Inspection on 20/03/07 for Augusta Court

This inspection was carried out on 20th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Augusta Court 23/06/08

Augusta Court 11/09/07

Augusta Court 30/09/05

Augusta Court 11/05/05

Augusta Court 24/08/04

Augusta Court 19/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Augusta Court Winterbourne Road Chichester West Sussex PO19 4TT Lead Inspector Mrs A Taggart Unannounced Inspection 20th March 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 Augusta Court DS0000014380.V328486.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. Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Augusta Court Address Winterbourne Road Chichester West Sussex PO19 4TT 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) 01243 532483/584495 01243 771173 sharon.blackwell@anchor.org Anchor Trust Mrs Susan Pamela Hoskins Care Home 46 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (46) of places Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of one person in the category DE(E) (Dementia) over 65 years to be accommodated 30th September 2006 Date of last inspection Brief Description of the Service: Augusta Court is a care home in a residential area of Chichester providing personal care for up to 46 service users in the category of Older People. Augusta Court is a detached two-storey establishment providing 44 single and one double flat, each of which comprises of a bed, sitting room, kitchenette and shower room. Each floor has two distinctive wings with a lounge and on one wing, a hairdressing salon. A centrally placed lift gives access between the floors and the ground floor dining room, conservatory and offices. Anchor Trust voluntarily owns the service with their representative Mrs Jane Ashcroft appointed as responsible individual. The registered manager is Mrs Susan Hoskins. Current fees from 1st April 2007 are £557 for a single flat to £1,150 for a double flat per week. Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In preparation for this visit, a pre-inspection questionnaire was sent to the registered manager for completion, survey forms were sent to residents and comment cards to families and professionals involved with the home. A planning document was also completed. Nine resident survey forms were returned, all made some positive comments about the home but also stated concerns about the unpredictable standard of food provided and insufficient staffing numbers. No family comment cards were returned but the inspector held telephone interviews with five family members, who also made similar comments to residents. Two healthcare professionals were also spoken to and they also had concerns about staffing levels and residents being isolated within the home. The unannounced visit was carried out at 8.45am and lasted for 6.5 hours. As the registered manager was not available at this time the inspector also went back to the home for a further two hours on 23/3/07 in order to complete the visit with information that needed to be provided by the manager. During the visit a large amount of the time was taken in making a tour of the building, spending time talking to residents in their flats and observing staff practice. Three visitors were also spoken with and they expressed concerns about the current standard of care being provided. Eight care plans and assessments were seen, four were tracked with any relevant issues discussed with the resident or staff on duty. Staff recruitment records were in good order. The main meal of the day was seen being prepared and served, residents said that because a lot of agency cooks were used the standard of food varied from day to day. The medication system was tracked with errors being found in storage methods and recording. Records for the running of the business including staffing rotas were seen and it was found that fire training for both the day and night staff was out of date and Regulation 37 reports had not been sent to the Commission as required. Records also showed that staffing is sometimes at unacceptably low levels putting both residents and the staff on duty at risk. An Immediate Requirement regarding the safety of some resident’s showers in their flats was made on 20/3/07. When the inspector returned on 23/3/07, the manager said that the problem had been addressed and new showers were being fitted. At the first visit feedback was given to the team leader on duty and feedback was also given to the manager after the second visit had been completed. The manager had completed the pre-inspection questionnaire and information from this document has also been used to inform the visit. Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 6 A letter from the Responsible Individual was received by the Commission on 3/4/07 confirming that the Immediate Requirement had been addressed. What the service does well: What has improved since the last inspection? What they could do better: Prospective residents should have their needs assessed prior to moving into the home to ensure that the home can meet their needs and care plans and risk assessments should be completed to contain information to direct the staff team to the current needs of each person . Further assessments should take place to ensure that the home continues to meet the needs of the people currently receiving a service. Healthcare support should be improved so that where people have increased or specialist needs their records are kept up to date and specialist equipment is used correctly. The management of medication should be improved to ensure that errors do not occur and risk assessments should be completed for residents who wish to self medicate. The home should ensure that it provides meals of a consistently good quality and recruit a permanent chef as soon as possible. Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 7 Recreational and occupational activities that are suitable for all residents should be provided and records kept of participation. Further training should be provided to ensure that all staff are knowledgeable about the correct procedures to follow if they suspect an abuse has taken place As part of the assessment process the home should ensure that the environment meets people’s needs and that they are not isolated and are enabled to meet regularly with other people. All equipment uses by residents, such as showers should be kept in a safe condition and checked on a regular basis. In order to ensure the safety of both residents and the staff team, fire training should be provided without delay. Staff should be provided in sufficient numbers to ensure the safety and meet the assessed needs of residents at all times and staff should not work long shifts that can affect their safety. The staff team should be provided with the supervision, training and support they need to carry out their roles and responsibilities. Additional training and support should be provided for staff members who are expected to provide a “team leader” role. The manager should ensure that a senior person such as a deputy manager has overall responsibility for the running of the home in her absence so that the staff team have the guidance and support they need to ensure the standard of care and safety of residents. Records for the running of the business such as Regulation 37 reports should be sent to the Commission as required. 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. Augusta Court DS0000014380.V328486.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 Augusta Court DS0000014380.V328486.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): 1 2 3 and 6 Quality in this outcome area is adequate . This judgement has been made using available evidence including a visit to this service. Although there is information available about the facilities in the home, all residents have not had a pre-admission assessment in order to ensure that the home can meet their needs. EVIDENCE: The information available about the home has recently been updated and has also been produced on a CD for people who have difficulty reading small print. Residents and their families confirmed that they had visited the home before moving in and one person was currently staying on a trial basis. Contracts of terms and conditions of residency are in place and have been signed by the resident or their representative. In tracking resident’s records it was found that not all people had a preadmission assessment in place and in some cases the documents were blank, Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 10 therefore there was not sufficient information available to guide the staff team to people’s basic support needs on admission. As the needs of some of the people living in the home have changed considerably, new assessments should be carried out to ensure that their needs can be met. Augusta Court does not provide intermediate care. Augusta Court DS0000014380.V328486.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 and 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Some residents living in the home are at risk because of lack of current care plans, and the reduction of risks to residents not being in place and errors in medication management. EVIDENCE: Although some care plans in the home are in place and have recently been reviewed, many are out of date and for one person who had been admitted to the home two weeks previously, there was a pre-admission assessment but no care plan or risk assessments completed; these documents were blank, so the staff team did not have the information they need to support this person. In other care plans risk assessments had not been completed and monthly reviews were out of date. For one person, who is being cared for in bed and had a “high risk” care plan in place regarding fluids and nutrition there were daily records in place which the home’s guidance said should have been completed two hourly. At 11.30am, when seen by the inspector, the documents had not been completed since 18.00 on the previous evening. There was therefore no evidence that this Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 12 person had received the care they needed during the night. A pressure mattress was in use but this was set at the incorrect pressure for the weight of the person, therefore potentially causing a risk to tissue viability. There was also no agreement in place for the use of bed rails. As the home uses a large amount of bank and agency workers a précis of this person’s current care plan should be available for reference and records completed as directed. In the period from 19/2/07 to 17/3/07, thirty-six accidents to residents, mostly falls, have been recorded, and almost all were unobserved by the staff on duty. There has also been an Adult Protection investigation, instigated by the manager of the home, into unexplained bruising to one resident. The home is registered for one person with dementia, but apart from some staff members having attended a training session there is no evidence that staff have the skills an experience to work with people with dementia and records and observation show that the needs of this person are clearly not being met. Incident forms show that this person regularly leaves the home unattended and is brought back by the Police, on one occasion the person went out at 4am in the morning. These incidents have also not been reported to the Commission as required under Regulation 37 of the Care Standards Act. Records also show that the staff team have to deal with incidents of aggressive behaviour but do not have training or support in dealing with this. Many of the people living in the home are now