Inspection on 30/01/08 for Erith House

This inspection was carried out on 30th January 2008.

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

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

Erith House 20/01/10

Erith House 09/07/09

Erith House 21/01/09

Erith House 21/03/07

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 30th January 2008 09:25 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.V357228.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.V357228.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.V357228.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st March 2007 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.V357228.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This report reflects a summary of a cycle of Inspection activity at Erith House since the last Key inspection visit to the home in March 2007. It also includes information from a Random unannounced Inspection carried out in October 2007 as a result of concerns raised by the Ambulance service. 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 or their relatives about what it was like to live at the home; A site visit 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, administrator, chairperson of The ‘friends of Erith House’, a visitor and the staff on duty; various records were sampled, such as care plans and risk assessments; a tour was made of the home; and time was spent with some of the people who live at the home both individually and in groups. This approach hopes to gather as much information about what the experience of living at the home is really like, and make sure that resident’s experiences of the home form the basis of this report. People who live at the home have requested they be referred to as ‘residents’, so that term is used wherever possible in this report. What the service does well: The home provides an attractive environment in a spacious and attractive period building. Accommodation is well maintained and gracious, with large communal rooms with high ceilings and feature windows. 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.V357228.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 friends of Erith House. 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. One said “My husband and I had visited friends in homes in London and Torquay, very unsatisfactory ones, and hoped we would never have to move into care. After I stayed here I wrote to the management committee thanking them and saying that the stay had taken away that fear.” Another said “I was recommended to this home by a vicar who met at the church I was attending at the time. He said he had introduced several people to Erith House and had all been very happy here. A staff member wrote “As someone who has only been here a year I have seen huge attempts to improve the service of the home, the staff and management really are trying. What has improved since the last inspection? Care plans have been provided for each resident, and are being updated regularly. Care plans ensure that staff can all be aware of the residents needs and how assistance is to be given. A new lockable refrigerator has been purchased. This is so that residents medication can be kept safely and at the correct temperature. The home has also had a new boiler installed and purchased more moving and handling equipment and a new sit on scale. A new summerhouse has been installed in the garden which has had new handrails and a path fitted for easier access. Repairs have taken place to skylights on the first floor which allow natural light into the corridors. A record is being maintained of the return to the pharmacy of controlled medication no longer required. This is so that a full audit trail can be maintained. There has been a big increase in the training provided for staff and the number of staff currently on or having completed National Vocational Qualifications. These help to show staff competency in their job role. The manufacturers recommendations for the storage of eye drops following opening are being followed. This is so that they can be used safely. Erith House DS0000018351.V357228.R01.S.doc Version 5.2 Page 7 What they could do better: 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. Prescribed creams administered to people must be signed for. Where a prescription is written as an “as required” dose a protocol should be developed to say when it should be given. If it is being given regularly then the prescription needs to be amended by the prescribing GP. This helps to protect people from receiving medication in a way for which it was not prescribed. 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 The registered person should further develop the quality assurance system to provide an annual report and development plan. This helps to ensure that the home is being run in the best interests of the people living there. 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. Risk assessments must be completed for the banister rail and hot surface in the bathroom and action taken as a result to safeguard the people living at the home from any accidents. Staff must receive training in Adult protection. This is so that all staff are clear about what to do in case abuse is suspected. Developing care plans should include risk assessments and consideration should be given to making them more person centred. Care plans should be signed by the person they relate to. Staff may benefit from additional training being made available on the Mental Capacity act. Some windows are now in a poor state of repair which needs to be addressed so that people can live in a comfortable environment. Please contact the provider for advice of actions taken in response to this Erith House DS0000018351.V357228.R01.S.doc Version 5.2 Page 8 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.V357228.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.V357228.