Inspection on 22/10/07 for Coniston House Residential Home

This inspection was carried out on 22nd October 2007.

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

Coniston House Residential Home 27/04/07

Coniston House Residential Home 03/05/06

Coniston House Residential Home 16/11/05

Coniston House Residential Home 04/05/05

Coniston House Residential Home 05/01/05

Coniston House Residential Home 24/08/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Coniston House Residential Home 75-79 Orwell Road Felixstowe Suffolk IP11 7PY Lead Inspector John Goodship Unannounced Inspection 22nd October 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Coniston House Residential Home DS0000060116.V353492.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. Coniston House Residential Home DS0000060116.V353492.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Coniston House Residential Home Address 75-79 Orwell Road Felixstowe Suffolk IP11 7PY 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) 01394 276201 F/P 01394 276201 Enviro Medical Limited Ms SallyAnn Royal Care Home 26 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (26) of places Coniston House Residential Home DS0000060116.V353492.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th April 2007 Brief Description of the Service: Coniston House is a registered care home for older people situated in a residential area of the coastal town of Felixstowe, close to town centre amenities and the seafront. The home was first registered in 1984 and was bought by Enviromedical Ltd in June 2004. This organisation also runs a similar home in Southend-on-Sea. The home was originally registered to provide accommodation and care for up to nineteen older people but in 1999 was extended into the property next door and is now able to accommodate up to twenty-six service users. There is private parking to the rear of the property. The rear gardens of the property have been landscaped to provide a particularly pleasant area for service users to spent time in the more clement weather. Service user accommodation is sited on three floors all of which are serviced by 2 shaft lifts. There are twenty-two single rooms and two shared rooms. 75 of rooms have the advantage of en-suite toilet facilities. The range of fees quoted in the Service Users Guide at the time of this inspection was £341.00 to £525.00. Coniston House Residential Home DS0000060116.V353492.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced and examined the outcomes for service users, using the standards which are listed under each Outcome Group overleaf. This inspection looked in particular at previous requirements and recommendations, and the action taken to improve in those areas. It used previous correspondence and documentation, feedback from service users and relatives, observation of staff practice, and discussion with managers, staff, service users and relatives. In addition, various procedures, policies, and essential records were inspected. The manager had completed an Annual Quality Assurance Assessment (AQAA) required by the Commission. This was fully completed with information about the home which was verified during the inspection. Items from the AQAA have been used in this report. The inspection took place on a weekday and lasted just over five hours. The manager was present throughout, together with staff on the morning shift and on the late shift. The inspector toured the home, and spoke to some of the residents, and two relatives who were visiting, and the staff, including two individually. The inspector also examined care plans, staff records, maintenance records and training records. All the places in the home were filled on the day of the inspection. A questionnaire survey was sent out by the Commission to residents, relatives and staff. Six residents responded, four relatives, and three staff members. Their answers to the questions and any additional comments they made have been included in the appropriate sections of this report. What the service does well: The staff know the residents’ needs well, and go about their work calmly, reassuring and treating residents respectfully. They were seen to provide the level of support to each resident set out in their care plan. Training in dementia care is helping staff understand some residents’ needs better, even if they do not have a diagnosis of dementia. Residents and relatives say that staff always have time to talk to them, are good at keeping relatives informed about changes, and relatives are made very welcome. A resident wrote: I am very happy here. The staff go out of their way to make me feel at home. Prospective residents have sufficient information to decide if this home is where they wish to live. The home will also collect information to assure the person that the home can meet their needs. Residents’ health and personal care needs are identified and met. The personcentred care of residents, particularly those with dementia, has improved with the use of the new care planning approach. Residents are protected from harm Coniston House Residential Home DS0000060116.V353492.R01.S.doc Version 5.2 Page 6 by the home medication policies and procedures. Residents are treated with respect and dignity including how their end of life wishes are met. The staff are starting to develop new activities suitable for the wishes and capabilities of the residents, using materials and ideas from the Alzheimers Society. A relative wrote: I cannot fault the care X has been given, not just practical help but a true sense of being loved and valued.” What has improved since the last inspection? What they could do better: The home must keep a record of all complaints made, including details of investigations and any action taken. The home should consider the provision of a weighing chair to enable all residents to be weighed regardless of their ability to stand. The home should continue to develop a wider range of activities for residents using questionnaires and staff skills and the guidance material available. Coniston House Residential Home DS0000060116.V353492.R01.S.doc Version 5.2 Page 7 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. Coniston House Residential Home DS0000060116.V353492.