Inspection on 23/10/06 for Camellia House

This inspection was carried out on 23rd October 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

Camellia House 30/08/07

Camellia House 04/05/06

Camellia House 13/12/05

Camellia House 06/07/05

Camellia House 25/11/04

Camellia House 15/06/04

Camellia House 02/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Camellia House 5 Belmont Place Stoke Plymouth Devon PL3 4DN Lead Inspector Megan Walker Key Unannounced Inspection 23rd October 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Camellia House DS0000048342.V313553.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. Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Camellia House Address 5 Belmont Place Stoke Plymouth Devon PL3 4DN 01752 509697 01752 509697 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) Miss Sunita Jhugroo Miss Sunita Jhugroo Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three named service users who are older persons and have a learning disability 4th May 2006 Date of last inspection Brief Description of the Service: The home is a large end of terrace building, approximately 150 years of age, and located on a small cul de sac road close to Stoke Village, Plymouth. A full range of amenities and facilities are within walking distance of the home. The home can accommodate up to fourteen residents over four floors. It has a shaft lift. There are two communal bathrooms in the home and one en-suite bathroom. The main lounge is at the front of the building and the dining room is towards the rear of the building, leading into the kitchen. At the back of the house is an enclosed patio area with pot plants, and garden furniture available for residents’ use. There are eight single and three double bedrooms in the home. Only one double room has en-suite facilities. The home is made up of the original building and a three-floor extension to the rear. The service offered by the home is primarily for older people who are more independent. The current scale of charges is £300 - £325. Additional charges include in-house hairdresser at £5.00; Chiropody at £6; Incontinence pads, toiletries, newspapers, magazines, journals etc are all charged at commercial rates. All charges’ information provided by the Registered Person in May 2006. The home does not have the specialist categories to provide care for people with significant dementia or mental frailty needs. The home does not provide intermediate care and it is not registered to provide nursing care. Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second Key Inspection of this service this year. Due to the number of requirements resulting from the first Key Inspection in May, three inspectors and a nurse from the Health Protection Agency completed the fieldwork part of this inspection. The report from the Health Protection Agency was sent independently to the Registered Provider although some of the information where relevant is used in this report. It is recommended that this report be read with reference to the previous one. The Registered Provider was working at the home on the day of this fieldwork inspection visit, responsible for cooking the midday meal. The Deputy Manager was called in to assist with the inspection visit as needed. The Assistant Manager was on annual leave for the week. Two other care assistants were also working on this occasion. There were thirteen residents. Staff and residents spoke to the inspectors about their experiences of the home. Care Home Workers Surveys were sent to all staff employed at the home at the time of this inspection. Two surveys were returned to the Commission. No other Comment Cards were sent out because the first Key Inspection was less than six months ago. As part of the inspection process care plans, staff files, a duty rota covering a three-week period and other records and documents were inspected, and there was a tour of the premises. As a consequence of this inspection twelve requirements and two “Good Practice” recommendations were made. What the service does well: What has improved since the last inspection? There has been overall improvement of the standards in three main areas (choice of home, daily life and social activities and the environment). There have been improvements in 13 of the National Minimal Standards since the last inspection. Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 6 The Registered Provider has formally appointed a Deputy Manager and an Assistant Manager. They are all now based locally which seems to have improved input into continuity and consistency in standards of care for residents. 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. Camellia House DS0000048342.V313553.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 Camellia House DS0000048342.V313553.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): 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There have been improvements since the last inspection and prospective residents are adequately assessed before moving into the home. EVIDENCE: Inspection of residents’ care plans found that only one was completed in detail although the others had some information. Most of the residents at Camellia House have lived here for a number of years so their care needs have changed since their initial assessments. There had been one new resident admitted since the last inspection. A preassessment was expected from a Care Manager, although this was not available at the time of this fieldwork inspection visit it was later received by fax. Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 9 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, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There has been improvement since the last inspection. Some progress has been made in ensuring that care plans are informative and up to date, but some work on this remains outstanding. Medication is well managed so residents are protected from harm of incorrect drugs being given. EVIDENCE: Residents’ care plans had been set up to provide the following information: • Resident’s history • Next of Kin information • Likes and dislikes • Mobility assessment • Risk assessment • Property list • Contract including with complaints procedure Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 10 • • Monthly reviews Local Authority Review Team reviews (where appropriate) Only one resident’s file was inspected and found to be completed in detail. There was a separate folder with Daily Statements about each individual. Evidence of medical appointments, blood tests, etc, for residents was found in a desk diary. The Accident Book was completed correctly and stored in a locked filing cabinet. One of the frailer residents has had an ongoing chest infection. Staff were keeping a daily record of all this person’s food and fluid intake, this was instigated by the home manager. On the day of this visit this resident was sitting out in a chair and responded positively when asked about their health care over recent weeks. It was not possible to see if there had been any significant change in the level of care needed by this resident as no review of care was on the Care File. The medication storage areas were examined and were found to be clean, well organised and stocked with containers clearly showing for whom the medication was prescribed. Medication administration records were well completed showing the time and the dosage of medication given out to the residents. No resident was looking after his or her own medication. The documentation, the observations made and the storage areas of medication would indicate that the home is successfully managing residents medication protecting them from harm from the incorrect drug being given. Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 11 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, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. This outcome area shows an improvement since the last inspection. Residents who are mobile and mentally well find the lifestyle experience in the home matches their expectations and preferences and satisfies their interests and needs. EVIDENCE: The atmosphere in the home was more relaxed than it has been on previous visits. Residents were seen around the home, some able to move around independently and others with assistance from staff. Observation showed staff being courteous and respectful to residents, taking time to assist residents who required help without them feeling they were being rushed. Music was playing in the sitting room throughout most of the day, it was the same disc replayed several times - the manager stated that the residents particularly request it. At the same time the television was switched on Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 12 although the volume was turned down. Residents were observed watching the television whilst singing along to the music disc, this could cause confusion. Another resident was seen being encouraged by a care assistant to colour in a children’s colouring book, it was confirmed that the resident enjoys colouring. Some of the residents were more mobile and independent than others so able to go out alone. The Registered Provider said that those residents who wish to go out she takes for car rides, shopping with her, and to local cafes and garden centres. Once a week there is a fitness session led by an independent instructor. This session was observed at a previous inspection last year and the Registered Provider confirmed this activity continues to be popular with residents. Residents have contact with family and friends as they wish. A couple of residents said that their families visit them regularly, and as noted in the previous report, comments received from relatives stated that they were made to feel welcome by staff, offered a hot drink, and could see their relative in private if they preferred. The Registered Provider prepared and served a chicken curry for the midday meal on the day of this visit. Some residents preferred not have this and were able to choose an alternative meal. The meal was unhurried and residents were prompted and assisted as needed in a discreet manner. Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 13 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, 18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents are at risk due to policies and procedures designed to protect them not being followed. EVIDENCE: Since the last inspection the Registered Provider has had to manage a serious incident that involved both residents and staff. Despite having been on a training course for “Safeguarding Vulnerable Adults”, the Registered Provider failed to follow the protocol about who to inform and what steps to take in the event of an incident such as occurred within the home. Consequently the relevant authorities were unable to take any action. The situation has since been resolved and the manager confirmed that policies and procedures would be followed if there were any future need. Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 14 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, 24, 26 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. There has been an improvement in this outcome area since the last inspection. The home is comfortably furnished however there are still health and safety measures that need to be put in place to ensure the environment does not put residents at risk. EVIDENCE: The home was clean, odour free and all parts of the home including communal areas had been personalised and made homely with ornaments and photographs. A tour of the premises found that residents’ rooms were personalised to suit their individual preferences. Most beds had extra bedding such as throws or blankets in addition to duvets. There were freestanding electric heaters in a Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 15 number of bedrooms. The Registered Provider explained that these were provided at residents’ requests if they were cold. On the day of this fieldwork inspection visit the heating was on and the downstairs part of the building was very warm. Temperature of bedrooms was variable around the home, some being warmer than others. The Registered Provider was advised during this visit that heaters should be fixed to prevent injuries to residents or staff should the heaters be accidentally knocked over. Rodent bait was found in a bedroom in front of the wardrobe. The Registered Provider stated that the local council Pest Control officers had put it there. The Registered Provider was advised during this inspection that rodent bait used any where on the premises must be placed so that it was discreet and would not be a potential risk to a confused resident. A top floor bedroom was found to have damp walls around the windows. The wallpaper was bubbling indicating that the plaster underneath had “blown”, a common sign of ingress of water or damp. This area however looked as if it had been recently painted. It is understood that this is an interim measure and the problem will be fully addressed after winter is over and the weather is better. The upstairs bathroom had water damage behind the wash hand basin and a sheet of tinfoil had been put up between the plaster and the water pipes. The Registered Provider confirmed that there had been a leak and that the tinfoil was a temporary measure. On testing the water temperature in this bath it went over the maximum on the thermometer. The Registered Provider confirmed that water temperature regulator valves had been fitted on all the baths and showers since the last inspection and as required in the last inspection report. The first floor bath water was checked and found to be 38 degrees Celsius. The corner of the bath panel was broken however staff confirmed that this had only happened recently and that they had reported it to the Registered Provider the day before this visit and it is understood that this bath has since been fixed. The Health Protection Agency Nurse highlighted potential areas of cross infection in the bathroom and first floor toilet such as hand towels and nailbrushes. The fire exit door on the second floor was swollen due to rain seeping into it. It was therefore stuck and required brut force to open it. Containers were found outside the fire door at the top of the steps causing potential trip hazards in case of an emergency – it is understood that this area has since been cleared and is free from obstructions. An assessment of potential risks in the environment such as water temperatures, trip hazards had not been completed. The risk assessment Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 16 highlighting fire safety did not cover all areas of the home or the use of door guards, it is understood that this has now been included. Bedroom doors do not have locks. This included rooms that have become vacant since the last inspection when it was agreed that locks would be fitted to offer the choice to the next occupant. There was no evidence of written risk assessments to support the non-provision of locks on bedroom doors. There has been an ongoing maintenance plan to upgrade all the vanity units in residents’ bedrooms and this seemed to be near completion. The kitchen had been retiled and painted. A window restrictor had been fitted to the first floor toilet window. The house looked attractive both from the outside and inside with eye-catching curtains hung in all the windows. In the back garden there was evidence of garden furniture that the Assistant Manager confirmed had been well used throughout the summer period. Some plants were still flowering and it looked pleasant and appealing for an autumn day. The Assistant Manager said that it had been a successful summer as all the hanging baskets and potted plants had provided a delightful flower show for many weeks that the residents had been able to enjoy. Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. Staffing levels continue to be low putting residents at risk. EVIDENCE: Staff files were inspected and it was evident that most of them had been updated since the last inspection. Most files had contracts, they all had photographs and some form of identification, an application form, two written references and a Criminal Records Bureau (CRB) checks (i.e. police checks). As found previously some CRBs were not sent for until after the staff member had started in post. During the last inspection some staff had expressed dissatisfaction about training. The Registered Provider subsequently explained that it was her intention to train all staff at Level 2 National Vocational Qualification (NVQ) in health and Social Care. She was advised to ensure that this was fully explained to staff both in team meetings and individually in supervision, and to be clear staff understood her reasons for doing this. The Registered Provider was also advised that this would also ensure there was a written record should staff continue to express dissatisfaction about training. Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 18 The Registered Provider confirmed that Manual Handling training was booked and due to happen soon. The Co-op (medication supplier) had agreed to provide “Administration and Handling of Medication” training, however the Registered Provider continues to wait for confirmation of dates. This is outstanding since the last inspection. Six staff attended Fire Safety training at the beginning of October, and two staff attended Food Hygiene training in midOctober this year. The working rota for the first three weeks of October 2006 was inspected. Care staff are responsible for doing some food preparation, serving meals and washing up. A week-day domestic is employed to clean the home in the mornings. At weekends there were two staff all day with a third staff member on duty in the mornings. On some days the Registered Provider is an additional fourth carer, but also has responsibility for cooking. The staff rota also indicated that it would be difficult for new staff to be supervised or not to undertake any personal care before their checks were complete. Overall there was still a low care-staffing ratio for the number of residents, more so as one resident was confined to her room for reasons of health and required regular checking. Staff were observed assisting residents with a variety of tasks throughout the day, this showed verbal interaction was limited to mainly instructions or taskorientated questions. Practical assistance was attentive and friendly. Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Registered Provider has made a lot of improvement by meeting many of the requirements of the last inspection, however certain aspects of residents’ health, safety and welfare need to be improved further in order to minimise risk. EVIDENCE: The Registered Provider has complied with the Commission in meeting most of the requirements made as a consequence of the last inspection. She has confirmed in writing to the Commission that the two people working as volunteers have formally been made Deputy and Assistant Manager. The Commission has not seen any evidence that they are employed to work at the Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 20 home and not still working in the capacity of “volunteer” and receiving an allowance. (This was a proposal noted at the previous inspection.) Inspection of staff files confirmed that they each had a staff file with all the required checks. Other staff files inspected showed staff were still being employed before all the relevant checks had been completed. Inspection of the staff rota showed low staffing levels that would make it difficult for these new staff to work in a supervised capacity until all checks were complete and good. Also, as care staff are expected to carry out domestic tasks that take them away from care of residents, the staff rota indicated that insufficient numbers of staff were on duty to guarantee residents’ safety and well-being. There was no evidence of any aspects of quality assurance although at the previous inspection residents had apparently been asked for their opinions and feedback about the home. Residents’ financial records were examined and found to be recorded with receipts in place for items purchased on behalf of residents. The receipts and page numbers of the recording system were not numbered. Numbering the pages and the receipts would make auditing and checking finances easier. A random sample of three residents’ accounts was examined and the amount of money balanced with the records, indicating that residents’ finances were being managed appropriately. An assessment of potential risks in the environment such as water temperatures, trip hazards had not been completed. The risk assessment highlighting fire safety did not cover all areas of the home or the use of door guards. In the event of a fire, residents, staff and visitors to the home were at risk due to a poorly maintained fire exit door and objects stored on the fire escape. A number of areas needing improvement to control the spread of infection were outlined in a separate report sent to the Registered Provider by the Health Protection Agency Nurse. The report also advised about good hygiene practices. Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 1 2 X X X X 2 X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X 2 2 Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 22 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 OP37 Regulation 14, 15 Sch 3 Requirement “Unless it is impracticable to carry out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan (“the service user’s plan”) as to how the needs in respect of his health and welfare are to be met.” “The Registered Person shall ensure that the assessment of the service user’s needs is – kept under review; and revised at any time when it is necessary to do so having regard to any change of circumstances.” This refers the incomplete care files that must have an individual care plan that is kept under regular review, and reflects any change in care needs. The review process must include the resident and/or their representative, and they must at least be aware that a review has taken place. This is outstanding from the previous three inspection reports. Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 23 Timescale for action 31/12/06 2 OP12 16(2,n) Sch 1 (9) The registered person shall having regard to the size of the care home and the number and needs of service users – (m) consult service users about their social interests, and make arrangements to enable them to engage in local, social and community activities; (n) consult service users about the programme of activities arranged by or on behalf of the care home, having regards to the needs of service users, activities in relation to recreation, fitness and training. This refers to: (1) the lack of attention by staff to ensure that activities such as watching television are not conflicting with other activities; (2) that activities are suitable for the assessed needs of each individual; (3) activities take into account the wishes and personal preferences of each individual. 