Inspection on 05/11/07 for Cool Runnings Too

This inspection was carried out on 5th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Cool Runnings Too 13/11/08

Cool Runnings Too 15/05/08

Cool Runnings Too 12/07/07

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 Cool Runnings 58/63 The Park Yeovil Somerset BA20 1DF Lead Inspector Barbara Ludlow Unannounced Inspection 5th November 2007 08:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cool Runnings DS0000068414.V354398.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. Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cool Runnings Address 58/63 The Park Yeovil Somerset BA20 1DF 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) 01935 414611 Cool Runnings Residential Home Ltd Mrs Maria Adele Hallett Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Both premises will be staffed by separate staffing rosters with not less than two staff on duty through the day/evening and one at night in each house. No more than 9 service users to be accommodated in No 58 The Park, and not more than 12 service users to be accommodated in No 63 The Park. To accommodate one lady, under 65 years, as named in application date 28/05/06. To accommodate one gentleman, under 65 years, as named in application dated 16/05/06. 12th July 2007 Date of last inspection Brief Description of the Service: Cool Runnings (No 58 The Park) and Cool Runnings Too (No 63 The Park) are residential care homes for older people. They are registered as one service with CSCI, named Cool Runnings Residential Home Ltd. The homes are located on opposite sides of a road in a quiet residential area of Yeovil, close to the town centre. The service has been reregistered with CSCI as a limited company, with no change to the ownership or management. The service is owned and managed by Mr Paul and Mrs Maria Hallett, who live close by. Cool Runnings accommodates 9 residents in single bedrooms and has a lounge/dining room and a conservatory. Cool Runnings Too accommodates 12 residents in single bedrooms and has a large lounge and dining room. Both homes are two-storey buildings and are staffed independently. Bedrooms are provided on both ground and first floors. Residents who are ambulant and able to use stairs are accommodated in first floor bedrooms. Those who are not able to use stairs either use the ground floor bedrooms or use stair lift if placed on first floor at number 58 The Park (Cool Runnings). Both homes have gardens and ample parking. Day care is provided to a limited number of non-resident people and the home offers short break residential care when vacancies permit. The current fees range from £373.00 to £385.00 per week. Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 5 Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. This unannounced inspection visit was made by two regulation inspectors, B.Ludlow and S.Hale and the pharmacist inspector, B.Brown. The visit commenced at 0800am and was conducted between the two houses that make up Cool Runnings care home. The inspection was well received by the staff and management of the home. Staff were spoken with at both premises and the registered manager Mrs Hallett was available shortly after the start of the inspection to the conclusion to receive feedback from the inspectors. A tour of both premises was made however the inspectors were mindful that it was quite early and many people were in their rooms at the start of the visit. Mr Brown observed staff management of medication and their administration practice. People who live at the home who were up and about were seen and were spoken with. Daily life at the home was observed. Records required to be kept by the care home under the care homes regulations were requested and inspected. A number of significant deficits in care and management practice were evidenced and immediate requirement forms were issued for urgent action. The requirements and recommendations made at the inspection in August were checked and no progress had been made to address these matters. The visit closed at 1300, a random unannounced follow up visit will be made. What the service does well: People who live at Cool Runnings confirmed that they are well cared for and enjoy living at the home. Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Requirements and recommendations that were made at the last inspection have received no attention and are carried forward. Care planning is poor with records not reflecting resident’s current needs, not reviewed and drawn up without their involvement. Risk assessments in relation to medication, falls and moving and handling were not in place to protect residents. Improvement and attention to management practice is required to protect the people who live at the home from the risk of harm. This refers to the management of medications, fire safety, staff recruitment and maintenance of the services, which were judged to be unsafe and poorly managed. Immediate requirements were issued at the time of the inspection and Mrs Hallett suspended two staff pending recruitment checks being completed. Staff were identified as needing training and updating in safe manual handling practice, this was outstanding from the last inspection. New staff induction was not based on the skills for care model. Staff should receive formal supervision of their practice to make sure that they have the skills and knowledge to provide a good standard of care. Mrs Hallett must make appropriate supervision arrangements in relation to the member of staff who is under 18 years of age. Mrs Hallett was unclear about her role and responsibility in reporting under the Safeguarding Vulnerable Adults policy for Somerset. CSCI have received only one Regulation 37 notification of event affecting the well being of a residents at the home since the re registration of the home on 4/08/2006. The inspector was aware that there had been one death at the home since the last inspection CSCI had not been notified. The registered manager was advised that all incidents pertaining to Regulation 37 must be notified without delay. A follow up visit will be made to assess the action taken to meet the immediate requirements made at this inspection. Failure by the registered person/s to Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 8 meet to meet the regulatory requirements may result in the Commission for Social Care Inspection considering further regulatory action. 