CARE HOMES FOR OLDER PEOPLE
Court House Residential Home Court House Station Road Cullompton Devon EX15 1BE Lead Inspector
Teresa Anderson Key Unannounced Inspection 09:30 6th August 2007 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 Court House Residential Home DS0000055579.V341748.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. Court House Residential Home DS0000055579.V341748.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Court House Residential Home Address Court House Station Road Cullompton Devon EX15 1BE 01884 32510 01884 32510 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) Mrs Manjula Odedra Mr Sandip Harish Odedra Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Court House Residential Home DS0000055579.V341748.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The registered person may provide the following category of service only: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category- Code OP The maximum number of service users who can be accommodated is 23. 23rd May 2006 2. Date of last inspection Brief Description of the Service: Court House is a large detached house that has been extended and adapted as a care home, providing care and accommodation for up to twenty three people. It is a short distance from the town of Cullompton and has ample parking. The home has twenty bedrooms, fifteen of which have some ensuite facilities, over two floors. These floors are linked by stairs and by a small passenger lift. There are aids and adaptations throughout the home but the layout and the number of steps mean that the home may not be suitable for people who use wheelchairs or for people with severe mobility problems. The home has a lounge and a separate dining room and numerous areas outside where people can sit. There is also a small courtyard sensory garden. Further information about this home, including inspection reports, is available direct from the home. The weekly fees range from £314.00 - £525.00. There are additional charges for items such as hairdressing, newspapers, clothing, toiletries and pendant type call bell systems (all detailed in the guide to the home). Court House Residential Home DS0000055579.V341748.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place as part of the normal programme of inspection. One inspector carried out the site visit, which started at 09.30am and finished at 5.30pm. During that time we looked closely at the care and services offered to three people as a way of judging the standard of care and services generally. Where possible we spoke with these people in depth, and tried to contact their relatives and any health or social care professionals involved in their care. We looked at their care assessments and care plans closely, and spoke with staff about their knowledge and understanding of the plans. We looked at their bedrooms and we looked at the overall environment from their perspective. We also spoke with approximately 10 others (of the 17 people living here), with the manager, with carers and with kitchen staff. We looked around the building at all communal areas and saw many of the bedrooms. We looked at other records including medication, staffing, accident and incident reports, training, fire safety and recruitment. Prior to the visit to the home we sent surveys to various people asking for feedback and comments. We sent surveys to people who live here and received 7; to health and social care professionals who attend people living here and we received 4; and to staff working here and we received 4. Their feedback and comments are included in the report. Other information given to the commission throughout the year has been taken into account. In addition, and before we visited the home, the manager provided information about the management of the home and his own assessment of what the home does well and what they plan to improve upon. What the service does well:
People who consider coming to live at Court House are given sufficient information about the home and are encouraged to come and visit before they make a decision. They are assessed so that the home can be sure they can meet their needs. People who live here say their needs are well met, that staff listen and act on what they say and that they get the care they need. One person said ‘thre are good standards of care’. Health and social care professionals, in surveys, have not raised any concerns. GP’s say they are called out when needed and people living here say they really appreciate this. Court House Residential Home DS0000055579.V341748.R01.S.doc Version 5.2 Page 6 Each person has a plan of care which details their needs and which helps to make sure they get the help they need. This includes help with moving and handling, with being safe from falls and with keeping their skin healthy. Their medication is safely handled so that people get the right medicines at the right time. Staff help to protect people’s privacy and dignity by ensuring that they get their care in private, in a way that suits them. People have visitors when they like. They are offered refreshments and some have their meals with their relative. The meals are described as ‘lovely’ and ‘improved’. There is a variety of food offered and snacks and drinks are available throughout the day. The home has a vegetable garden and greenhouse where many of the vegetables are grown. People who needs assistance with eating are given this. People are encouraged to make choices in their daily lives and to voice any concerns or grumbles they have. Actions are always taken to make any changes requested. People say they ‘feel happy and safe’ and are ‘very happy’ living here. The commission has not received any complaints about this service since the last inspection. People say the home is always clean and during this visit it was fresh, homely and odour free. Staff wash their hands, use protective clothing and use alcohol gel to help ensure that infections are not spread. Some carpets are being replaced and redecoration is carried out when needed. Staff are described as ‘lovely’ and ‘helpful’, with some being specially mentioned. They are well trained with 70 holding a National Vocational Qualification (NVQ) in care. They are recruited using robust checks to help ensure that only suitable people are employed. The home is well managed and there is a real commitment to continual improvement. Staff and the people who live here feel well supported. Systems for managing the home are successful and ensure the home is run in the best interests of the people who live here. The personal allowances of people who live here are managed safely. What has improved since the last inspection?