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People considering living at the home have access to good information and trial visits to help them decide if Erith House is the right place for them. The homes manager assesses people to make sure that their needs can be met. 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. This has recently been updated. 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 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. One relative who completed a questionnaire indicated Erith House DS0000018351.V357228.R01.S.doc Version 5.2 Page 11 that they would be asked to sign this after a trial period had been completed. This is good practice and helps people get a good idea about what living at the home is like before they make a commitment to live there. Files for five residents were selected for examination during the site visit, including two of the most recent admissions. The files seen contained information on the assessments that had been undertaken and these were then discussed with the manager. The manager visits people in their previous placements and talks to relatives, carers or hospital staff. She also obtains copies of social work assessments wherever possible before making a decision about whether the home is suitable or not to meet the persons needs. This also has to include an assessment of whether they will fit in with other people already living at the home. Two people who completed questionnaires felt that the needs of people being admitted were higher and included a higher level of mental frailty, which was altering the feel of the home. This was discussed with the manager. 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 if needed and a room is available. Erith House DS0000018351.V357228.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 good. This judgement has been made using available evidence including a visit to this service. Care plans are much improved. Some attention is still required to the medication systems to make them safe. EVIDENCE: Five peoples care plans were selected for examination on the visit. Plans were improved from the key Inspection and random Inspection visit which followed concerns expressed by the ambulance service who had been called to see someone who had fallen. They had expressed concerns that not enough information was recorded about the person and that the staff on duty were not clear about their needs. Further investigation revealed that work had been done to improve the care plans and this has continued. Plans now better reflect the needs of each person, but they are not signed by the individual concerned. The home has plans to introduce this along with further refinements. Discussion was also held on increasing the amount of Erith House DS0000018351.V357228.R01.S.doc Version 5.2 Page 13 social and personal history in the files and making the information contained more specific to the individual. As an example this would include not only what impairments the person had, but how these impacted on their life and information on their goals and strengths. Since the last inspection the home has purchased some sit on scales, a new electric stand aid and four new hospital beds. Specialist mattresses and other aids for relieving pressure are available or accessed via the district nurses. District nurses visit to apply dressings and carry out blood tests. First aid kits are available in the building and services such as chiropody and eyesight tests are available through domiciliary visits. The home manager said the home has built a good relationship with local medical practices. Medication administration records were seen. Since the last inspection the home has purchased a lockable medication refrigerator, which helps to ensure medication can be kept safely. Medication records showed that the controlled drugs records balanced with the stock held. Controlled drugs are those which due to their strength of effects are subject to greater restrictions on storage and use. Some medication in use is prescribed for ‘as required’ use but the records indicated that this was being given every day. No protocols were available in the persons file to indicate why this was happening. Some variable prescriptions –i.e. give 1 or 2 tablets, did not have a record of the number of tablets given. Creams are not being signed for so it is not clear whether these are still being used for the individual or not. Some people are able to administer their own medication. They have facilities to keep medication locked away ion their own rooms and the manager confirmed that they are monitored to make sure that they are safe to continue to do so. People spoken or who completed questionnaires said they were treated with respect and their healthcare needs were always or usually met. People felt supported to access healthcare outside of the home. One wrote “The carer always travels to hospital with me if I have to attend and informs my relative.” Another said “For visits to doctor, dentist or hospital the house has an account with a local taxi firm, and taxes for these visits are arranged for us at no charge.” Staff were seen knocking on peoples doors and people living at the home are referred to by their full title if they wish. This lends a sense of formality to the relationships. Erith House DS0000018351.V357228.