Inspection on 21/03/07 for Erith House

This inspection was carried out on 21st March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Erith House 20/01/10

Erith House 09/07/09

Erith House 21/01/09

Erith House 30/01/08

Erith House 07/02/06

Erith House 23/08/05

Erith House 07/01/05

Erith House 15/06/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Erith House Lower Erith Road Torquay Devon TQ1 2PX Lead Inspector Michelle Finniear Unannounced Inspection 21st March 2007 8:50 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 Erith House DS0000018351.V300495.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. Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Erith House Address Lower Erith Road Torquay Devon TQ1 2PX 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) 01803 293736 01803 211311 Erith House Management Committee Mrs Jane Hannaby Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability over 65 years of age of places (20) Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Erith House provides residential care for up to twenty older people, who may also have physical disabilities. The house was purpose built in Victorian times, and was solidly built, with gothic archways and fine windows. It is set in a large attractive garden in a quiet residential area in Wellswood, between Torquay and Babbacombe. There is level access throughout, with a shaft lift, and wide doors and corridors. Flagstones have been laid along the garden paths to make walking easier. There are raised toilet seats and two specialised baths to support residents with mobility difficulties or frailty. As well as a large lounge and dining room there is a library and a kitchenette for the use of residents. All bedrooms are single, with en-suite facilities. Several are large with lovely views over the town of Torquay and gardens. There is parking available in the grounds or on local roads. Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report reflects a summary of a cycle of Inspection activity at Erith House since the last inspection visit to the home in May 2006. To help CSCI make decisions about the home the owner gave us information in writing about how the home is run; information received since the last inspection was seen along with the records of what was found at the last inspection; Questionnaires were sent to residents about what it was like to live at the home; A site visit of nearly 9 hours was carried out with no prior notice being given to the home as to the specific date and timing of the visit; discussions were held with the registered manager and the staff on duty; various records were sampled, such as care plans and risk assessments; a tour was made of the home; time was spent with the people who live at the home both individually and in groups and some discussion was held with a representative of the management board who were visiting the home at the time of the site visit. In addition a sample group of residents were selected and their experience of care was ‘tracked’ and followed through records and discussions with staff and management from the early days of their admission to the current date – looking at how well the home understands and meets their needs, and the opportunities and lifestyle they experience. This approach hopes to gather as much information about what the experience of living at the home is really like, and make sure that residents experiences of the home form the basis of this report. What the service does well: The home provides an attractive environment in a period building. Accommodation is well maintained and gracious, with large communal rooms with high ceilings and period features. There are pretty and mature level gardens with level pathways and a vegetable garden, where some vegetables for the home are grown. All bedrooms have en-suite facilities and are bright and airy. Many have space for bedroom and separate lounge areas. Rooms, many of which have been furnished by residents themselves, are attractive and homely. Some residents have facilities to prepare their own hot drinks. Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 6 A variety of ways have developed for residents to have a say in the way that services are provided, including regular resident meetings and visits from the management board. Several of the residents at the home manage most of their own care needs, with some support from staff. Independence is encouraged. Residents commented favourably on the home. Comments such as “I have been at Erith House for over 6 years- I feel I know Erith House and it’s staff really well and enjoy their company” were typical. Staff commented that it was a friendly place to work. Policies and practices are being reviewed to ensure they are up to date and reflect current best practice. What has improved since the last inspection? Since the last inspection the home has: Increased the number of meetings with residents. This helps them to feel that they have a say in the way that the home is run. Issued staff with updated job descriptions and contacts for their employment. This helps staff be clear about their job role and their terms and conditions. Held regular staff meetings. These help staff to share information and work consistently to support residents. Improved terms and conditions and consistency between staff, and implemented a full package of training for all staff. This should mean that staff are better able to support residents. Updated many policies and procedures, so that they are up-to-date and support both residents and staff. trained all staff in the protection of vulnerable adults from abuse, which should mean that staff know what to do if they have any concerns about any practice they are aware of. This should help protect residents. refurbished the ground floor bathroom to provide an additional adapted bathing facility for people with disabilities, which should mean that residents can all bathe in comfort no matter what their disability or ability is. Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 7 Carried out work to provide information on the operation of the home to link to a quality assurance policy. This is so that residents and other stakeholders can influence formally the way in which the home operates. What they could do better: Care plans must be provided for each resident, kept under review and updated regularly. Care plans should include risk assessments and consideration should be given to making them more person centred. Care plans ensure that staff can all be aware of the residents needs and how assistance is to be given. The registered person must ensure that all medication is stored securely, including medication requiring refrigeration whilst in storage. This is so that residents medication can be kept safely and at the correct temperature. Medication dosages given to residents must be recorded on the medication administration record. This is so that a full accurate record is kept to minimise any errors or accidental overdose. A verbal prescription alteration should be confirmed by fax or listened to by two staff members to ensure the correct amount is heard and recorded. This is to protect residents from accidentally being given the wrong dose. A record must be maintained of the return to the pharmacy of controlled medication no longer required. This is so that a full audit trail can be maintained. A full recruitment procedure including checks for references and criminal records must be undertaken before a new staff member works at the home. This is to protect residents from being cared for by people who may be unsuitable to care for vulnerable people. Risk assessments should be developed to include safe working practices for staff. This is to ensure that staff are safe in their work. Training and induction in care work must be given to all staff working at the home. The registered person should further develop the quality assurance system to provide an annual report and development plan. All staff should receive supervision at least six times a year and signed records should be given to the staff member and one kept for inspection. This is so that staff are working consistently and to their full potential. Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 8 It is recommended that the manufacturers recommendations for the storage of eye drops following opening be followed. This is so that they can be used safely. 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. Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 6 Quality in this outcome area is good. Residents are assessed prior to admission to make sure the home is the right place for them, and receive information about what the home has to offer. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a statement of purpose and a service user guide, which provides residents with information about the home and the services and facilities available. Copies of this may be given to people considering whether Erith House is the right home for them. Contained within the service user guide are copies of the homes contract of residency. This contract explains in greater detail what the home will provide in exchange for the fees paid, and how much Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 11 these fees will be. This means that before moving into the home everybody is clear about the terms and conditions of living at Erith House. Files for five residents were selected at random for examination during the site visit, including the two most recent admissions. Pre- admission assessments of residents were available in four of the files seen, including the latest two admissions. Pre-admission assessments are important as they ensure that the home can meet the residents needs, and they allow the resident to gain as much information about what the home has to offer as possible. Discussion was held with the manager concerning how the two most recent admissions had occurred and then discussions were held with one of the residents about their understanding of the process that had been followed. This was reflected in the paperwork and records seen about the admission. It is good practice for a prospective resident to be able to visit the home before moving in, and one resident confirmed they had done so with their relatives. Another resident said they had relied on relatives to visit several homes before making the decision on their behalf. Erith House does not provide intermediate care. This means that they do not provide a specialist intensive facility dedicated to short term rehabilitation with a view to returning the residents to their own home. They do however provide short term and respite care is needed and a room is available. Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is adequate. Some areas were poor. The care planning and reviewing record-keeping systems do not provide sufficient information on residents needs or how their care is to be delivered. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Five resident files were selected for examination in depth, and other files were seen to cross reference particular issues. In the files seen not every resident had a full assessment of need, or a resident plan of care. Care plans and assessment of needs are important as they identify the support required by a resident to carry out their day-to-day life, Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 13 and an action plan on the behalf of the home as to how they are to meet this need. It is acknowledged that the home is implementing a new care planning system, however this was commenced last October and many new files had not been started. For some residents information was available on the older system, however this was not comprehensive. Thorough regularly reviewed care plans should mean that staff can work in a consistent way and in accordance with the way in which the resident has expressed a wish their care to be delivered. Current care plans were not signed by the resident, and have no information on residents personal history or social history and needs. In addition records for personal care that had been given had not been completed consistently. As an example, one record indicated that the resident had not had a bath for eight weeks, however the discussions with the resident and staff on duty and other records of day-to-day care demonstrated that they clearly had. Some risk assessments had also not been completed or were missing. Risk assessments are a tool for assessing the levels of risk presented to the resident and how those risks can be minimised without undue restrictions. assessments. For some residents there was very little information available, particularly those who hadnt been admitted