Inspection on 27/02/07 for Camellia House Nursing Home Ltd

This inspection was carried out on 27th February 2007.

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 Nursing Home Ltd 17/06/09

Camellia House Nursing Home Ltd 17/02/09

Camellia House Nursing Home Ltd 20/08/08

Camellia House Nursing Home Ltd 29/02/08

Camellia House Nursing Home Ltd 01/11/07

Camellia House Nursing Home Ltd 21/06/06

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Camellia House Nursing Home Ltd 5 Oak Park Villas Elm Grove Road Dawlish Devon EX7 0DE Lead Inspector Clare Medlock Unannounced Inspection 27th February 2007 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 Nursing Home Ltd DS0000066799.V325308.R02.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 Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Camellia House Nursing Home Ltd Address 5 Oak Park Villas Elm Grove Road Dawlish Devon EX7 0DE 01626 864272 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) Camellia House Nursing Home Ltd Susan Edey Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30), Old age, not falling within any other category (30), Physical disability over 65 years of age (30) Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Dementia - over 65 years of age (DE(E)) 30 Mental Disorder, excluding learning disability or dementia - over 65 years of age (MD(E)) 30 Old Age, not falling within any other category (OP) 30 Physical Disability - over 65 years of age PD(E)) 30 Date of last inspection 21st June 2006 Brief Description of the Service: Camellia House is a Care home that is registered to provide personal and Nursing Care to a maximum of 30 Residents. The house is a large, extending Victorian Villa built on level ground with an extensive walled accessible garden, which Residents access and enjoy during fine weather. The home is found within a quiet residential area, which is within one mile of the seaside town of Dawlish. The accommodation is arranged over two floors, which are accessed by stairs, lift or ramps. There are a variety of communal areas for residents to access. The home has been adapted to meet the needs of residents. The home has ramps, grab rails and specialist equipment, which include disabled shower and bathing facilities. There is a registered nurse on duty 24 hours a day. The home is under new ownership. The registered manager is a registered nurse and is supported by a team of registered nurses and care staff. The Inspection report can be found in the Managers office in the home. The scale of charges at the time of inspection varied depending on care need and room. These fees ranged from £ 373 to £ 650. The fees did not include: Hairdresser- £3.00-£25.00, Chiropody- £10-£12, Physiotherapist- variable, Papers- 20p-£1.20 and Transport (Taxis) which depended upon vehicle and distance of trip. Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the third inspection performed on Camellia House since April 2006. This inspection was performed to monitor the changes and improvements made at the home. This inspection took place on Tuesday 27th February 2007 from 10am until 3.30pm. It consisted of a tour of the building, looking at records, speaking with residents, their relatives and staff. Communication with health care professionals was also obtained. A period of time was spent observing life in the lounge and the care of three residents was followed closely (This is referred to in the report as ‘case tracking’.) What the service does well: What has improved since the last inspection? There has been a constant improvement in the standard of care, level of service and accommodation provided for Residents. The Manager continued to Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 6 stress that she felt the home had further to go to reach the standard that expected. Throughout the inspection, the Manager was clear with what been achieved, what was planned and what had not been achieved. Manager gave reasonable explanations as to why some Recommendations not been met. she had The had The standard of cleanliness and organisation continues to improve at the home. New cleaning staff have had a big impact on the standard of cleaning. The office area appeared more organised with a shelving system to store care plans. New equipment has been purchased. This includes a new drugs fridge, which improves the standard of storage for drugs and prevents the spread of infection when staff have to enter the kitchen to access the medication. New nursing beds are being ordered and a budget for redecoration and re furnishing bedrooms has been introduced. The EHO (Environmental Health Office) Inspector has found vast improvements in the kitchen management at the home. Care Plans are also improving to provide staff with documents to recognise, monitor and treat changes in resident’s conditions. Staff training has also greatly improved since the last inspection with the vast majority of staff receiving training on the subject of how to prevent, recognise and report abuse of the elderly. Moving and handling and fire training has also been introduced with the majority of staff having completed this training. Staff also have access to more training which benefits Residents by ensuring they have enough knowledge and information to do their jobs safely and properly. What they could do better: The Manager must ensure the changes she has introduced are continued and updated. The new assessment record that has been introduced should be completed adequately by the manager to obtain all information needed to ensure the staff are able to meet the new residents needs. This is practice is important especially where assessments from hospitals, health care professional or social workers are unavailable of inadequate. Once admitted, the residents must be treated as individuals at all times. Staff must make sure that when they provide personal care they interact with the resident and explain what is happening. This increases the dignity of the resident and makes them feel part of the process. Staff should learn from other members in the home to see good examples of interaction. Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 7 The social stimulation and activities must be improved within the home. Staff must make sure the care they give is based on the needs of the resident and not the task or routine of the home. Staff must look at creative ways of making sure residents have stimulation throughout the day. This will prevent residents sitting for long periods of time with nothing to do or watch. The range of organised activities must be reviewed to ensure resident have access to things other than music and TV. Staff must ask residents about their choices rather than guessing or deciding for them. Food provided at the home is generally good but consideration for those who need a pureed diet must be given. Meals should be pureed separately so those residents are able to enjoy the different flavours and textures and have their appetite increased by an attractively presented meal. The standard of hygiene in the home has also improved. The Manager has acted on previous requirements and Recommendations set by the environmental health and Commission for Social Care Inspection regarding kitchen hygiene. The Manager should now start considering advice given, which would improve hygiene. The Manager must ensure the timescale for introduction of door guards is met. This will promote safety and choice for residents. The recruitment of staff should also be improved by ensuring documents copied are signed to say the originals have been signed. This will minimise the risk of fraud. New staff recruited should also be tested to ensure they can understand, speak and write the English language. The planned programmes of supervision and Induction should be introduced. This would increase the quality and knowledge of staff and prevent Requirements being set by the Commission for Social Care Inspection. The planed programme of mandatory training should also be completed. The Providers should also consider ways of improving communication between themselves and relatives and residents. This would improve relations and open further channels of communication. Communication should also be improved by introducing staff meetings for all staff and not just trained staff. Please contact the provider for advice of actions taken in response to this Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 8 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 Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 9 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 Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 10 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): 2,3 and 5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents and their families have opportunities to visit the home prior to admission and are given sufficient information. The home obtain information on the Resident to ensure they are able to meet their needs, however the standard of documentation sometimes lacks detail. EVIDENCE: Three Residents were case tracked. This is where the care of a randomly selected number of residents is inspected and followed. These care Plans were examined on this inspection to check that the assessment process had improved. These records confirmed that the Manager obtains information before the residents comes to the home and does this by visiting the client where possible, and speaking with relatives and health care professionals. Records showed that where the assessment has been done by care management social workers, the registered person has insisted on receiving a Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 11 summary of the assessment and a copy of the plan. This is done to make sure that staff at Camellia House are certain they are able to meet the residents needs. Observation of the homes assessment record used showed that it was not adequately completed in some cases and did not contain all information recommended in the National Minimum standards. Inspection of records confirmed that this information is obtained but not recorded on the homes assessments tool. It is recommended that the Manager gets into a habit of completing this tool to ensure that when the homes assessment tool is the only one used or where social work assessments are inadequate a full history is obtained. Inspection of records, discussion with the manager and relatives confirmed that Camellia House is chosen by families, clients and social workers. Two of the three residents plans that were case tracked had evidence that families had looked at the home prior to admission. Feedback from health care professionals was positive. One professional said relatives had been very positive and they have been happy in the main to make Camellia their choice for their relatives. Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 12 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,elements of 9,10 and 11 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The standard of personal and nursing care given is good but interaction between residents and some staff could be improved. EVIDENCE: Observation confirmed that all residents seen on the day of inspection appeared well cared for. The finer details of care were present. Residents being cared for in bed appeared warm, pain free and had call bells and drinks within reach. Residents were seen to have clean eyes, teeth, and were dressed in their own clothes. Residents who wore glasses had them on and footwear appeared appropriate. Residents stated that they felt very well cared for. One resident said ‘the staff are marvellous and make sure I get what care I need’ another resident said that she sees the GP when needed and another talked about physiotherapists visiting the home. The Manager stated that the level of Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 13 nursing care has increased at the home with more poorly patients being admitted. Observation confirmed that these ‘poorly’ residents had devices to assist with pain and special mattresses to prevent sores developing. Discussion with staff confirmed that General Practitioners and staff had agreed appropriate care pathways for these residents. This is where all health care professionals work together to make sure any symptoms are under control. The Manager has also introduced new observation/turning charts for residents who are cared for in bed. These charts were completed and provided prompts for staff to give the right care. One relative said she found the charts very reassuring because they showed when the staff had been to