Inspection on 20/06/07 for Durland House

This inspection was carried out on 20th June 2007.

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

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

Other inspections for this house

Durland House 15/12/05

Durland House 02/08/05

Durland House 10/01/05

Durland House 19/07/04

Durland House 17/12/03

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Durland House 160 High Street Rainham Gillingham Kent ME8 8AT Lead Inspector Anne Butts Key Unannounced Inspection 20 June 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Durland House DS0000029067.V339958.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. Durland House DS0000029067.V339958.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Durland House Address 160 High Street Rainham Gillingham Kent ME8 8AT 01634 364305 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 Margaret Agnes Hartley Mr Royston George Hartley Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Durland House DS0000029067.V339958.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. admission of resident below 65 Three service users with dementia whose dates of birth are as follows: 31.12.1915, 31.12.1915 and 02.02.1923. 24th August 2006 Date of last inspection Brief Description of the Service: Durland House is a listed building in Rainham High Street. The home is nicely decorated and care has been taken to ensure that it is in keeping with the age of the property. Although the house is close to the main road traffic noise is not noticeable within the property. All bedrooms have en-suite facilities; there is a chair lift available to the first and second floors for those less able. There is a small amount of parking accessed at the side of the building and there is a small garden and patio area to the rear. As it is situated in the High Street it is close to local shops and amenities. The fee range at this home £318.50-£335.00 Durland House DS0000029067.V339958.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a Key Unannounced inspection that took place in accordance with the Inspecting for Better Lives (IBL) process. Key inspections are aimed at making sure that the individual services are meeting the standards and that the outcomes are promoting the best interests of the people living in the home. The IBL process for a Key inspection involves a pre-inspection assessment of service information obtained from a variety of sources including an annual selfassessment, surveys and a visit to the home. It is now a legal requirement for services to complete and return an Annual Quality Assurance Assessment (AQAA). This assessment is aimed at looking at how services are performing and achieving outcomes for people and information provided in this has been used as part of this report. Judgements have been made with regards to each outcome area in this report, based on records viewed, observations and verbal responses given by those people who were spoken with. These judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable The Commission for Social Care Inspection (CSCI) to be able to make an informed decision about each outcome area. Further information can be found on the CSCI website with regards to the IBL process including information on KLORA’s and AQAA’s. The actual site visit to the service was carried out over one day by one inspector, who was in the home for approximately five hours. The main focus of the visit was to review any improvements made since the last visit and the well-being of the service users. A large proportion of the time was spent talking to people living in the home and any visitors. Time was also spent talking to staff and reviewing a selection of assessments, service user plans, medication records, staff files and other relevant documents. Prior to the site visit the AQAA had been returned and surveys had been sent out to service users, families and professionals to gain further feedback as to their opinion of the service. A large number of surveys have been returned. At all times the manager and staff were helpful and demonstrated a pro-active approach to ensuring that service users were being supported to the best of their abilities and resources. This report contains evidence and judgements made from observation, conversation and records. What the service does well: Durland House DS0000029067.V339958.R01.S.doc Version 5.2 Page 6 The home provides a warm friendly atmosphere within which service users live. It was clear throughout the visit that the people living in the home and staff interacted well and there was a positive friendly rapport between people. A large proportion of the visit was spent talking to people and asking them about their experiences of living in the home. Without exception everyone stated that they liked living here and that they were well supported and cared for. Comments included: “I feel very lucky to be here. You only hear and read about the bad homes, never the good ones and this home is really lovely. A real home from home”. “I am always telling my daughter how wonderful they are and how I could not be happier. I always say that I am such a lucky person to have found such a nice home”. All the service users at the home praised the food, and there was choice offered at all meals. The home fosters an open atmosphere where people can be confident in expressing views and know that they will be listened to and their opinions valued. What has improved since the last inspection? What they could do better: Record keeping and maintenance of staff and service user records would continue to benefit from further continuity and improvement. Care plans need to reviewed on a regular basis and the outcomes of any ongoing assessments should be incorporated into these plans. Movement and handling and other risk assessments need to be updated