Inspection on 06/07/06 for Cairndhu Rest Home Ltd

This inspection was carried out on 6th July 2006.

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

Cairndhu Rest Home Ltd 18/06/09

Cairndhu Rest Home Ltd 18/07/08

Cairndhu Rest Home Ltd 18/07/07

Cairndhu Rest Home Ltd 13/03/06

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 Cairndhu Rest Home Ltd 6 Warren Road Blundellsands Liverpool Merseyside L23 6UB Lead Inspector Ms Lorraine Farrar Unannounced Inspection 6th July 2006 11:30 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 Cairndhu Rest Home Ltd DS0000065360.V295419.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. Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cairndhu Rest Home Ltd Address 6 Warren Road Blundellsands Liverpool Merseyside L23 6UB 0151 924 8427 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) Cairndhu Rest Home Ltd Ms Veronica Parker Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th March 2006 Brief Description of the Service: Cairndu is registered to provide personal care without nursing for seventeen older people. Staff are available in the home 24 hours a day to assist residents and meals and laundry facilities are provided. The house is semi-detached in a residential area of Blundellsands, it fits in well with local houses and does not stand out as a care home. The home is well located for accessing local facilities including shops, cafes, pubs, Crosby Beach and public transport. Cairndu is operated and managed by Veronica Parker who has worked in the home for many years. She is assisted by a deputy manager and a staff team who are experienced carers and well known to the people living there. Accommodation within the home is provided over three floors. Private accommodation is available in either single or double bedrooms, with a lift providing access to the upper floors. Shared accommodation is all downstairs and consists of a sitting room to the front of the house and a large dining room with lounge to the back of the house. The home has a large front garden and rear gardens with seating areas. Fees for living in the home range from £323 to £360. Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information for this inspection was gathered in a number of different ways. This included an unannounced site visit where time was spent reading records and looking at the building. ‘Case tracking’ was used as part of the visit. This involves looking at the support a person gets from the home including their care plans, medication, money and bedroom, time is also spent meeting with the residents and with staff about how they meet the persons needs. Case tracking was used to look at life in the home for three of the people living there. Discussion also took place with the relative of a resident, other residents, two members of staff and the manager. Any information the Commission for Social Care Inspection (CSCI) has received since the last inspection about the home is also taken into account. This included the results of comment cards sent out to residents, professionals involved with the people living in the home and relatives. Four relatives and five health and social care professionals returned comment cards to the CSCI. The home also contributed information to the inspection by completing a preinspection questionnaire. Since the previous full inspection of the home in March 2006 the CSCI has carried out 2 random inspections of this service. The first in May 2006 concentrated on evidencing how the home were meeting previous inspection requirements. The second, also in May 2006 looked at how the home manage resident medication. What the service does well: All residents spoken with during the inspection were positive about the home and their experiences of living there with comments including, “You couldn’t ask for better, staff are helpful, the place is kept clean” “The place is excellent, staff are very attentive, the food is lovely” and “We get a variety (of meals), everything is perfect, I like it here.” The home provides clear information to residents and their relatives about the service they offer and how to make a complaint. The home offers nutritious home cooked food which all residents spoken with agreed was of a good standard. All confirmed that staff would offer an alternative if they chose. Staff have built a good, friendly relationship with residents and were observed spending time talking with residents talking. Residents said that there are enough staff available and that they always respond quickly if asked for help. Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 6 Cairndu provides and promotes a pleasant, homely atmosphere with the environment well maintained and clean. Residents are able to personalise their bedrooms and spend their time as they choose. A variety of activities are offered and residents who wish to go out alone are supported to do so, 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. Cairndhu Rest Home Ltd DS0000065360.V295419.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 Cairndhu Rest Home Ltd DS0000065360.V295419.