see her mother and showed what care had been given. The home diary showed that residents have access to the optician, dentist, speech and language therapist, chiropodist and NHS out patient appointments. Three care plans were inspected and showed that wound care plans were still being used. These detail any wounds residents have, and clearly show changes and treatments that are given. These were well completed and staff said they were easy to use. The remaining care plans were inspected and found to be complex but well written and reviewed regularly. New risk assessments were seen. These included risk of falls, moving and handling risks, accident risks and skin assessments. All three care plans looked at had been reviewed to detect any changes in care. Observation showed that the home ensures that each resident’s plan is reviewed regularly with either the resident or their family. The Management of the medication system was not closely inspected but sharps boxes were clearly labelled and creams were only being used for the prescribed resident and lids of creams had the date of opening on to prevent the spread of infection. A new drug fridge had been purchased since the last inspection. One care plan that was used as part of the case tracking process was for a resident who had died at the home. These records showed that the resident had been given adequate pain relief and had been cared for appropriately. Diet records and charts to show the resident had changed position regularly were present. Records showed that friends and family were able to visit and be with their relative. Discussion with one relative confirmed that the home had made sure their relative was clean and comfortable and that their relative always looked clean and comfortable. Staff contacted the family and the family dog was even permitted to visit. Relatives spoken to say staff were very kind, sensitive, considerate and polite. Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 14 Observation on the day of inspection confirmed that attention is generally given by staff to ensure privacy and dignity when delivering personal care. However interaction when care is given was seen to be inconsistent and depends on which staff are delivering care. Sometimes communication was seen to be good but at other times it is absent or even poor. Feedback from health care professionals was positive. One comment included: When I visit any residents of mine either on an appointment or unannounced, I have found no difference in how I have been greeted or the condition of the residents. Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. For some Resident the social stimulation is poor at the home. Care is sometimes task based rather than individualised. EVIDENCE: Residents were observed in the lounge for a period of time following lunch. The majority of residents were sleeping off their dinner but the observation showed that interaction by staff was poor at times, with tasks being performed with no interaction from staff. This was highlighted to the Manager at the inspection. There was an apparent lack of stimulation for some residents and on three occasions residents rather than staff started conversation. Discussion with staff regarding residents stimulation and activities confirmed that staff think an entertainer is used for this purpose rather than finding simple solutions which would give stimulation. Some examples were seen Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 16 where residents had objects, which provided stimulation. These included a newspaper, bag of sweets and cuddly toy. Observation confirmed on several occasions’ staff performed tasks with no communication with the resident. On one occasion two staff moved a resident from a hoist to a chair with no communication, interaction or explanation. On another occasion a member of staff walked into the room turned a light on and turned some music on without asking residents their preferences and the same staff member peeled a banana for a resident without asking if this is what she wanted. However, other staff were heard talking with residents in an appropriate way. The Manager explained that occasional entertainers came to the home. At the previous inspection it was suggested that alternative activities continue to be sourced for those residents who are unable to come to the lounge. This has not been acted on. Residents spoken to said they were able to go out with friends for lunch and enjoyed receiving visitors. One resident said she was looking forward to a holiday in a nearby hotel with family. The visitor’s book confirmed that visitors are welcomed at all times of the day. Visitors spoken to on the day of inspection said staff at the home make them feel very welcome. Relatives spoken to state that although staff are very kind and work very hard there was sometimes a lack of stimulation and residents were ‘often left sitting staring into space’. The diary showed that the home tries to be flexible and ensures on request that residents are got up in time for a visit from relatives or a trip out with families or to attend hospital appointments. Residents are able to have personal possessions in their room, wear their own clothes and be called by their chosen term of address. Residents spoken to were complimentary about the food provided. On the day of inspection lunch was Sheppard’s Pie, cabbage and swede or lasagne followed by chocolate sponge and custard. Observation showed that kitchen staff puree all contents of the main course together which means residents miss the different flavours and textures of the different foods if they need a pureed diet. This was pointed out to the manager at inspection. Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident complaints are well managed and training protects Residents in the awareness, prevention and correct reporting of adult Protection issues EVIDENCE: Discussion with the Manager confirmed that there have been no formal complaints received at the home, but that minor issues are dealt with promptly. One resident spoken to said ‘you can’t ask for better.’ Relatives spoken to said ‘little things are sorted out quickly and don’t become complaints’ Another relative said the manager and the senior nurse are there each day which prevents problems getting bigger. All residents and relatives spoken to said they knew who to go to if they needed to complain and would feel confident that complaints would be dealt with. The Commission for Social Care Commission have not received any complaints or concerns regarding Camellia House since the new ownership. The Manager showed a complaints book, which was used for recording minor issues and their outcomes. Records showed that the Manager and Provider have made training a priority at the home. This makes sure that staff have all the skills and knowledge to Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 18 provide the best care they can. Records and Discussion with the manager showed that the majority of staff have now attended POVA (Protection of Vulnerable adults) training. Discussion with staff confirmed that staff have found this ‘eye opening’ and now know ‘that the little things can be interpreted as abuse’. Records showed that training for the remaining few day staff has been booked. There have been no further referrals to the vulnerable adults team as a result of lack of incidents, rather than a lack of understanding when incidents should be reported. Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The continued improvements in the standard of hygiene and decor in the home protects residents from infection and provides a pleasant environment in which to live. EVIDENCE: A Tour of the building showed that the Providers continue to improve the standard of décor at the home with vacant rooms having a budget for redecoration and new furniture purchase where needed. Specialist nursing beds continue to be purchased which means residents have more control over how they are positioned in bed. Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 20 During the inspection it was noted that the standard of cleanliness continued to improve. The sluice had been repaired and the use of gloves and aprons increased by staff. Discussion with staff confirmed that they now use gloves and aprons as a matter of routine. Observation of the home and discussion with the Manager confirmed there is a budget for repairs and plans to improve the facilities for Residents which included the introduction of a ‘wet room’ where Residents could enjoy a shower in an environment where staff can give assistance in a safe was using hoists and other aids. The home was clean, tidy and free from offensive odours on the day of inspection. Staff said the Provider and Manager had purchased new towels, linens and equipment. An EHO (Environmental Health Office) Inspection was occurring at the same time as the Commission for Social Care Inspection. The environmental health officer stated that there have been vast improvements at the home and that staff are implementing the food standard agency guidance ‘safer food, better business’ but needed to ensure the records were completed. Minor recommendations and advice were given which included repair of ceiling, repair of sugar scoop, calibrating probes, food labelling and consideration of where staff have access to make drinks for residents. Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of staff on duty but the level of spoken English of some staff makes it difficult for Residents and other staff to have instructions understood. The Inadequate induction has the ability to put Residents at risk of being cared for by staff who are not given sufficient information. EVIDENCE: Off Duty Records showed that staffing at the home continues to improve. Staff said morale has increased with the reduction of agency staff and said that residents are given care by the same staff. Discussion with staff confirmed that the continued presence of the manager is reassuring and supportive. The Manager stated that registered nurses do access advice and support at all times. The Manager stated that she has been unsuccessful recruiting local staff and so has been employing overseas staff through an agency. Discussion with residents, relatives and staff showed that there has been a problem with some staff from overseas and the difficulty in speaking and understanding the English language and local accents. The Manager gave reassurance that any Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 22 new staff would be tested for their ability to speak, understand and write English. Brief inspection of staff files confirmed that information is obtained regarding the identity of staff. Photos are obtained and CRB (Criminal Record BureauPolice check) and POVA (Protection of Vulnerable adults checks are made on new staff. Inspection showed that photocopies of documents are kept but no confirmation is present to show the original document has been seen. Evidence that the General Social Care Council Code of Practice is showed to all new employees. Induction records are poor at the home. The Manager confirmed she has obtained the skills for Care (National induction) document but is adapting this to ensure it is relevant to the home. Discussion with staff confirmed induction consists of a tour of the home, working with staff and location of emergency equipment. Staff spoken to said training has been improved at the home and the manager sources training when it is needed. One member of staff said that the provider has funded NVQ (National vocational training) courses. Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,elements of 35,36,37 and 38 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The improved management at the home and changes being introduced continue to increase the level of care and safety of Residents and morale of staff. Once these are fully implemented the home will be effectively managed and will be a safe and effective place to live and work. EVIDENCE: The Manager said she has nearly completed the management course and has found this useful for sourcing information on supervision. The Manager also Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 24 stated that the planned staff supervision is still not yet fully implemented, but now a document has been found will ensure this is introduced. Staff were very complimentary about the manager and senior nurse. Comments included ‘Always there’ ‘supportive’ and ‘approachable’ Residents said it was nice to know that the manager and nurses were there every day. Relatives spoken to say they always went