Since the last inspection the manager has registered with the commission. He has taken action in relation to all the requirements and recommendations made at the last inspection. This includes making sure that all medications not in use are returned to the local chemist; improving the type and range of activities offered; arranging training for people in safeguarding people and ensuring that staff know the procedures to follow if an allegation or disclosure of abuse were made; ensuring that staff receive mandatory training and carrying out a training audit and arranging training accordingly; carrying out electrical testing on portable electrical equipment. In addition the home now has a Registered Manager.
Court House Residential Home DS0000055579.V341748.R01.S.doc Version 5.2 Page 7 What they could do better:
This inspection resulted in a number of requirements and recommendations being made. The manager has been required to: Carry out reviews of the care planned to ensure that each person is receiving the most effective care. Ensure that controlled drugs kept in the home are kept safely. This means attaching the cupboard in which they are kept into another cupboard. Contact Devon Fire and Rescue Service to ensure that the fire escape is safe. Carry out an audit of accessibility in the home and provide adaptations and/or aids as needed. This particularly relates to toilets and bathrooms. In this way people will have maximum independence with minimum risk to their safety. Ensure that electrical testing which is due to take place includes an assessment (and action if needed) of the extension leads in use in one bedroom (as discussed with the manager). The following good practice recommendations have been made: The manager should ensure that assessments of people undertaken prior to their admission are detailed. The level of detail included in care plans should be kept under review to ensure that it is detailed enough for staff to be able to meet all needs. The same person should not order the medications for the home and receive and check these into the home. These tasks should either be carried out by different people, or two people should check the medications into the home. People should be able to see a menu before they sit down to lunch and lunch should be served on time so that people can organise their days. The cook should be made aware of those people receiving cholesterol reducing medication so that she can plan meals accordingly. The manager should carry out an infection control audit of the home and take any actions needed to ensure that effective steps are being taken to control infection. There should be a protective screen over the window in the kitchen to prevent flies coming in when it is open. Court House Residential Home DS0000055579.V341748.R01.S.doc Version 5.2 Page 8 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. Court House Residential Home DS0000055579.V341748.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 Court House Residential Home DS0000055579.V341748.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): 1, 2, 3 and 5. Standard 6 was not inspected as this home does not provide intermediate care. Quality in this outcome area is good. The people who come to live here will have their needs assessed and the staff will be able to meet those needs. Some improvement in the depth of assessment would help to improve care planning. People have good information about the home that helps them to make a decision about where to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the guide to the home has been reviewed and reproduced. This is a comprehensive document providing a wealth of information about the service. There is also a brochure produced by the home
Court House Residential Home DS0000055579.V341748.R01.S.doc Version 5.2 Page 11 to accompany this document, which is briefer and acts as a ‘taster’. In surveys people who live here all say that they had enough information about the home on which to make a choice. They also say that either they or a supported visited the home prior to coming to live here and were shown around. They say what that their expectations are met. Each person living here has a contract which includes terms and conditions of occupancy. These have recently been revised and expanded upon and are included in the updated guide to the home. People who come to live here are always assessed by the manager and/or the deputy manager. We looked at three assessments. The form used has recently been revised to include more detail. The manager reports that these are probably now too complex and for that reason tend not to get completed. The assessments we saw contained basic information but did not provide a ‘picture’ of the persons needs. In addition, the did not provide enough information about moving and handling and skin needs to ensure these needs would be met when first admitted. However, all the people who live here are having their needs well met. Court House Residential Home DS0000055579.V341748.R01.S.doc Version 5.2 Page 12 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. People who live here have their health and medication needs planned and met. Further improvements would ensure that care is delivered in a person centred way. The privacy and dignity of the people who live here is respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys people living here say that they always or usually receive the care and support that they need and always receive the medical support that they need. When spoken with people say that staff are very quick to call for the doctor or district nurse when they are not well and this was confirmed by local GP’s. People say they are treated with respect and their privacy is protected. One female said she is bathed by a male carer. She says she does not mind this