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 The quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. New and existing residents are provided with sufficient information about the home. However the manager does not always obtain sufficient information to ensure staff and the environment can meet the person’s needs and choices. EVIDENCE: Clear information about the home and the service it provides is made available to new and existing residents. Copies are kept in each bedroom and provide details about, the services the home provides, staff structure and qualifications, the environment and how to complain, along with other relevant information. One care plan read during the inspection contained copies of assessment information about the person’s needs that had been completed by the home and by the person’s social worker. However a care file for a newly admitted resident contained only assessment information completed by the manager, Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 9 prior to the person moving in. The manager must ensure that she obtains a copy of the person’s health or social care assessment and care plan before the person is offered a placement in the home. This will help to make sure that staff have all the relevant information about the person, their needs and choices and are able to meet and plan for these. Cairndu does not provide an intermediate care service. Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 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 the following standard(s): 7, 8, 9 & 10 The quality in this outcome area is poor. This judgement has been made using available evidence, including a visit to this service Staff have access to an assessment for each resident but do not always have access to detailed instructions on the care required. Medications are not always managed safely. Staff treat residents with respect. EVIDENCE: Throughout the inspection staff were seen to interact with residents in a positive, respectful manner and one resident explained, “ the place is excellent, staff are very attentive” and another stated, “We are spoilt”. Information about residents, their support needs and care provided is recorded in care plans, daily records and the daily diary. The manager must ensure that no personal information is recorded in the diary as this is in general use and confidentiality cannot be guaranteed. Three care plans were looked at for existing residents. No care plan was in place for a fourth resident who had not long moved into the home. A previous inspection of the home in March 2006 highlighted that the manager must Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 11 ensure that care plans are produced for new residents within a set timescale, this had not been addressed. Without a care plan in place staff may not be fully aware of all of the persons support needs and choices and therefore fail to meet these. The contents of care plans varied, with all providing an assessment of the person’s general health and social needs. Some plans contained information about the persons likes and dislikes and how to meet their needs, others did not. Good practice was noted in that staff have discussed care plans with residents, who have signed their agreement with the contents. Not all health assessments were up to date, for example two plans contained an assessment of skin integrity, these had not been completed since April 2006. The lack of up to date information about how to meet the persons health and social needs and out of date assessments and review of plans could lead to changes in residents needs not being identified and acted upon. The manager must ensure that an up to date care plan, which identifies and provides information on meeting all of the persons needs, is in place and regularly reviewed. Five GP’s and four relatives sent comment cards to the Commission for Social Care Inspection regarding their experiences of the home. All stated that they are satisfied with the overall care provided. All GP responses agreed that, they can see residents in private, staff have a clear understanding of residents support needs and communicate and work in partnership with the GP. They also agreed that staff take appropriate action if they can no longer manage the care needs of a resident. Daily records evidenced that the home provides support to residents in accessing health appointments and works with families to provide support to attend these. A resident spoken with explained that, staff help her to see her GP as “staff know what I need”. A random pharmacy inspection of the home was carried out in May 2006, this concentrated on how the home manages residents medication. Following this inspection 5 requirements were given to ensure medication was managed in line with legislation and 9 recommendations were made to help make sure medication management was as safe as possible. At this inspection the home had met 1 of the requirements and carried out 9 of the recommendations. During this inspection medications were looked at for four residents along with the general storage facilities provided. Medication is stored in a locked large glass fronted cupboard in the dining area, consideration should be given to storing medication out of sight, both for security reasons and also because light can have an adverse effect on the stability of medication. One resident has medication, which needs to be kept in the fridge. This was stored in the general fridge but was not in a lockable container, no records of the fridge temperature were kept. The manager must Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 12 ensure all medication is stored correctly and check it is maintained at the correct temperature. Records of all medication received and administered were in place. However there was no record of medications that had left the home for any reason. The manager must ensure this record is maintained so that there is an accurate audit trail in place and possible mistakes or errors can be identified quickly. One residents MAR sheet was handwritten, as identified at the previous inspection, where an entry is handwritten this should be signed by two members of staff to reduce the risk of incorrect information being recorded. Good practice is in place in that staff support residents to manage some of their medications. However no risk assessment is in place for this, the manager should complete and regularly review risk assessments for all residents who look after their own medications to ensure the risk is at an acceptable level. Oxygen is kept in one room, it is recommended that the cylinder be stored on a trolley or link chained to the wall in order to reduce risk of harm should the cylinder fall or in case of fire. A cupboard contained a box of loose dressings, which were not labelled with a resident’s name. The manager must ensure that all medication is in a correctly labelled container and that any unused medications are returned to their pharmacy, this will help reduce the risk of medications including dressing being used incorrectly. Cairndhu Rest Home Ltd DS0000065360.V295419.