Inspection on 02/05/07 for Caburn House

This inspection was carried out on 2nd May 2007.

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

Other inspections for this house

Caburn House 10/03/10

Caburn House 12/03/09

Caburn House 17/03/08

Caburn House 25/04/06

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 Caburn House 15 Caburn Road Hove East Sussex BN3 6EF Lead Inspector Jane Jewell Key Unannounced Inspection 2nd May 2007 12:30 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 Caburn House DS0000066419.V339066.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. Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Caburn House Address 15 Caburn Road Hove East Sussex BN3 6EF 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) 01273 771945 01273 526795 Vigcare (Caburn) Limited Vacant Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users must be older people aged sixty-five (65) years or over on admission The maximum number of service users to be accommodated is twenty-eight (28) 23rd November 2006 Date of last inspection Brief Description of the Service: Caburn House was purchased and registered in March 2006 by the current owners, who also own many other residential and nursing homes within the East Sussex area. The home is a residential care home registered to provide personal and social care to a maximum of twenty-eight older people. The home also provides three intermediate care beds. The premises are a converted and extended domestic property situated in a residential road on the border between Brighton and Hove. It is located near to local amenities such as shops, pubs and cafes with public transports links near by. The home is presented across three levels with a passenger lift and chair lifts providing access to the various floors. Accommodation consists of twentytwo single and three double bedrooms with four bedrooms providing ensuite facilities. Communal space consists of a dining room, lounge, first floor TV lounge and small paved courtyard garden. The homes literature states that “service users needs are met in a friendly and efficient way, we strive to preserve and maintain their dignity, individuality and privacy”. The fees for residential care are currently £268 to £500 per week, depending on the services and facilities provided. Intermediate care is £400 per week. Extras such as: newspapers, hairdressing, chiropody, toiletries are additional costs. Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The information contained in this report has been comprised from an unannounced inspection undertaken over six and half hours and information gathered about the home prior to the inspection. This includes: residents survey questionnaires, discussion with relatives, stakeholders involved in resident’s care and health care professionals. Records were also submitted to the Commission for Social Care inspection (CSCI) prior to the inspection. The inspection was facilitated by Barbara Warren (Acting Manager, appointed by the provider and who is currently applying to become the registered manager). The inspection involved a tour of the premises, observation, examination of records and discussion with residents and staff. There were twenty-one residents living at the home at the time of the inspection. The focus of the inspection was to look at the experiences of life at the home for people living there and assess the progress made towards meeting the areas of shortfall noted at the last inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at the home have requested to be referred to as ‘residents’. In order that a balanced and thorough view of the home is obtained, this inspection report should be read in conjunction with the previous inspection reports. The Inspector would like to thank the residents, staff and management for their assistance and hospitality during the visit. What the service does well: Intermediate care residents are provided with the necessary support by trained staff and have sufficient equipment to promote their independence. A sample of comments made by residents regarding their experiences at the home include: “I like it as there is someone to talk to”; “I Like living here very much” and “alright”. The arrangement for planning care are good ensuring that health, personal and social care needs of residents are identified and guidance provided for staff to follow. Personal support is offered in ways, which promotes and protect resident’s privacy and dignity. Residents benefit from friendly trained staff, a sample of comments made about staff include: “People who work here are very nice”; “always a staff Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 6 member around if needed”; “very nice” and “Staff all very nice always very busy they need more staff” What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 7 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 Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 8 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 4 5 and 6 People who use the service experience Adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents do not have access to a range of up to date information about the home to help them make informed choices about whether to live at the home. Staffing levels need to be sufficient to be able to meet the range of residents needs being accommodated. Residents move into the home following an assessment of their needs. Intermediate care residents are provided with a good level of support aimed a maximising their independence. EVIDENCE: There is literature available about the home, which includes a Service Users Guide. It has been required since April 2006 that the homes statement of purpose is updated. The acting manager reported that the provider had reviewed it and it was currently with them for retyping. It remains necessary Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 9 that this document accurately reflect the services and facilities provided and is made readily available to help inform residents and interested parties about the home. Residents admitted for intermediate care were not provided with information about the home, all other residents are provided with a copy of the service user