Inspection on 09/01/08 for Craigarran Care Home

This inspection was carried out on 9th January 2008.

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

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

Craigarran Care Home 09/02/09

Craigarran Care Home 08/03/07

Craigarran Care Home 18/01/06

Craigarran Care Home 24/06/05

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Craigarran Care Home Margaret Terrace Deaf Hill Trimdon Station Co Durham TS29 6AW Lead Inspector Rachel Martin Key Unannounced Inspection 9th January 2008 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 Craigarran Care Home DS0000062500.V356868.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. Craigarran Care Home DS0000062500.V356868.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Craigarran Care Home Address Margaret Terrace Deaf Hill Trimdon Station Co Durham TS29 6AW 01429 880550 01429 882100 craigarrannursing@tiscali.co.uk 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) Mr Matt Matharu Mrs Jean Kennedy Brenda Hall Care Home 35 Category(ies) of Dementia (15), Old age, not falling within any registration, with number other category (35), Physical disability (5) of places Craigarran Care Home DS0000062500.V356868.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th March 2007 Brief Description of the Service: Craigarran is a care home that provides personal care and nursing care for older people and people with dementia. The home is owned by a business partnership, consisting of Mr Matharu and Mrs Kennedy, who became the registered providers on 26th January 2005. The home consists of a purpose built building and an older building, which is currently being renovated to provide more accommodation. At the time of this inspection, this building work was not finished and the home consisted of a single storey building, built in a rectangle and enclosing an inner garden. All bedrooms are used as single bedrooms with en suite toilets and washbasins. Communal lounge facilities, bathrooms and toilets are situated throughout the building. There is one dining room and meals are served in two sittings in order to accommodate all of the residents. At the time of this inspection the home’s fees ranged from £399.50 to £590.00 per week, depending on the level of care people needed. This does not include hairdressing, personal papers and magazines or personal toiletries. Up to date information about fees should be sought from the manager. Craigarran Care Home DS0000062500.V356868.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. Before the inspection site visit, the home’s manager completed a self assessment, which gave CSCI information about the home, what it did well and what needed to be improved. Surveys were sent to the home for residents, relatives and staff to complete. Six residents, 5 relatives and 4 staff completed surveys, telling CSCI about their experiences of living in, visiting and working in the home. The site visit for this inspection took place on 9 January 2008 and was unannounced. A selection of the home’s records were inspected, the manager and a selection of staff were spoken to and observed, and the inspector looked around the home. During this site visit, an ‘expert by experience’ (someone who has experience of using care services) visited and talked to a number of people who live at Craigarran, to get their views about the service. The expert provided the inspector with a written report of her findings, which has been used as evidence in this report. More information about ‘experts by experience’ can be found on CSCI’s website at www.csci.org.uk What the service does well: People spoke highly of the staff and manager at Craigarran. The expert by experience commented that ‘given the wide mix of residents, the staff do a good job in this home. They treat people with courtesy and respect. I do not doubt that they are well meaning and have the best interests of the residents at heart’ and ‘the manager is particularly well-liked’. Comments made to the expert by experience included ‘there’s a good set of people in here like’, ‘Brenda’s (the manager) a lovely lady, she’d do anything for you’ and‘ if there’s owt you need, she’ll get it’. Visitors felt that they were made welcome and could visit when they wanted to. Each person has their own records, which include assessments of their care needs, care plans setting out what care they need and records of the care and support people have been given. These records, and talking to people about their care, showed that people had access to other health and social care professionals when they needed them. For example, doctors, specialist nurses and clinics, social workers, opticians and dentists. Some people had been provided with specialist equipment, to help staff meet their needs in a better way. Craigarran Care Home DS0000062500.V356868.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Care plans could be developed to contain more person centred and detailed information about people’s preferences and choices. This is particularly important for people who have dementia or who cannot communicate their wishes clearly to staff. Care plans could also be used to develop a more individual and personal approach to social activities at Craigarran. At the moment, activities appear more group focused, with traditional games (like bingo and dominoes) being used a lot. Nursing staff need to make sure that they are following good practice when administering medication. The home had quite large stocks of some medication and it was sometimes difficult to tell from the records how much of some medications were available in the home. A maintenance and refurbishment plan is needed, to plan the work that is needed in the home to improve the general standards of the fixtures, fittings and furnishings. Currently, the home appears a little shabby, with the majority of furniture and equipment looking old and worn. This plan should include how the environment can be improved to meet the specific needs of the people living at the home. For example, making the environment more suitable for people with dementia. The manager hasn’t always had enough management time, due to working as a nurse in the home when there are staff shortages. The manager needs to have enough time to carry out her management role fully. For example, time to develop training records and plans and to carry out formal staff supervision sessions more regularly. Craigarran Care Home DS0000062500.V356868.