Court House Residential Home DS0000055579.V341748.R01.S.doc Version 5.2 Page 13 because she has got to know the carer first and that they take instructions well. Staff were observed knocking on bedroom doors before entering. Each person living here has a plan of care. These record referrals made to other health care professionals such as the chiropodist, dentist and optician. They also provide staff with information about how to meet each persons needs. The level of detail is proportionate to the needs of the people who live here. That is, all the people who live here, apart from one, are fairly independent. Each person has their needs assessed in relation to ensuring they get the support they need to be moved or to move around; to help prevent pressure sores (and no-one has one) and for their risk of falling. People were seen moving around the home safely using the aids available. These include handrails and ramps. In addition care plans include information about the persons daily routine so that staff can follow this, making care more ‘person centred’. People in their rooms were comfortable and had their call bells close to hand. People with visual impairments said that staff usually make sure that what they need is close to hand and that they know where it is. Care plans are reviewed by the deputy manager. However, the records made by care staff do not meaningfully contribute to these reviews. Care staff tend to report very basic information but do not report how the care is contributing to the intended outcome or what effect their interventions are having. The system for managing medications was checked. All medicines received into or leaving the home are recorded. Records show that staff ensure that they sign when they have given a medication or indicate why when they have not. Medications no longer needed are returned to the pharmacy as soon as possible. Medications are generally kept safely and securely. However, the Controlled Drugs cupboard should be fixed inside another cupboard. It was also noted that the person who orders the medications is the same person who receives and records the medications into the home. It is best practice for two people to check medications received or for the person ordering to be different from the person checking the medications into the home. Good links between medications and care planning are made. For example, care plans and medication records show that staff record when someone has been given a pain killer and call the doctor if they feel pain relief needs reviewing. In addition the staff say that the doctor was called to help a resident understand their medication. Court House Residential Home DS0000055579.V341748.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 and 15. Quality in this outcome area is good. Improvements in the way that people’s social needs are met mean that people living here are offered variety in their social life. People benefit from a diet which is varied and nutritious and which they thoroughly enjoy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys people say that they enjoy the activities. Those who indicated that they do not join in say this is their preference. One person with a visual impairment says they like to listen to what’s going on but also still prefers to do their own thing. Since the last inspection the activities co-ordinator has really improved this whole area of care. She finds out about the people who come to live here, about their interests and about what they like to do. She arranges trips out and has worked really hard to meet the diverse range of needs of the people who live here. Activities now include bingo (which people who live here say is a
Court House Residential Home DS0000055579.V341748.R01.S.doc Version 5.2 Page 15 real favourite), discussing the news, knitting, singalongs, scrap booking and reminiscence. In the fine weather people say they enjoy sitting outside or going for a walk down the drive and in the garden. At other times people like to sit and chat, and many people have developed special friendships within the home. One person has their own computer and others have their own TV and radios/CD players in their bedrooms and there is a TV in the lounge. People are helped to celebrate national events such as St Patrick’s Day and the Grand National and are supported to join in. Some people say there used to be more quizzes and that they wish these would be reinstated. In surveys people say they enjoy the food served at the home. Although a choice of meal is not offered, people say they only have to ask and that they can have something different. One person said that they felt awkward having to ask at the table for something different and another said they did not know what was on the menu until they went to the dining room. When we checked we found that the menu is displayed in the hall but some people do not use this area. People who are visually impaired say that staff always cut their food up for them (as is their wish) to make it easier to eat. Some people also said that lunch is meant to be served at 12.30 and that it was often late. This sometimes mean that they miss the lunch time news which is very important to them. The home has its own garden and greenhouse. All vegetables grown are organic and the chef ensures that vegetables are picked and frozen quickly for future use. People are helped to make choices in their daily lives. They say they are helped to choose what they wear, what they do, what time they go to bed and what time they get up. People could not think of any other choices they would like to make. The cook has received training in preparing special diets including diabetic diets and keeps a list of those people requiring special diets. Although the cook reports that she tends to produce low fat meals she has not been told of those people living at the home who are receiving cholesterol reducing medication and has therefore not been able to take this into account when planning their meals. People say that their visitors are always made welcome and relatives, in surveys, say that they are kept up to date with changes and with their relative’s progress. Visiting is ‘open’ and some visitors choose to have their meals with their relative.
