Inspection on 31/10/05 for Darlington Court Care Home

This inspection was carried out on 31st October 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Darlington Court Care Home 22/07/08

Darlington Court Care Home 24/04/06

Darlington Court Care Home 10/06/05

Darlington Court Care Home 18/10/04

Darlington Court Care Home 22/04/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Darlington Court Care Home The Leas off Station Road Rustington West Sussex BN16 3SE Lead Inspector Helen Tomlinson Unannounced Inspection 31st October 2005 07:30 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 Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 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. Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Darlington Court Care Home Address The Leas off Station Road Rustington West Sussex BN16 3SE 01903 850232 01903 775595 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) Care UK Community Partnerships Limited Mrs Ruth Streeter Care Home 61 Category(ies) of Dementia (6), Dementia - over 65 years of age registration, with number (61), Old age, not falling within any other of places category (61), Physical disability (6), Physical disability over 65 years of age (61) Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum of 61 service users may be accommodated. A maximum of 6 service users aged 50 years and over in the category (PD) A maximum of 6 service users aged 50 years and over in the category dementia (DE) 10th June 2005 Date of last inspection Brief Description of the Service: Darlington Court is a care home providing nursing care and accommodation for up to 49 older people and 12 people aged 50 years and over. The service users needs can be physical or resulting from dementia. The home is owned by Care UK Community Partnerships Limited. This organisation owns around 80 care services in the UK. The building was purpose built around 10 years ago. It is situated on a residential cul-de-sac close to a main road. It stands in its own gardens to the rear and has a car park at the front. Accommodation is provided on 2 floors with a passenger lift and stairs providing access to all floors. The service users who were mentally frail were accommodated and cared for on the ground floor with those whose main problems were physical frailty were accommodated on the first floor. Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by Miss H. Tomlinson. She arrived in the home at 7.30am and left at 5pm. The Registered Manager, Mrs Streeter was present throughout the inspection. At the last inspection, on 10th June 2005, seven statutory requirements and eight good practice recommendations were made. The registered manager and the operations manager had met with the inspector and the regulation manager, to discuss progress towards meeting these requirements and improving the service. Some of these improvements were noted at this inspection whilst others, particularly on the unit for the mentally frail, had not yet begun. This is discussed further throughout the report. The inspector examined six care records in detail and others for specific pieces of information. Twelve residents, six members of staff and three visitors were spoken with. A tour of the premises took place and records were examined. What the service does well: What has improved since the last inspection? The use of agency staff had reduced. This resulted in more permanent and bank staff being used, who were more familiar with the residents and their individual needs. The working practices on the first floor unit for the physically frail older person, resulted in more appropriate and timely care being given. The provision of a second medicine trolley on the first floor unit had resulted in the two nurses on Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 6 duty being able to administer the medication and for this to take less time, allowing time for other nursing needs to be adequately met. The registered manager confirmed that all fire doors were now in full working order. On the first floor unit all residents had their call bells close to hand. All necessary information for new members of staff had been obtained, prior to them starting work at the home. The medication administration charts were more thoroughly completed at this inspection. What they could do better: In the unit for older people who are mentally frail, there were long periods were all staff were busy in resident’s bedrooms. This left the communal areas and those residents who were walking around the building or sitting in their own rooms without supervision. During this time two incidents were witnessed which could have put the resident at risk. Also a G.P. visited the unit and was unable to gain the assistance they needed. The unit manager and the registered manager explained that with the new working practices this will not happen, since the residents are split between staff, who are responsible for their welfare throughout the whole day. This system was not in place during this inspection. There will also be additional numbers of staff on duty during the day. Since the last inspection a risk assessment for the use of call bells, by the mentally frail older people, had been carried out and documented. This was not a true risk assessment, did not specify the individual risk and was present for all residents, regardless of their individual abilities or needs. It was discussed with the registered manager that this should be reviewed for all residents on this unit. No activities took place on the unit for mentally frail older people. There had been an activities organiser who had taken employment as a care assistant. It was explained that when the new system of working was introduced the activities would form part to the daily care for each individual resident. The lounges should be made more homely and inviting for the residents. They were sparsely furnished and not domestic in nature. Items of clothing going missing from the laundry was still an issue for residents at this inspection. A review of the laundry system should result in this being resolved. Some medication labels did not correspond with the medication administration sheets. Residents and other stakeholders should be more involved in the review of the quality of care offered in the home. All parts of the care home must be free from offensive odours at all times. Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 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. Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 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 Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed at this inspection. Standard 3 was met at the last inspection. Standard 6 is not applicable to Darlington Court. EVIDENCE: Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 All residents had a plan of care documented. The health care needs of the residents were met on the unit for the physically frail. The lack of supervision of residents on the unit for the mentally frail could result in health and welfare care needs being unrecognised and unmet. The procedures for administration of medication protect the residents. The privacy and dignity of the residents was understood and protected. EVIDENCE: All residents accommodated in the home had care plans in place. These contained information about their individual needs and how these should be met. At the time of the last inspection two requirements and three recommendations were made in regard to the health and welfare of the residents. These included the production of risk assessments for the use of bed rails and for those residents who did not have access to a call bell. Both of these issues had been looked at by the staff and manager of the home. A bed rail risk assessment had been produced. This had been completed for several residents. It was discussed that it did not include any other measures considered by staff in the home and should do so. The majority of residents had bed rail protectors in place when they were in use. The risk assessments Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 11 for residents not having call bells, on the unit for mentally frail older people, was not individualised and all residents had the same one in place. It was discussed that the individual risk to each resident should be specified and the measures taken for this specific risk recorded. There was a requirement made that all residents must have sufficient amounts to eat and drink. On the unit for the physically frail older person staff gave out drinks at suitable intervals in the day. The assistance individual residents needed was not always forthcoming and several residents had cold drinks in front of them. The staff numbers on the unit for the mentally frail meant that, in the morning, staff were not available to assist residents with drinks as was necessary. The records and charts for the recording of health care given to the residents were more fully completed than at the last inspection. These gave a clearer picture of the health care needs and status of the residents on each unit. In some instances the records were not consistent, with some health assessments having been updated and the corresponding plan of care not having been changed. This was evident for one resident in the case of pressure sores, where in the daily notes was recorded a different pressure relieving mattress than in the care plan. For two others the plans had not been changed when a wound had been noted or healed. One of these residents had no plan of prevention before the sore was noted. The staffing numbers, skill mix and reduced number of agency staff, on the unit for the physically frail, was improved since the last inspection. The supervision of residents on this unit was greatly improved and as a consequence the residents said it was a calmer atmosphere with more help available. On the unit for the mentally frail there was a long period of time, from 10.30am to 11.10am, when staff were in the bedrooms of individual residents, attending to their personal needs. This left those residents up in the lounge or their bedrooms without supervision. One resident knocked over a table whilst another was in their bedroom in an undignified state of undress. This lack of supervision cannot safeguard the health or welfare of the residents on this unit. The registered manager discussed the plans for this unit, which included the staff being responsible for the total care, including health and social care, of a fixed number of residents. It was hoped this approach would reduce the workload on the staff, encourage more individualised care instead of task-orientated care and make sure the residents received the supervision they need. Since the last inspection an additional medicine administration trolley had been provided on the first floor. Staff said this made the medication round less time consuming and gave them more time to carry out other nursing tasks, as well as supervision of staff and residents. The recommendations made at the last inspection had been met. There was a discussion regarding medication labelled “as directed” without any explanation of this from the G.P. being present. The registered manager and unit managers will follow this up with the pharmacist. Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 12 Staff spoken with understood the need to protect the privacy and dignity of the residents. Residents spoken with said that staff knocked on bedroom doors before entering, closed bathroom doors behind them, addressed the resident with the name of their choice and spoke to them politely. As discussed the lack of supervision on the unit for the mentally frail left one resident in an undignified manner, with no staff around to correct this. Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 and 14 Residents on the unit for the physically frail benefited from appropriate activities. Residents on the unit for the mentally frail did not have sufficient opportunity for appropriate, supported activities. Residents were assisted to maintain contact with friends and relatives. Resident’s choices were understood and respected by the staff. EVIDENCE: At the last inspection two activities co-ordinators were employed. They worked together to organise and carry out appropriate activities on both units. At this inspection one of them had changed roles to become a care assistant. The remaining co-ordinator was on the unit for the physically frail. She organised activities which were enjoyed by those residents who wished to join in. On the day of the inspection they were enjoying making Halloween crafts. An activities programme was on display in the home, but the activities which were recorded for the day were not carried out. On the unit for the mentally frail the plan is for the care, including social activities, to be undertaken, on a daily basis, by designated care assistants. An Occupational Therapist is being employed in order to offer advice and assistance with this change of working practice. Some of the resident’s care plans seen had their social history and interests recorded. Others were blank. Some had a record of the activities they had recently enjoyed, for others this was not completed. The Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 14 requirement made at the last inspection for the social and recreational needs of the residents, in both units, remains unmet. Visitors spoken with said they could come into the home at any reasonable time to see their relatives and friends. They were complimentary of the reception they received by staff saying they were “friendly and tell me about my relative if there has been any change.” Visitors were seen in both the communal areas and individual resident’s bedrooms, as they wished. Some concerts for Christmas by local groups were organised for the residents. Residents spoken with said the staff asked them what time they wished to get up and go to bed on a daily basis. Those who were up at 7.30am when the inspector arrived said it was their choice to be up then and they could get up later if they wished. Night staff spoken with said they would ask residents if they wished to get up and not presume that they liked to be up, or in bed, at the same time each day. Residents could chose where to eat their meals, either in the dining room, or their bedrooms, whichever they wished. Some of the individual preferences of the residents were recorded. On one plan, for someone who was unable to tell staff of their choices themselves, this was very detailed including what they liked to wear, their make up preferences and their preferred company of males. The person who would advocate on behalf of those residents who needed this was recorded. Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Residents and relatives were happy to approach the management of home with any complaints and were confident they would be taken seriously. Residents were protected from abuse. EVIDENCE: Four complaints had been made to the manager of the home, since the last inspection. These had been fully investigated to the complainant’s satisfaction with the investigations and any subsequent actions to prevent recurrence being recorded. One complaint, which had been made to the home before the last inspection in June, was not fully resolved to the complainant’s satisfaction at this inspection. The manager and higher management of the company which owns the home continued to communicate with the complainant to find an acceptable resolution. A copy of the complaints procedure was on display on the notice boards in the home. Those residents and visitors spoken with said they felt they could discuss any complaints or issues with the manager, unit managers or any other staff member. They said if they had raised concerns they had been dealt with swiftly and appropriately. Staff spoken with were aware of their responsibility to protect the vulnerable adults in their care. All staff received some training on the protection of vulnerable adults during their induction period. This was expanded on with a more in depth training at a later date. Staff spoken with were aware of their responsibility to report any incidents which they felt were abusive towards the residents. They had seen a copy of the whistle blowing policy when they began work, but could not recall the detail of it. They felt it would be worthwhile to have another copy of this provided. The registered manager confirmed, following the inspection, that a copy of this procedure had been put Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 16 on display in all staff rooms. At the last inspection not all checks on new staff, to make sure they were fit to work with vulnerable adults, had been carried out for all staff. At this inspection all new staff had these checks completed before they started work. Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,22 and 26 Residents live in a safe, well maintained home. Appropriate and sufficient indoor and outdoor space was available for the residents accommodated. The lounges were not domestic or inviting. Residents had the equipment they needed supplied for them. The home was clean and tidy. There was an offensive odour in parts of the unit for the mentally frail. EVIDENCE: The home was tidy, clean and well maintained. Since the last inspection the necessary adjustments had been made to the fire doors and they were all in good working order. Staff spoken with were aware of the fire procedure and had received up to date fire safety training. The fire procedure was displayed in appropriate places around the home. The man employed to maintain the home said staff told him when things needed doing and wrote them down in a book so that he could attend to issues as they arose. He was mending some lights and faulty call bells at the time of the inspection. Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 18 There was sufficient communal space on both units. Both have at least two lounges and one large dining room. Smaller seating areas are also available on the ground floor. At the last inspection it was noted that the lounges, on both units, were sparsely furnished and not homely. This remained the same at this inspection. The registered manager discussed plans to refurbish some of the lounge areas, creating smaller, more domestic style spaces. She said the budget for this was in place and the work was to commence in the near future. The equipment needed to meet the resident’s needs was available in the home. There was a variety of hoists available to meet the safe moving and handling requirements of the residents. Aids for transferring residents and slide sheets were present. At the last inspection there was an issue raised with the lack of availability of call bells for the residents, particularly on the unit for the mentally frail. As discussed in standard 8 this had not been appropriately addressed at this inspection and a recommendation is made. The bathrooms and toilets had raised seating, handrails and assisted bath seats to make sure the residents could use these facilities safely. The home was clean and tidy, with equipment and furniture being safely stored. The unit for the physically frail was free from offensive odour, but the unit for the mentally frail was not. This offensive odour was present in various places on the unit, including communal areas, corridors and specific bedrooms. It was discussed with the registered manager that this must be eliminated. Staff wore protective clothing, to prevent the spread of infection, when delivering personal care and handling food. All staff received training on infection control during their induction and a more in depth training had been provided in August of this year. Those staff spoken with were aware of their role and responsibility for preventing the spread of infection. At the last inspection several residents discussed clothing going missing from the laundry. The registered manager said this had been resolved with the labelling of clothing. There was evidence that this had not been fully resolved with staff saying one resident had no clean trousers and it had been recorded for another that the same shirt was replaced following washing, due to no clean ones being available. Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29 and 30 The number and skill mix of staff on the unit for the physically frail was adequate to meet the needs of the residents. The numbers of staff on the unit for the mentally frail was not sufficient to fully meet the needs of the residents or provide adequate supervision. The recruitment procedures of the home protected the residents. Resident’s benefit from staff who have received appropriate training. EVIDENCE: At the time of the last inspection the reliance on agency staff gave a cause for concern that the residents were not receiving consistent care. At this inspection the use of agency staff had reduced. Both staff and residents said this was much better in terms of the care given and general working environment. Part of the way the reliance on agency staff had been reduced was the introduction of new care staff, through an employment agency, who work at the home on a temporary to permanent contract for thirteen weeks. Following that period they can choose to take a permanent contract, with the home, should they wish. The manager and other staff said this worked well as it gave both parties time to assess the situation, before a decision was made. Transport to the home was provided for these staff members. They received the full induction training and were included in all other training in the home. The use of agency staff will be further reduced with the introduction of staff from overseas. The registered manager explained the recruitment procedure which had taken place for these staff members, which included appropriate managers travelling overseas to be involved in the interviews. The duty rota on the unit for the physically frail showed sufficient qualified nurses and care Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 20 assistants to meet the dependency of the residents. On the unit for the mentally frail one staff member did not report for work, on the day of the inspection. This left the unit short of staff, and contributed to the lack of supervision for residents. The registered manager discussed the intended changes which include the employment of an Occupational Therapist for thirty hours per week and one extra care assistant. Until this time the numbers of staff on the unit must be sufficient, at all times to meet the needs of the residents. Three staff files were examined. These contained the checks necessary to make sure these staff members were fit to work with vulnerable adults. These had been obtained prior to the person starting work. For two of the three there were gaps in employment which had not been explained at