Inspection on 28/02/08 for Cheney House

This inspection was carried out on 28th February 2008.

CSCI found this care home to be providing an Adequate service.

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

Cheney House 14/05/09

Cheney House 08/12/08

Cheney House 05/04/07

Cheney House 06/04/06

Cheney House 11/10/05

Cheney House 20/04/05

Cheney House 16/12/04

Cheney House 01/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Cheney House Rectory Lane Middleton Cheney Banbury Oxon OX17 2NZ Lead Inspector Irene Miller Unannounced Inspection 28th February 2008 10:15 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 Cheney House DS0000012735.V359945.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. Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cheney House Address Rectory Lane Middleton Cheney Banbury Oxon OX17 2NZ 01295 710494 01295 712784 cheney@regalcarehomes.com www.regalhomes.com Regal Care Homes Ltd 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) Ms Marie Williams Care Home 34 Category(ies) of Dementia - over 65 years of age (34), Old age, registration, with number not falling within any other category (34) of places Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No person falling within the category of DE(E) may be admitted into Cheney House where there are 34 service users who fall within the category of DE(E) already accommodated within the home. No person falling within the category of OP may be admitted into Cheney House where there are 34 service users who fall within the category of OP already accommodated within the home. 5th April 2007 Date of last inspection Brief Description of the Service: Cheney House is a care home providing personal care and accommodation to thirty-four older people who may have a dementia related illness. Regal Care Homes Ltd are the Registered Providers of the home. The home is located in the village of Middleton Cheney and is set within its own grounds. The building was a former rectory and is a listed building. There are nineteen single bedrooms of which nine have en-suite toilet facilities. Of the eight bedrooms, which are shared by two people, two have en-suite facilities. Middleton Cheney has amenities such as three churches, shops, post office, chemist, doctor’s surgery and three public houses. The village is on a bus route to the town of Banbury, which is approximately three miles away. The fees confirmed by the registered manager as being current at the time of this inspection range between £350 to £550 per week, the fee is dependant on whether residents are funded by the local authority or by private arrangement. The service user guide gives details on the difference in fees and how they are set dependent upon the care and support required and type of bedroom facilities chosen. The fees include accommodation, personal care, meals, laundry and some activities and entertainment. Chiropody and hairdressing services can be arranged and are charged separately. Other costs would include clothing, dry cleaning, some outings and toiletries. The homes statement of purpose and service users guide had been reviewed since the last inspection and the range of fees had been included within the service users guide. Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is based upon outcomes for Service Users and their views of the service provided. This visit was unannounced and focused on ‘key standards’ under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for older people. The care needs of three people living at the home were looked at in depth this involved looking through written information available on their care, such as the care plans (a care plan sets out how the home aims to meet the individual service users personal, healthcare, social and spiritual needs). During the visit a period of two hours was spent with residents who were present within the large communal lounge. During this time observations were made of the interactions between staff and residents. The time spent observing provided a snapshot of ‘life within the home’ and gave an insight as to the quality of the staff support and how the residents living at the home occupy their time. Discussion took place with the staff and visitors that were present. Some of the service users were unable to comment on their care therefore observations of staff and service users interactions were made with an aim to establish if service users were satisfied living at the home. Sample checks were carried out on the homes policies and procedures and records in relation to staff recruitment, complaints, and general maintenance and upkeep of the facility were viewed. Prior to the visit the Commission for Social Care Inspection sent out to the home the Annual Quality Assurance Assessment (AQAA) for the registered provider to self assess their performance, the AQAA was returned to the Commission for Social Care Inspection prior to this visit taking place and it provided additional information on the homes management and administration, processes. The registered manager Marie Williams was available at the home on the day of the visit. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? At the previous inspection there was concern that the residents personal care needs were not being met, during this inspection all residents seen appeared well groomed, and staff were seen to attend to personal care needs respecting the residents dignity. Radiator protection covers had been put into place to protect residents from coming into harm from hot surface temperatures. Staff training has taken place on moving and handling; however there is still some concern in this area and a requirement has been made. The information about fees in the service user guide had been reviewed. Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 7 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. Cheney House DS0000012735.V359945.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 Cheney House DS0000012735.V359945.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): Standard 3 (standard 6 is not applicable to this service) Quality in this outcome area is good. People choosing to live at the home have their needs assessed, and only move into the home once it has been established that their needs can be fully met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Within the care plans viewed there was records available of pre assessments having been carried out prior to residents moving into the home. There were records available within the care plans of assessments having been carried out by the placing authorities prior to admission into the home, and these assessments had formed the basis of the care plans. The homes statement of purpose and service users guide had been reviewed since the last inspection and the range of fees had been included within the service users guide. Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 10 Within the care plans there was copies of information sheets that are made available for residents and their representatives upon admission to the home. The information sheets summarised the information within the homes statement of purpose and service user guide. Cheney House DS0000012735.V359945.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): Standards 7,8,9 & 10 Quality in this outcome area is good. The health & personal care needs of the people living at the home are met, however for people who lack capacity to make informed decisions regarding their prescribed medication a multi disciplinary team approach would ensure that decisions made are in their best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There were records within the care plans viewed of having moving and handling, continence management and pressure area care assessments in place. There were records of these assessments being regularly reviewed and the residents changing needs being acknowledged within the reviews. Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 12 Within some of the bedrooms there were records available on the pressure area care provided for frail residents who require to be turned whilst in bed, to prevent the risk of developing pressure area sores. However staff need to be mindful of maintaining residents confidentiality as it was noted that within some of the bedrooms viewed, there was notices on display regarding continence management. There were records within the care plans of when residents had received treatment from the district nurse and of resident’s weights being monitored, to identify weight gains and losses. There were records of residents having received treatment from the other healthcare professionals such as chiropody and optical services. There was information for staff to follow within the care plans to assist them when providing care for residents whose dementia is more progressed. This included basic information such as to the cadence of speech and body language to ensure that staff can communicate as effectively as possible with residents who have limited communication skills. There was information within the care plans on how the residents personal hygiene needs are to be met, and to ensure that staff respect the residents likes and dislikes, and preference in terms of the type of clothes they like to wear and colour of clothing preferences. The medication records looked at showed that medication administration systems were followed and a sample check of the controlled drugs in use evidenced that these were stored safely and accurate records were being kept. Within one of the residents care plans viewed there was a letter that had been signed by the residents representatives consenting to the staff administering the residents medication disguised in foods. There were records of this residents’ medication being reviewed by their general practitioner. However there were no records available to demonstrate that the general practitioner had been involved in this decision to administer the medication ‘covertly’ nor of the resident lacking the capacity to make an informed decision. Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 & 15 Quality in this outcome area is adequate. A higher staff ratio would assist in giving staff more time to spend with the residents to meet their social and emotional needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Within one of the care plans viewed there was a life history available that provided information on the residents likes and dislikes in terms of their social activity preferences, their hobbies and interests and the names of significant people in their lives, this information serves to aid the staff in responding appropriately to the residents social and emotional needs. There was information within the care plans on the residents food preferences and gave details where residents may have difficulties with eating and drinking such as soft diets and foods that needed to be cut into small pieces. There was information for staff to follow when dealing with challenging behaviour. Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 14 The home employs an activity co-ordinator, however on the day of the visit this member of staff was not on duty. There were records available within the ‘activity file’ of when residents had participated in activities that had taken place. Within the activity records staff enter comments as to how the resident had responded to the activity, for one of the residents there was entries that they had joined in with pass the parcel, throwing a beach ball, and had taken part in a reminiscence discussion. However within the comments section for this individual there were few entries made to establish how the resident had responded to the activities and to determine whether these activities had been suitable for this resident. During the inspection visit a period of two hours (12:30 – 14:35) was spent with the residents within the large communal lounge. During this time observations were made of the type of interactions between staff and residents and the general care provided by the staff. This period of observation gave some insight as to how the residents occupy their time and the quality of the care and support provided. Over the two-hour period the care of three residents were observed in more depth to ascertain how they spent their time and the quality of the care provided. One resident had lots of staff involvement; over the two hours staff were observed to spend time sitting and chatting with this resident on at least fourteen different occasions. One resident was observed occupying their time busily moving furniture and actively walking around the home, this resident was observed to have the direct attention of staff on four occasions, however staff were observed to watch the resident from a distance and allowed the activity to safely continue. One resident was observed to spend the majority of their time passively watching what was happening within the lounge and lapsed between states of being withdrawn or asleep, this resident was observed to have the attention of staff on only one occasion. The overall findings over the observation period showed that generally the quality of staff interactions ranged from being good to neutral. The neutral interaction observed involved the staff responding to residents through simple exchanges of information, such as answering yes or no to resident’s questions. Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 15 The good interactions observed involved staff taking time to stop carrying out their practical tasks and to spend quality time with residents, to attempt to acknowledge their anxieties and provide reassurances. However it was noted during the observation period that the staff had a tendency to address the residents as ‘darling’ and ‘love’, and that on very few occasions were residents addressed by their first name or their full title. This was particularly noticeable when used with one particular male resident and appeared an inappropriate way to address this person. Over the lunchtime period, there was three/four staff present within the lounge to attend to the needs of approximately twenty-five residents, some residents required more support over the mealtime and the staff were observed to offer practical assistance and this was provided in the main with sensitivity and tact. However on a few occasions over the lunchtime some staff were observed to stand next to a resident spoon-feeding them this is seen as poor practice which should be discouraged. Relatives spoken with said that they were pleased with the care their relative received at the home, they said that they were aware that the physical and emotional needs of their relative were becoming much greater and had some concerns on how the home would be able to continue caring for their relative. Comments received from visitors were that ‘Staff do their best’, ‘could do with more staff on duty to spend time with residents who need more one to one support’. One relative said they had brought in magazines and puzzles for their relative, and that these items ‘somehow seem to go missing from their relatives bedroom’. Relatives spoken with confirmed that visiting arrangements at the home are flexible saying that they were able to visit as and when they wished. Cheney House DS0000012735.V359945.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): Standards 16 & 18 Quality in this outcome area is good. There is information available at the home on ‘how to complain’ should people living at the home or their representatives by unhappy about the care or services provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection of April 2007 the Commission for Social Care Inspection (CSCI) have received one complaint about the service and are satisfied that this complaint was fully investigated by the Social Services Safeguarding Adults Team and the Registered Provider. The homes training plan was viewed and it was identified that training is provided on the Protecting of Vulnerable Adults (POVA). It is recommended that ancillary staff employed at the home that has contact with the residents also receive this training In discussion with the care staff on duty they confirmed that they had attended (POVA) training. Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 17 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): Standards 19 & 26 Quality in this outcome area is adequate. The resident’s health, safety and welfare may be placed at risk due to doors being wedged open and a lack of documentation to evidence when moving and handling equipment has been serviced. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A limited tour of the building was conducted which included the communal lounges, a sample check of bedrooms, the kitchen and laundry The communal areas were clean and comfortably furnished, and bedrooms viewed were personalised. One of the shared bedrooms viewed did not give privacy screening between the bed spaces, the beds had previously been moved to accommodate a Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 18 married couple that had occupied the room. Presently two female residents occupied the room and the beds had not been returned back to their correct position to allow for the privacy screens to be of use. This was brought to the attention of the registered manager during the visit and was rectified immediately. Within one of the bedrooms there was no call bell available, the registered manager confirmed that it was being repaired, the call bell was repaired and returned back into position before the end of the inspection. It was noted that within some bedrooms the residents had received treatment from the district nurse and that the small open waste bins within their bedrooms were overflowing with bags of used dressings and clinical waste, this appeared unhygienic and untidy. The registered manager confirmed that the clinical waste would be cleared away, however in an effort to overcome this problem the registered manager should consider having available larger bins, preferably with a lid, within the rooms which are occupied by residents that require treatment from the district nurse. A fire safety inspection had identified that the home needed to move the location of the staff kitchen, and to fit fire resistant doors to the laundry store these areas had been addressed by the home. Some of the doors within the home were held open with door wedges and in discussion with the registered manager she confirmed that the home was considering putting into place battery operated door hold open devices that close in response to the fire alarm being activated. The registered manager should consider consulting with the fire authority before implementing the use of this equipment. Within the conservatory radiator protection covers had been put into place. When checking the bathing facilities it was difficult to establish when one of the bath hoists was last serviced or when due its next service, as the service label on the piece of equipment was not legible. During the inspection the registered manager was unable to locate a record of the last service report for this piece of equipment. The registered manager confirmed that once she had located the report that a copy would be provide to the Commission for Social Care Inspection, however a copy of the report was not received by CSCI and therefore there was no evidence to prove when it was last serviced. Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 19 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): Standards 27,28,29 & 30 Quality in this outcome area is adequate. The home needs to place more emphasis on meeting the resident’s emotional, spiritual and social needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the visit the staffing levels were five care staff, two domestic staff, two kitchen staff, one laundry worker and one maintenance worker, on duty. The registered manager confirmed that this is the usual level of staff employed on a morning shift. The home is registered to care for thirty four people with a dementia related condition, it was noted that during the time spent with residents within the lounge, that the residents living at the home require much attention from the staff to meet their emotional and social needs. In addition there are residents who also have high physical dependency needs that require the input from two staff at any one time, such as when moving and handling with the use of a hoist. During the inspection visit residents were heard to say to staff that they wanted to go out of the building, they were heard to seek comfort and reassurance from the staff. The staff were unable to accommodate the residents wishes in terms of leaving the building as under the current staffing Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 