on a regular basis or when there are any identified changing needs and outcomes recorded into care plans. Durland House DS0000029067.V339958.R01.S.doc Version 5.2 Page 7 Daily records are mainly a menu list and need to reflect that the care is provided in accordance with peoples needs. Overall medication is reasonably well managed – however there is a need to improve systems of how any returned or excess medication is stored and the record keeping with regards as to what is exactly is kept in the needs to be improved – a requirement has been made that this is resolved. Two requirements were made at the last visit with regards to a programme of activities and supporting people in going out and about – the views of the people living in the home are varied as to whether they feel that they have enough to do with some people stating that they do not want to take part or go out, whilst others would like more opportunities. The home generally supports people with their individual choices where possible but the requirements remain outstanding at this visit whilst the home continues to develop opportunities with regards to individual preferences. The daily management and support provided in the home is dedicated to promoting the best outcomes for people living there but there is room for improvement with regards to record keeping required by regulation to fully protect service users. 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. Durland House DS0000029067.V339958.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 Durland House DS0000029067.V339958.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): 3, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from an assessment of their needs prior to moving into the home and they and their relatives have the opportunity to visit the home prior to admission to assess the quality, facilities and suitability of the service EVIDENCE: A selection of service user files was sampled to review how the home assesses people. Records showed that there is a pre-assessment process in place. The assessment covers peoples’ history, care needs for their personal and physical well-being and any specialist needs. The information from these, however, is not fully incorporated into care plans and where there are any ongoing changing needs with regards to movement and handling these are not updated on a regular basis. Durland House DS0000029067.V339958.R01.S.doc Version 5.2 Page 10 People have opportunities to visit prior to moving into the home and are able to spend a trial period before making a decision as to whether the home is suitable for them and that the home is confident that they can meet their needs. Service users and relatives all stated that they had been fully involved in the decision to move into the home and comments included: “I visited before I moved in and this is much better than my previous home” “I had 4 weeks in the home to decide if I liked it and wanted to stay”. “When I visited they made me really welcome”. Most of the staff have achieved an NVQ in care and there is further training to support people in meeting individual needs. Staff spoken to all demonstrated an awareness of the individual needs of people. To meet ongoing needs as stated elsewhere in this report the assessments need to be reviewed and updated on a regular basis. The home does not provide intermediate care. Durland House DS0000029067.V339958.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 and 11. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whilst service users benefited from having individual care plans some areas of the plans need to improve so as to fully support peoples individual needs and updated assessments that identify changing needs should be incorporated into the plans. Health needs are met and service users have full access to all professional health care services as required. Improvement in the storage and record keeping for medication would further protect service users. People can be confident that they will be treated with dignity and respect and that their privacy will be respected. EVIDENCE: A selection of care plans were reviewed and they showed that the home takes into account people’s health, personal and social care needs. The detail Durland House DS0000029067.V339958.R01.S.doc Version 5.2 Page 12 provided was adequate and did inform staff how to support people with their needs and took into account individual preferences and abilities. They are not, however, being reviewed on a regular monthly basis and where any reviews did identify any changes or daily records stated about any changing needs – these were not being reflected into the care plans. Although there were some movement and handling assessments in place, not all service users had these in place and some contained very little detail. People using the service all confirmed that they were well supported and cared for and that they felt all their needs were well met. The Manager/Proprietor does need to make sure that care plans are reviewed and contain up to date detail on how to fully support people. Service users’ health is documented in daily records. The home has separate records for when the GP had been called in to give treatment or advice. Appointments are diarised for each service user and it was evident the home arranges for health professionals such as Chiropodists, Opticians and Dentists to visit or supports people in accessing visits to the hospital etc. All service users should be weighed on a regular basis, but this is not happening and the home needs to make sure that this is monitored. Medication systems in the home were reviewed as part of the site visit. Medication is stored securely in locked cupboards with appropriate security measures in place and there are samples of staff signatures and initials for auditing and record keeping