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, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities are regularly planned for the home, but some of these would benefit from being tailored more to the needs of individuals. Meals are of a good quality. EVIDENCE: People living at Erith House can benefit from a programme of activities organised by the home or the “Friends of Erith House”. The friends visit the home monthly and they also visit two people living at the home on a monthly basis so that during the year each person living at the home has a chance to spend time with one of them in private talking about the home. There are also residents meetings held every other month when people can raise any issues or talk about any changes they would like to see made to the home. n the month of the inspection people had enjoyed a visiting pianist, tea party, exercise to music and plans were being made for a Beetle drive and a fundraising coffee morning. Some people living at the home felt the activities were hard for them to access as they had a specific impairment. One wrote “Being profoundly deaf makes some activities inappropriate for me.” Erith House DS0000018351.V357228.R01.S.doc Version 5.2 Page 15 People living at the home are enabled to maintain contacts with friends and relatives wherever possible and several relatives visited during the course of the day. “ The manager could also outline how one persons family communicate with them by email, which is printed off for the person in a large font. One person wrote” I am really happy to be here in my lovely room with some of my own furniture and treasures and being looked after by such caring staff -- my friends who visit me are quite amazed at the high standard of this home. Staff spoken to outlined the different ways people living at the home like to spend heir time. Some like to socialise, others prefer to spend more time in their rooms, just coming down for meals or events. The home last year installed a large summerhouse in the gardens and the manager confirmed that during the summer people had chosen to sit there and read their papers over coffee. The meals served are of a good quality. On the day of the unannounced visit the lunch was Roast lamb, roast potatoes, swede, carrots, sprouts and a black forest gateau for dessert. The people living at the home were co0nsulted about what they wanted for their evening meal from a choice of soup, cheese salad or sandwiches. Some relatives who responded to questionnaires said that their relative living at the home didn’t receive enough exercise since moving in and that their health had deteriorated as a result. One resident wrote about their day to day experience: “On Thursday morning there is exercise to music, which I used to attend. The GP referred me to the physiotherapist at the hospital and I was given a set of personal exercises which I do in my room and they bring relief for the arthritis. Each month there is a speaker on various topics or an entertainer, pianist or a group of singers. This is followed by tea and cakes. Films can be shown on a large screen with a good selection of titles. We have an excellent cook, and I feel the meals are of a high standard. Breakfast trays are bought to my room, good to have a quiet start the day. It is a light meal with cereal, toast and a pot of tea. For lunch on Sunday and Wednesday we have a roast with casseroles, pies, liver and bacon on other days, and a fish dish on Friday. Vegetables, salad and fruit are grown by a gardener so all are very fresh. The supper menu is bought round in the morning with a wide choice of options, salads with cheese or ham, soup (home-made) sandwiches with a choice of three fillings. “ Erith House DS0000018351.V357228.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes complaints procedure and adult protection policy should help to protect residents from abuse. 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. Members of the Trustees visit the home regularly and see residents individually. There are also resident meetings at which residents could voice concerns and a suggestions box. Some of the home’s staff have received in house training in the Protection of Vulnerable Adults procedure and have access to locally issued policies and procedures in relation to Adult protection. Other staff need to do this as a priority. One who completed a questionnaire felt that they would not know what to do if someone told them about abuse at the home. Discussions with other staff indicated that they had a good understanding of what was abusive practice. This should help to protect residents in case of issues of concern. One person wrote “we are all human and odd hiccups can occur but these are dealt with promptly to ensure continuing good practice at the home. Erith House DS0000018351.V357228.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, 20, 21, 22, 23, 24, 25, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Erith House provides a comfortable environment to live and work in. Some areas of risk and maintenance require attention. 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. Each room is individual, with many pieces of furniture and other belongings brought in by the resident themselves. Rooms are in some cases very large and allow for a division between sleeping and lounge areas. Some have Erith House DS0000018351.V357228.R01.S.doc Version 5.2 Page 18 facilities for making drinks, so that residents can be more independent. Attention is required to some windows which are now becoming in a state of poor repair. One room has a magnetic door closure fitted which was in a position that the person living in the room would not be able to access, and so would have to ask staff to close their room door. This reduces their independence. There are large communal rooms on the ground floor, which provide both for a sunny lounge and a quieter library room. The 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. The home has not used the Essential steps system for the auditing of Infection control practices, but the manager confirms she will do this. One resident wrote “The home is kept to a high standards of cleanliness, with rubbish baskets cleared daily. “ During the tour of the property it was noted that the banister rail to the first floor is low and presents a risk to people living at the home. The home is also advised to risk assess the hot towel rail in the ground floor bathroom and take action as appropriate. Since the last inspection site visit the home has installed an attractive summerhouse to the landscaped gardens and has installed a new boiler. Erith House DS0000018351.V357228.