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. Craigarran Care Home DS0000062500.V356868.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 Craigarran Care Home DS0000062500.V356868.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 People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People can look round the home, have their needs assessed before they decide to move into Craigarran and are provided with written information and contracts. This helps people decide if Craigarran can meet their needs and is a place they want to live. However, clearer information needs to be provided about the variety of different people who live at Craigarran and how their very different needs are managed in one home. EVIDENCE: The home provides people with written information about Craigarran, including an information pack that is kept in people’s rooms. However, Craigarran currently provides a lot of different types of care, with no separation between the different groups. This means that people with dementia, including some Craigarran Care Home DS0000062500.V356868.R01.S.doc Version 5.2 Page 10 people with quite challenging behaviour, share the same facilities, communal space and staff as people with complex general nursing needs. The home needs to clarify what types of care provides and think carefully about how it will develop the service to meet the very different and individual needs of these people. The home’s Statement of Purpose and Service User Guide still need to be reviewed to make sure that people have access to very clear information about the types of care the home provides and how they are provided. This is very important so that people know what to expect when they decide to come to live at Craigarran. The manager and provider have discussed these issues and decided that it will be best to review the written information available, once the building work is completed and the service has been reorganised accordingly. It would also be good practice to develop alternative formats of the information, such as versions that are more accessible to people with dementia. Since the last inspection, the home’s contracts/terms and conditions have been updated. The manager confirmed that everyone has been issued with a new contract and that these are now routinely given to people when they move into the home. The care records of four people who have recently moved into Craigarran were inspected. These records contained assessments that had been completed before the people came to live at the home. The assessments included information that had been gathered by the home and supplied by the local authority, hospital or other relevant professionals. The manager confirmed that people and their relatives are encouraged to come and look round the home. The expert by experience said in their report; ‘one man had been for a visit to Craigarran before finally making the choice, but other residents could not remember or told me that they had relied on others (eg. a carer) to choose the home’. When asked in surveys if they had received enough information about the home before they moved in to decide if it was the right place for them, three people said yes and three people said no. Craigarran does not provide a specialist intermediate care service. Craigarran Care Home DS0000062500.V356868.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 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Each person has their own plan of care, although these could be made more personal and detailed. People receive care from other health and social care professionals when they need it. Staff are friendly and treat people with respect. Trained nurses assist people with their medication but some need to improve their practice around recording the assistance they give. EVIDENCE: Each person who lives at Craigarran has their own record and plan of care. This provides staff with information about people’s care needs. Four of these records were inspected. The daily records were detailed and the records showed that people had access to other professionals when they needed them. For example, one person had recently seen a dietician, optician and community psychiatric nurse, while another had recently seen a dentist and was attending a ‘stop smoking’ clinic. All six people who returned surveys felt that they received the medical support they needed. Craigarran Care Home DS0000062500.V356868.R01.S.doc Version 5.2 Page 12 The care plans were made up of pre-printed forms. The pre-printed issues that were relevant to the person were ticked and brief relevant information about each person was added. Although they covered the majority of relevant areas, the information contained in them wasn’t very detailed or personal. There was little detailed information about people’s wishes or preferences and, in some cases, more detail would have been useful. For example, one care plan mentioned regular positional changes but didn’t provide any information on how often or how this should be achieved. Another care plan on mobility didn’t give any information about the number of staff or equipment needed, despite the risk assessment highlighting these issues. Each person’s care plans were reviewed monthly. Since the last inspection, the manager has made improvements to the way medication is managed. These included amending the home’s policies and procedures, particularly the rules for the disposal of medication and what to do if a medication error is made; regular checks to make sure that medication is stored within appropriate temperatures; increasing the storage space available for controlled drugs and improving the way the use of prescribed dressings and the reasons why drugs have not been administered are recorded. Craigarran is a home that provides nursing care, so medication is administered by qualified nursing staff. A member of staff was observed while administering medication and the arrangements for the storage of medication were checked. Generally, arrangements for storing and administering medication seemed to be safe and appropriate. However, staff need to be reminded to sign the medication administration record after medication has been taken, rather than