purposes. Staff that assist people with medication had received training The home uses a blister pack system provided from the pharmacy, although some additional medication is also provided in boxes and bottles. It was, however, observed that if there was any medication to be carried over, for example medication that had been received into the home for additional prescriptions, then these were not being recorded in the appropriate place in the MAR (Medication Administration Record) sheets, therefore not indicating as to the exact amount of medication that was being stored within the home and, also not supporting a robust auditing system. This had been identified at the last visit, and although the Manager/Proprietor was able to explain the process there was no evidence to support this and a requirement is being made that records must show as to how the home maintains their records in accordance with the Pharmaceutical Guidelines. It was also observed and discussed at the time of the visit that any medication to be returned, spare medication, or tablets for ‘as and when’ (often known as homely remedies’ - such as aspirin etc) were all being stored in the same part of the cupboard – again in order to promote a robust system for auditing and minimise the possibility of errors these all need to stored separately – this is being included in the requirement. Durland House DS0000029067.V339958.R01.S.doc Version 5.2 Page 13 At all times during the visit to the home, conversations with people living there, staff and relatives and also from surveys returned it was shown that people are treated with dignity and respect and that their privacy is maintained. Comments from relatives included: “Treats the residents with respect and as if they were their ‘mother’ ”Staff always give 100 of care and attention and Durland House is a complete home from home with excellent care at all times”. “The girls are lovely – they are so kind to my Mum and everyone else here – nothing is too much trouble”. People living in the home also stated that everyone who worked in the home was kind and polite. One lady stated “The carers are so helpful and kind, they don’t interfere – but they are always there if I need them”. Information in care plans and assessments also showed that the home considers peoples preferences with regards to any personal care. Peoples’ wishes with regards to end of life issues and terminal care are respected and handled sensitively. A card from a relative stated “Thank you for allowing my Nan to live her life the way she wanted and the dignity for her to slip away”. Durland House DS0000029067.V339958.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. This judgement has been made using available evidence including a visit to this service. People’s individual choices and preferences on how they spend their day are respected although they do not benefit from having a full activity programme that includes the opportunity to go on outings on a regular basis. People are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. Service users benefit from a choice of home cooked meals. EVIDENCE: A large proportion of the visit was spent talking to people who use the service and people were asked about the range of activities that are facilitated by the home. Everyone spoken to all stated that they could choose how they spent their day. People described how they could follow their own individual hobbies and preferred pastimes including spending time reading, knitting or chatting. The home does arrange some organised activities including keep-fit activities Durland House DS0000029067.V339958.R01.S.doc Version 5.2 Page 15 and sing-a-longs. special occasions. Parties are also arranged for people’s birthdays or other Some people stated that they were happy with the amount of activities but others stated that they felt that sometimes there wasn’t enough to do. Several people also stated that they would like the opportunity to go out more, and this was discussed with the Manager/Proprietor. She had already identified that there was a need to expand the opportunities for people to go out more. Family and friends are welcome at any time and conversations with families visiting showed that they all felt that they were always made welcome. One relative described how the home supported her in allowing her to assist with her Mums care – something both the service user and relative had been able to make a positive choice about. Other comments included: “We are fully involved in my Mum’s care and we are always made welcome”. “We are always welcome to visit and have been invited for meals. “They always notify us if there are any concerns and my Mum is really happy here – What more can I say” People are promoted in taking control over their own lives with the home listening to their choices and preferences. This included taking into account any individual religious needs, choice of how people preferred to spend their day and the fact that individual opinions were listened to. There are no restrictions on getting up or going to bed. Care plans did evidence individual preferences for assistance with any care. All people spoke to and returned surveys showed that people felt that they had control over their daily lives. Comments included: “There are no restrictions we always have a choice”. “We have lots of choices and there is nothing negative I can say about living here”. “I am treated as an individual and listened to if I need to talk to anyone” The Manager/Proprietor and staff all demonstrated awareness that people can have a diversity and range of different needs and that a key part of addressing this was talking and listening to people wishes. Mealtimes and menus were not fully reviewed at this visit – as surveys and comments from people were all favourable about the standard of food. There is a choice of cooked breakfast, lunchtime meals and people spoke favourably of the evening meal that one lady described as “A magnificent high tea – a real spread”. Drinks and snacks are available throughout the day. Durland House DS0000029067.V339958.