CARE HOMES FOR OLDER PEOPLE
Auckland Residential Care 2 Ken Road Southbourne Bournemouth Dorset BH6 3ET Lead Inspector
Marjorie Richards Unannounced 5 May 2005 09:30 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 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. Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Auckland Residential Care Address 2 Ken Road Southbourne Bournemouth Dorset BH6 3ET 01202 427166 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr David John Hart Mr Job Hart CRH PC - Care Home Only 10 Category(ies) of OP - Old age (10) registration, with number of places Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None. Date of last inspection 14th January 2005 Brief Description of the Service: Auckland Residential Care is a detached property, adapted to provide residential care. It is situated on a corner plot in a quiet residential area of Southbourne, with local shops, a pub and bowling green a short walk away. The cliff-top, with a variety of coastal walks, is approximately a quarter of a mile from the home. Buses are available to and from Southbourne, with a full range of shops, churches, library etc, as well as other parts of Bournemouth, Christchurch and beyond. Parking for visitors is available on roads adjacent to the home. Auckland is registered to accommodate up to ten older people within eight bedrooms on two floors. The two double rooms are currently used as singles, unless two people request to share. It is intended that all eight bedrooms will soon be used by Bournemouth Social Services in a scheme to provide Intermediate Care, a specialised service to deliver short term intensive rehabilitation, enabling service users to return to their own homes afterwards. A lounge and separate dining room are situated on the ground floor. Small garden areas are available at the sides of the property with seating for service users. There are sufficient communal bathrooms and WCs and seven of the bedrooms have en-suite facilities. A stair lift is being installed shortly to assist access between floors. Auckland provides older people with twenty-four hour care, all meals, laundry and domestic services. The home offers stimulation in the form of regular activities and assists service users if they wish, to make arrangements in accordance with their religious beliefs.
Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out on the 5th May 2005, from 9.30am until 7.30pm. The purpose of this inspection was to review the requirements and recommendations that had previously been made and to check that the people who were living there were safe and properly cared for. Part of the inspection was also spent in discussing the day-to-day management of the home and future plans for intermediate care. Neither of the registered persons, Mr D. Hart or his father, Mr J. Hart could be available in the home on the day of the inspection. However, Mrs Hart and the senior care assistant gave time to the inspection and this was appreciated. The premises were inspected throughout and a variety of records and related documentation examined. Discussion was held with Mrs Hart, the senior care assistant and two care staff. Only three service users were accommodated so time was spent talking with them in depth to get a real feel of what it is like to live at Auckland. What the service does well:
Auckland has a homely, relaxed, non-institutional atmosphere. Care is provided by a stable staff group who work well as a team and have developed good relationships with service users as well as each other. This results in a supportive, caring and relaxed environment where service users feel comfortable and secure. Staff treat service users with respect. Comments from service users include, I am happy here, I feel at home and I feel safe here. I do what I can but staff are there if I need them. (Staff were also witnessed dealing with an unexpected death in the home and handled this in a dignified manner and with great sensitivity.) Staff demonstrated a good knowledge of service users care needs. Communication between staff is good and this ensures continuity of care. Independence is encouraged and the daily living arrangements are flexible, to fit in with the needs of service users. Open visiting arrangements are in place and service users are encouraged to retain links with visitors and with the community. Service users spoke highly of the meals provided, I have not eaten so well in ages. The home is very clean throughout and a service user commented, Everything is always nice and fresh, the home smells nice.
Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better:
Safety. It is important that all bedrooms should have a lockable facility where service users can keep medicines or other valuables etc. One radiator, just inside the entrance to the lounge, has not been fitted with a guard to eliminate any risk of residents burning themselves against the hot surface. First floor window limiters are in place, but these need checking to ensure the safety of windows for service users. One window catch is broken and needs repair or replacement. Some of the floor tiles in the laundry are cracked or loose and need attention before they become in tripping hazard.
Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 7 Policies. Some additions are needed to the Adult Protection policy and not all staff have received training in Adult Protection matters, to ensure a proper response to any suspicion or allegation of abuse. The infection control policy needs slight amendment to take account of the fact that the laundry room does not contain a wash hand basin where staff may wash their hands after dealing with dirty linen in etc. Employment. Improvements must be made with obtaining written references before staff commence employment in the home, to ensure the protection of service users. Management. At present, neither of the registered persons is communicating a clear sense of direction and leadership in the home as they do not spend much time at Auckland during the day, although Mr and Mrs D. Hart are on wakeful duty or sleeping in, on call, from 8 p.m. until 8 a.m. Much of the day-to-day management is left to the senior care assistant supported by Mrs Hart in her free time, as she has a full-time occupation elsewhere. It is expected that one of the registered persons should be managing the home during the day so that service users and staff benefit from their leadership and support. It is also expected that the registered person should have a qualification at NVQ level 4, or equivalent, in management and care but this has not yet been achieved. Although not assessed on this occasion, two recommendations from the last inspection report are carried forward. No scores or outcomes have been allocated in respect of these. (Recommendations, Standards 33 and 34.) 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. Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 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 standard(s) 6 Auckland does not, at present, provide dedicated accommodation and staff for intermediate care. EVIDENCE: In recent years, Auckland has been providing a mixture of permanent placements, as well as short-term intermediate care to service users who were being rehabilitated to return to their own homes. No new permanent admissions have been accepted for some time, with the intention of eventually moving solely to the provision of intermediate care. Currently, Auckland is participating in a scheme with Social Services to provide short-term assessment and respite care. However, discussions are currently taking place regarding the provision of a dedicated resource for intermediate care, with all eight beds contracted to Social Services. This will ensure specialised facilities, equipment and staff are available to deliver short-term intensive rehabilitation and maximise service users independence before returning to their own homes. It is anticipated that Social Services and members of the Community Assessment and Rehabilitation Team (CART) will also provide support to those receiving intermediate care and to the home in terms of equipment, staff training etc.
Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 9, 10 and 11 The arrangements for storing and handling medicines in the home ensure resident safety and, where appropriate, residents are responsible for their own medication. Residents are treated with respect and care is offered in a way that both promotes and protects the resident’s right to privacy, dignity and independence. At the time of death, residents and their relatives are treated with all due care, consideration and respect. EVIDENCE: A number of requirements and recommendations were made in respect of medicines storage and practice, following a visit by the Commission for Social Care Inspection Pharmacist Inspector in September 2004. Of the two requirements, one has been met and one almost met, with minor additions still needed to the medicines policy. Of the five recommendations, four have been met in full. The fifth recommendation will be met shortly as a Controlled Drug cupboard has been ordered. Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 11 It is important that bedrooms have a lockable facility where residents who are self-medicating can keep medicines or other valuables. This facility is not available in every room at present. This will also be particularly important in future where residents are to receive intermediate care and will be expecting to manage their own medication. Observation during the inspection and discussion with staff confirm that the home has a good awareness of how to protect service users privacy and dignity. Staff were observed to be interacting with residents in a friendly, caring yet professional manner. Staff demonstrated a good knowledge of individual care needs, We are here to fit in with what the service user wants. They are all different and we respect those differences. Service users commented that staff are polite and considerate and respect their right to privacy. I can come and go as I please. If I want to be on my own in my room I can be. They always knock on my door and wait to be invited in. Sadly, on the morning of inspection, there had been an unexpected death in the home. This was handled with great sensitivity and respect. Care documentation had been completed and was up-to-date. The relatives and other representatives had been informed and staff spent time talking with and supporting the remaining service users, whilst also dealing very professionally with the GP, funeral directors etc. Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 12 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 standard(s) 13 and 15 Service users are encouraged to maintain contact with family and friends and retain links with the local community. The home provides a balanced and varied selection of food that meets residents’ tastes, choices and special dietary needs. Meals are served at times and locations that are convenient to service users. EVIDENCE: Because service users are receiving only short-term care, every effort is made to maintain contact with family and friends and the wider community. Service users and staff confirm that visitors are made welcome at any time and provided with refreshments. Encouragement is also given to retain links with friends, church etc, whilst staying at Auckland. Such contacts are recorded in the care documentation and visitors book. Three full meals a day are offered at Auckland and are prepared by the care staff. Although there is no choice of menu, service users say they only have to ask and any personal preferences are always accommodated by staff. One service user has special dietary requirements. These are well documented and discussion with the service user concerned demonstrated complete satisfaction with the meals provided. Lunch on the day of inspection was sausage and chips, followed by fruit cheesecake, ice cream or tinned fruit in juice. One service user commented, We have a very good breakfast, then a lovely dinner and pudding, then we have another cooked meal if we want it for tea. I have
Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 13 not eaten so well in ages. A bowl of fresh fruit is available in the dining room and service users are encouraged to help themselves whenever they wish. One service user was observed helping staff prepare the afternoon tea, I like to feel useful and that I can still help others. Mealtimes were seen to be relaxed, unhurried and flexible to fit in with daily living arrangements. Service users may choose where they eat their meals. Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 14 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 standard(s) 16 and 18 A system is in place for dealing with any complaints. Service users are confident their complaints would be listened to and dealt with appropriately. The home has an Adult Protection policy and procedure in place; however, recommendations for further additions to this policy have not yet been acted upon. Not all staff have received Adult Protection training to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The complaints policy and procedure has been updated and is included in the information provided to service users. One complaint has been made to the home since the last inspection. This has been dealt with appropriately and the complaints record demonstrates that a full investigation is currently taking place. Service users commented that they had no difficulty in raising any concerns with staff and these were always dealt with appropriately. Service users said, I have no complaints at all about this home. I feel safe here, but if I was worried I would speak to the lady in charge. The home has a comprehensive Adult Protection policy in place to protect service users from possible abuse. It is recommended that this policy should make reference to the Department of Health No Secrets document, which is also available to staff. Recommendations made following a previous inspection concerning amendments/additions to the Adult Protection policy have not yet been acted upon and are therefore repeated. Staff confirm that they have not all received Adult Protection training, but it is intended this will be arranged as part of the training programme for the provision of intermediate care.