Court House Residential Home DS0000055579.V341748.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 and 18. Quality in this outcome area is good. People who live here have their complaints heard and acted upon. They are kept safe and are protected from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the home report that they have received a number of complaints. When we looked at these, these are personal requests that staff ensure are fulfilled. The commission have not received any complaints. In surveys people say they would talk to staff if they were not happy or wanted to make a complaint. They also say that staff act on what they say. Some people, in discussions, say that they would like to see more of management on a day-to-day basis. The manager reports that he is always available, but also suggested that perhaps he should go out of the office instead of people coming to him. Since the last inspection a training programme relating to safeguarding people has been commenced. Staff spoken with have a good understanding of what abuse is and the procedures to follow if an allegation or disclosure were made.
Court House Residential Home DS0000055579.V341748.R01.S.doc Version 5.2 Page 17 People who live here say they feel safe and well cared for. Observations between people and staff show respectful, kind and thoughtful interactions. Court House Residential Home DS0000055579.V341748.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, 21, 22 and 26. Quality in this outcome area is adequate. Whilst people benefit from living in a clean and homely environment, improvements to some areas would mean that the people who live here would have their safety assured. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys the people who live here say the home is always clean and fresh and we found this to be the case on the day that we visited. Cleaning materials are stored safely and securely. Communal areas are tidy and homely and bedrooms are personalised. Court House Residential Home DS0000055579.V341748.R01.S.doc Version 5.2 Page 19 Some of carpets (hall and stairs) are creased in places and a little worn. The manager reports that these are to be replaced on 19th/20th August. Staff report that those with sight problems or are less mobile do not use these areas to prevent them from tripping or falling. Since the inspection, and before this report was completed, the manager had the creased carpets stretched and a steep step reduced in height. Some toilets around the home are raised to help promote the independence for those with mobility problems. However, the toilet next to the lounge (a well used toilet) is not raised. Some people said they are not bathed often enough and that the baths are very low meaning they cannot bath independently. Others said they would prefer to have a shower or a shower attachment on the bath. Staff were observed using protecting clothing and washing their hands. In addition alcohol gel is available for staff to use to further help control the spread of infection. Whilst the manager has not yet completed an Infection Control audit (‘Essential Steps’), he does plan to do this. Radiators in the home are covered to prevent accidental scalding and upstairs windows are restricted to prevent people falling out. The home has recently bought a hoist and staff have been trained in how to use this. We noticed that the fire escape had some potential obstacles on the steps and staff removed these immediately. However, the fire escape surface is uneven and rusty in places. The manager agreed to contact Devon Fire and Rescue Service for advice. When spoken with a new member of staff demonstrated an excellent understanding what to do if the fire alarm sounded. Court House Residential Home DS0000055579.V341748.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 and 30. Quality in this outcome area is good. People who live here are supported by kind and caring staff who are trained and employed in adequate numbers to meet their needs. Recruitment processes ensure that people are cared for by suitable staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are usually 3 carers on duty in the morning, 2 in the afternoon and 2 at night. In addition the manager, deputy manager and administrator are supernumerary. The manager and deputy manager also work alternative weekends. There are 2 cleaners, a cook and a laundry manager. And the activities co-ordinator works every 3rd Saturday. In surveys people say that staff are always or usually available when needed and that they listen and act on what people staff. Staff say they are well supported and that they are not asked to care for anyone outside their area of expertise. Staff are described as ‘lovely’, ‘wonderful’, ‘helpful’ and ‘always willing to help’. Some were frequently mentioned as being particularly good or helpful.