recently. Residents spoken to however confirmed that the care that they received was of a high standard, and that their privacy and dignity were respected. One resident in particular confirmed that they had come to the home because they had previous knowledge of it and that they knew they would be cared for in a friendly, compassionate and caring environment. Staff spoken to had a clear idea of the needs of the people they were looking after. Time was spent with two staff members in particular talking through the care delivered to individuals. This was then related to the records and the individuals experiences of living at the home. Residents spoken to felt that their care needs were being met. Some residents spoken to felt they were mainly self caring and needed little support from staff as the preferred to remain independent and active. Specialist equipment has been provided where needed to support residents health care, for example a second specialist adapted bathroom facility has been recently provided. One resident confirmed that for “visits to doctor, dentist or hospital” residents were able to take Taxis and charge them to the homes account, which was greatly appreciated. Examination was made of the medication systems, including administration and storage. The home completes administration record sheets to show when medication has been given to residents, and these were completed appropriately. The home also records the number of medicines received into the home, so that an audit trail can be completed. These are areas were all Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 14 seen by the CSCI a pharmacy inspector who visited in May 2006 and completed a full audit. However the administration of a particular medication was not clearly identified on the medication administration record sheet and no dose was recorded on the chart. This medication is one that might be subject to a variable prescription, which is determined following a regular blood test. The home was advised that the dosage administered should be recorded, and that where a verbal prescription alteration is received from the district nurse or doctor, two staff should listen to this to ensure that the correct alteration to the dose is heard and recorded. It is preferable that this information be faxed. On a couple of occasions within the medication administration charts there were instances where no amount of medication administered had been recorded. This is required when you might have for example a prescription that reads one or two tablets given four times a day. This could put residents at risk Medication is stored safely in a locked cabinet, however medication requiring refrigeration is kept in a large fridge in the dining area. This is not locked or secured. A record is maintained for controlled medication, which is medication that due to its potential harm needs to be recorded and stored with extra security. Where some residents were no longer requiring medication and this has been returned to the community pharmacist there was no record of this in the book. Some residents who self administered their own medication commented that prescriptions were not always available when needed. The manager felt that some residents left notifying her until very late before requesting additional tablets. Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. Opportunities to take part in activities are available, and this may be increased, with more person centred activities. Residents are receiving a wholesome and balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion was held with the manager on increasing the social history element within resident files. This is to ensure the home has full information about a residents earlier life, personality, likes and dislikes etc to assist them in supporting residents to lead full and active lives at the home. Visitors are welcomed to the home, and may be able to support the home further in this area. Discussion with the homes management and with individual residents indicated that they have the ability to exercise choice in relation to many activities of daily living, for example whether to participate in leisure and social activities Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 16 provided, some choices at mealtimes as to what to eat and where, choices in personal and social relationships and support to follow chosen religious observance. This might include for example being taken to a local church or the home arranging for an in-house communion service. The home provides a programme of activities, some of which are, as on the day of the inspection provided by the friends of Erith House and the board of trustees. These are detailed on the homes notice board, on a daily programme, and the manager confirmed she is considering developing a newsletter. Residents who completed a questionnaire commented that there are activities they participate in. One commented: “ the ladies management committee….. have arranged monthly tea parties with many fine speakers on their varied topics, or showing of photographs by retired gentleman taken on their holidays, or a musical entertainment. There is also a large screen for showing films. Each Thursday there is movement to music led by a qualified physiotherapist. Discussion was held on ways of further involving and recording more person centred activities that are individual and based on the particular needs, interest and wishes of the people who live at the home. The meal being served on the day of the site visit was poached salmon and new potatoes with peas, and fruit crumble and cream for dessert. Residents who completed questionnaires indicated that the food was of a good standard. Residents spoken to confirmed that the food served was plentiful, and some were having to ‘cut back a bit’ as they were ‘putting on weight’. Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. The homes complaints procedure and policies on abuse should protect residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Erith House has a complaints procedure that is available in the home and a copy of which has been given to each resident. Residents spoken to or who completed questionnaires indicated that they would know who they would speak to if they had any concerns, which was either the manager, or the homes administrator. In addition one noted that “Carers are quick to notice if they think you have a problem”. Members of the Trustees visit the home regularly and see residents individually as dos the home’s housekeeper to make sure that all areas of their rooms/laundry etc are satisfactory. There are also resident meetings at which residents could voice concerns and a suggestions box. The home’s staff have received training in the Protection of Vulnerable Adults procedure and have access to locally issued policies and procedures in relation to Adult protection. Discussions with staff indicated that they had a good Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 18 understanding of what was abusive practice and of the rights and protection of residents. This should help to protect residents in case of issues of concern. Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 19 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, 20, 21, 22, 23, 24, 25, 26. Quality in this outcome area is good. Erith House provides a comfortable environment for residents to live in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Erith House is situated in a quiet but central residential area of Torquay. The building is Victorian and impressive with high ceilings and wide corridors, with mature private level gardens and parking. The home provides for up to 20 residents, all in single rooms. All bedrooms are en-suite, with toilet seats and grab rails being provided according to assessed need. There is a Parker bath, and a newly fitted assisted bathroom on the ground floor, so that all residents can bathe with ease. Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 20 Bedrooms are well decorated, with attractive soft furnishings, and good lighting including table lamps and wall lights. One resident commented that they were hoping for some additional lighting when their room is refurbished, which is imminent according to the manager. This room also had some damage to décor under a window sill and required a new carpet. Each room is individual, with many pieces of furniture and other belongings brought in by the resident themselves. Several residents commented on this, and discussion was held with the chair of the trustees who was preparing a room for a resident about to move in, who wished to bring much of their own furnishings with them. Rooms are in some cases very large and allow for a division between sleeping and lounge areas. Some have facilities for making drinks, so that residents can be more independent. There are large communal rooms on the ground floor, which provide both for a sunny lounge and a quieter library room. The spacious dining room is adjacent to the kitchen and all rooms have been decorated to retain a feel of the period of the property. The home was clean and free from odour throughout communal areas, including laundry and service areas. One resident room had a specific odour problem, which was discussed with the manager. There are two washing machines, and a tumble drier in the laundry. Disposable gloves and aprons are provided and the manager has further implemented more ways of reducing the risk from the spread of infection i.e. staff have access to soap free hand cleaners that they are encouraged to use between attending to individual residents. A separate self contained flat in the basement has recently been refurbished. Currently it does not appear that this is registered accommodation. Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is adequate. Some areas were poor. The homes files do not show that a full staff recruitment procedure has been consistently followed. This could put residents at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Five staff files were selected at random on the site visit for review. In addition two staff were interviewed, three spoken to informally and five completed anonymous questionnaires about the operation of the home. Time was also spent with the homes administrator and manager. The staff files seen contained information on the recruitment procedure followed when appointing staff, some of whom have been at the home for many years. Files showed several gaps in the recruitment processes followed, which the home were already aware of and are attempting to remedy. All the files seen contained application forms, but only one contained two written references, only one contained a criminal records bureau check and two had evidence of a POVA first check having been undertaken whilst waiting for a CRB to be returned. No other evidence was available that a criminal records Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 22 bureau check had been undertaken. The manager was sure that these had been completed. Failure to complete a full recruitment procedure, including all required checks, could place residents at risk of being cared for by people who are unsuitable to be working with vulnerable adults. In addition records of training and development were variable and there were no records of supervision for two staff members, the last being July 2006 for those recorded. Prior to the inspection the home manager and administrator had identified shortfalls in the homes training and induction systems and the administrator has begun preparing training files for each staff member and is commencing delivering a training package for staff. This should also provide for an induction period as only one file seen contained evidence of the induction that staff had been offered when starting work at the home. Induction and staff training is important as it ensures that staff are working consistently and in accordance with best practice to support residents. Residents complimented the staff at the home for their kindness. One said they had moved to the home as they know they would be “among friends” having known some of the staff previously. The interactions seen were respectful and courteous. Staff who completed questionnaires indicated that the home was a good place to work in, that the quality of care given was good and that it was like working in a “big family house”. Another indicated that the home would benefit from greater teamwork. Staff rotas supplied prior to the site visit showed four members of care staff on duty in a morning, three to four in the afternoon and two waking and one sleeping in at nights. In addition, the Manager is present for five days a week. Care staff are supported by two general assistants, a cook, a kitchen assistant and a kitchen domestic. Residents who completed questionnaires indicated that staff always or mostly were available when they needed them and listened to what they had to say. Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 23 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 Quality in this outcome area is adequate. Some areas were good. The home is being well run. Development is still to occur to the systems for quality assurance and staff supervision. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mrs Jane Hannaby has worked at the home for several years and is now the registered manager. Registration means that she has been found to be a “fit person” to be managing the home and is responsible for and in control of the day to day activity in the home. She manages the home on behalf of the Board of Trustees and is supported by an administrator as well as senior staff. Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 24 Discussion was held on the homes quality assurance systems with the homes administrator. Information is being gathered from residents and other stakeholders about the operation of the home. The information gathered now needs to be incorporated into a continuous self monitoring cycle of information gathering using an objective, consistent method and an annual report. This will ensure residents views on the way the home operates are heard and acted upon, helping to improve the quality of their lives. Likewise policies and procedures have begun a process of review to bring them into line with current practices and changes in the legal framework. The arrangements for the management of residents finances held in trust by the home were satisfactory. The home manager holds a small amount of cash for several residents. Individual transactions are recorded and each item of expenditure made on a residents behalf is receipted. This includes for example payments for hairdressing or chiropody. The running balance was checked at random and found to tally with the individual resident recorded accounts held. The staff at the home receive training in health and safety practices and there is a health and safety policy file available which contained details of some of the homes arrangements, for example the storage of cleaning materials. Data sheets were generally available for products in use. Data sheets contain information on all the chemicals used at the home, how they should be used and what to do if these are accidentally misused. Discussion was held with the manager on risk assessments and an environmental audit system. A staff member checks the building regularly for hazards and any maintenance issues, and there were some risk assessments available for the environment, but none for safe working practices. Evidence was seen of maintenance contracts for such areas as hoists, electrical safety and lifts. This helps to ensure serve users live in a safe environment. Checks of the fire log book indicated that all the appropriate fire tests are being carried out. This includes the testing of the fire alarm system and checks of the emergency lighting. A risk assessment has been provided for the fire precautions but was still needed for first aid risks at the home. The hot water supply is regulated to all baths and showers, and one tested at random was at a suitably low level. This means residents are protected automatically from any risks of scalding. Window openings above the ground floor are likewise restricted to prevent residents accidentally falling from windows. Radiator covers have been provided to ensure residents cannot be accidentally injured by coming into prolonged contact with hot surfaces. Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 1 x 2 Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (1) (2) Requirement The registered person shall after consultation with the resident….prepare a written plan as to how the residents needs in respect of his health and welfare are to be met. (Care plans must be provided for each resident, kept under review and updated.) The registered person must ensure that all medication is stored securely, including medication requiring refrigeration whilst in storage. Previous compliance date not met. 30/06/06 Medication dosages given to residents must be recorded on the medication administration record.. A record must be maintained of the return to the pharmacy of controlled medication no longer required. The registered person shall not employ a person to work at the care home unless ….he has obtained in respect of that DS0000018351.V300495.R01.S.doc Timescale for action 21/06/07 2. OP9 13(2) 21/04/07 3. OP29 19 21/04/07 Erith House Version 5.2 Page 27 4 OP30 18 (1) ( c ) (i) person the information and documents specified. ( References, Criminal records bureau or POVA first checks Supervision, proof of identity, evidence of fitness and evidence of qualifications must be obtained before a member of staff commences employment at the home.) The registered person shall ensure that the persons employed by the registered person to work at the care home receive training appropriate to the work they are to perform. (Training and induction must be given to all staff working at the home) 24/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3. 4 5 Refer to Standard OP7 OP9 OP38 OP33 OP36 Good Practice Recommendations Developing care plans should include risk assessments and consideration should be given to making them more person centred. A verbal prescription alteration should be confirmed by fax or listened to by two staff members to ensure the correct amount is heard and recorded. Risk assessments should be developed to include safe working practices for staff. Further develop the quality assurance system in line with the NMS 33. All staff should receive supervision at least six times a year and signed records are given to the staff member and one kept for inspection It is recommended that the manufacturers recommendations for the storage of eye drops following DS0000018351.V300495.R01.S.doc Version 5.2 Page 28 6. OP9 Erith House opening be followed. Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Erith House DS0000018351.V300495.R01.S.doc Version 5.2 Page 30 - 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. 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