to either the manager or senior nurse with any comments or issues and felt confident they would be sorted out. One relative gave an example of an issue that was sorted out immediately and said they were confident that their relatives were in good hands. Staff, resident and relatives spoken to all said they do not see much of the owners (Providers) One relative stated that it would be nice if they came in to the home more and made their presence known. Staff spoken to say they would speak with the nurse in charge first and did not regularly speak with the Providers. Staff spoken to said they had not had any staff meetings but felt able to speak with the manager on a day to day basis. Discussion with the manager confirmed two trained nurse meetings have been held since the new ownership where new ideas were discussed. Discussion with the manager, one resident and two relatives confirmed that the manager, provider and staff at the home do not manage the finances of the majority of the residents and that this is done by family or solicitors. One relative said she was happy with the fact that bills for services such as hairdressing is sent to whoever manages the finances for the resident. Inspection confirmed maintenance of equipment and services are ‘contracted out’ to other businesses and certificates are obtained of maintenance. Records were seen for Gas and Electrical safety, waste management, specialist baths, lifts, and fire. The Manager explained that a fire risk assessment has been carried out and as a result clear signs, information booklets and repairs to fire doors have been made. First aid boxes are available throughout the home and systems to regularly check these have been introduced. Water temperature records are also maintained. Automatic door closures were required to be fitted at the previous inspection. The Manager confirmed these have been ordered and will be fitted before the timescale expires at the end of March. Discussion with the manager confirmed that that staff training has been introduced on a rolling programme but not yet 100 complete. The Manager explained that moving and handling is regularly booked and POVA training is Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 25 near completion and ready for repeating on the rolling programme. The Manager was honest throughout the inspection about what had and had not been done. Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 X X X 2 3 2 Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 27 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 OP10 Regulation 12(4) Requirement Health and welfare of service users 12. (4) The registered person shall make suitable arrangements to ensure that the care home is conducted (a) in a manner which respects the privacy and dignity of service user Timescale for action 30/06/07 The Manager must ensure that staff interact with residents when personal care is given and explain what is happening. 2. OP12 12 (1,2,3) Health and welfare of service users 12. - (1) The registered person shall ensure that the care home is conducted so as (a) to promote and make proper provision for the health and welfare of service users; (b) to make proper provision for the care and, where appropriate, treatment, education and supervision of service users. (2) The registered person shall so far as practicable enable service users to make decisions with respect to the care they are to DS0000066799.V325308.R02.S.doc 30/06/07 Camellia House Nursing Home Ltd Version 5.2 Page 28 receive and their health and welfare. (3) The registered person shall, for the purpose of providing care to service users, and making proper provision for their health and welfare, so far as practicable ascertain and take into account their wishes and feelings. The Manager must ensure staff ensure residents have some stimulation on a day to day basis and have a choice of what activities they participate in. (this relates to staff not asking residents what they would like to listen to or eat) 3 OP38 23(4a) (4) The registered person shall after consultation with the fire authority (a) take adequate precautions against the risk of fire, including the provision of suitable fire equipment; 31/03/07 The Manager must install door guards or other suitable devises to residents who like their doors kept open. 4 OP38 18(1) Staffing 18. - (1) The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users (c) ensure that the persons employed by the registered person to work at the care home receive (i) training appropriate to the work they are to perform; and (ii) suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. 30/06/07 The Manager must complete Camellia House Nursing Home Ltd DS0000066799.V325308.R02.S.doc Version 5.2 Page 29 the training programmed in respect of: • Fire safety • First Aid • Infection Control • Food hygiene and • Moving and handling And maintain the system introduced to ensure training occurs on a regular basis 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. Refer to Standard OP3 OP15 Good Practice Recommendations The Manager should ensure that the homes admission assessment is completed adequately prior to admission. The Manager should ensure kitchen staff puree the food separately so those residents are able to enjoy the different flavours and textures and have their appetite increased by an attractively presented meal. The Manager should consider acting on the advice of the Environmental Health officer The Manager should improve the recruitment process by ensuring: • Copies of documents are signed to show that the original has been seen • The spoken and written English ability of staff is assessed prior to employment The Manager should continue with the planned programme of induction The Manager should continue with the planned programme of supervision. The Providers should consider ways of improving communication between themselves and residents and visitors. The Manager should ensure staff meetings are held for all staff and not just trained staff 3. 4 OP19 OP29 5. 6 7 8 OP30 OP36 OP32 OP32 Camellia House Nursing Home Ltd DS0000066799.V325308.R02.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 Nursing Home Ltd DS0000066799.V325308.R02.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. 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