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 Coniston House Residential Home DS0000060116.V353492.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): 1,2,3,4,5. Standard 6 is not a service offered by this home. Quality in this outcome area is good. New residents can be assured that they will only be admitted to the home if it can meet their needs, and they will have sufficient information to assess for themselves if the home will be suitable for them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose and the Service Users’ Guide were examined. Both contained all the items of information required by the Regulations and national minimum standards. The information on the admission criteria included the statement that the home was registered for 7 beds for older people with diagnosed dementia within the total of 26 places. At the time of inspection, there were nine people with dementia. This included two residents whose dementia had been diagnosed since their admission. This was permitted within the home’s registration. Coniston House Residential Home DS0000060116.V353492.R01.S.doc Version 5.2 Page 10 The provider had applied to the Commission to vary the registration to allow the home to admit up to 26 people with diagnosed dementia. The home had not yet received notification of the outcome of this application. Each resident had a statement of terms and conditions for their residence. This was confirmed by residents’ responses to the survey. The previous inspection report from the Commission was available in the hall. Information on the fees charged was included in the service users’ guide. Currently the fees ranged between £341.00 and £525.00 dependent on the type of room and the provision of en-suite facilities. Residents and relatives said that they had visited the home to look round before coming in. Pre-admission assessments were undertaken, usually by the manager. These were held in the care plans. The information gathered included health and social care needs, mobility, medication, nutrition and what activities the prospective resident enjoyed. The AQAA stated that this information was discussed with relatives to ensure the fullest picture of the person was obtained. It also stated that it was the intention to send a written statement of the assessment to prospective residents to assure them of the home’s ability to meet their needs. Coniston House Residential Home DS0000060116.V353492.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 good. Residents can be assured that their health and personal care needs will be identified and met, as will the special needs of those with dementia through the use of person-centred planning. Residents are protected from harm by the home medication policies and procedures. Residents are treated with respect and dignity including how their end of life wishes are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were examined. The plans included full assessment of needs under all aspects of care, together with risk assessments appropriate to each person, including moving and handling and pressure area care. Records were kept of all visits by health professionals, and all appointments for treatment. One relative said that the home was very good at keeping in touch with information about their relative. The AQAA stated: “We liaise on a regular basis with local doctors and district nurses and have good relationships with these Coniston House Residential Home DS0000060116.V353492.R01.S.doc Version 5.2 Page 12 health professionals as well as local dentists, chiropodists, and the community psychiatric team.” If residents needed their weight to be monitored, the home only had bathroom scales for weighing, not a weighing chair, so only those who could weight bear were weighed. The last inspection report had found no evidence in care plans that the specific needs of those residents who had been diagnosed with dementia had been identified with plans to meet them. It had not been clear how this diagnosis impacted on their needs nor how the staff should address those needs. The home had now started to introduce care plans developed by the Alzheimers Society to meet these deficiencies. The format was called “Building on strengths” and put the resident at the centre of the care planning. Emphasis was placed on identifying people’s abilities and strengths, and specifying ways that staff could support these. These templates were a clear improvement and were being completed gradually by the manager and a senior carer. The plan also included all aspects of personal care needs. It emphasised the importance of gathering information about a person’s early life history and subsequent major events. The home was asking relatives to prepare these histories with photos if possible to form an album. Relatives were also asked what the person’s favourite things were. All this information would be used to support the person to reminisce either one-to-one or in a group. During the inspection, a visitor was talking to their relative about their life as part of gathering this information. Any changes to the care plan were shown in red to draw staff’s attention to these. An omission from the new templates used for the care plan was that there was no obvious place to record when reviews took place and who with. Nor was there a place to record if the plan had been audited as part of the home’s quality assurance process. The manager accepted this and suggested that the record sheet in the previous care plan format could be inserted. The home’s improvement plan of 3 August 2007 stated that all care plans would be reviewed monthly by the head of care, and audited three monthly by the manager. Some reviews were recorded but no audits had yet taken place. The entries in the daily record in each plan were full and informative giving a record of daily life which could be related to the care plan and used to assess the need for changes. A sample check on the administration of drugs showed that the correct procedures were followed. Administration charts were fully completed with no gaps in signatures. These