guide upon admission. It was discussed that this information also needs to be made available prior to admission to help inform any decisions about moving into the home. The acting manager agreed to ensure that in future all residents are provided with information about the home. In line with previous requirements residents are provided with a written contract of terms and conditions of residency. This can be used with residents and their families to make explicit the placement arrangements and clarify mutual expectations around rights and responsibilities. There are various placement arrangements that the home offers to cater for, this includes: intermediate care, short and long term care and emergency placements. There is also a wide range of needs being accommodated from residents who live independent lives to residents who have complex nursing intervention. The home is not currently able to evidence that they are able to meet the needs of most residents due to the need to increase staffing levels, this is further discussed under standard 27. Residents consulted with in the main spoke positively about their experiences at the home. A sample of their comments include: “I like it as there is someone to talk to”; “I Like living here very much”; “alright” and “I had no choice to but to come here”. The acting manager ensures that prospective residents are accommodated only following an assessment of their needs by them or Social Services. The acting manager demonstrated a clear understanding of the needs that could be accommodated at the home and when needs go beyond that which the home can meet safely. Prospective residents and their relatives are provided with the opportunity to visit and assess the quality, facilities and suitability of the home. Residents who are receiving intermediate support said they did not have the opportunity to visit but instead sent a representative where possible. Staff showed some understanding of the aims and objectives of intermediate care and felt equipped and supported to work with intermediate care residents. Intermediate placements have single accommodation with ensuite a visiting intermediate care nurse said “quite happy with the facilities here”. Any specialist equipment is identified and provided by the various external agencies involved in providing the intermediate support. This includes District nurses, occupational therapy, physio and speech therapists. All of the health care professionals consulted with spoke positively about the homes support of intermediate residents. A sample of their comments include: “Staff listen to the instructions given and they seem to have the skills to deal with the care support needed”; “find the staff very helpful quick to feedback if things are not Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 10 working out”; “Running well at the moment initially there were some teething problems”; “everything seems to be going ok” and “always very good Communication between the home and the intermediate care team”. Caburn House DS0000066419.V339066.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 People who use the service experience Adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The arrangement for planning care are good ensuring that health, personal and social care needs of residents are identified and guidance provided for staff to follow. Personal support is offered in ways, which promotes and protect resident’s privacy and dignity. The health needs of residents are met with evidence of regular input from health care professionals, however medication practices do not ensure that medication is being accurately administered or accounted and placing residents at potential risk. EVIDENCE: Much work has been undertaken to implement new care planning documentation since the last inspection. Care plans now provide guidance for staff on the assessed needs of each resident and how these needs can be met. Guidance is provided for staff on the needs of intermediate care residents by Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 12 the intermediate care team. Where additional care needs have been identified for these residents then the acting manager has provided additional guidance for staff on how these should be met. A system for regularly reviewing care plans demonstrated that changes in needs and preferences are recorded. The standard of daily recording was noted to be good with a clear account of actions and events that had occurred. The risks faced and posed by residents are assessed, recorded and any actions identified in order to reduce or manage the risk are included in the residents care plan. Records of medical intervention showed that the home works closely with health care professionals including GP’s, district and specialist nurses to ensure residents receive a range of health care intervention. Health care professionals consultants with all felt that staff were prompt to seek medical support. There are separate medical supports procedures and teams for intermediate and long term residents. A district nurse involved in providing nursing intervention for long term residents fedback that staff had recently not followed their instructions, which had prevented them from being able to make an accurate assessment of the residents needs. The system for the administration of medication did not provide for a clear audit trail of medication, therefore it was not always possible to ensure that medication was being accurately administered or accounted for. The follow areas of shortfalls were noted, which the acting manager agreed to address as a matter of priority in order to ensure residents safety. • • • • • Medication administration instructions not being written in full on medication administration records. Not all medication being recorded as having been received and checked that the correct number dispensed to the home. Not all “as prescribed” medication having specific individual instructions for their use. A discrepancy in the outstanding balance of a “As described medication”. The method for the disposal of medication did not ensure that there was an accurate clear record of medication awaiting disposal. During the inspection staff were seen to be respectful and considerate to all residents and visitors. Staff were observed using residents preferred forms of address and knocking bedroom doors prior to entering. Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 and 15 People who use the service experience Good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are able to excise some choice over their daily lives. Opportunities are made available for occupation and stimulation in order to enhance resident’s lives, but can be limited by staffing levels. Residents are supported and encouraged to maintain links with family and friends. Dietary needs of residents are catered for with a balanced and varied selection of food available that meets resident’s tastes and preferences. EVIDENCE: Observation of the daily routines and discussion with residents confirmed that staff try to accommodate resident’s personal wishes with regard to meal times, going to bed, rising and bathing as far as is possible, however it was noted that the current staffing levels often meant that staff struggled to ensure that residents individual preferences were observed or individual time could be spent with residents. A staff member commented that they felt that they did not have enough time to spend individual time with residents. Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 14 Since the previous inspection more opportunities have been provided for residents to engage in social activities. The acting manager stated there is now an organised activity most days. This includes external entertainers, exercise classes, music, board games, bingo and clothes parities. There is also a religious service held at the home each week. Residents said that they particularly enjoyed playing bingo, while for many other residents they preferred to occupy their own time and said that staff respected this. Staff are in the main responsible for organising the activities in the afternoon along with their other duties. A staff commented : “it is a struggle to squeeze in activities as there is not enough staff” Several residents spoke of the importance of keeping in regular contact with their friends and relatives and had their own telephone to do so, a resident said “couldn’t be without my telephone as I can keep in contact with my family”. A visitor said that they could visit at any reasonable time, is made to feel welcome by staff and is sometimes offered a drink. A sample of feedback received regarding the food include: “food very good too much – If you don’t like the meal they will always make me an omelette”; “pretty good”; “chef comes around every morning if you don’t like something they will do you something else” a resident on a specialist diet felt that they received enough variety in their diet. The majority of residents eat their meals in the pleasantly decorated dining room. The meal served at inspection looked appetising and was presented well. The kitchen environment looked old with the surfaces being worn. The acting manager reporting that the kitchen is due to be refurbished in the next 12 months. The chef said that environmental health had recently visited and had made several recommendations. The acting manager stating that these are currently in the process of being addressed. Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a complaints system in place with residents and relatives feeling able to raise any concerns that they may have. Staff have the guidance and training necessary to show them how to safeguard residents and what to do if abuse is suspected. EVIDENCE: There is a complaints procedure for residents, their representatives, and staff to follow should they be unhappy with any aspect of the service. Residents and relatives consulted with said that they felt able to share any concerns they had with the provider and staff. In line with the previous requirement a record is now maintained of complaints, however there was no record of the outcome of a recent complaint. The acting manager stated that they had spoken to the complainant who was happy with the outcome. The acting manager agreed to update the complaint record with this information. The acting manager reported that there are written policies covering safeguarding adults and whistle blowing, which make clear the vulnerability of people in residential care, and the duty of staff to report any concerns they may have to a responsible authority for investigation. The acting manager confirmed that in line with previous requirements the staff have undertaken or are in the process of undergoing training in safeguarding adults. Staff showed Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 16 an understanding of their roles and responsibilities under safeguarding adult guidelines. Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 17 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 21 22 24 25 and 26 People who use the service experience Poor outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents generally live in a comfortable environment with their private accommodate having recently been redecorated, further work is needed to ensure that the environment and facilities can meet the range of residents needs being accommodated. EVIDENCE: The home is presented across three levels with a passenger lift and chair lifts providing access to the various floors. A resident descried parts of the environment as “shabby”. Parts of the home is in need of minor redecoration and upgrade. The acting manager reported that since the provider purchased the property all bedrooms have been redecorated. The acting manager was not aware of a plan of redecoration, repair and renewal. This is needed to ensure that residents have a consistent well-decorated and maintained environment throughout. Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 18 The layout of the home is such that bedrooms are spread out with several residents commenting that they like to keep their bedroom doors open so they could see people walking past. The inspector expressed concern regarding a resident who was currently unable to leave their bedroom and who was at risk of being isolated, a staff member confirmed that they did not always have the time to go and see if they were ok. A staff member said “the building is isolating can leave some residents alone for long periods”. A health care professionals involved in the intermediate care services said “quite happy with the facilities here”. Communal space consists of a dining room, lounge, first floor TV lounge and small paved courtyard garden. Despite meeting requirements in the past regarding the removal of rubbish and stored furniture from the courtyard it was again noted that this area was being used to store furniture awaiting removal. A residents sitting out in the courtyard said that it was “unsightly”. Although some efforts have been made to improve this area with additional plants further work is still need to ensure that this is an attractive and safe environment for residents to use independently. The acting manager said that they have requested some new furniture for this area. All residents consulted with said that they liked their personal accommodation with a resident saying “my bedrooms very nice, lots of my own things in it”. Some bedrooms had lino flooring, it was not clear as to why this was fitted. Bedroom doors are fitted with Yale locks which for one resident meant that when the door was closed it required a key to open it and considerable dexterity in order to turn the key and lift the handle at the same time. Concern was noted that this type and style of lock prevented some residents being able to access and leave their rooms independently and a review of their suitability must be undertaken to ensure residents safety. Four bedrooms have their own ensuite facilities with a high proportion of bedrooms without ensuite provided with commodes. There are currently no facilities to ensure that the commodes are being emptied and cleaned in accordance with good infection control practices. Because of the high use of commodes it has been required that suitable facilities are now provided to ensure the health and safety of staff and residents. It was noted that many of the commodes were in a poor state of maintenance and cleanliness. There was a range of individual aids and adaptations to assist resident’s mobility and independence, including raised toilet seats, walking aids, hoist ramps and grab rails. Bedrooms have a call point fitted that enables assistance to be summoned. Residents said: “I ring the bell often at night, they always come promptly” and “if you press it they come very quickly” There are three standard baths and one assisted bath. The assisted bath is manually operated, which a staff member said was often very hard to use. Staff said that there was a shower, which is not used, and the standard baths Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 19 are too low for many residents to use independently therefore the vast majority of residents use the assisted bath. It was discussed that further suitable bathing facilities must be provided to ensure that residents are able to bath safely either independently or with assistance. Parts of the home visited were observed to be clean with any melodious odours confined to a few areas. Caburn House DS0000066419.V339066.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 People who use the service experience Adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a staff team who are trained to work safely and competently with them, however there needs to be sufficient staff on duty at all time to ensure the health and welfare of residents and have flexible staffing levels to be able to meet changing residents needs. EVIDENCE: At the time of inspection there were two care staff, manager and cook on duty. In addition to care duties care staff are also responsible for laundering, washing up after each meal and cooking supper. As previously noted the current staffing levels are insufficient to enable resident individual routines to be observed and suitable opportunities for occupation and stimulation to be provided. A staff member said “very little personal time able to be spent with residents at the moment, not able to chat so rushed not giving quality care”. It has been required that there is sufficient staff on duty as is necessary to ensure the health and welfare of residents. All interactions between staff and residents, observed during the inspection, were courteous and respectful e.g. when entering residents’ private rooms and when providing personal care . The process for establishing staffing levels needs to reviewed, as currently levels are determined by occupancy and the provider and must be based Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 21 primarily on residents needs also taking into consideration the layout of the building, care staffs other duties and the wide range of intermediate care placements that can be placed at the home. A sample of comments made about staff included: “People who work here are very nice”; “always a staff member around if needed”; “very nice” and “Staff all very nice always very busy they need more staff”. The acting manager reported that five staff are currently working towards National Vocational Qualifications, this would mean that the majority of staff are working towards or have attained this qualification. Several staff spoke about the poor terms and conditions of employment, which they felt lead to low moral and a high staff turnover. The homes records indicate that there has been some turnover of staff since the last inspection there was no evidence to suggest that this had impacted on residents care and staff were encouraged to discuss their concerns directly with the provider. The personal files of newly appointed staff were inspected and these showed that a recruitment process is followed which includes the use of an application form, interviews, CRB checks and written references prior to employment commencing. The shortfalls in practices noted at the last inspection relating to employment documentation had been fully addressed. The acting manager reported that the main source of training is the use of training videos in addition health care professional involved in the intermediate care placements are currently providing additional specialist training. They were aware of the need to ensure that the induction and training undertaken by staff was in accordance with the standards provided by the government body “Skills for care”. Staff consulted with said that they had undergone most of the mandatory training needed to work safely with residents. The acting manager was aware of the need to ensure that there was an ongoing training and development plan, which ensured that staff were kept up to date in changes in good practices in the care of older people. Caburn House DS0000066419.V339066.