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Inspection on 27/09/05 for Caer Gwent Care Home with Nursing

Also see our care home review for Caer Gwent Care Home with Nursing for more information

This inspection was carried out on 27th September 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents benefit from a clean and tidy home, which is well maintained and provides a homely atmosphere, despite the large building. Access to a well kept garden gives a safe and enjoyable outdoor space for the residents. Staff received training appropriate for the work they were doing and residents benefit from being cared for by people who understand and can meet their needs. Staff were polite and respectful to the residents, working well as a team across all positions in the home. A long standing core management team helps to provide consistency of direction for all staff. The numbers of staff on duty was adequate to meet the needs of the residents and was kept under review.The residents health care and social care needs were understood to be of equal importance by the staff. Both these needs were explored and understood with individual plans of care providing clear direction for staff. A varied activities programme was in place, which included both group activities and one to one. Residents said they felt included in the day to day life of the home and described living there as being in a "community with friends". They had meetings with committee members and also with the registered manager, on a regular monthly basis. They said they felt consulted about the running of the home, should they wish to be involved. Residents of all abilities were assisted and encouraged to maintain their independence, as far as possible. This included hobbies and interests as well as physical independence. Residents needs were assessed thoroughly prior to becoming accommodated in the home. Specialist nursing equipment was provided when necessary. This was of a high standard and met the needs of the most dependant residents. Residents praised the quality and variety of food served. They were consulted about the menu, on a regular basis and could suggest changes and additions, which were generally accepted by the chef.

What has improved since the last inspection?

Several improvements to the premises have been made. A new assisted bath has been installed in the one bathroom. The room has been redecorated. A digital enhanced television system has been installed. This provides channels one to five and BBC news twenty four. This has been provided in all bedrooms. Residents can add other channels to the package, should they wish, on an individual basis. A new floor covering has been laid in the residential food service area and this area has been redecorated. A loop system has been installed in two lounge areas. This is to provided in the activities room also. Seven bedrooms have been redecorated. Four bedrooms have had new carpet laid. The staff room for smoking has become the storage room. A staff smoking area has been provided outside. The garage has been converted to a storage area for ten outdoor wheelchairs. The fire panel has been upgraded and amalgamated into one panel for the entire home.

What the care home could do better:

Some risks to residents, documented on assessment, did not always have a plan of care implemented to reduce or manage them. These included the risk of falls, developing pressure sores and having inadequate nutrition. Care staff who are responsible for the administration of medication should receive updated training for this procedure. The way dependant residents were assisted with meals did not preserve their dignity. This should be reviewed with staff. Some staff, who may be in charge of the home, were unfamiliar with the procedure to follow should an allegation of abuse be made. All staff should know the correct procedure to follow. Residents own money must not be paid into any bank account, unless that account is in their name.

