Inspection on 14/08/06 for Avarest

This inspection was carried out on 14th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Avarest 05/01/06

Avarest 21/07/05

Avarest 07/12/04

Avarest 29/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Avarest 35 Chambres Road Southport Merseyside PR8 6JG Lead Inspector Daniel Hamilton Key Unannounced Inspection 09:30 14th August 2006 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 Avarest DS0000005393.V295720.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. Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Avarest Address 35 Chambres Road Southport Merseyside PR8 6JG 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) 01704 544646 01704 530551 Mr Keith Wright Mrs Patricia Wright Mrs Patricia Wright Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 15 OP Date of last inspection 5th January 2006 Brief Description of the Service: Avarest is a residential care home providing accommodation for up to fifteen older people. The home is situated in a quiet residential area not too far from the centre of Southport and all its amenities and is within easy reach of public transport. The home is a large detached 3-storey building with 14 single bedrooms and 1 double room. There is a large, well-kept garden to the rear of the property and a small sitting area at the front. The communal areas in the home consist of a dining room and a lounge. Toileting and bathing facilities are located throughout. The home is well maintained internally and externally with good quality furniture and fittings. There is a passenger lift servicing all floors and a call bell system is fitted in the home. The Care Home Fee is £360.50 per week. Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day and lasted a total of 9 hours. 13 residents were living in the home at the time of the visit. A partial tour of the premises took place and observations were made. A selection of care, staff and service records were also viewed. The Registered Manager / Owner, three staff members, one visitor and seven residents were spoken to during the visit. Furthermore, satisfaction survey forms “Have Your Say About.” were distributed to a number of residents and / or their relatives prior to the inspection, to obtain additional views / feedback about the home. All the core standards were reviewed and previous requirements and recommendations from the last inspection in January 2006 were discussed. What the service does well: Avarest presented as a warm and caring environment. The home was clean, pleasantly decorated and furnished to a good standard. Rooms viewed were comfortable and had been personalised with personal belongings and pictures. Staff were observed to be attentive and sensitive towards the needs of the people living in the home and were seen to spend time talking and offering support to residents throughout the day. Residents appeared relaxed and happy and spoke highly of the care provided. One resident spoken with said; “The staff and owners are very kind, loving and dedicated people.” The home had produced information on the home for prospective residents to view. This included a Statement of Purpose, Service User Guide and a Contract / Terms and Conditions of Residency. An assessment and care planning system had also been developed, to ensure the needs of residents were identified and planned for. Staff spoken to during the visit demonstrated a good awareness of the needs of residents and their individual support requirements. Residents reported that they were generally satisfied with the lifestyle experienced in the home and confirmed that they had access to regular activities, control of their day-to-day lives and a wholesome and appealing diet. Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 6 Comments included; “It’s a pleasant and relaxed home. I am free to choose my own routines and what I want to do each day”; “The activities vary each week. There is bingo, card games and exercises which I enjoy”; “Visitors are always welcome and we are free to come and go as we wish” and “The food is very good. Alternatives are always available. The tables are nicely laid and refreshments served in bedrooms are nicely presented.” Sufficient numbers of trained staff were on duty to meet the needs of residents and safeguards were in place to protect the people living in the home from abuse. Staff had access to a range of training to ensure they understood their role and responsibilities and a system had been developed to monitor and review the standard of care provided in the home. No complaints had been received since the last inspection and residents were satisfied with the service provided. A resident stated; “They [the staff] are understanding and caring and attentive to how one is feeling.” What has improved since the last inspection? Since the last inspection, the manager had taken appropriate action to improve systems and practice for the recording, handling, safekeeping and administration of medication. The changes made by the home ensured the health and welfare of residents was safeguarded. Residents had been asked about their preferred leisure / recreational activities and a new programme had been developed in consultation with the people living in the home. A record of all activities had also been established, to monitor participants and the range of activities provided. Recruitment practice had further improved as the home had obtained evidence that staff were physically and mentally fit for their work. New employees had completed health declarations as part of the home’s recruitment process. Receipts had been obtained for all money handled on behalf of residents. This ensured accountability and protected the Provider and the financial interests of the people using the service. A summary of the results of the home’s quality assurance questionnaire had been produced, to provide information for current and prospective service users, their representatives and other interested parties. A service record / certificate had been obtained to provide evidence that all hoisting equipment in the home was safe and in good working order. Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Avarest DS0000005393.V295720.