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 and 38 People who use the service experience Adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a motivated and experienced acting manager who has improved many areas within the home, however they are currently not able to address all of the shortfalls in practices noted due to restrictions placed upon their current acting manager role. A range of regular health and safety checks generally promotes the health and safety of residents and staff, however some medication and parts of the environment need to be reviewed to ensure the safety and wellbeing of all. Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 23 EVIDENCE: The acting manager was in the process of applying to the commission for social care inspection to become the registered manager of the home. They have many years experience in working and managing care services. It was clear that areas in which the manager has autonomy to act upon, there has been much improvements since the previous inspection. For example in care planning, activities and general administration, however there limited financial responsibilities means they have little control of staffing levels, maintenance and repairs, areas in which shortfalls have been noted. This needs to be addressed if they are to be able to fulfil all of their legal responsibilities as the registered manager. A sample of comments made about the manager include: “very nice lady indeed”; “not always very effective as everything has to go through the owner”; “wonderful pleasant if pushed for time will lend a hand”; “kind really good” and “ not always very helpful”. In line with previous requirement the acting manager reported that the providers representative undertakes a monthly recorded visit to the home to monitor standards, however a copy of their visits could not be located at the time of inspection. The acting manager agreed to ensure that they retained a copy of this report within the home. The systems for resident consultation is good with a variety of evidence that indicates that resident’s views are both sought and acted upon. Staff consulted with said that they received formal supervision from senior staff every couple of months and felt able to approach staff with any issues that they had. Residents are encouraged to retain control of their own finances for as long as they are able to do so and if unable then this responsibility is taken on by a relative or another responsible persons external to the home. The acting manager reported they hold small amounts of monies for some residents. Written guidance is available for staff on issues related to health and safety issues. Records submitted by the acting manager at inspection stated that the necessary servicing and testing of health and safety equipment has been undertaken. Systems were in place to support fire safety, which included: regular fire alarms and emergency lighting checks, staff training and maintenance of fire equipment and fire drills were reported to have been undertaken. The acting manager reported that in line with previous requirement a fire risk assessment had been undertaken by a fire safety expert, which recorded significant Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 24 findings and the actions taken to ensure adequate fire safety precautions in the home. As previously noted practices, which need to be addressed in order to improve resident’s safety include: a review of the suitability of the locks on bedroom doors, medication and parts of the environment. Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 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 2 3 3 2 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 2 1 1 x 2 x 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 X 2 Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 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 OP1 Regulation 6 Requirement Timescale for action 30/07/07 2 OP9 13(2) 3 OP19 23(2)(d) 4 OP20 23(2)(o) That the home’s Statement of Purpose and Service Users Guide be reviewed and revised as necessary, under the ownership of Vigcare Limited. (Made at inspection of 25/4/06 with timescales of 01/09/06 & 30/12/06 not met) That there are arrangements in 30/06/07 place for the adequate recording, handling, safekeeping, safe administration and disposal of medicines at the home to ensure that service users receive medication in accordance with their prescribed instructions. That all parts of the home are 30/06/07 decorated and furnished to a good standard to ensure a consistently pleasant environment throughout. That the external courtyard is 30/07/07 cleared of all rubbish and stored furniture and is a suitable equipped and maintained in order that service users can use this space safely and independently. Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 27 5 OP26 23(2)(k) 6 OP24 13(4)(c) 7 OP21 23(2)(n) 8 OP27 18(1)(a) That suitable sluicing facilities are provided for the safe disposal of human waste and cleaning of commodes to ensure the health and safety of staff and service users. That bedroom doors have appropriate locks fitted which protects service users privacy and ensures their safety by being able to leave their bedrooms independently. That there is sufficient number of suitable bathing facilities to ensure that service users are able to safely bath independently or with assistance. That at all times adequate staffing levels are maintained to ensure the health and welfare of service users. 30/08/07 30/07/07 30/09/07 30/06/07 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 Caburn House DS0000066419.V339066.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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