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. This judgement has been made using available evidence including a visit to this service. Complaints and adult protection procedures within the home serve to safeguard service users. EVIDENCE: There is a complaints procedure in place and everyone who was spoken to as part of this visit stated that they knew who to speak to if they had any concerns. There had been no formal recorded complaints since the last visit and everyone also confirmed that they had not reason to make a complaint, but if they did then people expresses a confidence in approaching the Manager/Proprietor, who they said was always available. Surveys returned also stated that people had not made any complaints. Comments included “The owner is always there to listen to you and work things out for you – but it doesn’t very often happen that I have to say anything”, and “Have no complaints I am cared for at all times”. Since the last visit staff have received updated training in Adult Protection issues, this was identified on the returned AQAA and through staff records viewed. Members of staff also confirmed that they had undertaken training in this area. There have been no Adult Protection alerts raised against the home. Durland House DS0000029067.V339958.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from living in an environment that is homely and well maintained. EVIDENCE: A full tour of the environment was not undertaken, as previous visits have continually evidenced that peoples’ bedrooms are comfortable and homely with en-suite facilities in all rooms. Conversations at this visit also supported that people are happy with their individual living space and one lady described how nice it was that she could relax in her own room and spend time reading. Communal space consists of a dining area and two living rooms – one of which is designated as the ‘quiet room’ where people can relax and talk without any television or music if they choose. Durland House DS0000029067.V339958.R01.S.doc Version 5.2 Page 18 All areas are nicely decorated with nice quality furniture and fittings. There is a continual ongoing maintenance programme with regular redecoration taking place. There is a garden area at the rear of the property where people can sit out in the summer months. It should be noted that the home has no lift, there is, however, a stair chair lift to the first and second floors but this makes the stairs narrow and, therefore, only the ground floor is suitable for people with poorer mobility. There are toilet facilities on the ground floor. The laundry area is situated close to the back door and is a main thoroughfare into the home – the area is kept clean and tidy. The last visit noted that the washing machine did not have a sluicing facility and this had not been addressed at the time of this visit – the Manager/Proprietor needs to make sure that is dealt with. Durland House DS0000029067.V339958.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their care and support needs are met by trained and competent staff, who respect their preferences and choices. Ongoing staff training would further support people living in the home. EVIDENCE: The home employs 12 care staff who as well as providing care for the service users also clean the home and cook meals. The home was using sufficient care staff hours as calculated on the Care Forum Formula. The Manager/Proprietor also works hands on with the care staff for a substantial amount of time during the week and is available at night on call in case the two waking night staff have any problems. Families and service users felt there were sufficient staff on duty at all times. One lady stated, “If I can’t sleep at night all I have to do is ring my buzzer and there is someone there immediately” Although there is little diversity within the staff group – the composition reflected the cultural and gender needs of the people using the service. Everyone spoke highly of the care and support provided and comments included: Durland House DS0000029067.V339958.R01.S.doc Version 5.2 Page 20 “Carers are lovely and caring and are always there for me” “They treat us with respect and as if we were their ‘mother’ they are always spotlessly clean” “Staff are always so patient with my mother and she has confidence in the support they give her”. A selection of staff were viewed and they all showed that the appropriate checks were in place including references and Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks were in place. This had improved since the last visit when some of the documentation had been missing. Staff spoken to confirmed that when they started they had an interview and that references and checks were applied for. A new member of staff confirmed that she had undertaken an induction and that she had been given training and support at the start of her employment. All staff have either completed an NVQ or are undertaking one – which exceeds the minimum standards. Ongoing training is now arranged on a more regular basis with people receiving training in movement and handling, adult protection, food hygiene and medication. The Manager/Proprietor is aware of the importance of ingoing training and is now actively making sure that staff are able to access appropriate courses. There is still some refresher training updates needed but the home is addressing this. Staff confirmed that they felt well supported by the Manager/Proprietor on a daily basis. Durland House DS0000029067.V339958.