records were now clearly marked regarding PRN (“as required”) medication. The tablets remaining in blister packs tallied with the quantity delivered and administered to date. The drug fridge had been relocated to the office and had a built in thermometer which showed a temperature within the safe range. Bottles had been dated when opened. The Coniston House Residential Home DS0000060116.V353492.R01.S.doc Version 5.2 Page 13 contents of the controlled drugs cabinet were examined. All drugs were properly recorded and accounted for. A staff member who provided hand and nail care wrote that: “I am kept up-todate about the well-being of all the residents. I have a lot of feedback from the staff.” A relative wrote: “As my relative has glaucoma, it is difficult for them to do the things they would like to do, but the staff try to help them as much as they can.” A resident wrote: “My hearing and speech are very poor. The staff are very kind and try very hard to understand me.” A resident with a terminal condition had chosen not to go into hospital as they preferred to stay in the home. The home was able to respect their wishes and continue caring for them with the assistance of the district nurse and the support of the GP. Coniston House Residential Home DS0000060116.V353492.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. Residents can be assured that the home will continue to develop opportunities and activities suited their wishes and abilities. They can expect to be able to choose nutritious and varied menus. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two senior carers were tasked with the responsibility of organising and managing the activities under the supervision of the manager. Both had attended a study day. This had led to a wider range of activities such as bonnet making and a fancy dress party. The latter had been supported by a relative who had supplied the costumes. Photos of this party were on display. Memorabilia sessions had been held using everyday items and photographs. The manager showed the inspector more helpful material from the Alzheimers Society giving many suggestions for activities, reminiscence and exercise. The manager explained that there would be an extra carer on in the afternoons when activities were planned. Daily activity charts were in care plan files, Coniston House Residential Home DS0000060116.V353492.R01.S.doc Version 5.2 Page 15 completed daily by staff, recording when residents had taken part in activities within or outside the home. One resident said that, although there were always activities in the home, they did not wish to take part in activities. Another said: “The staff are to be commended on the many and varied activities which they themselves are sometimes able to join in, helping those not so able to enjoy. It is nice sometimes to see visitors joining in with enthusiasm.” There was a list on both notice boards of the week’s activities. These included visits from the manicurist and the hairdresser as reminders to residents. It also included the day when residents would be weighed. This was not an appropriate activity to be included in this list. A relative also confirmed that a monthly religious service was held in the home. The new care plans gave clear guidance to staff on supporting the strengths of those with dementia, including how to allow them to do things for themselves, and how to communicate effectively with them. All residents were served breakfasts in their room, and most came to the dining room for lunch. There was always a choice of two main and dessert dishes for lunch. A photocopy of each resident’s choice was in the kitchen. On the day of inspection, a Monday, about two thirds of residents had chosen cold meat, and the others had chosen egg mornay. There was a similar split for the desserts. The supper menu was soup with pork pie, tuna sandwiches and cakes. No resident was seen to need support to eat their meal, although some had the food cut up for them. One person was seen using special cutlery which helped them to continue to be able to manage their own meals. The residents who responded to the survey said they always or usually liked the meals. One wrote: “Lovely dinners.” A visiting relative told the inspector that, since their relative had come to live in the home, they had never seen them so content. Another, while commending the home on the excellent food and the service, wished that staff had more time for chats to residents and perhaps a little walk round the garden on fine days. This comment was also made by a staff member. Coniston House Residential Home DS0000060116.V353492.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 good. Residents feel confident that they can complain and raise concerns. Staff and management are trained to protect residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s complaints procedure was prominently displayed in the hall. It included the name, address, and telephone number of the Commission as required at the previous inspection. All the residents in the survey said that they knew how to make a complaint and raise any concern. The home did not maintain a complaints log. There was a book in the hall for comments, but nothing had been entered for a very long time. The AQAA stated that the home had received no complaints since the previous inspection. However the Commission had received two complaints, one from a relative and one from a former member of staff. The first one was investigated by Social Care Services who found that allegations about the behaviour of a member of staff was unfounded. The second was investigated by the home. There were several issues in the complaint about care practices and the work standards of some staff members in the home, covering a lengthy period of time, and received at third hand without specific names or dates. A detailed investigation by the provider found nothing to substantiate the complaint. This was accepted Coniston House Residential Home DS0000060116.V353492.R01.S.doc Version 5.2 Page 17 by the Commission who informed the complainant of the outcome. The home did not maintain a complaints log. The manager agreed that this was a