioner. Regular checks should be carried out to ensure staff are giving medicines correctly and identify any weaknesses in medication handling systems in need of improvement. All staff should have training in understanding safeguarding vulnerable people. Further sheets for keeping the Food Safety Record up to date, as required by the Environmental Health Officer, must be obtained and recordings re-instated. Action must be taken to make good the upstairs bedroom window which has been temporarily repaired. Action should be taken to investigate the cause of the loose floorboard outside Room 9 and make good. The hours allocated to cleaning should be reviewed and to include cover over weekends. The registered manager should have a qualification at level IV NVQ (or equivalent) in management and care. 3. OP8 4. 5. 6 7 8 9 10 OP9 OP18 OP19 OP19 OP19 OP26 OP31 Attwoods Residential Care Home DS0000064183.V348369.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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. 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