interview. This should be done to make sure a full employment history is present. All other information required was present on the files. Staff spoken with said there were good training opportunities in the home. They had induction training which included all statutory training, said they were well supervised through their induction period and could discuss any gaps in their knowledge and skill with more experienced staff who would help them. A workshop day to up date staff on the statutory training was carried out. Additional training was provided, in more detail, for specific training needs of staff and to make sure staff could meet the needs of the residents. Three student nurses were on the unit for the physically frail. They discussed the opportunities they had for various training and other staff discussed how this helped them to keep up to date with their own knowledge and practice. Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Residents and staff benefit from the home being managed by an experienced person. There are various procedures in place to check the quality of care given to residents. Resident’s financial interests were safeguarded. The health and welfare of the residents was protected and promoted. EVIDENCE: The registered manager is a Registered General Nurse. She has completed her qualification in care home management in the last year. She has worked in the care of older persons for many years as a manager of other care homes. She has been at Darlington Court for ten years as a unit manager and deputy manager, before being promoted to manager four years ago. She up dates her knowledge and skills with frequent appropriate training. Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 22 The company which owns Darlington Court has various quality assurance measures in place. These include audits against specific criteria for example, infection control. These are carried out by someone from the larger organisation and not someone who works in the home. The registered manager has devised various audit tools specific to the two units in the home which includes documentation, pharmacy issues and nursing procedures. Staff said they could contribute to the review of quality of care in the home by having regular staff meetings and informal opportunities to discuss the running of the home with the manager. The resident’s views are sought informally and currently no residents meetings take place. The views of visitors to the home and resident’s relatives are sought through questionnaires. Further measures to include the residents more in the review of the quality of care in the home should be introduced. Some resident’s personal monies are managed by staff at the home. All transactions are recorded, receipts kept and monies securely stored. Any valuables deposited at the home are securely stored and receipts given. Staff were aware of their responsibility to make sure the residents health and welfare were protected. There were no issues of health and safety raised following the tour of the premises. Accidents were documented with a record of investigations into the cause of the accident and any action taken to prevent recurrence. It was discussed with the registered manager that there were no notes made for one resident who had obvious bruising to her legs. The registered manager agreed to investigate this and remind all staff of the need to record all incidents of injury. The registered manager confirmed that all equipment in the home was serviced and maintained according the manufacturers recommendations. As discussed earlier the lack of supervision on the unit for the mentally frail did not protect them. Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 23 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 2 x 3 x x x 2 STAFFING Standard No Score 27 2 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 3 Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? 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 OP8 Regulation 12(1) Requirement The health and welfare of the residents must be protected by the level of supervision given by staff. This must include assistance given with drinks. Residents must be consulted about their social and leisure interests and appropriate activities take place. This requirement remains unmet since the inspection of 10/6/05. The timescale given of 31/07/05 has expired All parts of the care home are to be kept free from offensive odours. The numbers of staff must be sufficient, at all times, to meet the needs of the residents. This was an issue on unit for the mentally frail only. This requirement remains unmet since the inspection of 10/6/05. The timescale given of 30/06/05 has expired Timescale for action 31/12/05 2 OP12 16(2)(m)( n) 31/07/05 3 4 OP26 OP27 16(2)(k) 18(1)(a) 31/12/05 30/06/05 Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 6 Refer to Standard OP8 OP8 OP20 OP26 OP29 OP33 Good Practice Recommendations The risk assessments for the use of bed rails and the none provision of call bells must be more thorough and individualised to each resident. All information in the care plans and health assessments should be consistent. The lounges should be more homely and inviting. The system of returning laundry to residents should be reviewed to make sure clothes do not go missing. Gaps in employment should be explained and full employment history recorded. The residents should be more involved in the review of the quality of care in the home. Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 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 Darlington Court Care Home DS0000024133.V251442.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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