before. This is important to make sure that the records are accurate. The home also had quite large stocks of some medication for some residents and it was sometimes difficult to see from the medication administration records what stock of particular medication was available. The manager needs to make sure that records show the stock available, that any unused medication is appropriately disposed of and that new medication is only ordered when needed. A clear audit trail for all medication should always be available. The expert by experience said in their report; ‘I observed a high level of interaction of staff with residents. They treated residents with respect and shared a joke with those who could understand. The residents all spoke highly of the staff. The visitors I met also praised the staff for doing a difficult job well’. Comments made to the expert by experience by residents and visitors included ‘There’s a good set of people in here like’. All six people who returned surveys said that the staff always listened and acted on what they said. When asked in surveys if they received the care and support they needed, three people said always, two said usually and one said sometimes. Out of five relatives who were asked in surveys if the home met the needs of their relative, four said always and 1 said usually. Craigarran Care Home DS0000062500.V356868.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 People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Group activities and social events are regularly organised in the home but there aren’t many trips out and a more individual approach to providing social stimulation could be developed. Visitors are made to feel welcome and can visit when they want to. People who can express themselves are listened to and can make choices about their daily lives but it’s less clear how choices are given to people who are less able to communicate their wishes. A balanced diet is provided but the dining experience and choices of food available could be improved for some people. EVIDENCE: The home employs an activities’ coordinator who arranges social events, which include group activities and visiting entertainers. Staff told the inspector that entertainers visited about once a month and that lots of activities, like bingo, dominoes and ball games go on but there are not many outings. The care plans inspected did not contain much information about people’s social Craigarran Care Home DS0000062500.V356868.R01.S.doc Version 5.2 Page 14 interests or the activities they would be interested in taking part in. This should be developed and would help the activities’ coordinator to develop the way social activities are provided in a more personal and individual way. The expert by experience made the following observations: ‘I joined an activity session which was already underway with two staff throwing a big soft ball round a group in a large lounge and encouraging everyone to take part as best they could’, ‘one resident recalled the ball activity, bingo (which he wasn’t keen on) and in December making toys for the Christmas tree, which he had found interesting’, ‘residents told me that they did not go out.’ While some were content to stay in the home, one resident commented that ‘I’d like to be out more. I lived on a farm. I wish they would take us out a bit’, ‘One set of visitors said that the home used to do trips out for residents, but that they had not noticed any trips recently’, ‘one relatively new resident told me about Christmas activities in the home, including a local school choir visit and a party. She very much enjoyed this and said ‘I had a better Christmas than I would have had at home’, and ‘I observed some of the residents, who were not capable of communicating, being seated in each lounge area in a position where they could not see the TV’. The expert by experience spent time talking to visitors. ‘I observed visitors coming freely and being made welcome with drinks etc. The visitors I spoke to were happy with the home’. The manager confirmed that there are no restrictions on visiting and that people can see visitors in their rooms if they want to. Staff said that they supported choice by asking people what they wanted to wear or if they wanted to go to bed in the evening. However, care plans didn’t really contain detail about people’s preferences or preferred routines, which would help staff when assisting people who were confused or could not communicate clearly. The expert by experience had her lunchtime meal with the residents in the dining room. She observed ‘most residents said that they liked the food and one who did not said that it was just because it wasn’t the way she would cook it at home. Several residents commented on the porridge they had for breakfast as being particularly enjoyable. One resident told me that he had mentioned pork chops to the chef and was delighted that the chef had bought and cooked some for him. Although there was theoretically a choice, I observed residents being given the set meal of the day (sausage casserole), although individual preferences (eg. no carrots) were observed and I noticed one resident asking for and eating sandwiches. It appeared that there was no positive choice but rather a ‘default’ in that if a resident actually stated that they did not want a particular dish, then alternatives such as omelettes or sandwiches would be offered. If residents know or remember that this is the case then this is not a problem but I wondered if people with memory problems might be disadvantaged with this system. The dining tables were covered in tablecloths, some of which were stained, and the dining room did not feel homely but rather like a noisy canteen. Two residents sat side by side, facing the wall. Although there were theoretically 2 sittings, these were Craigarran Care Home DS0000062500.V356868.R01.S.doc Version 5.2 Page 15 not clearly defined’. Staff felt that the food was nutritious and that there was always plenty for people to eat. They confirmed that if someone doesn’t like something they can always have something else. However, some staff also felt that the amount of choice could be improved. Craigarran Care Home DS0000062500.V356868.