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 Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments of need had been undertaken prior to admission, to ensure the needs of residents were identified. Prospective residents had access to a range of information on the home to enable them to make an informed decision about the service provided. EVIDENCE: The home had developed a Statement of Purpose, Service User Guide and Contract to provide information to prospective residents on the service provided and their rights and responsibilities. The manager reported that a copy of the document was given to residents or their representatives prior to admission. Residents confirmed via Care Home Surveys and through discussion that they had received a Contract and information about the home. Signed copies of contracts were also available on files viewed. The information available enabled prospective residents or their representatives to decide if the home was able to meet their needs and expectations. Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 10 Files were viewed for two residents who had moved into the home since the last inspection. Each file contained a ‘Resident Assessment Prior to Admission’, dependency and functional assessments and a ‘Personal Profile’, which covered a range of areas relevant to the needs, preferred lifestyle and wishes of each resident. The assessment form contained the necessary assessment criteria to enable the home to undertake a full assessment of a prospective resident’s needs, however there was limited space to record information. The manager confirmed that assessments completed by social workers were obtained for residents referred through care management arrangements. Information gained from the assessment process had been used by the home to devise a plan of care for each resident. Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care plans were in place that detailed residents’ individual needs and the support required to meet them. Medication was well managed and systems were in place to protect the welfare of residents. Residents were satisfied with the quality of care provided and felt their individual rights were valued and respected. EVIDENCE: Two files were viewed for residents who had moved into the home since the last inspection. Each file contained a Care Plan, which outlined each resident’s personal, health and social care needs and the support required from staff to ensure identified needs were met. Plans viewed had been kept under monthly review and had been signed by residents or their representatives. Supporting documentation and records were also in place. These included; daily report sheets, health care records, accident / incident records and person centred and moving and handling risk assessments. Advice was given to the manager on the use of cot sides and further considerations to be included in a Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 12 risk assessment. Separate records of personal care and weights were maintained for all residents. Health Care Records showed that residents had access to health care services / professionals, subject to individual need. Feedback received from residents via Care Home Surveys and discussion confirmed residents had access to the medical support they needed. One resident reported; “I always get a doctor when I need one and have been take to hospital on occasions by the staff.” Another resident stated; “If anyone is unwell the staff arrange for a doctor to call straight away. In my opinion we are well looked after.” The home had developed a Medication Policy. Since the last inspection the manager had obtained a copy of guidelines issued by the Royal Pharmaceutical Society of Great Britain for staff to reference. A record of staff authorised to administer medication together with sample signatures and a system to check the identity of residents prior to administering medication was also in place. Staff responsible for the administration of medication had completed external training and a ‘Training and Competence’ form had been developed by the manager to ensure the competency of staff responsible for the administration of medication was checked periodically. The manager had also introduced an audit system to check medication on a monthly basis. Medication Administration Records were checked for three residents. Records were well maintained and the date, initials of staff and quantity of medication received had been recorded. Variable doses had been noted and controlled drugs had been recorded in a register. All entries had been witnessed. No evidence of secondary dispensing was found during the visit. Medication packaging had been dated when opened to provide an audit trail. Patient information leaflets for all medicines had been retained for reference. The disposal of medication had been fully witnessed in a formal dedicated register. Medication prescribed as when required had been outlined in care plans and the non-administration of medication had been explained using codes. Copies of prescriptions had been retained on files. A lockable fridge had been purchased to securely store medication requiring cold storage. The manager was advised to maintain daily temperature records. Staff spoken with demonstrated a good understanding of how to promote the values of respect, privacy and dignity. Staff were observed to be respectful and sensitive to the needs of residents during the visit. A range of policies and Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 13 procedures had been developed by the home, to provide guidance to staff on value based issues. Feedback received from residents via Care Home Survey forms and via discussion confirmed they were satisfied with the standard of care provided and that they felt listened to by staff. Comments included; “All the staff are very helpful”; “The staff are the kindest people I have ever met” and “The staff and owners are very kind, loving and dedicated people.” Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Daily life and activities within the home were flexible and varied to meet the preferred routines and recreational needs and interests of residents. Although the menu lacked information on the full range of meals provided, residents were satisfied with the choice and quality of meals received. EVIDENCE: Since the last visit, the manager had developed a programme of activities in consultation with residents and maintained a record of activities provided and participants. The programme for week commencing 14/08/06 included; Hair and Beauty on a Monday; Bingo on a Tuesday; Card Games on a Wednesday; Dominoes on a Thursday and Jig Saws / Exercises on a Friday. The home continued to employ an activities coordinator who worked on a Thursday and Friday. Feedback received from residents via Care Home Survey forms and through discussion confirmed residents had access to a range of activities on a regular Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 15 basis and were generally satisfied with the range of activities provided. One resident requested more