Court House Residential Home DS0000055579.V341748.R01.S.doc Version 5.2 Page 21 The manager reports that 70 of the care staff working at the home hold a National Vocational Qualification (NVQ) to level 2 or above. This is above the 50 target set by the government. Since the last inspection the manager has carried out a training audit. As a result training in caring for people with dementia is planned to take place in September and he also plans to carry out training in caring for people who are dying. Two randomly selected staff recruitment files were checked. These contained all the checks recommended to ensure that suitable staff are recruited. These include written references, a police check and proof of identity. Court House Residential Home DS0000055579.V341748.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, 35 and 38. Quality in this outcome area is good. People benefit from living in a well managed home which is working hard towards trying to make sure the home is run in their best interests. People who live here can be assured they, and their belongings, will be kept safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager of Court House is Sandip Odedra. He is currently undertaking the Registered Managers Award, (as is the deputy manager). He is
Court House Residential Home DS0000055579.V341748.R01.S.doc Version 5.2 Page 23 well respected by his staff and liked by the people who live here. Some said that they would like to see more of him. Prior to this inspection Mr Odedra completed a pre inspection questionnaire giving information about the management of the home. This has prompted the manager to produce some extra policies to help support the people who live here. It also shows how the home has carried out improvements based on the feedback from the last inspection. This questionnaire did not address equality and diversity in relation to disability in a comprehensive way. As shown in this report, there are some environmental issues within the home which might limit accessibility for some people and have yet to be assessed or addressed. The home carries out comprehensive quality assurance processes that have resulted in changes in the way the home is run. For example the questionnaire says that the menus have been revised based on feedback from the people who live here and activities have been increased. In addition, the manager has used feedback from the commission to bring about improvements in the home, and has addressed the requirements made at the last inspection. The personal allowances of two people were checked. Receipts are kept and the system is auditable. Access to these accounts are restricted. Monies are stored safely. The manager reports that staff receive mandatory training and staff confirm this. They say that the extent and type of training is ‘really good’ and helps them to do their job. Mandatory training includes First Aid, Moving and Handling, Fire Safety, Food Hygiene and Infection Control. The cook follows the ‘Better Food, Better Business’ guidance for ensuring the kitchen and equipment are safe. The kitchen and equipment are clean and she has not recorded any problems with the fridges or freezers. The window to the kitchen was open for ventilation but did not have a protective screen over it to prevent flies coming in. The manager reports that electrical testing is due to take place shortly. This should include the use of extension leads as seen in one bedroom as discussed with the manager. Staff report they have received induction training which is ongoing. Court House Residential Home DS0000055579.V341748.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 3 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x 3 x x x 3 STAFFING Standard No Score 27 3 28 4 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 3 Court House Residential Home DS0000055579.V341748.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 OP7 Regulation 15 (2) (b) Requirement Each person living at the care home has a plan of care and the manager must ensure these are meaningfully reviewed. This will ensure that the care being delivered is effective and the most appropriate. Controlled drugs must be kept in a cupboard that is fixed inside another cupboard (as per Pharmaceutical guidelines) to ensure their safe keeping. To ensure that the means of escape is safe the manager must consult with Devon Fire and Rescue Service about the state of repair of the fire escape. An audit of accessibility and the need for adaptations within the home should be carried out. This will ensure that the people who live here have maximum independence with minimum risk and that equality is promoted. This should include toilets and bathrooms. The manager must ensure that the electrical testing takes place and this includes the use of
DS0000055579.V341748.R01.S.doc Timescale for action 31/10/07 2. OP9 13 (2) 30/09/07 3. OP19 23 (4) (b) 30/09/07 4. OP22 23 (2) (n) 31/01/08 5. OP38 13 (4) (a) 30/09/07 Court House Residential Home Version 5.2 Page 26 extension leads in one bedroom (as discussed with the manager). RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP3 Good Practice Recommendations The manager should ensure that assessments include a level of detail which helps to identify people’s needs and which helps staff to meet those needs when they are admitted. The level of detail contained within care plans should be kept under review to ensure that staff have all the information they need to meet peoples needs in a person centred way. It is best practice for two people to check medicines into the home, or for the person ordering medications to be different from the person who checks them into the home. People should be able to see the menu before they sit down to lunch so that they can arrange for something different to eat in private if they wish. Lunch should be served at the time agreed with the people who live here so that they can organise their day. The cook should be made aware of those people receiving cholesterol reducing medication so that she can ensure these people get an appropriate diet. The manager should carry out an infection control audit and take any actions needed that effective steps are being taken to control infection. There should be a protective screen over the window in the kitchen to prevent flies coming in when it is open. 2. OP7 3. OP9 4. OP15 5. 6. OP26 OP38 Court House Residential Home DS0000055579.V341748.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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