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. Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, NMS 6 does N/A Quality in this outcome area is adequate. Pre admission assessment is made but more attention to the assessment for nighttime frailty is required where the person is considered for accommodation in Cool Runnings Too (No 63, The Park) where there is no waking night staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No new service users have come into the home. Since the last inspection there has been one death in the home (No 58) where there is no waking night staff, only emergency cover. The inspector heard that one service user has left the home to have night support available to them. Care must be taken to ensure that care managers and people offered a place in Cool Runnings Too (No 58) are aware that there is only sleeping night staff available for emergency assistance and that only people who are independent at night are offered accommodation in this house. Cool Runnings DS0000068414.V354398.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 Quality in this outcome area is poor. The handling of medicines in the home is potentially dangerous and unsafe. Care planning records were in place but the reviews were not current, self medication risk assessments were not in place and are required. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mr Brown sampled care plans and information in the care plan folder was shared with B.Ludlow. The last care plan reviews recorded were 03/06, at the key inspection in August Mrs Hallett had agreed to reinstate the review page, this had not been done. One care plan was sampled in detail. The daily record was detailed and was in a ‘kardex’ format recording day to day changes in a person’s health and condition. We observed that medicines in the home were not being handled safely. On arrival at the home all medicines to be administered at breakfast time had Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 12 been pre-dispensed into pots with the peoples names in them. We observed a different member of staff asking for the pots and also selecting the pots to be given to people. The carer who had set up the pots was then observed to sign all the medication administration record (MAR) charts to say that they had administered the medicines. We observed that this is not in accordance with the policy on display in the office in the home. We also found that some medicines had not been kept securely and access to them was available to all members of staff in the home. We found that for most people prescribed to be administered a variable dose that although the records indicated that they had been given something the actual dose administered had not been recorded. There was evidence in the minutes of a staff meeting held in 2006 to indicate that there is a need to record the actual doses administered. We found that people are enabled to look after some of their medicines. However there is no record of a risk assessment having been performed for this and we were told that the home do not carry out risk assessments. We were also told that a risk assessment would only be carried out if the home felt it was needed and that the use of medicines would be monitored as they go along. We could find no evidence of this monitoring. The manager said if they feel it is a problem then they would take over the persons medication management. We also found that the home had used a photocopied Medication Administration Records (MAR) from a different care home when a person had moved into the home. For this person there was no record of the medicines received into the home. We also found for the same person that they had been prescribed some medicine and records indicated that it had been administered although again there was no record of it having been received into the home. Cool Runnings DS0000068414.V354398.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): 12,13,14,15 Quality in this outcome area is good. Service users spend their time as they wish. There is a homely atmosphere, a number of people socialise together in the communal areas. Meals can be taken together or in private. There is no main menu choice offered at lunchtime. No complaints were made about the food. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The newspapers had arrived and were being sorted when the inspection commenced. One person arrived for breakfast in the dining room at Cool Runnings; others were taking breakfast in their rooms. The home was warm, clean and comfortable. People who live at the service were asked about life at the home and about the meals. People responded positively and said they enjoy being able to spend their time as they choose. Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 14 Cool Runnings has a pleasant conservatory and garden that is accessible and well maintained. Lounge areas are comfortable and homely. There were no organised activities at the home during the morning of the inspection, just individual hobbies such as knitting. People were reading the paper and socialising together in the lounges. Mrs Hallett and other staff were seen chatting and spending time with those in residence during the morning. The people in residence chose how they spend their time and go out as they wish. Those who are able go out to the park adjacent to the home for walks. Family members seen in August said they visit as they wish and take their relatives out. Two people have cars to allow them to get out and about. Lunch is a social occasion and was seen observed at Cool Runnings Too. The tables were nicely laid and the food served looked appetising. Staff who were catering confirmed that fresh vegetables were prepared and that although a choice of main meal was not offered the people living at the home could request an alternative. The menus are on a four week rota and although prepared separately are the same menu in each house each day. No complaints were heard about the catering. The kitchens were clean and tidy and the kitchen temperature records seen were maintained and up to date. Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is poor. The recruitment records seen demonstrated that the recruitment practice was poor placing the service users at the risk of harm from potentially unsuitable people being employed at the home. The manager was not clear about her role with regard to the policy for Safeguarding Adults in Somerset. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of the duty rota for the week of the inspection was given to the inspector. On one evening a member of staff who is aged 16 years was on duty with an unnamed agency staff worker. The carer aged 16 years at the time of the inspection, did not appear to be on a recognised training course and did not have an age related risk assessment on file. National Minimum Standard for Care Homes for Older People, 27.6, states that ‘Staff providing personal care to service users are at least aged 18; staff left in charge of the home are at least aged 21’. National Minimum Standard for Care Homes for Older People, 28.3, states that ‘Trainees (including all staff under 18) are registered on a TOPSS-certified training programme’. Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 16 Such staff should work under the supervision of an experienced care worker at all times. Mrs Hallett is using an agency for care staff where the checks for robust recruitment practice must be checked by the care home provider. Mrs Hallett did not have any recruitment details on the staff providing cover at the home to demonstrate their qualifications or CRB status checking. All recruitment files were requested, not all staff files were available, one recent leavers file was missing from the file box. S.Hale examined the files. Two staff did not have CRB checks on file. One was a recent recruit another had worked at the home for over two years. S.Hale explained and made clear to Mrs Hallett that these individuals could not work at the home until the correct documentation was obtained. Immediate requirements were made to Mrs Hallett to address this. Mrs Hallett agreed to suspend the staff from working at the home until she has obtained a minimum of a satisfactory POVA First check. Two members of staff had made false declarations of having no convictions on their applications forms to the home. Although this was a breach of trust there was no evidence that Mrs Hallett had taken this seriously and spoken with the staff concerned as there was no documented record to support the reasons for these false declarations. The staff working at a registered care home must make a full declaration under the exemption order of the Rehabilitation of Offenders Act. Mrs Hallett said she understood that spent convictions were exempt, which they are not. Two members of staff, one who had left and one employed, had positive CRB checks and no risk assessments were seen on their files. One person employed at the home did not have a second reference. Overall the standard of recruitment practice was very poor. Recruitment records must be better organised, thoroughly checked and updated in line with the care home regulations (2003) Cool Runnings DS0000068414.V354398.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): 19,26 Quality in this outcome area is good. Both houses were in good decorative order and fire safety equipment and detection measures are in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Both houses were clean and tidy. No unpleasant odours were detected. Communal areas are clean, comfortable and homely. Infection control has not been problematic and there are staff hand washing and separate toilet facilities. Both houses have fire detection and fire safety equipment. There is a nurse call system in both buildings; this was newly installed after the last inspection. Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 18 There is a stair lift to the first floor in Cool Runnings, which has a maintenance contract; a letter dated November 2006 supported this. The fire alarm sounded at 0950hours, this was a routine test carried out by the home’s handyman. There is assisted bathing in both premises but no patient hoist equipment. Cool Runnings DS0000068414.V354398.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): 27,28,29,30 Quality in this outcome area is poor. There are some experienced staff working at Cool Runnings. The home has poor recruitment practices that have placed service users at the risk of harm as people have started work at the home without thorough checks being carried out and with no risk assessments recorded on their files. An agency where the checks for robust recruitment practice must be checked by the care home provider has been used to supply staff who have been in charge of the home. There was no evidence of CRB and qualifications and this has placed people at the risk of harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a core of staff that have NVQ levels 2 & 3 and are skilled in their work. Staff employed at the home were happy and said it is a good place to work and that they enjoy caring for the residents. Staff spoken with confirmed having undertaken NVQ training and other training arranged by the home. Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 20 All staff employed at the home and recent leavers recruitment records were requested for inspection. In the recruitment files a form confirming training received was signed by staff members, in one case the member of staff signed a form but the training received section was blank. There was no evidence of certified mandatory training seen. Copies were requested to be sent to S.Hale after the inspection. The staff application form was found to need updating to meet current good practice employment law and to promote equality of opportunity. Mrs Hallett was given advice on where to obtain the relevant information from to do this. Mrs Hallett does not make interview notes, this is recommended for good practice at this inspection. Mrs Hallett has not given copies of the General and Social Care Council (GSCC) code of conduct to new staff, Mrs Hallet was given advice on how to obtain individual copies for all staff. Two members of staff had started work without satisfactory POVA First and CRB checks. One of the members of staff has been employed since 2005. This had been raised at a previous inspection. One new member of staff did not have a second reference. One member of staff that has left the home did not have a recruitment file available for inspection. Two staff had falsely completed the declaration of criminal convictions on their application forms and those with past convictions did not have a risk assessment on file. Mrs Hallett appeared unaware that this was a serious matter and breach of the care home regulations and of trust. The staff recruitment records examined were found to be poor and not robust enough to protect the residents from the risk of harm. See also protection evidence. It was requested via Immediate Requirement written by S Hale, that recruitment checks are fully completed and two staff identified as not having a CRB check carried out for Cool Runnings must not work at the home until satisfactory information has been obtained via a POVA First check and a CRB check has been applied for. Mrs Hallett confirmed that the staff concerned would be suspended from working in the home until these recruitment checks had been carried out. Mrs Hallett has been using an agency where the checks for robust recruitment practice must be checked by the care home provider, to supply care staff for the home. Mrs Hallett had not requested any evidence of the people coming to work at the home having undergone recruitment checks or evidence of their qualifications, their names were missing from the duty rota. This is Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 21 unacceptable as these staff have been left in charge of the home and have therefore put the people in residence at considerable risk. The duty rotas were seen and Mrs Hallett gave the inspectors a copy of the rotas for the week of the inspection. Mrs Hallett said she does not include the hours she works at the home on the rota. The rotas showed that on one day a member of staff aged 16 years was rostered on duty at Cool Runnings with a member of staff from the agency. Persons aged less than 18 years who are not on a training course should not be working at the home in a care role and if on a suitable training course must work alongside a suitably trained senior person as they must not provide any intimate personal nor carry out any manual handling. A risk assessment should be on file for any person aged less than 18years who is working at the home. The staff complement at the home appeared to be sufficient with the exception of occasional periods where evening staff may be on duty on their own, between 7pm and 9pm, there is a condition of registration for two staff to be on duty during the whole waking day. Mrs Hallett said she is available as a second person if the home’s staffing number drops to one. Staff induction is not the skills for care format. Staff looked smart and were very helpful. All observed and overheard interactions between staff and the people who live at the home were helpful and caring. Care staff also do the catering. One person was spoken with who described her duties as cleaning only. Cool Runnings DS0000068414.V354398.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): 31,33,38 Quality in this outcome area is poor. Mrs Hallett is an experienced homeowner but has not undertaken a number of management tasks to a satisfactory standard. A suitably competent person does not maintain the home’s mains services and equipment. There is no formal quality assurance undertaken. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mrs Hallett was asked if she had taken action since the last key inspection to formalise the quality assurance auditing of the service. Mrs Hallett said she had not done this. Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 23 The home does not have an annual Quality Assurance policy or procedure to formerly monitor how the service users and their relatives find the service. This was required at the last inspection and is restated to ensure service users have the opportunity to offer feedback and as continuing best management practice in line with the National Minimum Key Standards. National Minimum Standard 35 was not inspected. Records were requested for inspection. Mrs Hallett employs a handyperson to attend to the maintenance of the home. There was no evidence on file to demonstrate that a suitably competent person carries out maintenance and repairs. This refers to the service, repair or maintenance of the electrical appliances, gas or fire alarm. There were no PAT results available; Mrs Hallett confirmed that her husband and the maintenance man undertake the maintenance and that neither have any electrical or other qualifications. Mrs Hallett is an experienced care homeowner / manager but the evidence gathered at this inspection did not demonstrate good management practice. In some areas the practice was poor and places the service users at risk of harm. Mrs Hallett when asked said she did not have a fire risk assessment for the premises nor an evacuation procedure and that she was unaware of the requirement to have these documents in place. The risk assessment was required by Immediate Requirement issued at the inspection by B.Ludlow. The fire service last visited the premises in August 2006. The manual handling training for staff by a qualified instructor required at the last two inspections by 29/9/06 and restated for 6/9/07 following the key inspection in August 2007 had not been carried out, this requirement is restated for the third time at this inspection. At the inspection in August 2007 a recommendation was made that the manager records accident in a format designed to meet the requirements for data protection. This had not been carried out. Accident records were requested and Mrs Hallett presented a small hard backed red book for inspection, the last entry in this book was 20/11/06 yet staff reported one service user is sometimes found on the floor and requires lifting up. There was no record of this or any other incident or accident in the red book. There is no hoist at the care home all manual handling other than the bath hoist is without hoisting equipment. The stair lift is maintained under a service and maintenance contract. Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 24 The home has a mains gas service to the premises, which for the cooking and central heating boiler Mrs Hallett said the servicing is due before Christmas and is usually carried out every two years. No landlord’s gas certificate was available for inspection. Cool Runnings DS0000068414.V354398.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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 3 X X X X X X 3 STAFFING Standard No Score 27 1 28 1 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X X X X 1 Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement All medicines must be administered to people in the service using a safe practice and the administration must be recorded at the time of administration. An Immediate Requirement was left at the home on 05/11/07 To ensure that people do not receive either an under dose or overdose of their medicine the actual dose administered must be recorded when a medicine is prescribed to be administered with variable dose. In order for the home to be able to audit the medicines held in the home they must record the receipt of all medicines into the home. The Registered person shall establish and maintain a system for reviewing the quality of care provided at the care home. This system must be developed and evidence commitment to developing and improving the care service to meet the service DS0000068414.V354398.R01.S.doc Timescale for action 06/11/07 2 OP9 13(2) 05/01/08 3 OP9 13(2) 05/01/08 4 OP33 24(1)(3) 05/01/08 Cool Runnings Version 5.2 Page 27 users needs. See dates below This was required by 29/09/06 and 6/9/07 5 OP30 18(1)(a) The registered manager must ensure that staff receive statutory training. A suitably qualified manual handling instructor must give manual handling training. This remains outstanding from 29.09.06 and 06/09/07 6 OP18 OP31 13(6) The registered manager must undertake Protection Of Vulnerable Adults training and familiarise herself with the county procedure for the reporting any incidents. Staff recruitment must be of a sufficiently high standard to protect people living at the home from the risk of harm from unsuitable people working at the home. All staff must have a minimum of a satisfactory POVA First check and two satisfactory references before starting work at the home. In line with the national Minimum Standards and Care Home Regulations (2003). An Immediate Requirement was left at the home on 05/11/07 Staff recruitment must be of a sufficiently high standard to protect people living at the home from the risk of harm from unsuitable people working at the home. All staff must have two satisfactory references on file. In line with the national Minimum Standards and Care Home Regulations (2003). An Immediate Requirement was left at the home on DS0000068414.V354398.R01.S.doc 05/12/07 05/01/08 7 OP18 19(1) (b)(i) and 4(b)(i) Schedule 2 05/11/07 OP29 8 OP18 OP29 19(1) (b)(i) Schedule 2 12/11/07 Cool Runnings Version 5.2 Page 28 9 OP27 OP29 13(6) 18(1)(a) 10 OP28 OP27 19(5)(b) 11 12 OP30 OP30 18(1)(c) (i) 18 (1) (a) & (c) 13 (5) 23(4) (a)(c) (iii) &(v) 05/11/07 Agency staff must have their CRB status and their qualifications verified before they are invited to work at the home. A record of this information must be retained. An Immediate Requirement was left at the home on 05/11/07 All staff engaged in a care worker capacity that are aged less than 18 years must be supervised by a sufficiently experienced and senior worker. All staff aged less than 18 years of age must have employment risk assessments for the workplace. New staff must receive induction in line with Skill for Care. Staff must receive certified mandatory training and updating. The registered person must prepare a fire risk assessment for the premises. An Immediate Requirement was left at the home on 05/11/07 An appropriately competent persons must carry out maintenance and servicing of gas and electrical equipment. Certificate of completion to be forwarded to CSCI 05/11/07 12/11/07 05/12/07 05/01/08 13 OP38 19/11/07 14 OP38 23(2)(c) 18(1)(a) 18(c) (i) 05/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000068414.V354398.R01.S.doc Version 5.2 Page 29 Cool Runnings 1 2. Standard OP9 OP38 It is recommended that the registered manager should develop a risk assessment for people looking after any of their own medicines. The registered manager should purchase a Health and Safety Executive accident book to standardise the recording of accidents within the two homes. Staff supervision should be provided and recorded up to six times per year for care staff. Protection Of Vulnerable Adults training should be cascaded to all staff working at the home. A copy of the General and Social Care Council’s code of conduct should also be made available to all staff. New admissions to No 63 The Park should be screened for their level of independence at night, frailty and any night time needs to ensure the person needs can be met without waking night staff attendance. Care planning should included assessment of risk including medication management, falls risk, manual handling. Recreational activities should be available for the more dependent people at the home. A choice of main meal should be available each day. The registered person should take appropriate advice in relation to the development of a staff application form that meets current employment law. All staff engaged in a care worker capacity that are aged less than 18 years should be registered on a certified training course and should not carry out any intimate personal care or manual handling. 3. 4. OP36 OP18 5. OP1 OP7 6. 7. 8. 9. 10. OP7 OP12 OP15 OP29 OP27 OP28 Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Taunton Local Office 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 Cool Runnings DS0000068414.V354398.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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