shortfall. The manager did say that the open policy in the home meant that residents and relatives could raise matters of concern, which would be dealt with as quickly as possible. This was confirmed by comments from relatives and residents. One wrote: “Responded immediately when I raised one concern”. Training for new staff on the protection of vulnerable adults was included in the induction programme which used the County Council local course of three days. This met the Common Induction Standards set by the Skills For Care national organisation. Training records showed that four staff had completed a POVA training session as well. However the manager was planning refresher training for all staff using an outside training organisation. Two staff interviewed were aware of the importance of safeguarding vulnerable adults, and knew what action to take if they suspected any resident was being abused in whatever way. The home did not manage the financial affairs of residents. Many families had power of attorney, and solicitors dealt with others. When cheques or cash were brought into the home by relatives to enable residents to buy items such as toiletries, a receipt was given to them and the monies locked in the home’s safe. Each resident’s cash float was kept according to the home’s policy and procedure. A random check of two residents’ cash showed that the float for one person reconciled with the record book, and that for the other person contained a few pence more than the record showed. Coniston House Residential Home DS0000060116.V353492.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): 19,20,24,25,26. Quality in this outcome area is good. Improved fire safety measures mean that residents can be assured that they live in a safe and secure environment, in comfortable communal rooms, and with rooms containing their own possessions. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the previous inspection, the home had installed new fire prevention and fire escape equipment and fittings to ensure residents’ safety. These measures included automatic release mechanisms, and alarm activated devices for some room doors of residents who wished to have their doors open, and the repositioning of a corridor fire stop door. The three main entrances/exits to the Coniston House Residential Home DS0000060116.V353492.R01.S.doc Version 5.2 Page 19 home had been fitted with keypad systems for residents’ security. These can be over-ridden in the event of a fire. Tumescent strips had been fitted to all doors. These followed the requirements and recommendations of the county fire prevention officer. The bathroom next to room 32 needed redecorating and the hoist chair needed to be repainted. The manager’s attention was drawn to a number of storeroom doors which had a notice on them “Keep locked shut”. They were often neither. The only room that posed a potential hazard to residents contained a hot water tank. The manager explained that the maintenance man was currently working on a hot water problem and needed to get into this room. Action was taken to make this room safe. All residents’ rooms that were viewed showed evidence that they were personalized with pictures, knick-knacks, mementos, flowers, books and some own pieces of furniture. All residents in the survey said that the home was kept fresh and clean. At the previous inspection, the manager had said that work was due to start in May 2007 to repair the significant cracks in the walls of one end of the home. Permission was sought from the Commission for temporarily changing a small lounge to a bedroom while work was undertaken. To date, this work had not started. The inspector was told that the contractors were still assessing the cracks for any sign of movement. The small lounge would be temporarily closed to residents. There were two other lounges for residents to use. All bathrooms now had thermometers to allow staff to check the temperature of the water before immersion of the resident. A sample check showed that the hot water temperatures were within the safe parameter. A monthly check on all hot water outlets was done by the maintenance man and recorded. It was noted that this record also included checking and cleaning showerheads to prevent legionella. Three residents said that the home was always or usually fresh and clean. Dedicated cleaning staff were employed by the home. Staff were provided with alcohol gel dispensers for hand cleaning as a supplement to hand washing. Coniston House Residential Home DS0000060116.V353492.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 good. Residents can be assured that sufficient numbers of staff with appropriate skills are on duty at all times to provide for their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information from the AQAA and from the rota confirmed that the staffing levels remained at four carers on in the morning, three in the afternoon/evening, and two waking staff at night. Short shifts had been added at the peak activity times in the morning and the evening. A senior person was also on call at night. Three residents said that there were always or usually staff available when they needed them. Staff always listened to them. “They are very nice.” A relative also confirmed that “staff will always listen to any concerns about my relative and endeavour to meet their needs.” Staff interviewed stated that sufficient staff were rostered on each shift. Staff were heard responding to call bells quickly’ and spending time talking to some residents who needed reassurance. Coniston House Residential Home DS0000060116.V353492.R01.S.doc Version 5.2 Page 21 The home did not use agency staff. The manager said that cover was provided by their own staff. The files of two recently appointed carers were examined. All identity checks and protection documentation had been received before their starting dates. One of them had completed their induction programme with the county council training course which was held locally. The other person was booked for the next course. Training records were examined for each member of staff. They recorded all in-house and external training courses and sessions, with