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 The quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents are encouraged to become part of the local community, receive visitors when they choose and participate in arranged activities. Staff support residents to make choices, which affect their lives and provide a nutritious home cooked diet. EVIDENCE: During the inspection several residents were seen to go out and about in the local community as they choose. A couple of people use mobility scooters for which the home provides storage. During the inspection the TV was on in one lounge and music available in the second lounge area. As it was a warm day, many residents were sat outside on the patio area, eating fresh melon and being served drinks by staff, whilst another resident played bowls in the garden. A member of staff explained that time is set aside each afternoon for supporting residents with activities and that there was always time for a chat. The manager stated on her pre inspection paperwork that the home provides a variety of entertainment, including card games, horse racing, bingo and trips Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 14 out. One resident explained, “the food is lovely, we do things I like. Like bingo, music and have an entertainer”. Another resident explained that they go on a barge trip each year and have visited a local garden centre recently or afternoon tea. The statement of purpose advises that visitors are welcome at all times, this was further evidenced in discussion with a visiting relative who said she was happy with the home and staff always make her feel welcome. Staff encourages residents to maintain their individuality and make choices about how to spend their time. During the inspection some residents were out and about engaged in different activities, others spent time reading in their room, watching TV or socialising. One resident spoken with explained that she had been able to bring her TV with her when she moved into the home and all bedrooms visited had photographs, ornaments and personal items belonging to the person using the room. Another resident explained that she can get up and go to bed when she wants and that as she had difficulty getting to sleep the night before, staff brought her a malted milk drink and had a chat and, “it helped me get to sleep”. All residents personal monies are handled by themselves or their relatives, the manager explained that the home do not get involved in managing peoples personal finances. Meals are served in the newly refurbished dining room, care had been taken to make sure tables were nicely laid, condiments available and drinks supplied. A member of staff explained that each day residents are asked what they would like from the menu and an alternative is always provided on request. A resident spoken with confirmed, “we get a variety, everything is perfect, I like it here” and confirmed that alternatives meals are always provided if requested. During the meal staff were observed quietly offering support to residents where needed and ensuring the mealtime was unrushed with a pleasant atmosphere. There were plentiful supplies of fresh and frozen vegetables and meat, fresh fruit, salads and other food stores and staff were observed serving drinks throughout the day. Cairndhu Rest Home Ltd DS0000065360.V295419.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service Effective complaints and adult protection procedures are in place within the home, staff receive training in safeguarding vulnerable adults and information on how to complain is readily available. EVIDENCE: Residents and their relatives have access to the homes complaints procedure, with copies available in all bedrooms. All relatives who returned a survey form prior to the inspection stated that they are aware of the complaints procedure and two residents spoken with said that they knew who to talk to if they were not happy with the service. A record is available in the home for recording of complaints, although none have been received about the service. Copies of the local authority adult protection procedures are available in the home and all staff have recently undertaken training in this area. The home does not act as appointee for residents benefit money and does not hold any residents monies. Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 16 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 & 26 The quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service Cairndu provides a comfortable, clean and welcoming environment for residents to live in. The home needs to further develop their infection control policies to ensure residents safety in this area. EVIDENCE: Cairndu is nicely decorated and has a homely and welcoming atmosphere throughout. It is well located for accessing local facilities and transport and provides pleasant, well maintained garden and seating areas, which are well used by residents in warmer months. In her pre- inspection paperwork the manager states that recent work in the home has included, several bedrooms re-carpeted and decorated, both lounges decorated and the dining room refurbished. In addition to this work, it was observed that a new floor covering to the kitchen has added to the overall appearance of the home. Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 17 A resident said that in her opinion “ this home is very clean” and all areas visited during the inspection were noted to be well maintained and clean. Ramps and a passenger lift are provided to make all areas accessible to residents. The home has a no smoking policy in the lounges with smoking outside or at certain times of the day, in the dining room. The home has a laundry in the cellar with a washing machine, there is no dryer so clothes are dried outside or on lines in the laundry room in wet weather. There are stores of clean sheets and blankets stored in this room, the cat eats her meals there and parts of the floor paint are missing. The manager must carry out an assessment of this area to ensure it is maintained in line with current infection control policies and guidance. The home does provide disposable, bags, aprons and gloves however their infection control guidelines are out of date, the manager should replace these with a copy of current guidance. Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 18 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 & 30 The quality in this outcome area is poor. This judgement has been made using available evidence, including a visit to this service. There are sufficient staff working in the home to meet residents needs, staff training needs further development to ensure staff are up to date with their practices. The home do not always ensure their recruitment polices protect residents. EVIDENCE: All of the GP’s who completed comment cards said that there is always a senior member of staff working in the home who they can confer with, and a community nurse commented, “staff are very helpful and chatty when I visit, they relay appropriate information when requested. The home maintains a staff rota which evidenced that there are two care staff during the day, with one carer and a sleep in staff at night, in addition the manager, deputy manager a cook and cleaner work in the home. An extra staff is present until 10 am to support residents to get up and the home employs a young member of staff to work weekend afternoons to help with residents activities. All residents spoken with, said that if they ring their buzzer or request help staff respond quickly. The manager confirmed that all staff employed to provide personal care are over the age of 18. Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 19 Many of the staff working in the home are experienced carers who are well known to residents. However none hold a care qualification, therefore the home does not meet national standards for providing a staff team with at least 50 who have achieved this qualification (NVQ). A member of staff said that she would like to obtain this qualification. The manager should provide support to staff to achieve this award. No trainee or agency staff work in the home. Staff files were examined for two members of staff. Not all contained evidence that the home had carried out relevant safety checks to make sure staff are suitable to work with vulnerable people. A file for a newly employed member of staff contained no references or evidence that a Criminal Records Bureau (CRB) check had been carried out. None of the files contained sufficient evidence for identification of the member of staff. All files contained copies of the person’s terms and conditions of employment and two had copies of their job description. The manager employs a young member of staff to work weekend afternoons in the home, they do not provide personal care to residents. No references, employment file or CRB had been obtained for this member of staff. The manager explained that they are a family member who she knows well, and the carer without references and CRB had worked in the home previously. The manager must ensure that no new member of staff is employed in the home without satisfactory safety checks including references, POVA and CRB being obtained. She must also ensure that all current staff have all the required checks and identification in place. Staff files evidenced that staff have recently undertaken training in adult protection and that they obtained certificates in 2005 for the safe handling of medication. Records also evidenced that the manager is in the process of training in staff in fire prevention and is undertaking a safe handling of food course. Training was booked for moving and handling and 1st aid and the manager advised that once this was completed she intended to arrange a basic food hygiene course for all. There was no evidence that new staff had received a formal induction to the home or been enrolled on a formal induction course. This training helps to familiarise staff with the home and provide them with the information they need to effectively support residents. Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 20 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 & 38 The quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service The home is managed by an experienced manager, who has begun the process of introducing a formal system to monitor and improve the quality of the service however this requires further development. The environment is safely maintained. EVIDENCE: The registered owner / manager, Miss Veronica Parker has many years experience within the field of care for older people and has worked at the home for some time, she also holds a management qualification. Lines of accountability within the home are clear and this information is passed to residents and their relatives via the homes statement of purpose. Miss Parker has undertaken several training courses and is in the process of passing this training to the staff team. Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 21 The manager has begun the process of carrying out regular audits to maintain and improve the service offered. Monthly checks are carried out on various parts of the environment and paperwork and planning for environmental improvements has become more formal. During the inspection residents were given time to talk in private with the inspector. The quality assurance system needs further development, to include establishing the views of residents and others with an interest in the home. Satisfactory records and certificates were available to evidence that safety checks are carried out at regular intervals. Fire drills and system checks are carried out regularly although the emergency lights had not been checked for over two months. A Fire Officer has not visited the home for several years, the manager should consider arranging a visit to check the home are operating in accordance with current guidelines and legislation. Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 2 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X N/a X X 3 Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15(1) Requirement Where an assessment identifies a need for support the home must provide written guidelines in their care plan. This is a requirement from the last two inspections The manager must ensure that care plans are produced for new residents within a set timescale. This information must be developed into a clear policy. This is a requirement of the last inspection The home must introduce a system for quality assuring the service they provide. Timescale for action 01/09/06 2 OP7 15(1)(2) 18/08/06 3 OP33 24 30/10/06 4 OP9 13(2) Sch 3 (i) RECORDS: The registered person 18/08/06 must ensure that full and accurate records are kept of all medicines received, administered and leaving the care of the home. There must be a full record of all medication currently prescribed for each resident. This is a requirement of the last inspection DS0000065360.V295419.R01.S.doc Version 5.2 Page 24 Cairndhu Rest Home Ltd 5 OP9 13(2) STORAGE: The registered person must ensure that medication be stored securely at all times. This is a requirement of the last inspection ADMINISTRATION: The registered person must ensure that risk assessments be completed (and reviewed) for those residents wishing to selfmedicate. This is a requirement of the last inspection. The manager must ensure that she obtains a copy of the person’s health or social care assessment and care plan before the person is offered a placement in the home. The manager must ensure that no personal information is recorded in the daily diary. The manager must ensure that an up to date care plan, which identifies and provides information on meeting all of the persons needs, is in place and regularly reviewed The manager must ensure that all medication is in a correctly labelled container and that any unused medications are returned to their pharmacy, this will help reduce the risk of medications including dressing being used incorrectly. The manager must carry out an assessment of the laundry room to ensure it is maintained in line with current infection control policies and guidance. DS0000065360.V295419.R01.S.doc 18/08/06 6 OP9 13(2) 18/08/06 7 OP3 14(1) 11/08/06 8 OP10 17(1) (b) 11/08/06 9 OP7 15 (1) (2)(b) 01/09/06 10 OP9 13(2) 11/08/06 11 OP26 13(3) 15/09/06 Cairndhu Rest Home Ltd Version 5.2 Page 25 12 OP29 17 (1)(a) 19 The manager must ensure that no new member of staff is employed in the home without satisfactory safety checks including references, POVA and CRB being obtained. She must also ensure that all current staff have all required checks and identification in place. 18/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations The manager should consider replacing the glass doors on the medication cupboard with something more secure and appropriate for the safe storage of medication. A second member of staff should witness all hand written annotations on Medication Administration Record charts. Medicines must be stored at the appropriate temperature. A record of temperature must be maintained for all areas where medicines are kept (fridge should be monitored daily) Oxygen cylinders should be chained to the wall or stored on a trolley Photographs of residents should be kept with the Medication Administration Record charts to aid resident identification. Warfarin books (or copies) should be kept with the Medication Administration Record charts. These are previous inspection recommendations. 2 OP29 The manager should familiarise herself with current good practise for induction training. This is a previous inspection recommendation. DS0000065360.V295419.R01.S.doc Version 5.2 Page 26 Cairndhu Rest Home Ltd 3 4 5 OP26 OP27 OP38 The manager should obtain a copy of current infection control polices and guidance. The manager should support staff to obtain a care qualification (NVQ) The manager should consider arranging a visit from the Fire Officer to check the home are operating in accordance with current guidelines and legislation. Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 27 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 Cairndhu Rest Home Ltd DS0000065360.V295419.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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