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users benefit from living in a home where the manager is very experienced with the care of older people. The service users benefit from living in a safe, warm and inclusive atmosphere. Improved record keeping would further support the changing needs of people living in the home. EVIDENCE: The Manager/Proprietors of the home have over twenty years experience in running the home. However, they do not have any formal qualifications but Durland House DS0000029067.V339958.R01.S.doc Version 5.2 Page 22 they participate in all the training that is provided for the care staff. Conversation demonstrated that they were aware of the particular needs affecting older people and the individual views of people were listened to and their opinions valued. The management of the service is open and transparent with staff and service users alike expressing a confidence in the proprietors. Comments included “This is an excellent and friendly home where the owners are really helpful and always available”. And “The owner is an angel and always has time to talk to me”. The home values the opinions of people living there and also welcomes comments and feedback from relatives. Satisfaction surveys are sent out on a regular basis and people confirmed that they always felt they could discuss any aspects of the home with the Manager/Proprietor. There is an ongoing maintenance programme that makes sure that the standard of the environment and the health and safety of people living there is maintained and promoted. Personal monies were not inspected at this visit as previous visits have shown that money is managed in accordance with peoples needs and safeguarded. Record keeping and maintaining accurate and ongoing individual records have always been an issue within the home. Records for maintenance of the home and health and safety checks are well maintained. Records relating to individual care such as pre-assessments, care plans, ongoing risk assessments and daily notes, however, are not as robust as they should be. They are not always fully completed and not formally reviewed on a regular basis. The Manager/Proprietor is aware that these are not maintained as they should be and has made some headway in improving these systems – but there are still shortfalls in this. The Manager/Proprietor stated that the well-being of the service users is her priority and feels that too much time spent on paperwork detracts from the actual care given. Time was spent at the inspection discussing the importance of being able to evidence that the care given was appropriate to peoples changing needs and that the records needed to be able to demonstrate this. A requirement is being made with regards to the maintenance of individual peoples records. The AQAA stated that all current safety checks had been carried out in accordance with their due dates. Again, though, in order to fully promote health and safety individual movement and handling assessments and other risk assessments need to be updated on a regular basis. The daily management and support provided in the home is dedicated to promoting the best outcomes for people living there but there is room for improvement with regards to record keeping required by regulation to fully protect service users. Durland House DS0000029067.V339958.R01.S.doc Version 5.2 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 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 3 2 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X 2 2 Durland House DS0000029067.V339958.R01.S.doc Version 5.2 Page 24 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 OP7 Regulation 15 (1) (2 (b)) Requirement Timescale for action 30/08/07 2 OP7 13 (4) (c) 3 OP9 13 (2) The Registered Provider must make sure the service user plan should continue to be expanded upon so as to incorporate all areas of support that is provided and that they are reviewed on a regular basis. Evidence must forwarded to the Commission in the timescales stated. Risk Assessments for service 30/08/07 users must be implemented and updated regularly, thereafter, in particular with regards to movement & handling and the risk of falls. This has been partially met but ongoing records need to be maintained. Evidence must forwarded to the Commission in the timescales stated. The Registered Provider must 15/08/07 make sure that the medication is stored in accordance with pharmaceutical guidelines and that accurate records of medication stored in the home is maintained. DS0000029067.V339958.R01.S.doc Version 5.2 Durland House Page 25 4. OP12 14,15,16, 5. OP13 16,12 6 OP37 17 The registered person ensures 31/10/07 that there is a programme of varied activities for the service users to choose from through the week. This has been partially met but the registered provider needs to continue to address this. Service users are able to access 31/10/07 and maintain links with the local community these are developed and/or maintained in accordance with service users’ preferences, by enabling the service users to go out, either locally or on larger organised trips. Will need to be recorded. This has been partially met but the registered provider needs to continue to address this. The registered provider must 31/10/07 make sure that records for service users are maintained to a standard that support there health, safety and well being. 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 OP26 Good Practice Recommendations The home is reminded that when they need to replace the current washing machine they will need to purchase a sluicing type washing machine. Ensure that staff continue to benefit from an ongoing training programme. 2. OP30 Durland House DS0000029067.V339958.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Durland House DS0000029067.V339958.R01.S.doc Version 5.2 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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