qualification or attendance certificates. Medication training records for the Deputy and senior carers were included. Training during the previous twelve months, and training planned for the rest of this year showed that staff had attended, or were scheduled to attend the mandatory courses and their updates as necessary. All senior carers who were responsible for administering medication had been trained by the pharmacy supplier in the first instance, and were now going to do the ‘Safe Handling of Medicines’ distance-learning course with a local college. Staff had completed or were booked to do distance learning courses on Dementia Awareness, Health and Nutrition, and Occupational Health and Safety. Although the home’s training programmes were comprehensive, there was only one carer with NVQ Level 2. Four staff were working towards their NVQ. This ratio was well below the national minimum standards target of 50 of care staff. The home recognised this in their AQAA. “While we find that all our staff are highly committed to the care that they give, many of them are concerned about the academic side of the qualifications and perceive them to be very involved and intensive. We have reassured them that the qualification is relevant and that the course work is carried out whilst they are working.” Training records evidenced regular training in fire safety, moving and handling, food hygiene, and infection control. A staff member wrote: Training courses are on-going all the time and are of great use and help. There were two male carers on the staff. This allowed residents to express a preference for the gender of the carer undertaking personal care for them. The manager said that only two residents had stated a preference in the past. This preference could only be met whenever a male carer was on duty. Two members of staff were interviewed, one a recent starter and the other a senior carer. The junior carer was eighteen years old, and felt that they had been given sufficient induction training to allow them to deal safely with residents. They were aware of the adult protection policy of the home. The senior carer expressed their support for the introduction of the new care plan templates, initially for residents with dementia. They confirmed that if care plans were changed, either at a review or due to day-to-day incidents, staff were told about them at handover and encouraged to read the care plan. Coniston House Residential Home DS0000060116.V353492.R01.S.doc Version 5.2 Page 22 Coniston House Residential Home DS0000060116.V353492.R01.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): 31,33,34,35,36,38. Quality in this outcome area is good. Residents and relatives can expect the home to be well run, by competent staff. Their safety is assured by the home’s health and safety practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager was a registered nurse, and was planning to start the registered manager award in January 2008. She was experienced in the care of older people and had undertaken training in the care of people with dementia. She was planning to undertake the Diploma in Dementia Studies run by Bradford University. She was also a qualified assessor and verifier for NVQ training, but because of the workload involved, her time on this was restricted. Coniston House Residential Home DS0000060116.V353492.R01.S.doc Version 5.2 Page 24 A full Quality Assurance policy had been compiled. This included audits for care standards, housekeeping, catering, medication, administration, staff training, health and safety and accidents. Monthly reports by the provider were part of the QA programme and met the requirement of Regulation 26. These reports were seen by the inspector and were up to date. Residents’ meetings and staff meetings were held regularly. The last staff meeting had taken place the week prior to the inspection. The AQAA stated that the provider was planning to send out an annual questionnaire to residents, relatives and staff, and provide a Comment Book in the entrance. Details of how residents’ finances were safeguarded was included under “Complaints and Protection” above. The home was properly covered by insurance covering its legal liabilities to employees, residents and third parties. The certificates were displayed and were up-to-date. The formal supervision of care staff was scheduled to take place six times a year. The manager had divided the staff between three senior people, each responsible for the sessions. The schedules for these were examined and were up-to-date. The staff who were interviewed confirmed that these sessions took place. As detailed in the outcome group “Environment”, fire precautions and fire prevention measures had been brought up to the standard required by the county fire prevention officer. The home had an up-to-date fire risk assessment, and weekly tests of fire alarms were carried out and recorded. Monthly checks were made of hot water outlets, and shower heads were also cleaned monthly. Coniston House Residential Home DS0000060116.V353492.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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 3 3 X X X 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 3 3 X 3 Coniston House Residential Home DS0000060116.V353492.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 OP16 Regulation 17(2) Schedule 4 Requirement A record must be kept of all complaints received, any investigations undertaken, and any action taken. Timescale for action 01/12/07 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. 2. Refer to Standard OP8 OP12 Good Practice Recommendations The home should consider purchasing a weighing chair so that all residents’ weight can be monitored regardless of their ability to stand. The home should continue to develop a wider range of activities for residents using questionnaires and staff skills and the guidance material available. Coniston House Residential Home DS0000060116.V353492.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Coniston House Residential Home DS0000060116.V353492.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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