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, 30. Quality in this outcome area is adequate. Some areas were poor. This judgement has been made using available evidence including a visit to this service. Staff training has greatly improved, but gaps in the recruitment process remain which have the potential to put people at risk. EVIDENCE: During the site visit a sample of staff files were selected for inspection. Staff files showed an increase in staff training which is an improvement since the last inspection. The home delivers training internally with a system of training videos, tests and instructions. Some staff have still to receive this training. Most staff at the home are now also taking national Vocational Qualifications, which are a system for recognition of competency of staff in their working role. Staff files also contained evidence of the recruitment processes that were followed when they started wok at the home. For some files seen this showed that the system is not being used consistently, and records such as references and criminal records bureau checks were not always taken up before people started working at the home. Induction training is not being recorded. This could potentially put people living at the home at risk of being cared for by someone who was not suitable to be working with vulnerable adults. This was a requirement at the last inspection. Erith House DS0000018351.V357228.R01.S.doc Version 5.2 Page 20 Three members of staff were spoken to on the day of the site visit. All were clear about the needs of the people they were caring for and about their job role. One said Erith House was “one of the best places I have ever worked.” Questionnaires returned from staff indicated that they were happy in their job. One wrote The home tries hard to keep both residents and staff well informed, safe and happy. We have regular meetings, training etc, and this reflects well on the care and attitudes of everyone. One person felt the home was more short of staff at the weekends, and another that more staff were needed as the home is now full. A person living at the home wrote in their questionnaire “Staff will help at any time, are most caring and attentive. Staff provide a very good service. “ Erith House DS0000018351.V357228.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is being well run. Development is still to occur to the systems for quality assurance and staff supervision. EVIDENCE: Mrs Jane Hannaby has worked at the home for several years and is 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. 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. This will ensure residents views Erith House DS0000018351.V357228.R01.S.doc Version 5.2 Page 22 on the way the home operates are heard and acted upon, helping to improve the quality of their lives. An annual report is prepared. Likewise policies and procedures have begun a process of review to bring them into line with current practices and changes in the legal framework. Staff working at the home are not receiving supervision. Supervision is a system which combines personal development and work/performance management and is designed to ensure staff are working to their full potential and in a way that ensures people are being cared for consistently. The last recorded supervision for one persons file looked at was in 2006. Supervision is expected to be given six times a year. 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 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. 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. There is no First aid risk assessment. The chef is to undertake an audit system for the safe preparation of food proposed by the Environmental health department called – “Safer food, better business”. 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, however the banisters do need to be assessed and action taken as needed. Radiator covers have been provided to ensure residents cannot be accidentally injured by coming into prolonged contact with hot surfaces. One heated towel rail in the bathroom needs assessment to ensure people could not be injured by coming into contact with the hot surfaces. Erith House DS0000018351.V357228.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 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x x 2 x 2 Erith House DS0000018351.V357228.R01.S.doc Version 5.2 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 OP9 Regulation 13(2) Actual Medication dosages given to residents must be recorded on the medication administration record. 2. OP29 19 The registered person shall not employ a person to work at the care home unless ….he has obtained in respect of that 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.) Previous compliance date 30/10/07 not met. Risk assessments must be completed for the banister rail and hot surface in the bathroom and action taken as a result to safeguard the people living at the home. DS0000018351.V357228.R01.S.doc Requirement Timescale for action 15/02/08 15/02/08 3. OP19 13, 23 28/02/08 Erith House Version 5.2 Page 25 4. OP30 13 Staff must receive training in Adult protection. 30/03/08 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 OP33 Good Practice Recommendations 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 Prescribed creams administered to people must be signed for. Where a prescription is written as an “as required” dose a protocol should be developed to say when it should be given. If it is being given regularly then the prescription needs to be amended by the prescribing GP. 4. OP7 Developing care plans should include risk assessments and consideration should be given to making them more person centred. Care plans should be signed by the person they relate to. Risk assessments should be developed to include safe working practices for staff. Staff may benefit from additional training being made available on the Mental Capacity act. Some windows are now in a poor state of repair which needs to be addressed. 2. OP36 3. OP9 5. OP38 6. 7. OP30 OP19 Erith House DS0000018351.V357228.R01.S.doc Version 5.2 Page 26 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.V357228.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!