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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 standard(s) 19, 22, 25 and 26 In general, the home provides safe, comfortable and well-maintained surroundings, although some risk is posed by one radiator where the hot surface is not guarded and first floor windows, where limiters are fitted but need adjustment. Work is still being carried out in response to recommendations made by an Occupational Therapist, following an assessment of the premises to ensure suitable equipment and adaptations are available to meet the needs of service users. The home is kept clean and smells fresh, making daily life for service users more pleasant. Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 16 EVIDENCE: The entrance at Auckland does not provide a good first impression. On entering the front gate, the garden is rather overgrown and weedy and the garden wall needs attention. The lawn also needs cutting and the whole area looks rather uncared for. Mrs Hart explained the reasons for this and promised immediate action. Repairs have been carried out to kitchen units and a programme introduced for the replacement of some armchairs. An assessment of the premises and its facilities was made by an Occupational Therapist in November 2004. An action plan has been produced for taking forward the outstanding recommendations made in the subsequent report. Aucklands is domestic in size and character and provides comfortable homely accommodation. A stair lift is soon to be installed to aid access between the ground and first floors. Radiator guards have been fitted to ensure residents safety, with the exception of the radiator just inside the lounge door. Methods of fitting a suitable guard without hindering access through the door are still being explored. For the present, the temperature of this radiator has been turned down to minimise any risk. Window limiters are fitted to first floor windows, but in some cases the casement windows still open fairly wide and need checking. The window catch in one bedroom is broken and needs repair. Service users commented, The staff are always cleaning here. My room is spotless. Everything is always nice and fresh, the home smells nice. During the morning, staff were busy preparing a bedroom for an expected admission in the afternoon. This bedroom was spotlessly clean, had been thoroughly aired and smelled fresh. Clean linen, soap and towels were in place and staff took pride in arranging everything so that the room was well presented and welcoming. The small laundry room does not contain a wash hand basin and, although a risk assessment is in place, it is recommended that the infection control policy be amended to take account of this. There are also some cracked and loose floor tiles that need attention. Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 and 29 Auckland has a dedicated team of care staff who work positively with service users to ensure their needs can be met. The home is working to achieve the minimum ratio of 50 trained members of care staff at NVQ level 2, to ensure service users are in safe hands. Practices in relation to recruitment of staff have been improved since the last inspection, but some work is still needed to ensure the protection of service users. EVIDENCE: Examination of the staff rota and observation throughout the inspection demonstrated a sufficient number and skill mix of staff to meet the needs of service users. Staff commented, We work well together and make a good team. Staff duties include care, cooking, laundry and cleaning and separate domestic and catering staff are not employed. There are two care assistants on duty throughout the day. Mr and Mrs D Hart are on duty, one on call and one wakeful, from 8.00pm until 8.00am. Should Mrs Hart not be available, a member of care staff provides the wakeful duty. The staffing levels and arrangements at the home are such that, at present, all the necessary tasks are carried out satisfactorily. Staffing levels may need to be increased when dedicated intermediate care is introduced. Of the six care staff employed at Aucklands, two have National Vocational Qualification level 2 in care and two are studying for this qualification, so the
Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 18 target of 50 NVQ level 2 trained staff by 2005 will soon be met. The senior care assistant is enrolled on NVQ level 4 training. Staff commented, Although I have worked in care homes for some time, the NVQ training has made me look at how I work and sometimes to re-think my approach. I find the NVQ training has taught me a lot. Staff get together to discuss what they have learned and how this can best be used to benefit service users. The previous inspection identified difficulties regarding employment and recruiting procedures. Although progress has been made, those files examined indicate that the home has not yet undertaken all of the necessary checks to ensure the protection of service users. Mrs Hart says that she is currently chasing outstanding references to ensure that all staff have two in place. Documentation is now available for Mrs Harts son who works in the home, including a Criminal Records Bureau check. However, references have not yet been obtained. Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 and 38 Although both of the registered persons have considerable experience of caring for elderly people, there is a lack of obvious leadership in the day-to-day management of the home, which is not in the best interests of service users. Systems are now in place to promote the health safety and welfare of service users and staff within the home. EVIDENCE: Mr J. Hart and his son, Mr D. Hart have experience of managing care homes over many years. Mr D. Harts wife has a full-time occupation but is also involved in the running of the home in her free time. She has successfully obtained her National Vocational Qualification (NVQ) level 4 in care and has enrolled for the NVQ level 4 in management. Discussions with service users demonstrate that they believe either Mrs Hart or the senior care assistant to be in charge of the home. Service users said they could not remember meeting Mr D Hart or his father and were unaware that
Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 20 they were responsible for the management of the home. Care records viewed show entries by Mrs Hart, but none from either her husband or Mr J Hart. Mrs Hart had documented the death of a service user on the day of inspection. At present, neither of the registered persons is communicating a clear sense of direction and leadership in the home. Mr D. Hart is on the premises from 8.00pm until 8.00am but is not present for a large part of the day. Much of the day-to-day management is being left to the senior care assistant, supported by Mrs Hart when she is not working elsewhere. The senior care assistant is very experienced and capable and is currently studying for a NVQ level 4 in care. The registered persons may wish to consider her possible registration as manager of the home to ensure regular management support to service users and staff during the daytime. The recommendation that the registered person has a NVQ level 4, or equivalent, in management and care by 2005 has not been achieved and there is little evidence of periodic training to update knowledge, skills and competence. Following the last inspection, five requirements and a recommendation were made in respect of health and safety within the home. All of these have now been dealt with satisfactorily and measures are in place to ensure the safety of service users. Examination of the fire records shows regular maintenance and checks are carried out at appropriate intervals and staff and service users confirm this. Fire training and drills are taking place at monthly intervals. All except the newest member of staff have received moving and handling training and all staff are currently taking part in a medicine administration course. Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x 2 HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 2 x x 2 x x 2 2 STAFFING Standard No Score 27 3 28 2 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 2 1 x x x x x 3 Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 9 Regulation 13(2) Requirement The medicines policy must be revised and updated to include the recommended additions, according to guidance issued. (Previous timescale of 30/12/04 not met.) A lockable facility must be provided in bedrooms, where service users can keep medicines or other valuables. It is required that staff receive training in Adult Protection issues, to ensure a proper response to any suspicion or allegation of abuse. The grounds of the home must be properly maintained so that they are suitable and safe for service users. Attention is required to the radiator in the lounge and also first floor windows, to ensure service user safety. Cracked and loose tiles in the laundry area present a tripping hazard and must be repaired all replaced. It is required that the registered person shall not employ staff to work in the care home unless the information and documents Timescale for action 31/7/05 2. 9 23(2)(m) 30/9/05 3. 18 13(6) 30/9/05 4. 19 23(2)(o) 31/7/05 5. 25 13(4)(c) 31/7/05 6. 26 23(2)(b) 31/7/05 7. 29 19(1)(b) and Schedule 2 31/7/05 Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 23 8. 31 9. 31 10. 32 specified in Schedule 2 have been obtained. 12(1) It is required that the registered 31/8/05 (5)(a) and persons be in full-time day-to8(1)(b)(3) day charge of the care home. If this is not possible, the registered persons must appoint a full-time manager. The Commission must be informed in writing by 31/8/05 of the steps proposed to meet this requirement. 9(2)(b)(i) It is required that one of the 31/8/05 and 10(3) registered persons demonstrates he has the qualifications and skills necessary for managing the care home. This includes the previous recommendation to have a qualification at NVQ level 4, or equivalent, in management and care. The Commission must be informed in writing by 31/8/05 of the steps proposed to meet this requirement. 8(1)(b) The registered persons must (iii) ensure that the home is properly managed. A registered manager must be appointed if the registered persons do not intend to be in full time day to day charge of the home. 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 18 Good Practice Recommendations It is recommended that the Adult Protection policy be amended to include the name and address for the Protection of Vulnerable Adults list (POVA). It is also recommended that the whistle blowing policy is amended so that staff are aware they can contact CSCI at any time, without notifying the Registered Persons first (regardless of having ‘good grounds’ as is presently stated in the
D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 24 Auckland Residential Care 2. 3. 4. 5. 6. 18 22 26 28 33 7. 34 policy). Repeated. It is recommended that the Adult Protection policy makes reference to the Department of Health No Secrets guidance. It is recommended that the action plan in relation to the Occupational Therapists report be implemented. It is recommended that the infection control policy be amended to take account of the lack of wash hand basin in the laundry room. It is recommended that a minimum ratio of 50 trained members of care staff (NVQ level 2 or equivalent) is achieved by December 2005. It is recommended that an annual development plan is put in place, based on a systematic cycle of planning, action and review, reflecting aims and outcomes for service users. This should include the latest plans for intermediate care. Repeated. It is recommended that an up-to-date business plan be submitted to the Commission, to include the changes planned for intermediate care. Repeated. Auckland Residential Care D55 S3916 Auckland Residential Care V229233 050505 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole Dorset BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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