quite frail and are suffering from confusion but the environment does not support their needs in that people are isolated in their rooms almost all day and are not observed by the staff on duty. Two people were seen wandering around in a distressed manner but were just taken back and left in their rooms by the staff on duty. The home works with other healthcare professionals including local doctors and district nurses but one healthcare professional who visits the home regularly commented that they were surprised it was a registered home as they thought it was run more as supported flats. A resident said, “ The staff are very good but there just aren’t enough of them. I have been ill recently but nobody comes to see you as they are always busy running around. I think it is alright while you are independent but a different story when you are not”. Medication is provided by a local pharmacy and a monitored dose system is in place. The pharmacist also provides training and only “team leaders” administer medication. Medication was stored in two medicine cabinets in a locked room, however the night time medication was not locked in the cabinet and was left out on the side in the room as was a large amount of medication waiting to go back to the pharmacy. Errors were found in the Medication Recording Sheets in that there were gaps in signing and medication that was not being used had not been identified and crossed out. Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 13 Some of the people living in the home choose to self medicate and disclaimers have been signed but there are no current risk assessments in place or systems to audit that the medications are being taken correctly or to identify when the person might not still be capable of safely caring for their own needs. Controlled medication was adequately stored and records were current and correct. Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Lifestyle choices for people could be improved by activities being available that are suitable for all residents and the standard of food could be improved by the appointment of a permanent chef. EVIDENCE: For residents who are independent and can take advantage of the facilities Augusta Court provides opportunities and experiences that meet lifestyle choices and these people have a high degree of control over their own lives. One person said, “ I can’t complain about anything, they make people quite comfortable and I feel there are enough staff but then I am independent and go out on my own. I do not think though that there are many suitable activities”. For people who are less mobile and have higher support needs the experience is not so positive and people say they are isolated as has been recorded in other parts of this report. An activities co-ordinator has recently been employed and some activities sessions are displayed in the home but as yet no records of activities or interaction with other people is recorded in people’s care plans. Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 15 There was also no evidence of specialist activities being provided for people with dementia. Visitors say they are made welcome at any time but often have problems with tracking down a staff member to give feedback on their relative’s condition. Lunch, which was the main meal of the day was cottage pie or baked haddock with fresh vegetables and tapioca pudding to follow. There was also a cooked breakfast available, which some residents enjoy and others residents said that they preferred to make their own breakfasts and suppers in their own kitchens. Although the meal being provided was attractively prepared and of good quality comments from both residents and families was that since the permanent cook had left and the home was using agency cooks, the standard of meals was variable from day to day depending on who was in the kitchen. Mrs. Hoskins said that she is actively trying to recruit a new cook. Records showed that kitchen assistants, who prepare and service suppers on some days when there is not a cook on the premises do not have food hygiene certificates in place. Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although complaints are recorded and responded to, there are risks to residents by all staff not being aware of their responsibilities regarding adult protection issues. EVIDENCE: There is a complaints procedure in place a copy of which is displayed in the lounges and on the notice board in the home. In the last year there have been fourteen complaints recorded, all of which have been investigated by the manager. Many are concerns regarding falling standards in the home. One complaint is still outstanding and has not been resolved and a report is being compiled by the manager to address this. Residents said they would feel confident in making a complaint and if they did not speak to a member of staff, would speak to their families. One Adult Protection investigation, which was instigated by the home’s manager, has also been held, regarding unexplained bruising to a service user. The service user alleged that the bruising had been caused by poor manual handling. The outcome of the investigation was that the reason for the bruising could not be determined. Most of the staff team have attended training in the protection of vulnerable adults from abuse but not all of the staff on duty were aware of their Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 17 responsibilities should they suspect an abuse had occurred. When asked what they would do if they saw a manager or member of the senior staff shouting at a resident, one staff member replied, “ I don’t know, I would let it pass if it was the manager as you cannot challenge seniors can you”. To ensure that the people living in the home are protected from risk of abuse, further training should be undertaken by all staff regarding safeguarding residents from risk of abuse. Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 23 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the standards of accommodation at Augusta Court are very high, the way the home is laid out means that many people with higher care needs can be isolated and at risk and there are additional risks from showers with too high a water temperature. EVIDENCE: Augusta Court offers a warm, well-furnished and attractive environment for the people who live there but the way the home is laid out means that many people with poor mobility or who are more frail or ill can be isolated for long periods of time. The home is set out in four distinct wings, two on the ground floor and two on the first floor. Each room has a front door with a letterbox, a bedroom/living area, small kitchen and shower room. Bedrooms are attractively decorated and have been personalised with furniture and belongings brought to the home by residents. Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 19 For people who are independent and have good mobility this works very well as people can come and go as they please and make tea and snacks in their kitchens. One person said, “ This is a very good home for me as they just leave me alone to do what I want to do”. For people who are frail and confused the home is not meeting their needs. People were sitting in their rooms for long periods of time unobserved and alone and many said they were lonely and hardly saw anyone all day. The staff on duty did make an effort to go in to see people but they were very busy and there were not enough of them and as already stated when people came out of their rooms, sometimes distressed, they were taken back again. This also happened immediately after lunch. The home has several lounge areas and a large attractive dining room and sun lounge but apart from the mealtime, all but one resident, who was asleep in a chair all day, were in their rooms. Some people also had their meal in their rooms, which meant that they saw no one but the staff member on their wing all day. During the visit a resident said that their shower was too hot and too forceful and another resident was also heard making the same comment to the staff on duty. When these showers were checked, they were found to be at a temperature that could scald an elderly person and the force of two of them could have knocked a frail person off their feet. Some of the staff on duty said they were aware of the problems, which, they said had been caused by a new boiler having been fitted but no remedial action had been taken. An Immediate Requirement was made regarding the safety of the showers. The home was clean and hygienic throughout except for the carpet and armchair in one resident’s room that needed cleaning. This was pointed out to the staff on duty. Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There are insufficient numbers of staff with the skills and experience to ensure that resident’s needs are met. Additional training needs to be provided to ensure people have the skills to carry out their roles and responsibilities and the staff team needs to be supervised and supported by the management of the home. EVIDENCE: The staffing rotas show that there should be four carers and a team leader on each shift but this is not always the case and for two days over the week of the 18th and 19th March there were only two carers and one team leader on the early shift. As there were thirty-six residents in the home, some with high support needs needing two people to provide their care, this is unsafe and unacceptable. The staffing rotas also showed that working twelve hour shifts is quite common and on occasion staff had worked from 4pm on one day to 4pm the next day, carrying out a waking night as part of the shift. This is unsafe practice for both the staff member and the people they are supporting. The home has a very high turnover of staff and records show that the home uses large amounts of bank or agency cover. During the visit, the staff on duty were working very hard to support people but as the home is built in four separate wings, staff were working in isolation Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 21 and did not have time to spend with residents. If two staff were needed to offer personal care to a resident it meant that there was no one available for that wing. As well as offering personal care and other support the staff team are also expected to carry out the laundry duties as part of their role, which also takes them away from direct care. Both residents and their families made positive comments about the staff team but all said that there were not enough staff around to meet their needs. Comments included, “ As far as homes go this is very good but there are not enough staff. I am a wheelchair user and am here out on a limb and don’t see many staff all day”, “I have been here for over four years, there is a lot of coming and going of staff and there are not enough of them. The seniors are very good. There are not many activities I can join in with and I am on my own a lot” and from a family member, “I feel there are not enough staff and the impression of the home is that there are never any staff around especially at weekends, then they are very thin on the ground. I go in every day and often see residents wandering around unsupervised, the staff are overstretched and there do not seem to be anyone in charge to give overall support and guidance”. There is a robust recruitment procedure in place and all of the four staff files seen had the required documentation including two references and a current Criminal Bureau Checks. An induction and training programme is in place but all of the staff team have not completed all mandatory training and assistants working in the kitchen who helped to prepare and serve food did not have food hygiene certificates. One of the staff team holds an NVQ award and there is no evidence in records that team leaders have attended additional training to support them to carry out a senior role. Records show that staff supervision is not in place and some staff members have not had supervision in over two years. A staff member commented, “I have never had supervision. There are more staff needed to allow us to spend time with residents. Once the deputy manager left we have no direction and have to make decisions off our own backs”. Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 36 37 and 38 Quality in this outcome area is Poor. This judgement has been made using available evidence including a visit to this service. The home needs to ensure that there is management cover available to meet its stated purpose, aims and objectives at all times and promote the health, safety and welfare of service users and staff. Staff need to be provided with guidance and supervision, records need to be improved to ensure that residents are kept safe at all times. EVIDENCE: Although the registered manager has the qualifications, skills and experience to manage the service she has agreed absences from the home for long periods of time, during which time as there is no deputy manager there is no one to guide and support the staff team and monitor care practice. Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 23 Mrs. Hoskins said that she was largely responsible for the business side of running Augusta Court but had recently recruited a deputy manager who would hold a responsibility for “on the floor” supervision of care practice. Records show that staff team do not receive supervision and staff meetings are out of date so the staff team are working without the support, training and guidance they require to provide a good service. Where the home holds small amounts of money on behalf of residents, records are kept in good order and receipts sent to families. Records for the running of the business were seen including maintenance books, fire records, visits from registered provider, staff fire training records and complaints log. The insurance certificate displayed in the hall is out of date and should be replaced with the current version. Fire training is out of date for both day and night staff and should be addressed without delay. Electrical appliance testing is out of date but Mrs. Hoskins said was going to be completed in the near future and Regulation 37 records regarding the death or serious incident to a service user are not always being provided to the Commission as required. As previously recorded in this report an Immediate Requirement was made regarding the safety of residents using the showers in their rooms. Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 24 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 3 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 1 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 1 3 X X 2 X X 3 STAFFING Standard No Score 27 1 28 1 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 3 X 3 1 1 1 Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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 13 (2) (b) Requirement The registered manager must ensure that the needs of service users are re assessed in order to ensure that the home can meet their needs. To ensure that the staff team are aware of the needs of the people they are supporting current care plans and risk assessments should be in place and must be regularly reviewed. To ensure that service users receive the healthcare assistance they need, records must be completed and specialist equipment such as pressure mattresses used correctly. The registered manager must ensure that the storage and recording of medication is correct and risk assessments must be completed for people who wish to self medicate. In order to ensure that residents are protected from risk of abuse all staff working in the home must receive adult protection training All equipment that is used by DS0000014380.V328486.R01.S.doc Timescale for action 30/04/07 2. OP7 15 (2) (b) 30/04/07 3. OP8 12 (3) 15/04/07 4. OP9 13 (2) 30/04/07 5. OP18 13 (6) 30/04/07 6. OP25 13 (4) 23/03/07 Page 26 Augusta Court Version 5.2 7. OP27 18 (1) 8. OP30 18 (1) 9. OP36 18 (2) 10. OP38 23 (4) 11. OP31 18 (1) 12. OP37 17 (1) 13. OP38 12 (1) service users such as showers must be safe at all times Immediate Requirement made (a) The registered manager must ensure that there are safe and sufficient numbers of staff on duty at all times to provide the assessed needs of service users. (c ) The staff team must receive the training (including NVQ) and support they require in order to fulfil their roles and responsibilities, this includes team leaders. All of the staff team working in the home must receive regular supervision to ensure they are competent in their roles. (d) All of the staff team, including night staff must receive fire training as an urgent priority, and then 3 monthly for night staff and six monthly for day staff. (a) The registered manager must ensure that when she is absent, suitable management cover is provided to ensure the safety of the home. The registered manager must ensure that the records for the running of the business including Regulation 37 reports are completed and sent to the Commission as required (a) The registered manager must ensure the health and safety of the people living in the home and ensure that they are protected from harm at all times 30/03/07 30/04/07 30/04/07 15/04/07 30/04/07 30/04/07 15/04/07 Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Augusta Court DS0000014380.V328486.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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