Inspection on 08/11/06 for Carrington House

This inspection was carried out on 8th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Carrington House 20/09/07

Carrington House 14/02/06

Carrington House 26/07/05

Carrington House 02/03/05

Carrington House 09/08/04

Carrington House 01/03/04

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 Carrington House Carrington Way Wincanton Somerset BA9 9BE Lead Inspector Sally Murphy Unannounced Inspection 8th November 2006 10:20 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 Carrington House DS0000016102.V317283.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. Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carrington House Address Carrington Way Wincanton Somerset BA9 9BE 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) 01963 32150 01963 33590 Somerset Care Limited Mrs Karen Roberts Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44) of places Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14 February 2006 Brief Description of the Service: Carrington House is located within the centre of Wincanton close to shops, the medical centre and other amenities. Service user accommodation is provided over three floors. All areas of the home are accessible via the passenger lift. There are a number of lounges and communal areas within the building. The home has a patio area with seating that is accessible to service users. The home is registered with the Commission for Social Care Inspection to provide care to up for forty-four service users who require assistance with personal care. Carrington House is owned by Somerset Care Limited and the Registered Manager is Mrs Karen Roberts. Carrington House has two interim beds where care may be provided to individuals for a period of up to six weeks, to prevent them being admitted or to assist them when being discharged from hospital. Fees at this home range from £361 to £470 per week with additional charges being made for newspapers, dry cleaning, toiletries and personal items. Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and was completed by three inspectors over one day. Sally Murphy, Regulation Inspector and Sue Burn, Regulation Manager assessed standards relating to care practice and the environment whilst Brian Brown, Pharmacist Inspector provided specialist advice on the management of medication. On the day of the inspection there were thirty-six service users residing at the home. During the course of the visit the Inspectors were able to speak with a number of service users, one visitor, service users receiving day care, the Registered Manager and members of the staff team. Records were examined, care practice observed and a tour of the premises made. What the service does well: What has improved since the last inspection? Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 6 A new menu has been introduced by Somerset Care Ltd. Service users confirmed that they are always provided with a choice of meals. The Inspectors observed lunch being served. There was a relaxed and unhurried atmosphere within the dining room. A range of vegetables was available in serving dishes on each table and staff provided assistance as required. Since the last inspection work has been completed on the patio area that has a range of seating for service users, and a water feature. Twelve service user room have also been re-decorated during recent months, with new furniture purchased and carpet fitted. The monies that are kept securely for service users are now held separately rather than as a collective sum. Staff have continued to study for NVQ qualifications and received further updates in mandatory training. What they could do better: Some of the care plans seen did not contain sufficient detail to enable staff to fully assist service users, and some required updating to ensure that they were reflective of service users’ current needs. Where there is an identified area of high risk, reviews must be completed regularly and appropriate actions taken. A comprehensive diabetes care plan must be developed for those service users who have diabetes. Action must taken to ensure that temperature within the medication storage room does not exceed 25 C. Oxygen cylinders must be stored securely to prevent them falling over. The whistle blowing policy does not provide details of any external agencies that may be contacted. This policy must be reviewed to ensure that it complies with the Public Information Disclosure Act 1998. Three recruitment files were examined. One file did not contain a satisfactory reference, and it was found that each of these staff had started employment prior to a POVA First check being received. This is of serious concern as the POVA First checks applicants against a list of staff who are not suitable to work with vulnerable adults. For the protection of vulnerable service users, two satisfactory references and a POVA First check must be received prior to any care staff commencing employment at the home. The staff member must then receive appropriate supervision until the enhanced CRB is obtained. The Inspectors discussed this fully with the Registered Manager during the inspection and issued an Immediate Requirement stating that this process must be followed for all future staff employed. Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 7 The Registered Manager must ensure that both pages of the registration certificate are displayed so that service users and visitors to the home may seen which categories the home is registered for. The fire risk assessment must be updated as circumstances change, so that relevant information may be provided to the fire service in the event of an emergency. For the protection of service users all hazardous substances must be stored securely, and staff using these products must have a good understanding of the actions to be taken in the event of chemical being spilt or coming into contact with their skin. 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. Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides prospective service users and their families with appropriate information to make an informed decision regarding admission to the home. An assessment of need is completed prior to any service user moving in, to ensure that the home will be able to fully meet their needs. Service users are encouraged to visit the home to assess the facilities provided. EVIDENCE: Somerset Care Limited has produced a Statement of Purpose and Service User Guide that provide details of the services and facilities offered at the home. Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 10 A comprehensive assessment of need is completed prior to any service user moving into the home. One service user who had moved in earlier this year recalled the Registered Manager visiting her in hospital to complete the assessment. On the day of the inspection, the Deputy Manager visited a further prospective service user to complete an assessment of need. Service users and their families are invited to visit the home to assess the services and facilities provided. Service users are admitted on a one-month trial basis. One service user spoken with stated that they had made the decision to move into the home permanently following a period of respite care. The home has two interim beds where service users are provided with assistance which is aimed at preventing them going into hospital or facilitating early discharge from the ward. Service users may stay in the interim beds for a maximum period of six weeks. These placements can sometimes be made on an emergency basis, and the Registered Manager seeks to ensure that appropriate information is provided prior to them moving in. Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9, 10 &11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans did not always contain sufficient detail to enable staff to meet service users’ needs. Care plans had not been reviewed systemically to ensure that they are reflective of service users’ current needs. Service users receive appropriate support in accessing health care services. The temperature of the medicine storage area has the potential to place service users at risk of harm. Service users feel that they are treated with kindness and respect. Service users receive appropriate care and are treated with dignity at the time of their death. EVIDENCE: Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 12 Care plans are maintained for each service user. Five care plans were examined in detail during this inspection. Care plans provided details of services users needs and preferences. Three of the care plans seen required updating to ensure that they reflected service users’ current needs. A moving and handling assessment had been completed for each service user. Risk assessments and fall analyses had been completed as required. Pressure risk assessments had been completed and appropriate equipment provided. The pressure risk assessment for one service user indicated that they were at very high risk of tissue damage but the assessment had not been reviewed since 10/3/06. This service user required turning every two hours throughout the night, but this was not identified within their care needs. The nutritional assessment for one service user did not provide details of the actions being taken to address their poor appetite. The care plan for a service user who is diabetic, did not provide appropriate guidance to staff regarding the normal blood sugar levels for that individual, and did not provide clear instruction on the actions to be taken should these fall above or below appropriate levels. Some service users had been weighed on a regular basis, whilst others had not. The care plan for one service user made reference to creams being applied but did not state what they were or where they were to be applied. Social histories had been completed in some of the care plans, but not for all plans seen. Staff support service users in accessing health care services. Service users confirmed that they are assisted to visit the medical surgery or a home visit is requested whenever they require assessment from the GP. The District Nursing team, and staff from the Community Mental Health Team visit the home as required. A chiropodist regularly visits the home. Each year an external agency provides assistance to those in the home who use hearing aids. The temperature of the medicine room was 25.5C at the time of the inspection and the thermometer showed a minimum temperature of 24C and a maximum of 26.2C. Most of the medicines stored are recommended by their manufacturers to be stored below 25C. There is an unlagged hot water pipe from the heating system passing through the room. For service users with diabetes the staff have a good understanding of the condition although there are no specific actions detailed in the individual care plan. The staff member spoken to was unaware of how to safely remove the used needles, using the sharps bin provided. Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 13 For those service users looking after any part of their own medication, there are risk assessments in place and secure storage is provided. However there is no system in place to enable monitoring the use of these medicines. There is good communication with visiting healthcare professionals and it was seen that some are recording when medicines are administered, however others are not and this means that the home does not have a complete record of the medicines administered. The home has a list of available homely remedies. However the same list is used for all service users including those already prescribed with medicines containing Paracetamol. The home are currently storing some Oxygen cylinders, and whilst these are stored in a room with the correct signage the cylinders are not secured to prevent them falling over. Service users provided positive feedback regarding the care that they receive. Interaction between staff and service users was observed to be friendly and respectful. Service users confirmed that they are always treated with dignity. One service user commented that this was especially the case when they were receiving assistance with personal care. The home will provide support to service users until the end of their life whenever possible. One service user has recently passed away at the home, and additional staff had been provided during the last few weeks to spend time with them. With permission from the service users’ family, a photograph of the service user had been displayed on the notice board, commemorating them and inviting service users to attend their funeral. Staff described how breaking the news that a service user had passed away was shared with service users in a sensitive manner. Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 14 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 good. This judgement has been made using available evidence including a visit to this service. Service users are able to participate in a range of activities. Service users are encouraged to maintain links with the local community. Service users are encouraged to exercise choice over their lives. Meals are of a high standard and offer a well-balanced diet. EVIDENCE: Service users are able to participate in a range of activities, including games, puzzles, board games and manicures. An Activities Co-ordinator is employed. On the day of the inspection a student completing their work placement at the home was organising activities within one lounge. Staff also spend time with service users on a one-to-one basis. Service users are able to visit the library each week. Service users described trips to the coast that had taken place during the summer. The home had Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 15 recently held a Halloween party. On the day of the inspection, one service users was attending Stroke club. A church service regularly takes place at the home. One visitor spoken with during the inspection stated that they are always made welcome at the home, and are kept up to date with changes in their relatives’ needs. Service users are able to spend time within their rooms or communal areas, as they prefer. A poster advertising the Age Concern Advocacy service is displayed in the home. Meals are prepared on the premises. The Cook has achieved the NVQ Level 2 qualification in catering and is working towards Level 3. Staff have a good understanding of service users dietary needs and preferences. The home is able to cater for specialist diets, and is currently providing meals for service users who require gluten free, diabetic and low cholesterol diets. The daily menu is displayed in the dining room. Service users confirmed that they are always provided with a choice of meals. The menu has been developed by Somerset Care Ltd and is aimed to offer a nutritious and well balanced diet. During the course of the inspection, the Inspectors observed lunch being served. There was a relaxed and unhurried atmosphere within the dining room. A range of vegetables was available in serving dishes on each table and staff provided assistance as required. Records had been maintained of the fridge and freezer temperatures and all food stored had been dated. There were good supplies of fresh fruit and vegetables. All of the service users spoken with provided very positive feedback on the meals provided. Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 16 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 adequate. This judgement has been made using available evidence including a visit to this service. The home has developed an appropriate complaints procedure, to ensure that service users are listened to. The whistle blowing policy must be reviewed to ensure that it complies with the Public Information Disclosure Act 1998. EVIDENCE: The home has a complaints procedure entitled ‘seeking your views’, which is included in Service user Guide and is displayed within the home. There has been one complaint received by the home since the last inspection. Appropriate records had been maintained of the complaint, meetings held and actions taken to address the issues raised. The home has a policy on the Protection of Vulnerable Adults and has a copy of the policy produced by Somerset County Council entitled ‘Safeguarding Vulnerable Adults’. Staff spoken with during the inspection were aware of the whistle blowing policy and stated that they would feel able to raise any concerns. Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 17 The whistle blowng policy was examined. This advises staff that concerns should be raised with initially with their immediate line manager or Area Manager or a Director. The policy does not provide details of any external agencies that may be contacted. It is required that the whistle blowing policy be reviewed to ensure that it complies with the Public Information Disclosure Act 1998. Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe and well-maintained environment. There is sufficient communal space and bathing facilities to meet service users’ needs. Service users live in comfortable rooms, with their own possessions. Appropriate equipment has been provided to meet service users’ needs. The home was found to have a good standard of cleanliness EVIDENCE: Service user accommodation is provided over three floors. All parts of the home are accessible via the passenger lift. Some service user rooms have en Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 19 suite facilities. There are sufficient assisted bathrooms within the home to meet service users’ needs. There are a number of small lounges on the ground and first floor, and a large dining room on the first floor. There is an additional lounge / dining room on the top floor which opens on to roof terrace. The roof terrace offers pleasant views of the surrounding areas, but now requires some attention to ensure that it continues to be an attractive area for service users to access. Since the last inspection work has been completed on the patio area that has a range of seating for service users, and a water feature. Twelve service user room have also been re-decorated during recent months, with new furniture purchased and carpet fitted. Service users are encouraged to bring personal possessions such as photographs, pictures and small pieces of furniture with them to individualise their room. Service users are provided with a lockable space to store medication or valuables. There is a passenger lift, assisted bathrooms and a call bell system available. Handrails have been provided in corridors and chair raisers and raised toilets provided as required to meet service users needs. The temperature of hot water has been thermostatically controlled to prevent the risk of scalding. Radiators have been covered and window openings have been restricted on upper floors. The laundry was seen. There is a clear system in place for the management of laundry. However chemicals had been stored in a number of places within the laundry and the area required some re-organisation to ensure that procedures can continue to be followed correctly. Alginate bags were available. The number of hours for domestic staff had been increased. The home had been maintained to a good standard of cleanliness. Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staffing levels are appropriate, and flexible to meet service users’ needs. The home has not operated a robust recruitment procedure. Staff have received the training required to undertake their roles. EVIDENCE: Duty rotas are maintained. Staffing levels are varied to reflect the number of service users in occupancy and their levels of dependency. Staff spoken with during the inspection confirmed that staffing levels had recently been increased in response to an increased level of need for one service user. Staff are encouraged to study for NVQ qualifications in care. Thirteen care staff have achieved the NVQ level 2 qualification and a further nine staff are working towards this. The Cook has completed the NVQ level 2 qualification in catering and is now working towards level 3. Three staff recruitment files were examined. A completed application form, and declaration of offences had been completed for each person. Two of the files contained two satisfactory references whilst one file included one written Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 21 reference and a verbal reference. The file contained record of the verbal reference being received but did not include any details of this, and it had not been dated. The verbal reference was not from the person identified on the application form. Each of the three staff members had commenced employment at the home prior to a POVA First check being received. One staff member had worked in the home for a period of three weeks before the POVA First check was received. For the other staff members there was a period of one week. This is of serious concern as the POVA First checks applicants against a list of staff who are not suitable to work with vulnerable adults. All of these staff members had commenced employment as night care staff where there are only two staff on duty, therefore it is not possible for them to be fully supervised during their shifts. For the protection of vulnerable service users, two satisfactory references and a POVA First check must be received prior to any care staff commencing employment at the home. The staff member must then receive appropriate supervision until the enhanced CRB is obtained. The Inspectors discussed this fully with the Registered Manager during the inspection and issued an Immediate Requirement stating that this process must be followed for all future staff employed. Newly appointed staff are provided with Induction training. Supervisors must undertake a comprehensive induction programme, which includes certain tasks that must be completed before they may be in charge of the shift. Staff are provided with regular updates in mandatory training. Manual handling and food hygiene training had recently taken place at the home. Staff have also been provided with training in First Aid, safe handling of medicines, infection control and positive dementia care. Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well managed. There is an appropriate structure of senior staff in place. There are systems in place to seek the views of service users, visitors and staff. Service users’ financial interests are safeguarded. Staff receive appropriate supervision and guidance to undertake their role. The Registered Manager must take further actions to ensure the health and safety of staff and service users at the home. Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 23 EVIDENCE: The Registered Manager is Mrs Karen Roberts. She has been in post for two years and has completed the Registered Managers Award. Staff and service users stated that she was approachable and that they would be able to raise any issues of concern. There was a relaxed and open atmosphere within the home. Service users are able to express their views at service user meetings, family meetings and care reviews. There is also a suggestion box available. The home will keep money securely for any service users that wish them to. A record is maintained of all transactions, which are supported by receipts and a staff signature. Monies are held separately for each service user. Staff from the home assist one service user in managing their finances. The Registered Manager should ensure that they receive appropriate support to take their monies to the bank when required. Staff confirmed that there is good teamwork within the home and that they feel able to express their views at staff meetings and during supervision. They confirmed that supervision is received a minimum of six times each year and that all staff receive an appraisal on an annual basis. Supervision records were seen within staff files. Records relating to service users had been appropriately maintained, and stored securely. The Registered Manager should ensure that both pages of the registration certificate are displayed so that service users and visitors to the home may seen which categories the home is registered to provide care for. The home displays appropriate Employers Liability insurance. Fire safety records and equipment servicing records had been appropriately maintained. The fire risk assessment made reference to oxygen cylinders being provided in several service users rooms. This is no longer the case, therefore the fire risk assessment must be updated appropriately to ensure that up to date information is available to the fire service in the event of an emergency. Electrical hardwiring has been tested and found to meet appropriate standards. Portable appliances had been tested on 28/2/06 however no record could be found for the electrical fan on the first floor. The home had recently received an inspection from the Environmental Health Officer and has some further work to complete in order to comply with their requirements. Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 24 During a tour of the premises it was found that a number of cleaning solutions were accessible to service users and visitors in the hallway. The domestic staff spoken with did not appear to have a good understanding of Control of Substances Hazardous to Health (COSHH). The cleaning fluids cupboard was secured with only a bolt on the door, but this was not in use at all times. For the protection of service users all hazardous substances must be stored securely, and staff using these products must have a good understanding of the actions to be taken in the event of chemical being spilt or coming into contact with their skin. Accidents had been recorded and reported as required. Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 3 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 2 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 2 2 Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? no 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 The registered person shall prepare a written plan outlining how staff will meet service users health and welfare needs. This is with regard to: - ensuring that a record is maintained of the plan to meet service users nutritional needs. - that comprehensive diabetic care plans are developed for those service users who have diabetes. - sufficient information being recorded regarding which creams are to be applied and to which areas of the body. - ensuring that care plans provide staff with clear guidance when a service user need to be turned during the night. - social histories being completed for each service user. 2. OP8 15 (2) [a] The registered person shall keep DS0000016102.V317283.R01.S.doc Timescale for action 15/12/06 15/12/06 Page 27 Carrington House Version 5.2 the service users plan under review. This is with regard to: - pressure risk assessments being reviewed regularly, and at greater frequency when there is an identified high level of risk. - service users being weighed regularly and appropriate action being taken to address any significant changes in weight. - care plans being reviewed regularly to ensure that all appropriate sections within the care plan is updated to reflect a change in their needs. 3. OP9 13 (2) The registered person shall make 15/12/06 arrangements for the recording and safekeeping of medicines in the care home. This relates to the need to ensure that all medicines are stored within the temperature range as specified by the manufacturer. It also relates to the need to ensure that the home have a record of all medicines administered to service users in the home. The registered person shall make 12/01/07 arrangements by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. This relates to the whistle blowing policy, which must be reviewed to ensure that it complies with the Public Information Disclosure Act 1998. 4. OP18 13 (6) Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 28 5. OP29 19 (1) [b] & Schedule 2 The registered person shall not employ a person to work at the care home unless he has obtained in respect of that person the information and documents specified in (i) paragraphs 1 to 7 of Schedule 2. This makes reference to two written references and an enhanced CRB disclosure. A person may work under supervision providing that a POVA First check has been received, whilst awaiting the enhanced CRB disclosure. 08/11/06 6. OP38 23 (4) [a] The registered person shall after consultation with the fire authority take adequate precautions against the risk of fire. This is with regard to the fire risk assessment needing to be updated to reflect the current storage of oxygen, to ensure that relevant information is available to the fire service in the event of an emergency. 15/12/06 7. OP38 23 (2) [c] The registered person shall ensure that the equipment provided at the care home for use by service users or persons who work at the care home is maintained in good working order. Records did not evidence that the electric fan on the top floor had been subject to a portable appliances test. 31/01/07 8. OP38 13 (4) [a] The registered person shall ensure that all parts of the home to which service users have DS0000016102.V317283.R01.S.doc 15/12/06 Carrington House Version 5.2 Page 29 access are so far as reasonably practicable free from hazards. This is with regard to hazardous substances that were accessible to service users and visitors on the trolleys in communal hallways and the cleaning cupboard store that is secured by only a bolt. This must comply with COSHH Regulations 2000. 9. OP38 18 (1) [c] The registered person shall ensure that persons employed at the care home receive training appropriate to the work they are to perform. This is in relation to staff receiving COSHH training. 31/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations It is recommended that the homely remedy lists be reviewed to remove any risk of duplication of administration of Paracetamol containing preparations. It is recommended that the risk assessment for service users looking after any part of there own medicine be reviewed to include how the use of the medicine is to be monitored. It is recommended that the roof terrace receive attention to ensure that it continues to be an attractive area for service users to access. The registered manager should consider ensuring that more electrical sockets are made available in service users DS0000016102.V317283.R01.S.doc Version 5.2 Page 30 2. OP9 3. OP19 4. OP24 Carrington House rooms. 5. OP26 It is recommended that some re-organisation takes place in the laundry with regard to the storage of chemicals and service users belongings to ensure that procedures can continue to be followed correctly. Staff assist one service user in managing their money. It is recommended that they receive appropriate support to take their monies to the bank when required to prevent sums amounting at the home. The registered manager should ensure that both pages of the registration certificate are displayed so that service users and visitors to the home may seen which categories the home is registered to provide care for. 6. OP35 5. OP37 Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Carrington House DS0000016102.V317283.R01.S.doc Version 5.2 Page 32 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!