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 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People feel able to raise any issues with the staff and manager and are protected by the home’s policies and procedures for handling complaints and allegations. EVIDENCE: The expert by experience commented that ‘residents said that they felt comfortable raising issues with staff and particularly with Brenda, the manager’. The home has in place policies and procedures that set out how complaints and allegations will be handled by the home. These have been updated since the last inspection. All five relatives who returned surveys knew how to complain and those who had raised issues felt they had been handled appropriately. Staff who were spoken to or returned surveys knew what to do if someone raised a concern. There have been no formal complaints or allegations since the last inspection but four concerns had been raised. The manager had recorded these concerns and what had been done about them. The records showed that the concerns had been dealt with and handled appropriately. There was also evidence that any concerns were appropriately referred on to the local authority where this was necessary. Craigarran Care Home DS0000062500.V356868.R01.S.doc Version 5.2 Page 17 The majority of staff haven’t received training on recognising and reporting abuse. However, the manager is aware of this, has planned a training session and intends to update staff in this training every two years. Craigarran Care Home DS0000062500.V356868.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, 22 & 26 People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The home provides a clean and safe place for people to live and people were happy with their surroundings. However, a lot of Craigarran’s fixtures, fittings and furnishings are looking old and worn. Some aspects of the accommodation and equipment provided could be better adapted to the different needs of the people living there. EVIDENCE: During the inspection the manager showed the inspector and the expert by experience around the home. This included looking at some of the bedrooms, the communal areas and some of the toilets and bathrooms. Since the last inspection, the provider has purchased some new nursing beds, commodes Craigarran Care Home DS0000062500.V356868.R01.S.doc Version 5.2 Page 19 and a new hoist. A number of bedrooms have also been redecorated and new corridor carpets are to be fitted soon. However, no further refurbishment has taken place and the majority of the home’s fixtures, fittings and furnishings are looking dated and worn. Staff confirmed that the home’s equipment tends to be quite old, although it is maintained in good working order. The expert by experience commented that ‘the physical feel of the home was ‘shabby’ and in need of attention’. However, people’s bedrooms were clean, tidy and were personalised with people’s own belongings, such as pictures, ornaments and small pieces of furniture. The expert by experience noticed that ‘the bedroom doors were impersonal’, having no pictures or names on them which would help people recognise their own bedroom. This is particularly important for people who are confused or become easily disorientated. Any refurbishment should consider the needs of the different people living in the home (for example, people with dementia) and the environment should be tailored to meet their needs. The manager and staff confirmed that the home had provided equipment, such as sensory mats, to help staff meet the needs of particular residents. For example, someone who gets up during the night and is at risk of falling has a sensor mat so that staff are alerted if they get up during the night. The expert by experience noticed that ‘hearing problems meant that some residents could not hear the TV.’ The need to provide equipment that would enable people with hearing difficulties to hear the television without the volume having to be turned up to very loud (for example, loop systems) was discussed with the manager. The environmental health officer had visited the home in October 2007 and made a number of requirements. Some of these had been dealt with but the home’s kitchen floor remains in poor condition. The manager indicated that there are plans for a new kitchen, including new floor coverings, but there was no timescale in place for this. Craigarran Care Home DS0000062500.V356868.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 People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. People are treated with courtesy and respect by care staff. Staff levels are usually appropriate and staff make sure care tasks get done but they don’t always have time to spend ‘quality time’ with residents. Staff are recruited safely and provided with ongoing training but training records are not currently up to date. EVIDENCE: Out of four staff who returned surveys, one said that there were usually enough and three said there were sometimes enough staff on duty to meet the individual needs of people living in the home. Comments included ‘if we work short we haven’t enough time, if we have enough staff we spend time talking to people, if we are short you don’t feel they are getting that quality time’ and ‘we don’t spend very much time with the residents, we do the best we can’. People living in the home who returned surveys said that staff were always (2 people) or usually (three people) available when they needed them. The expert by experience found that ‘residents felt that there were sufficient staff and that, if none were nearby, they could either press the bell (if they were Craigarran Care Home DS0000062500.V356868.R01.S.doc Version 5.2 Page 21 near one) or shout to gain staff attention. However, I did observe a confused lady trying to walk across a lounge with no staff present and I felt that she could have been at risk of a fall’ and ‘given the wide mix of residents, the staff do a good job in this home. They treat people with courtesy and respect. I do not doubt that they are well meaning and have the best interests of the residents at heart’. The manager acknowledges that the home’s training records are not currently up to date. This made it difficult to determine what training had been provided and if training had been updated appropriately. However, training has been taking place since the last inspection and this was confirmed by staff and the manager. Recent training has included moving and handling, infection control, food hygiene, first aid and national vocational qualifications (NVQs) in care. The majority of staff have also recently completed a twelve week course on dementia. The manager has plans to provide training on recognising and reporting abuse and to update the training records so that she can plan training more effectively. During the inspection, the recruitment records for four staff were looked at. These staff had all come to work in the home in the last year or so. The records showed that staff had been recruited thoroughly, including obtaining two written references and a criminal records bureau (CRB) disclosure before the staff started work. Craigarran Care Home DS0000062500.V356868.