CARE HOMES FOR OLDER PEOPLE Caer Gwent Care Home with Nursing Downview Road Worthing West Sussex BN11 4TA Lead Inspector Helen Tomlinson Announced Tuesday, 27 September 2005, 09.00am, V243600 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Caer Gwent Care Home with Nursing Address Downview Road, Worthing, West Sussex, BN11 4TA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01903 536649 01903 535526 caergwent@btconnect.com Mr R. Benfield. Mrs Alison Williams CRH 61 Category(ies) of OP-61 registration, with number of places Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: NONE Date of last inspection 16/2/05 Brief Description of the Service: Caer Gwent is registered to provide accommodation for up to sixty one residents over the age of sixty five years. All sixty one could have personal or nursing care needs. The home combines a smaller old converted building and a large purpose built building. Accommodation for the residents is provided on two floors, in single, en-suite bedrooms. There is a large amount of varied communal space including three dining areas, four lounges of varied sizes and a conservatory. A hairdressing salon, small kitchen for residents and visitors use and a reception area, with seating, are also available. A third floor provides staff changing, refreshement and training areas. There is a large visitors car park to the front of the building and an enclosed garden to the rear. The garden is well maintained and accessible to residents, with some having patio doors from their bedrooms. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection. The inspector arrived at 9am and left at 6.30pm on the first day. A second day consisted of 4 hours discussion with the person in charge and the staff. At the time of this inspection the registered manager was unable to be present and the care services manager took her place as the person in charge. The inspector had been unable to re-arrange the inspection so that the manager could be present. Over the course of the inspection nineteen residents, four visitors and nine members of staff were spoken with. The chairperson of the Committee and a member of the “friends of Caer Gwent” also had discussions with the inspector. Staff were observed giving support and assistance. Four residents files were examined in detail and other records were seen as was necessary. A tour of the premises took place. Staff files were examined Twenty two comment cards were received from residents, prior to the inspection. These consistently showed overall satisfaction with the service provided. Two comments that the care provided “varied” dependant on the staff were received and one comment that the food was not always hot when served. These issues were explored during the inspection. 11 comment cards were received from visitors/relatives prior to the inspection. These also showed satisfaction with the services and facilities offered. Four people praised the cleanliness of the home and commented on the friendly and helpful nature of the staff when they visit. Two people said they had no cause to complain, but should they raise any issues they felt sure they would be dealt with quickly. What the service does well: Residents benefit from a clean and tidy home, which is well maintained and provides a homely atmosphere, despite the large building. Access to a well kept garden gives a safe and enjoyable outdoor space for the residents. Staff received training appropriate for the work they were doing and residents benefit from being cared for by people who understand and can meet their needs. Staff were polite and respectful to the residents, working well as a team across all positions in the home. A long standing core management team helps to provide consistency of direction for all staff. The numbers of staff on duty was adequate to meet the needs of the residents and was kept under review. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 6 The residents health care and social care needs were understood to be of equal importance by the staff. Both these needs were explored and understood with individual plans of care providing clear direction for staff. A varied activities programme was in place, which included both group activities and one to one. Residents said they felt included in the day to day life of the home and described living there as being in a “community with friends”. They had meetings with committee members and also with the registered manager, on a regular monthly basis. They said they felt consulted about the running of the home, should they wish to be involved. Residents of all abilities were assisted and encouraged to maintain their independence, as far as possible. This included hobbies and interests as well as physical independence. Residents needs were assessed thoroughly prior to becoming accommodated in the home. Specialist nursing equipment was provided when necessary. This was of a high standard and met the needs of the most dependant residents. Residents praised the quality and variety of food served. They were consulted about the menu, on a regular basis and could suggest changes and additions, which were generally accepted by the chef. What has improved since the last inspection? Several improvements to the premises have been made. A new assisted bath has been installed in the one bathroom. The room has been redecorated. A digital enhanced television system has been installed. This provides channels one to five and BBC news twenty four. This has been provided in all bedrooms. Residents can add other channels to the package, should they wish, on an individual basis. A new floor covering has been laid in the residential food service area and this area has been redecorated. A loop system has been installed in two lounge areas. This is to provided in the activities room also. Seven bedrooms have been redecorated. Four bedrooms have had new carpet laid. The staff room for smoking has become the storage room. A staff smoking area has been provided outside. The garage has been converted to a storage area for ten outdoor wheelchairs. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 7 The fire panel has been upgraded and amalgamated into one panel for the entire home. 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. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Residents were not admitted to the home without an assessment of their needs being completed. EVIDENCE: The resident’s files examined contained comprehensive assessments. These covered all areas of life and had detailed information about the resident’s needs and abilities. All the notes which the manager had made when meeting the prospective resident, had been kept on file. Notes were present, on one file, from when the resident had visited the home, prior to their admission. Assessments from other professionals were present where appropriate. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10 All residents had a plan of care documented. The health care needs of the residents were met, but the relevant documentation was not always present. Residents were protected by the practices and procedures for giving medication. Residents were treated with respect and their privacy was protected. EVIDENCE: The resident’s files examined had a detailed plan of care documented. This included all areas of daily life, social, physical and health needs. Residents spoken with said they had been involved in the drawing up of this plan, if they wished and were able. It included choices and preferences of how the resident wished to be cared for as well as their abilities and needs. The plans seen had been reviewed on a monthly basis. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 11 Health care assessments were present for some physical needs, including the risk of developing pressure sores, risk of falls and nutritional needs. Where these assessments showed there was a need for action by the staff, a plan of how this was to be done was not always present. Three of the five resident’s files examined had an assessment for the risk of developing a pressure sore which showed them to be at high risk. There was no plan of how this was to be prevented. Pressure relieving equipment was in place for these residents. For one resident the pre-admission assessment said they had lost weight. There was no nutritional assessment, including weights, or subsequent plan of care. One resident had hearing and sight difficulties. The degree of impairment this caused had not been explored fully or documented. No specific actions had been taken to meet this need. It was discussed with the person in charge that the documentation should reflect the care practices and all needs or risks assessed and recognised should have a plan of how they were to be met or minimised. Charts were kept for staff to document various care and assistance given to the residents, e.g. help with a bath or to change position. These were not always accurately completed which could indicate the necessary care had not been given. A physiotherapist carried out an assessment for all residents. This resulted in specific exercises, equipment or advice being given. Residents benefited from being encouraged to remain safely mobile and reducing the risk of falls. Residents could register with a G.P. of their choice. One of the local G.P.’s visited the home on a weekly basis. This provided medical support for the nursing and care staff and an efficient service for the residents. Should a resident be transferred to hospital up to date and relevant information was sent with them. A discussion took place regarding the daily recording by the staff. Some daily records did not reflect the actual picture. They recorded “care as plan” without the staff having reviewed the plan to ensure this was accurate with the actual care given. This should be reviewed. Residents had the choice to keep and administer their own medication, should they wish and be able. Where this was their choice the staff carried out an assessment to ensure this was safe for the resident. Where the resident was not able to administer their own medication the qualified nurses administered this to those residents requiring nursing care and the care assistants to those requiring personal care. The designated care assistants had received some training for this, however it had taken place several years ago and should be updated. At the time of this inspection the regulations regarding the disposal of waste medication had changed. The organisation had not yet got a contract for the collection and disposal of their waste medication. It was being stored separately in the treatment room, awaiting collection, but was not clearly labelled as waste medication. This was done during the inspection. Oxygen was stored in the treatment room. This room did not have the necessary hazard signs present. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 Residents benefit from support to enjoy their lives in the manner which they choose. There are excellent opportunities for activities within the home. The food served is good quality, varied and plentiful. EVIDENCE: An activities organiser works in the home for approximately twenty hours per week. Care staff have also allocated time to assist residents in social activities and outings. The social needs and wishes of the residents are viewed as important as their physical health needs. This is reflected in the varied activities which take place in the home. Residents said they enjoyed coffee mornings, sing-a-longs, arts and crafts, quizzes and bingo. One resident was entertaining visiting friends in the small lounge, playing a board game. Other residents spoke of the large amount of activity to join in with, if you wished. Residents said “you are never short of something to do.” Others spoke of how they wished to spend time alone in their rooms and had books, newspapers, television, radios and music. Staff provided one to one discussions with the residents. Residents were assisted to go out of the home and access community facilities such as local shops, parks etc. Outings to various local beauty spots, theatre and tea rooms were organised. The weeks activities were advertised, along with the menus, and a copy given to all residents at the start of the week. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 13 Staff had a good understanding of the residents past lives, including hobbies, occupation and family members. This resulted in meaningful and relevant conversations between the residents and staff. Visitors were welcomed into the home and said they could see their relative where they liked, either in private or in the lounge area. Visitors and volunteers were part of the day to day life of the home, joining in with activities and outings as they wished. A varied menu was served in the home at each meal time. This consisted of at least two choices of hot or cold meal with a choice of sweet. Specialist diets were catered for and liquidised meals were served if needed. Three meals per day were served with a later supper for those requiring this before bed. Hot and cold drinks were available throughout the day. A small kitchenette gave residents and visitors the opportunity to make hot drinks and snacks should they wish. Residents praised the food saying they enjoyed the variety and choice and it was well cooked and nicely presented. There is a dining room on both floors which provide a pleasant place to eat. Lunch in the ground floor dining room was a social event with residents and staff chatting. On the first floor the more dependant residents were eating their meals. Assistance was provided for those residents who required this. Some staff did not assist residents on a one to one basis, rather helping two residents with their meals at the same time. The person in charge agreed this was not acceptable and would review the current system to ensure this does not happen. Residents said they were consulted about the meals and menus and could provide feedback which was listened to and acted upon when possible. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Residents and relatives were confident that any concerns raised would be dealt with appropriately. Some staff members were not familiar with the correct procedures to protect the residents from abuse. EVIDENCE: Residents and relatives spoken with said they felt confident to approach any member of staff to discuss issues or concerns they may have. Residents said when they had raised any issues they had been taken seriously and dealt with quickly and appropriately. One complaint had been made since the last inspection. This was recorded with the outcome which was satisfactory for all parties. The complaints procedure was posted in various parts of the home. Staff had received training on the protection of vulnerable adults. Those spoken with had an awareness of their role in ensuring residents were not put at risk. Staff were aware of their duty and how to report any concerns they may have. Two qualified nurses, who may be in charge of the home, were not aware of the procedure to follow should an allegation of abuse be made to them. The person in charge discussed that the procedure had been reviewed in February of this year and all members of staff made aware. A copy was included in the supervisors handbook, which was given to all staff who would supervise more junior staff. All staff who may be in charge of the home, must be aware of the correct procedure to follow. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 15 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 standard(s) 19,22 and 26 Residents live in a safe, tidy, clean, hygienic and well maintained home. The specialist equipment required for the residents was available. EVIDENCE: The home was clean, tidy and free from offensive odours. The furniture, fixtures and fittings were well maintained and of a high standard. There were domestic furnishings which gave the communal areas a homely feel. These included plants, cushions and footstools. The home was bright and airy with all areas appropriately and tastefully decorated. Residents and visitors praised the cleanliness of the home. Domestics were seen to take pride in their work, saying they felt part of the whole team in the home. Maintenance workers were on site. They had responded quickly to a problem and were working discreetly, observing health and safety guidance. The gardens of the home were well kept, accessible and provided pleasant outdoor space for the residents. The deputy manager of the home carried out a daily check for any issues which required maintenance. Residents were consulted about the colours when the communal areas were being re-decorated. A rolling programme of refurbishment and decoration was in place. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 16 Staff had received fire training. Those spoken with were aware of the procedure to follow. Fire doors were held open with appropriate devices which meet the guidance of the fire authority. The fire procedure was posted around the building. Specialist equipment, required by some residents, was available in the home. This included moving and handling equipment, assisted baths and showers, grab rails, raised toilets, special recliner chairs, nursing beds and a call system. Pressure relieving mattresses and cushions were in use. Residents were assessed for the safe use of this equipment and staff had received necessary training. Some staff were seen pulling residents backwards in the wheeled recliner chairs. This should not continue. The home was hygienic and staff wore protective clothing to prevent the spread of infection. Appropriate hand washing facilities were available where necessary. Staff had received training on the control of infection in the care home, including the domestic staff. Necessary laundry and sluicing facilities were available. Staff commented favourably on the laundry facilities saying they got their clothes returned quickly and well laundered. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30 The numbers and skill mix of staff were sufficient to meet the needs of the residents. The recruitment procedures protect the residents in the home. Residents benefit from staff who receive appropriate training. EVIDENCE: The duty rota showed that at all times the numbers and skill mix of staff was suitable to meet the needs of the residents. There are usually two registered nurses and twelve care staff on duty during the day and one registered nurse and five care staff at night. The home has a bank of casual staff who fill any vacancies and so agency staff are seldom used at the home. Qualified nurses were in charge of those residents requiring nursing care and senior care staff were in charge of those requiring personal care. Two recruitment files were examined. These contained the necessary checks to ensure the person was fit to work with vulnerable adults. For both people there were unexplained gaps in their work record. The interview notes did not show this was explored and explained, although the interview record does allow for this. All gaps in employment should be explored. Staff said that Guild Care organisation did provide a large amount of training. This included moving and handling, fire safety, food hygiene, first aid, infection control, health and safety and protection from abuse. Specific training was provided about health or social care issues such as continence, diabetes and communication. Staff with responsibility for supervising new or more junior staff had received training for this. Managers received appropriate and relevant training for their role and responsibilities. Staff had the opportunities to take NVQ training, should they wish. Twenty two percent of care staff had Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 18 completed NVQ level two with this rising to fifty two percent when the current candidates complete the training. All staff were included in training appropriate to their work including the domestics, kitchen and laundry staff. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35 and 38 Residents are consulted about the running of the home. The current procedures do not safeguard the individual finances of the residents. The health and safety of the residents was protected. EVIDENCE: Residents said that they had varied opportunities to comment about the running of the home. They held monthly meetings between themselves, with a member of the committee, but no staff members present. They then met with the manager the following week to discuss any issues they had raised. They said these meetings were useful and their opinions and suggestions were valued and included in the running of the home. They were consulted about the redecoration of communal areas and their bedrooms and any other changes which would effect their lives. Residents said they got questionnaires to complete and comments were invited about various issues such as the food. They said the manager and all other staff were open and they could talk informally to anyone they chose. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 20 Some personal monies for most residents are kept centrally at the home. The organisation has an accounting system set up on the computer. Records were kept of the individual residents money and receipts were produced. The residents personal money was pooled together and some was held in the bank account of the organisation until the individual requested it. It was discussed, with the person in charge, that this did not meet the regulations and no money must be kept in a bank account, unless it is in the name of the resident. The administrator explained that a change in the system was imminent which would solve this issue. Staff were aware of their responsibility to protect the health and safety of the residents in the home. They had received appropriate training, including safe moving and handling. The home was tidy and free from hazards. Risk assessments had been done for environmental and individual physical risks. Records of accidents were kept. There was a discrepancy for one resident in the accident book versus the daily record with the number of falls. All accidents should be appropriately recorded. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 4 x x 3 x x x 3 STAFFING Standard No Score 27 2 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x 4 x 2 x x 3 Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 35 Regulation 20 (1) Requirement The registered person shall not pay money beloning to a resident into a bank account unless the account is in the name of the resident to which the money belongs. Timescale for action 31/12/05 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. 5. 6. 7. Refer to Standard 8 9 8 9 15 18 29 Good Practice Recommendations Risks identified should have a plan of action to reduce this documented. Care staff who administer medication should receive up to date training. The way of recording on a daily basis should be reviewed. Appropriate signage for the storage of oxygen should be in place. Residents should be assisted to eat on a one to one basis. all staff should be aware of the procedure to follow if an allegaton of abuse is made in the home. Any gaps in employment record should be explored and recorded. Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 Caer Gwent Care Home with Nursing H60-H11 S24126 Caer Gwent V243600 270905 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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