community based activities. Some residents spoken with reported that they preferred not to join in activities and confirmed this wish was respected by the staff. Feedback from residents included; “We have more activities now. I like to play bingo and I have won prizes” and “The activities vary each week. There is bingo, card games and exercises which I enjoy.” Residents spoken with confirmed that the daily life within the home was flexible and that they were able to choose their daily routines and follow their preferred lifestyle. Rooms viewed were comfortable and had been personalised with personal possessions and pictures. There were no set visiting times and residents were able to maintain contact with people of their own choice both inside and outside the home. One resident reported; “It’s a pleasant and relaxed home. I am free to choose my own routines and what I want to do each day”. Another resident stated; “Visitors are always welcome and we are free to come and go as we wish”. The manager reported that the home had a four-week menu and that special diets were catered for, subject to individual need. The home’s menu could not be located at the time of the visit and was not available for residents to view. A copy of a three-week menu was forwarded to the Commission for Social Inspection following the visit. The menu provided details of the two choices available for lunch-time meals only. No details of breakfast or tea-time meals were included on the menu. The lunch-time menu offered a good choice of wholesome and nutritious meals. Meals were served in the home’s dining room, which was equipped with tablecloths, flowers and condiments. Additional drinks were served throughout the day and residents were able to eat their meals in their room if they wished. Feedback received from residents confirmed the people living in the home received a choice of meals and that they were satisfied with the meals provided. Comments received included; “The food is very good. Alternatives are always available. The tables are nicely laid and refreshments served in bedrooms are nicely presented”, “The meals are lovely and we have a choice” and “The standard of catering is excellent. I receive very good food.” Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 16 Care staff were observed to be available to provide assistance with meals as required. Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. No complaints had been received since the last visit and residents were confident that any issues of concern would be listed to and acted upon. Safeguards were in place to ensure a proper response to any suspicion or evidence of abuse. EVIDENCE: The home had developed a Comments and Complaints procedure, a copy of which was included in the Statement of Purpose and Service User Guide. Records detailed that the home had not received any complaints since the last inspection and feedback received from residents via care home surveys and through discussion confirmed that the people living in the home knew who to speak to if they were unhappy and how to make a complaint. Residents spoken with confirmed that they felt listened to by the manager and her staff and were satisfied with the service provided. Comments from four residents included; “I have no complaints whatsoever”; “They [The Staff] are understanding and caring and attentive to how one is feeling”; “The care is excellent” and “I am very happy here. The staff and owners are all very good to me.” The home had a number of policies and procedures in place to provide guidance to staff and to ensure an appropriate response to suspicion or evidence of abuse. These included; a ‘Guarding Against Abuse’, ‘Whistleblowing’ and the ‘City of Liverpool and Borough of Sefton’ Adult Protection Procedures. Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 18 Ten staff (including the manager) had completed ‘Abuse and Restraint’ training. The manager reported that training would be provided for the seven staff who had not yet completed training in the protection of vulnerable adults. Staff spoken with during the visit demonstrated a good awareness of how to recognise and respond to the different types of abuse and their individual responsibility to protect the welfare of vulnerable people. Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 19 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment was pleasantly decorated, well maintained and clean. This provided residents with a comfortable and homely place to live. EVIDENCE: The home did not have a maintenance plan for the renewal of the fabric and decoration of the home, as the manager / owner lived on-site and monitored the environment on an ongoing basis. A health and safety book was in place to record work in need of attention. Pre-inspection records and discussion with the manager confirmed that there had been no further changes to the premises or further investment for refurbishment or repair since the last inspection. Areas viewed during the inspection appeared to be clean and hygienic, free from hazards and were generally maintained to a good standard. The carpet on the upper floor landing was showing signs of wear as noted at the last visit. Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 20 The home employed a part-time domestic. Infection control policies and procedures and cleaning schedules had been developed, to ensure staff were aware of their roles and responsibilities. Training records detailed that the manager was in the process of nominating staff to undertake infection control training. The laundry was appropriately sited away from food preparation areas and equipped with two washers (one of which had a sluice wash), two driers and a hand washing sink. Individual baskets were available to store laundry for each resident. Staff had access to protective clothing and suitable systems were in place for storing and washing soiled laundry. Feedback received from all the residents and their representatives confirmed the home was always kept clean and hygienic. For example, one resident reported; “The home is always kept bright and clean and smells fresh.” Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient numbers of staff were deployed to meet the needs of the people living in the home. Recruitment practice was robust and protected the welfare of residents. Staff had access to a range of training to ensure competency in their role. EVIDENCE: Inspection of the staffing rota, direct observation and discussion with the manager, staff and residents confirmed that staffing levels had not changed since the last visit. Two care staff and the manager / owner were on duty throughout the day. During the night, the home was staffed with one waking night staff and the manager / owner provided a sleep-in service. Feedback from residents via Care Home Surveys and through discussion confirmed the people living in the home received the care and support they needed and that staff were available when needed. The home employed 12 care staff. Records showed that six staff (50 ) had completed a National Vocational Qualification (NVQ) at level 2 or above. The manager reported that a further three staff had enrolled to undertake a NVQ. Pre-inspection records indicated that four staff had left employment since the last visit. Two of the staff had completed a National Vocational Qualification. The home had a recruitment policy in place. Records detailed that two new staff had commenced employment at the home since the last inspection. Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 22 Examination of staff recruitment records and discussion with staff confirmed that the home had undertaken Protection of Vulnerable Adults checks and obtained two written references prior to staff starting work in the home. An application form, interview records, health declarations, Criminal Record Bureau (CRB) checks, proof of identity, supervision and induction / training records were also in place on files viewed. Training records / certificates showed that new staff had completed an inhouse ‘Staff Induction to Work and Workplace’ and the ‘Working in Care Induction Standards’ course. Examination of the home’s training matrix and individual staff training records highlighted that staff had access to a range of training including: induction, safe working practice, medication and National Vocational Qualification Training. Staff interviewed spoke highly of the training provided. At the time of the visit, the owner was observed to be reviewing fire procedures with two staff, who were in the process of completing a questionnaire as part of the process. The manager had established systems to monitor the training needs of staff and when refresher training was due. Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 23 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, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives were consulted periodically about the quality of the service provided and the results of surveys had been published. Systems had been developed to protect the financial interests of residents and to safeguard health and safety. EVIDENCE: The Registered Manager (Pat Wright) was registered with the Commission and had managed / owned the home since approximately 1989. Records showed that the manager had undertaken the National Vocational Qualification (NVQ) level 4 Registered Managers Award; NVQ level 4 in Care, City and Guilds Advanced management in Care and NVQ D32/D33 (Assessment), D34 (Internal Verifier) and D36 (External Verifier) training. Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 24 Mrs Wright had also completed a range of safe working practice training and other courses relevant to the management of a care home for older people. Staff and residents complimented the manager and confirmed that she was both approachable and supportive in her role. The home commissioned an external consultant to undertake an annual quality assurance assessment. The last assessment had been completed during May 2006. The assessment involved distributing an annual questionnaire to residents and their relatives each year, to find out their views on the service provided. The outcome of the most recent assessment indicated that there was a high satisfaction level (99.85 ). The results had been published and were displayed in the hallway. No residents meetings had taken place since the last visit. Discussion with the manager and residents confirmed that the people living in the home did not wish to participate in meetings, as the residents preferred to have individual discussions with the manager and staff. The manager had also noted this point in a quality control record. The home had a procedure in place for the management of resident’s personal monies. At the time of the visit the manager did not act as an appointee for any of the residents. Residents looked after their financial affairs independently or with support from families / personal representatives. Systems had been established to collect fees via standing orders or cheques. The owner / manager supported three service users to manage their social security benefits and maintained a record of personal allowances paid to each of the residents. A record had been established to record income and money paid out to each of the three residents. Advice was given on how to improve the recording for one resident. The home also looked after personal spending money for two residents. Records of financial transactions were up-to-date, receipts had been obtained and balances were correct. The home had a Health and Safety policy in place and staff had access to Safe Working Practice as identified in Standard 30. Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 25 Pre-inspection records detailed that equipment within the home was regularly inspected and serviced. Since the last inspection, a service record / certificate had been obtained for hoisting equipment within the home. Inspection of fire records detailed that the home’s fire alarm system was tested on a weekly basis and that a monthly visual inspection of the fire extinguishers and emergency lighting was undertaken. Staff received fire refresher training at appropriate intervals and a fire risk assessment was in place dated 16th May 2006. Records showed that the fire officer had last visited the home on 30/01/06. Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 26 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 27 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. Standard Regulation Requirement Timescale for action 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 3 4 Refer to Standard OP3 OP9 OP12 OP15 Good Practice Recommendations The ‘Resident Assessment Prior to Admission’ form should be expanded to enable more information to be recorded on the needs of residents. Daily temperature records should be maintained for the fridge containing medication. The home should consult residents about their interest in accessing community-based activities. The home’s menu should be updated to provide information on breakfast and tea-time meals and a copy should be made available for residents to view. Avarest DS0000005393.V295720.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Avarest DS0000005393.V295720.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!