CARE HOMES FOR OLDER PEOPLE
Auckland Residential Care 2 Ken Road Southbourne Bournemouth Dorset BH6 3ET Lead Inspector
Marjorie Richards Unannounced Inspection 7th November 2005 09:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 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. Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 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 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) Mr David John Hart Mr Job Hart Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Two persons between the ages of fifty-five and sixty-five may be accommodated at any one time for short-term care. 5th May 2005 Date of last inspection 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, but two persons between the ages of 55 to 65 may also be accommodated for short-term care, as part of this number. Service users accommodation is located on the ground and first floors of the home with access between floors via the staircase or a stair lift. The home is centrally heated throughout. 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 eight bedrooms have en-suite facilities. The two double bedrooms are currently used as singles, unless two people request to share. All eight bedrooms are currently contracted to Bournemouth Borough Council Social Services in a scheme to provide service users with support during a time limited period of assessment and possible rehabilitation, before their longer term care needs are decided. Auckland provides 24 hour personal care, all meals, laundry and domestic services. Some service users are encouraged to do as much for themselves as possible as part of the rehabilitation process. The home offers stimulation in the form of activities and assists service users if they wish, to make arrangements in accordance with their religious beliefs. Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out on the 7th November 2005, from 9.45am until 5.00pm. The purpose of this inspection was to review the requirements and recommendations that had been made at the previous inspection in May 2005 and to check that the people who were living in the home 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 the provision of intermediate care. One of the registered persons, Mr D. Hart was available in the home on the day of the inspection, along with his wife, Mrs L. Hart. Mr and 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. As part of the inspection process, comment cards were distributed by the Commission and, to date, the following completed cards have been received: 1 from a resident, 1 from a relative, 3 from care managers/placement officers and 1 from a health care professional. Some of these comments are included in the following report. 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. The Statement of Purpose and Service User Guide contain all of the information required about the home and its facilities. This helps prospective service users to make informed decisions about admission to the home. Auckland Residential Care has a thorough admissions procedure in place and pre-admission assessments are always carried out to ensure care needs can be met. Prospective service users and their relatives and friends are encouraged to visit the home prior to admission to enable them to assess the facilities and discuss their care needs. The home has a detailed care planning system in place to ensure that staff
Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 6 have all the information they need when looking after service users. There is also good support from community health professionals, ensuring that health needs are well met. The arrangements for storing and handling medicines in the home ensure service users safety. Where appropriate, service users are encouraged to be responsible for their own medication. Staff treat service users with respect. Comments from service users include, The staff here are very pleasant, they are polite and show respect. and when I first came here, I was asked what I wanted to be called and how I wished to be addressed. They seemed interested in knowing about me as a person. Staff demonstrated a good knowledge of service users care needs. Communication between staff is good and this ensures continuity of care. All service users have their own single bedrooms, thereby offering opportunities to be on their own if they wish and allowing privacy for any visitors or personal care needs. Service users commented, I prefer to spend time in my room, but nobody seems to mind. I can go to my room whenever I want. A range of recreational and social activities is available within the home. Open visiting arrangements are in place and service users are encouraged to retain links with visitors and with the community. Independence is encouraged and the daily living arrangements are flexible, to fit in with the needs of service users. Service users are encouraged to exercise choice and control over their own lives and their individual preferences and routines are respected. A member of staff said, It is their home, they can do what they want. Service users spoke highly of the meals provided, The food here is very good. I have no complaints We have good English cooking, just as I like it. Service users live in a homely environment, which is safe and well maintained. The home provides access to a comfortable lounge and separate dining room, as well as small garden areas. There are sufficient communal bathrooms and toilets to meet the needs of service users and seven of the eight bedrooms have ensuite facilities. Bedrooms are comfortably furnished and personalised to varying degrees. Service users commented, I am very pleased with my room, I had everything I need here. Everything was lovely and fresh in my room when I arrived and I am very comfortable here. Auckland Residential Care has a dedicated team of care staff to ensure their needs are met. The home understands the importance of NVQ level 2 training in ensuring that service users are in safe hands at all times. The target of 50 NVQ level 2 trained staff by 2005 has been exceeded. Service users spoke highly of the staff and a number of positive comments were received including, I could not be in a better place. They are very good to me here. Everyone has been very kind and supportive to me. A staff training and development programme is in place to ensure that all staff receive appropriate training, including a 13-week induction programme. Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 7 The home has a Quality Assurance programme in place and actively seeks the views of service users, staff, relatives and other visitors to the home, to ensure the home is run in the best interests of service users. Comments received from service users include, I have never been looked after so well. Nice to meet such lovely people. Comments from relatives include, Thank you and your excellent staff for all the loving care and attention she enjoyed it during her stay. What has improved since the last inspection? What they could do better:
One radiator, just inside the entrance to the lounge, has not been fitted with a guard. Temporary measures have been put in place to eliminate any risk of residents burning themselves against the hot surface. The long-term solution involves moving the position of the radiator and it is hoped that this can be achieved as soon as possible. It is recommended that a training audit be carried out to ensure that all staff have received the training they need and that this is updated where necessary, e.g. first aid. Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 8 It is expected that one of the registered persons should have a qualification at NVQ level 4, or equivalent, in management and care but this has not yet been achieved. Proposals have been put forward to the Commission for achieving this in April 2006. A formal staff supervision system is now in place, but this is not being implemented at the recommended intervals to ensure staff are appropriately supervised. Supervision should take place six times a year but at present this is being carried out on a quarterly basis. 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 DS0000003916.V263162.R01.S.doc Version 5.0 Page 9 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 Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 10 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): 1, 3, and 5 Standard 6 is not currently applicable. (See below) Information provided about Auckland Residential Care and a thorough admissions procedure allows prospective service users to make informed decisions about admission to the home. The outcome of pre-admission assessments is confirmed in writing, so prospective service users are fully assured that their care needs will be met. Prospective service users and their relatives or representatives are invited to visit the home prior to admission to enable them to assess the facilities and services provided. EVIDENCE: The Statement of Purpose and Service User Guide contain all of the information required about the home and its facilities. The Service User Guide is easily readable and gives a good indication of what a service user can expect from the home. Individual care records are kept for each resident and three of these were examined. All showed that, prior to moving to the home, care needs had been
Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 11 assessed by Bournemouth Borough Council care managers who had provided a care plan to the home. On occasion, the home also visits the prospective service user prior to admission. The outcome of such assessments is confirmed in writing, so prospective service users are fully assured that their care needs will be met. Mr Hart says prospective service users and/or their relatives are always encouraged to visit the home prior to admission. He feels it is helpful for them to have opportunities to look round the home, meet with other service users and staff, assess facilities and ask any questions. Staff and service users confirm that prospective service users and their relatives/friends are able to visit the home prior to admission. Mr Hart is currently involved in discussions with Bournemouth Borough Council Social Services Directorate as the home wishes to provide Intermediate Care rather than an assessment/rehabilitation service. This would mean the provision of dedicated accommodation, together with specialised facilities, equipment and staff, to deliver short-term intensive rehabilitation to enable service users to return to their own homes. At present, all eight bedrooms are being used to provide service users with support during a time-limited period of assessment (usually six weeks) and possible rehabilitation, before their longer term care needs are decided. Service users may come from hospital or the community to consider their care needs and the choices available to them, whilst at the same time being encouraged to maximise their rehabilitation potential. Any rehabilitation is provided by the care staff within the home. Clearly at present, Auckland Residential Care is not providing Intermediate Care, although it hopes to do so in the near future. This standard will therefore be reviewed again at the next inspection. Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 12 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 and 10 Auckland Residential Care has a detailed care planning system in place, which ensures that staff have the information they need to meet the needs of service users. Good support from community health professionals helps to ensure that the health needs of service users are well met. The arrangements for storing and handling medicines in the home ensure service users safety and, where appropriate, service users are responsible for their own medication. Service users are treated respectfully and care is offered in a way that protects their right to privacy and dignity. EVIDENCE: All three of the care plans examined flow from the assessments made earlier and are clearly set out, informative about the needs of each service user and how staff are to meet these needs. The home aims to maximise the potential of each service user, whether to return home, or move to long or short-term
Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 13 care or sheltered accommodation. Relatives are encouraged to be involved in the provision of care if they wish and staff are often involved in assisting the service users relatives/carers in finding ways of coping better in their own homes. A review of care takes place with care managers two weeks after admission. Records demonstrate that care plans are regularly reviewed and updated where necessary. Detailed daily care notes, written by staff, support and evidence the care of service users. Risk assessments are in place and appropriate steps are taken to minimise any risks identified. Records also demonstrate that service users have access to GPs, district nurses, dentists, opticians, chiropodists, etc as necessary. This was later confirmed in discussion with service users and staff. Requirements made at the last inspection, regarding the updating of the medicines policy and provision of a lockable facility in bedrooms where service users can keep medicines or other valuables, have been met. Staff were observed throughout the inspection to be treating service users with courtesy, kindness and respect. Service users commented, The staff here are very pleasant, they are polite and show respect. Staff always knock when they come to my room. When I first came here, I was asked what I wanted to be called and how I wished to be addressed. They seemed interested in knowing about me as a person. All service users have their own single bedrooms, thereby offering an opportunity to be on their own if they wish, or allowing privacy for any visitors or personal care needs. Service users commented, I prefer to spend time in my room, but nobody seems to mind. I can go to my room whenever I want. Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 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, 14 and 15 A range of recreational and social activities is made available so that service users are able to experience a varied life within the home. Open visiting arrangements are in place, so service users are able to maintain contact with family and friends and retain links with the local community. Service users are encouraged to choose their own lifestyle within the home and their individual preferences and routines are respected. The home provides a balanced and varied selection of food that meets the tastes, choices and special dietary needs of service users. Meals are served at times and locations that are convenient to them. EVIDENCE: Service users have access to a range of board games, cards, indoor ball games, television and a selection of music and videos. The mobile library visits each month. Newspapers are provided and staff arrange occasional quizzes, reminiscence sessions and gentle exercise to music. Activities are also carried out on a one-to-one basis and tailored to meet the needs of the individual. This might include taking a service user to their own home, shopping or to the pub as part of an assessment.
Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 15 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 able to visit at any time. A relative commented, I am always made to feel very welcome whatever time I visit. Relatives are able to remain involved in care provision if they wish. 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. Within the rehabilitation and assessment framework, service users are encouraged to choose their own lifestyle within the home and make choices wherever possible. Independence is encouraged. A member of staff said, It is their home, they can do what they want. This includes choosing when to get up or go to bed, what to wear, what to eat or drink and to come and go as they please. As part of the review process, service users are also encouraged to discuss their wishes about what they want to do in future. Although generally only in the home for a maximum of six weeks, service users are encouraged to bring some of their own possessions to personalise their bedrooms. Service users confirmed that their individual preferences and routines are respected. 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 staff accommodate any personal preferences. Staff confirmed this and said jacket potatoes, omelettes, pasta and a variety of salads etc could always be made available. The three-course lunch on the day of inspection was as follows: - a choice of fruit juices, followed by toad-in-the-hole, with potatoes, swede and peas. This was followed by fruit cheesecake, ice cream or fresh fruit. Service users commented, The food here is very good. I have no complaints. I enjoy my meals. We have good English cooking, just as I like it. The toad-in-the-hole was very enjoyable today. A bowl of fresh fruit is available in the dining room and service users are encouraged to help themselves whenever they wish. As part of the assessment process, some service users are encouraged to help with the preparation of their own meals, e.g. putting out their own cereal for breakfast or making toast. Other service users are encouraged where possible to assist with tasks such as buttering their own toast, pouring a cup of tea or putting milk on their cereal. Staff assistance is always available whenever needed. Mealtimes were seen to be relaxed, unhurried and flexible to fit in with daily living arrangements. Service users may choose where in the home they eat their meals. Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 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): 17 and 18 Service users have their legal rights protected and are assisted in exercising their rights. The home has an Adult Protection policy and procedure in place. All staff have received Adult Protection training to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The Service User Guide states, The emphasis placed upon rights is an integral part of the quality of care we provide. The home undertakes to assist service users in utilising their rights fully, if necessary in full consultation with the service user and appropriate others, such as family, health and social care advisors etc. As service users are only in the home for a short time, it is not possible to ensure they are on the electoral roll. However, during local and national elections, opportunities are made available to all service users to vote if they wish. Transport to the polling station is provided if necessary. (This was seen in action at the time of the last inspection on the day of the General Election.) The home provides information about advocacy services, where service users lack capacity or require independent support or advice. Auckland Residential Care has a comprehensive Adult Protection policy in place to protect service users from possible abuse. A requirement from the last inspection that staff receive training in adult protection issues, to ensure a
Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 17 proper response to any suspicion or allegation of abuse, has been met. Recommendations concerning amendments/additions to the Adult Protection policy have also been acted upon. Staff confirm that they have received Adult Protection training. Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 18 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21 and 24 Service users live in a comfortable environment that is safe and well maintained. The home provides communal areas, including a garden, that are easily accessible to service users. There are sufficient communal bathrooms and toilets to meet the needs of service users. Bedrooms are comfortably furnished and personalised to suit their occupants. EVIDENCE: Aucklands is domestic in size and character and provides safe, comfortable and homely accommodation. A stair lift has now been installed to aid access between the ground and first floors. Radiator guards have been fitted to ensure service users safety, with the exception of the radiator just inside the lounge door. It is not possible to fit a guard without impeding this doorway so
Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 19 for the present, the temperature of this radiator has been turned down to minimise any risk. (There is a second radiator in the room.) Plans are being made to move this radiator further away from the door so that a guard can be fitted. Risk assessments are in place as necessary, e.g., for the lounge radiator and the stair lift. Equipment is regularly maintained, including Portable Appliance Testing. Since the last inspection, a number of improvements have been made. The dining room has been redecorated and recarpeted and new dining chairs have been provided. New carpet has been fitted throughout the hall and corridors. One bedroom has been completely refurnished and it is planned to provide new bedroom furniture for all bedrooms over the coming year. Lever taps are being trialled in two bedrooms to see these are easier for service users to manage. A new shower has been fitted over the ground floor bath and lockable cabinets have been provided in all bedrooms for storage of medication or personal items etc. Work has been satisfactorily carried out in respect of matters noted in the last inspection report, relating to first floor windows, cracked and loose tiles in the laundry and maintenance of the garden. It is intended to build a new perimeter wall to the garden at the front entrance. The communal space at Auckland Residential Care consists of a lounge and separate dining room, both situated on the ground floor. The lounge overlooks the rear of the property and is a comfortable room with a television and a variety of seating. The recently refurbished dining room is situated at the front of the home and has attractively presented tables. A Welsh dresser is used to accommodate books, games, magazines and a large bowl of fruit. Some service users also like to use this room as an alternative sitting area to the lounge or for reading, writing letters etc. There are small areas of garden laid mainly to lawn at the sides of the property, where service users may sit out if they wish. Communal bathrooms and W.C.s are situated on the ground and first floors. A portable bath lift is available to assist service users in and out of the bath if necessary. All but one of the bedrooms has en-suite facilities. A tour of the building confirms that residents bedrooms are comfortably furnished and personalised to varying degrees. Service users commented, I was able to bring some of my own things with me. I am very pleased with my room, I have everything I need here. Everything was lovely and fresh in my room when I arrived and I am very comfortable here. “A lockable facility is provided within each bedroom for personal items etc. Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 20 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 Auckland has a dedicated team of care staff who work positively with service users to ensure their needs can be met. The home understands the importance of NVQ level 2 training in ensuring that service users are in safe hands at all times. Practices in relation to recruitment of staff have been improved since the last inspection, to ensure the protection of service users. Training is provided so that staff are equipped with the knowledge and skills necessary to meet the assessed needs 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 spoke of working well together as a team. Staff duties include care, cooking, laundry and cleaning and separate domestic and catering staff are not employed. There are at least two care assistants on duty throughout the day. Mr and Mrs D Hart are on duty from 8.00pm and sleep on the premises on call overnight, until 8.00am. Mr or Mrs Hart (or care staff) provide a wakeful duty, as necessary, to meet the needs of service users. The staffing levels and arrangements at the home are such that, at present, all the necessary tasks are carried out satisfactorily. Staffing levels
Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 21 may need to be increased if and when dedicated intermediate care is introduced. Of the six care staff employed at Aucklands, four have National Vocational Qualifications level 2 in care, so the target of 50 NVQ level 2 trained staff by 2005 has now been exceeded, helping to ensure that service users are in safe hands. One care assistant is currently undertaking NVQ level 3 and the senior care assistant is undertaking NVQ level 4 training. Staff get together to discuss what they have learned and how this can best be used to benefit service users. A full range of policies and procedures is in place to offer advice and guidance to staff. Service users spoke highly of the staff at Auckland Residential Care. A number of very positive comments were received including, I could not be better looked after. They are very good to me here. Everyone has been very kind and supportive to me. I could not be in a better place. The home now has a thorough recruitment procedure in place, based on equal opportunities and ensuring the protection of service users. The two staff files examined showed that the necessary documentation, e.g., Criminal Records Bureau disclosures, references etc, was in place. Auckland Residential Care has a staff training and development programme, which aims to ensure that all staff receive appropriate training so they can fulfil the objectives of the home and meet the needs of service users. New staff are recruited into a thirteen-week induction programme, four weeks of which link in to the Social Services induction programme. Staff have recently received training in moving and handling, dementia awareness and Adult Protection. Copies of all training certificates are being retained to provide evidence that staff receive a minimum of three paid days training per year. It is recommended that a training audit be carried out to ensure that all staff have received the training they need and that this is updated where necessary, e.g. first aid. Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 22 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, 35 and 36 The management arrangements of the home support good care practices for service users. The home regularly reviews its performance and actively seeks the views of service users, staff and relatives to ensure the home is run in the best interests of service users. Service users are assured of sound management of their financial interests. A formal staff supervision system is now in place, but this is not being implemented at the recommended intervals to ensure staff are appropriately supervised. Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 23 EVIDENCE: The registered persons, 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. The requirement that the registered person has a NVQ level 4, or equivalent, in management and care by 2005 has not been achieved and is therefore repeated at the end of this report. There is still little evidence of periodic training to update knowledge, skills and competence. However, Mrs Hart says it is her intention to retire from her present job in the near future, at which time she will be seeking registration so that she can assume full-time involvement in the care home. Mrs Hart has already successfully obtained her National Vocational Qualification (NVQ) level 4 in care and management and is currently undertaking an NVQ assessors course. At the last inspection, it was felt that neither of the registered persons was communicating a clear sense of direction and leadership in the home. Staff and service users confirm that this has now improved and Mr D Hart spends more time in the home. Two service users said they enjoyed chatting with him. Mr Hart was able to demonstrate clear lines of accountability within the home. Mr and Mrs Hart and the senior care assistant say they regularly spend time talking with service users to obtain their views and this was confirmed in discussions with service users during the inspection. A quality assurance programme has been developed and questionnaires are being sent to relatives and other visitors to the home. A survey form is provided for each service user when they are ready to leave Auckland Residential Care, but at present not many of these are completed. Mrs Hart is currently looking at ways of improving the survey form. A visitors book is available for comments from service users and relatives. Recent comments include: From service users; I have never been looked after so well. The people were very friendly to me. Nice to meet such lovely people. From relatives; Thank you so much for making her stay so comfortable and making me feel so welcome. Thank you and your excellent staff for all the loving care and attention she enjoyed during her stay. The Commission for Social Care Inspection has received a comment card from a care manager stating, Aucklands provides a person centred approach to assessment and rehabilitation. The work Aucklands undertakes significantly reduces the number of service users entering permanent residential care.
Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 24 Mr Hart says that, in order to protect service users, it is the policy of the home not to have any involvement in their personal finances. Therefore, all service users who are unable or do not wish to handle their own affairs, have a relative or other representative to deal with their finances etc. At the present time the registered persons do not have any valuables for safekeeping and service users are encouraged not to bring such items into the home. Information about advocacy services is available to service users within the home and policies are in place precluding staff acceptance of gifts or involvement in residents wills. Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 25 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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 3 3 3 3 X X 3 X X STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 2 X X Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 26 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 OP31 Regulation 9(2)(b)(i) and 10(3) Requirement It is required that one of the 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. (Previous timescale of 31/08/05 not met). Timescale for action 31/03/06 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 2 Refer to Standard OP30 OP36 Good Practice Recommendations It is recommended that an audit of staff training be carried out to ensure all staff are receiving the training they need. It is recommended that formal staff supervision be carried out six times in every year. Auckland Residential Care DS0000003916.V263162.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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