20 levels this would place the remaining staff and residents under pressure and place residents and staff at potential risk. Two staff work at night and the suitability of this staffing level was discussed with the registered manager, who confirmed that residents get have to get ready for bed early in the evening, and this is partly through choice but also the only way that the practical personal hygiene needs can be met before residents retire to bed. For the home to truly deliver a quality dementia care service the staffing levels need to be in sufficient numbers to meet the emotional, spiritual, social and physical dependency levels of the residents. Comments received from some relatives during the inspection support the need for more staff at times. Within the staff recruitment files viewed there was records of staff having had pre employment checks carried out with the Criminal Records Bureau (CRB) and with the Protection of Vulnerable Adults Register (POVA). There were records of interview to assess the suitability of candidates and there was records of induction training that covered mandatory training for all staff. In addition there was records of staff having attended training on basic dementia care, equal opportunities, first aid, communication skills and infection control. The staff employed from overseas are employed on student visas, and work at the home on student placements through the college to gain the knowledge and practical skills towards achieving their qualifications in health and social care. Training for staff to achieve a National Vocational Qualification (NVQ) is ongoing. The need for all staff to be trained in moving and handling was discussed with the registered manager. The registered manager confirmed that in order for this training to be available the company has to access a qualified moving and handling instructor. The staff induction record indicates that on day two of the staff induction that the use of equipment is ‘explained’ this includes the use of: • The hoist • The lifting belt • The platform lift • Lifting techniques In the staff induction record the new member of staff is required to confirm whether they have understood the instructions for using the above equipment, it is essential to identify that although staff may sign to demonstrate they have Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 21 understood the instructions, this does not allow the staff member to use the equipment without first having completed a moving and handling training course that has been provided by a qualified moving and handling instructor. Cheney House DS0000012735.V359945.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): Standards 31,33,35 & 38 Quality in this outcome area is adequate. Residents may be placed at risk through staff performing moving and handling tasks prior to having received qualified moving and handling training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has been in post for approximately three years and holds a National Vocational Qualification level 4 in management and care. Since the last inspection additional quality assurance processes have been implemented these consist of audits that take place every three months and cover areas such as medication management and care planning. Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 23 Records of the money held on behalf of residents were sample checked and were seen to be satisfactorily managed. Satisfaction surveys are carried out with relatives and healthcare professionals involved with the home, these are carried out quarterly and the findings go to director of care for analysis and action plans are set up from the findings. In discussion with staff they confirmed that the communication between the management and the staff was good, and that they have the opportunity to discuss the residents care needs. There was risk assessments in place that identified how risks were to be managed to an acceptable level and there was records of the assessments being reviewed on a regular basis. However the risk assessments for the use of bedside rails were generic and not specific to the residents who required this equipment, the assessments would therefore benefit from being more individualised. Discussion with the registered manager identified that new staff work alongside an experienced member of staff during their induction period. The registered manager confirmed that it is difficult to access moving and handling training from a qualified instructor for new staff during the induction period. Within the staff induction programme the use of moving and handling equipment is explained on day two, it is important to stress that this does not constitute that staff can then use the equipment without having attended moving and handling training from a qualified instructor. For the home to fully deliver a quality dementia care service the staffing levels need to be in sufficient numbers to ensure that the emotional, spiritual, social and physical dependency levels of the residents can be met Comments received from some relatives during the inspection support the need for more staff at times. Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 24 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 3 8 3 9 2 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 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 25 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 OP9 Regulation 13 (2) Requirement Where medication is administered through any other method than the prescribed method, the medical practitioner must have stated that the person lacks ‘the capacity to consent to treatment’ and that the medicine is essential to their health and well-being. The registered provider must have the service reports for lifting equipment available for inspection within the home to ensure the safety of residents. The registered provider must ensure that staff receive moving and handling training from a qualified instructor before performing any moving and handling tasks with residents to ensure their safety. Timescale for action 11/04/08 2 OP38 17 11/04/08 3 OP38 13(5) 11/04/08 Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP12 OP27 OP38 OP38 Good Practice Recommendations The registered provider should ensure that the staff to resident ratio is sufficient to meet the social and emotional needs of people living with dementia. The risk assessments for the use of bedside rails should be individual to the bed occupant. The registered person should consult with the fire authority regarding suitability of battery operated sound activated door closing devices. Dementia care training should be made available to ancillary staff that are in day-to-day contact with the people living at the home. OP30 Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Cheney House DS0000012735.V359945.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!