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, 36 & 38 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service.. The manager is approachable, experienced and competent, although she hasn’t always had enough designated management time in the home. Systems for helping people safely manage their personal monies are in place. Staff don’t currently receive regular formal supervision, although they can ask for help whenever they need it. People are safeguarded by the home’s health and safety policies and procedures and maintenance systems. EVIDENCE: The manager has a lot of experience managing care and nursing services, is a registered nurse and is registered with CSCI. Staff spoke well of her and Craigarran Care Home DS0000062500.V356868.R01.S.doc Version 5.2 Page 23 described her as approachable. The expert by experience commented that ‘the manager is particularly well-liked’. Comments made to the expert by experience included ‘Brenda’s (the manager) a lovely lady, she’d do anything for you’ and‘ if there’s owt you need, she’ll get it’. The provider visits the home regularly and the manager can contact him whenever she needs to. The manager has had to work a lot as a nurse in the care home recently, to make sure that the correct levels of nursing staff are provided. This means that she hasn’t always had the time that she needs to focus on the management of the home. However, the levels of nursing staff are expected to be back to normal next week when a staff member returns to work and the manager plans to be supernumerary from then on. The home has in place systems for helping people store and access small amounts of money while they live in the home. These systems haven’t changed since the last inspection and include signed records and receipts for expenditures. Staff have not been receiving formal supervision as often as they should. Staff who returned surveys or were spoken to during the inspection confirmed that the manager was approachable and that they could get help if they had any problems. However, they also confirmed that formal support, such as supervision sessions and staff meetings, didn’t take place very often. Staff supervision records confirmed this. Information provided in the home’s self assessment and records seen during the inspection showed that equipment in the home was regularly serviced and maintained. Appropriate contracts were in place for regular servicing of fire equipment, manual handling equipment and for the disposal of medication and clinical waste. The manager had completed a fire risk assessment in December 2007 and is undertaking fire training in February 2008. A new electrical installations certificate was obtained in July 2007. Craigarran Care Home DS0000062500.V356868.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 2 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 2 X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Craigarran Care Home DS0000062500.V356868.R01.S.doc Version 5.2 Page 25 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 OP1 Regulation 4(1), 5(1) &6 Requirement The home’s Statement of Purpose and Service User Guide must be reviewed to make sure that people have access to very clear information about the different types of care the home provides and how these different needs are provided for and managed. This requirement remains outstanding from the previous inspection – the previous timescale of 30/06/07 has not been met. Training records in the home must be improved to provide easily accessible information about the training staff have completed and when update training is due. Staff who administer medication must ensure that they follow good practice guidance for safely administering and recording the help they give people with their medication. Timescale for action 31/08/08 2. OP30 18(1)(c) 30/05/08 3. OP9 13(2) 28/02/08 Craigarran Care Home DS0000062500.V356868.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP1 Good Practice Recommendations Alternative formats of the written information given to people who live at Craigarran should be developed, for example, a version that is more accessible to people with dementia. Care plans should be developed to contain more person centred and detailed information about people’s preferences and choices regarding their care and lives. This is particularly important for people who are confused or unable to communicate their wishes clearly to staff. Care plans should be developed to include information about people’s social interests, the activities they would like to take part in or any special needs (for example, due to dementia). This information should be used to develop a more personal and individual approach to social activities at the home. More accessible ways of offering choices of food and drink should be developed. These should consider the needs of people with dementia and short-term memory difficulties. A maintenance and refurbishment plan should be developed to improve the standard of the home’s fixtures, fittings and furnishings. This should include the outstanding issues identified by the environmental health officer and take into account the specialist needs of the different people living in the home. The registered manager should have sufficient supernumerary hours to realistically fulfil her management duties within the home. Care staff should receive formal supervision at least six times a year. 2. OP7 3. OP12 4. 5. OP15 OP19 6. 7. OP31 OP36 Craigarran Care Home DS0000062500.V356868.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Craigarran Care Home DS0000062500.V356868.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!