31/12/06 Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 24 3 OP18 10(2a) 13(6) “The registered provider shall undertake from time to time such training as is appropriate to ensure that he has the experience and skills necessary for carrying on the care home.” 31/12/06 4 OP19 OP38 13 (4a, c) 23 (1) This refers to the Registered Provider’s failure to follow local “Safeguarding Vulnerable Adults” protocol and procedure to ensure that the relevant authorities were alerted to take immediate appropriate action to prevent further such incidents occurring in this or any other care environment. “The registered person shall 31/12/06 ensure that – (a) all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety; (b) unnecessary risks to the health or safety of service users are identified and as far as possible eliminated.” “Subject to regulation 4(3), the registered person shall not use the premises for the purposes of a care home unless – (a) the premises are suitable for the purpose of achieving the aims and objectives set out in the statement of purpose;” This refers to the risks to service users and staff such as hot water temperature, freestanding radiators, and rodent bait, all identified in the Environment section of this report and by the Health Protection Agency Nurse. Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 25 5 OP19 OP38 13(4) 23(4) “The registered person shall ensure that – (c) all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety; unnecessary risks to the health or safety of service users are identified and as far as possible eliminated.” The registered person shall after consultation with the fire authority – (b) provide adequate means of escape.” This refers to the poor maintenance of the fire door on the first floor and the objects stored on the fire escape that could cause trip hazards in the event of an emergency. Appropriate door locks must be installed when rooms become vacant or if individual service users request this facility or if circumstances in the home change. This requirement is outstanding from the previous two inspections. The Registered Person shall ensure that at all times there is sufficient and suitably qualified, competent and experienced staff on duty. This refers to the low care staffing levels in the home. This requirement is outstanding from the previous two inspections. 31/12/06 6 OP24 12 (2,3,4a) 31/12/06 7 OP27 18(1a) 31/12/06 Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 26 8 OP28 18(1a) The Registered Person shall ensure that at all times there is sufficient and suitably qualified, competent and experienced staff on duty. This refers to the low care staffing levels that further compromise the care and safety of residents because care staff are deployed to do domestic duties as well as care duties during any one work period. This requirement is outstanding from the previous two inspections. The Registered Person shall not employ a person to work at the care home unless - subject to paragraph (6), (8), (9) he has obtained in respect of that person the information and documents specified in (i) paragraphs 1 to 9 of schedule 2. This refers to the lack of essential information held on staff files including relevant police checks and written references. This requirement is outstanding from the previous inspection. 31/12/06 9 OP29 19(1) Sch 2 31/12/06 Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 27 9 OP29 12(1a) 19 Sch2 The Registered Person shall not employ a person to work at the care home unless - subject to paragraph (6), (8), (9) he has obtained in respect of that person the information and documents specified in (i) paragraphs 1 to 9 of schedule 2. This refers to new care staff that may be providing unsupervised personal care to residents. They must not before the home has received evidence of a satisfactory police check and protection of Vulnerable Adults (POVA) register. 31/12/06 10 OP30 18(1) This requirement is outstanding from the previous inspection. The Registered Person shall 31/12/06 ensure that the persons employed by the registered person to work at the care home receive – (1) training appropriate to the work they are to perform (2) suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. This refers to outstanding mandatory training including induction courses that staff still have not had made available to them. This requirement is outstanding since the last inspection. Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 28 11 OP33 12 21 Sch1 (10) 12 OP38 13(4) An effective quality assurance 31/12/06 system must be developed to establish the residents’ level of satisfaction with the care services they receive in the home. This must also be extended to all visitors to the home including health and social care professionals, to establish their level of satisfaction with the care services being provided in the home. The results of all the surveys undertaken must be published and available to prospective service users and the Commission. This is outstanding from the previous three inspections. “The registered person shall 31/12/06 ensure that – (d) all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety; unnecessary risks to the health or safety of service users are identified and as far as possible eliminated.” This refers to the lack of written risk assessments of potential risks in the environment such as water temperatures and trip hazards. Also the risk assessment highlighting fire safety did not cover all areas of the home or the use of door guards. Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 29 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 OP27 Good Practice Recommendations The Registered Person should consider the employment of a cook. This should ensure that staff are not jeopardising the care needs of residents because they have to do too many different tasks during their shift. This should ensure that standards relating to food, meals and nutrition are fully met. This recommendation is brought forward from the last inspection. The registered person should ensure that any staff employed to work at the home who do not have English as their first language are able to communicate well with residents, their families, other staff and any visitors to the home. This includes written as well as spoken English. 2. OP30 Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Camellia House DS0000048342.V313553.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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