Inspection on 21/11/07 for Esther House

This inspection was carried out on 21st November 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

Esther House 14/08/06

Esther House 01/11/05

Esther House 28/06/05

Esther House 14/12/04

Esther House 30/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Esther House 34 Mauldeth Road Heaton Mersey Stockport Cheshire SK4 3ND Lead Inspector Sandra Buckley Unannounced Inspection 21st November 2007 09:00 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 Esther House DS0000008554.V354038.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. Esther House DS0000008554.V354038.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Esther House Address 34 Mauldeth Road Heaton Mersey Stockport Cheshire SK4 3ND 0161-432 0826 0161 947 9439 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr. Paul James Kelly Mrs Angela Kelly Cheryl Owen Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Esther House DS0000008554.V354038.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home is registered for a maximum of 15 service users to include: *up to 15 service users in the category of OP (Old age not falling within any other category). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The manager must obtain NVQ 4 in Management and Care by December 2006. 14th August 2006 Date of last inspection Brief Description of the Service: Esther House is a small home situated in the Heaton Mersey area of Stockport, close to local shops and amenities. It is a large detached house set in its own grounds. Esther House is registered to take people whose primary need for care is due to old age. At any one time, a minority of service users may suffer from short-term memory loss. The majority of service users have care needs which are relatively uncomplicated, i.e., help with washing, dressing/ undressing, assistance with toilet, administration of medication, acquisition of medical treatment, as and when necessary. A member of staff is employed to co-ordinate an activities programme for service users. Eight bedrooms have en-suite toilets. The home has a statement of purpose and service user guide which were reported to be given to prospective service users or their families when they visit the home to look round. The fees for staying at the home were reported to be between £328 and £339. Esther House DS0000008554.V354038.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was made to the home on 21st November 2007. This inspection looked at all the key standards and included a review of all available information received by the Commission for Social Care (CSCI) about the service provided at the home since the last inspection. During the site visit information was taken from various sources which included observing care practices and talking to people in the home. The manager, relatives and some members of the staff team were also interviewed. A tour of the home was undertaken and a sample of care, employment and health and safety records were seen. Comments from questionnaires returned from residents and their relatives are also included in this report. All but one of the requirements made at the last inspection had been addressed or were in the process of being completed. However, there still remain a number of service developments to be addressed. The CSCI requires the home to complete an annual quality assurance assessment (AQAA) in order to demonstrate the level of care provided. The lack of detail in this document, completed by the manager and provider, did not demonstrate their understanding of how and to what standard the home operates. This was discussed with the provider and manager who said they were unclear has to the level of information required. We gave examples of how this document should be completed for future inspections. What the service does well: Esther House is a small home, which offers a welcoming family atmosphere. Outcomes for people were positive - one person said, ‘I only came in for a short while but liked it so much I wanted to stay.’ Staff knew people’s care needs and could describe the needs of each person. One person said, ‘Staff are always on the spot when you need them,’ and ‘Carers are excellent.’ One relative said, ‘the home always keeps me informed to what is going on. My father is always clean shaven and is eating much better. He is a different person.’ Esther House DS0000008554.V354038.R01.S.doc Version 5.2 Page 6 Several friendships have been formed in the home and some people went out to access community facilities. We dined with residents and found the food to be well presented, nutritional and served in a congenial setting with staff dealing sensitively with people who needed assistance. One person said, ‘Food is always good here.’ Another said, ‘I had last Christmas here, it was lovely, just like being at home.’ Another said, ‘You do not miss your home because you are home.’ The small home environment ensured that effective communication was in place, even though there was a lack of recording on care practices. What has improved since the last inspection? What they could do better: For those who are funded by Local Authorities, an assessment of people’s needs must be obtained from professionals. The home’s assessment must be completed fully, detailing all the needs of people before they enter the home. To ensure the positive outcomes in the home, care planning, risk assessments and reviews must reflect people’s assessment of need. Risk assessments need to be in place for those people who choose to self medicate. Staffing levels need to be reviewed, especially in relation to ancillary staff. One resident said, ‘There are no activities now we have lost a member of staff.’ Regulation 26 of the Care Standards Act 2000 requires that the owner of the home must prepare a written report each month on an unannounced visit the provider has made to the service. They must interview, with the consent and in private, people who use the service and their representatives and staff working in the home. The report must include an inspection of the home, its record of events and records of any complaints. Esther House DS0000008554.V354038.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Esther House DS0000008554.V354038.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 Esther House DS0000008554.V354038.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): Standard 3 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The assessment process does not fully support that the manager is aware of people’s needs and is confident that such needs can be met prior to admission. EVIDENCE: The AQAA completed by the owners and manager stated that the manager assesses each person before coming into the home. Three care files were examined in depth. For people who are self-funding, the manager completes the assessment of people’s needs. Unfortunately, there was insufficient detail of people’s needs recorded. Esther House DS0000008554.V354038.R01.S.doc Version 5.2 Page 10 Assessments need to have full details, for example, the at risk of falls question was recorded yes. No further details were recorded of how, when and what aids may be needed. The lack of detailed assessments impacts on the quality of care planning and instructions to staff. A local authority funded one person. In this instance, the manager should have obtained a professional assessment of need from the referring agency. People interviewed spoke highly of the staff team and the care they offered. Introductory visits are advised. One person said, ‘I only came in for a short while but liked it so much I wanted to stay.’ Esther House DS0000008554.V354038.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 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service The lack of appropriate care plans in line with people’s assessed needs may impact on the outcomes for people living in the home. EVIDENCE: The lack of detailed assessments on the files examined impacted on the quality of care planning that was present. Although paperwork was in place, for example, nutritional screening, weight charts and risk assessments, none had been completed in full, some not at all. There was no record on the files examined that care needs had been reviewed. One person had eating problems and weight loss that had not been monitored. Risk assessments had not been completed for falls or people who self medicate. Esther House DS0000008554.V354038.R01.S.doc Version 5.2 Page 12 Other aspects of medication procedures needed attention, for example, changes to medication recording sheets had not been signed or dated. Esther House is a small home with a family atmosphere. People appeared well cared for and their personal choice was respected. Staff knew people and their needs well, with training being arranged in line with people’s needs. Comments from people who live there included: ‘The carers are excellent’, ‘Staff are always there on the spot when you need them’ and ‘Staff arrange for the podiatrist to come and also the hairdresser. They send for a doctor right away if I am not well.’ One relative interviewed said, ‘The home always keeps me informed to what is going on and my father is always clean shaven and eating much better.’ Also, ‘we moved him from another home and think he is 110 better cared for at Esther House. He is a different person.’ The inspector observed good practices and staff dealt sensitively with people’s needs. These positive outcomes for people must be reflected in record keeping, ensuring standards are maintained. The AQAA provided insufficient detail to the question ‘what do we do well regarding health and personal care.’ This stated, ‘We ensure each person feels well looked after, loved and cared for.’ The detailed completion of this would have provided an aide memoire for completion of care planning. However, it had been recognised that they need to improve the reviewing of people’s care plans. The lack of detailed care planning was also identified on the previous inspection and now requires immediate attention. Daily records were detailed and demonstrated staff’s awareness of people’s needs. Esther House DS0000008554.V354038.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People’s experience of daily life in the home was positive, although the introduction of additional activities would enhance this experience for people. EVIDENCE: Observations throughout the day showed that the small home environment Esther House offers promotes good interactions between staff and people who live there. Several friendships have been formed with people supporting each other throughout the day, promoting a feeling of self-worth. One person went out often to local amenities and supported another to go with her if they so wished. Three different denominations visit the home to give communion and one person went out to church when they were able. Esther House DS0000008554.V354038.R01.S.doc Version 5.2 Page 14 People said routines were flexible, which was also noted on the day of inspection, with breakfast being taken later by some people. We dined with a group of people who had nothing but praise for staff and the cook. One person said, ‘Food is always good here, there is no choice listed at lunch time but the cook knows us very well and what we like.’ Another person said, ‘I have what I had at home for breakfast which is crackers.’ One person said, ‘I still like my own paper to read, the Financial Times.’ And ‘I had been somewhere else before this and did not like it. My daughter found me this one.’ Food served was tasty and well presented and served in a congenial environment, with staff being observed to deal sensitively with people who required assistance. Ladies were dressed appropriately with a choice of personal jewellery and nails polished, if required, with men being clean-shaven. The manager said the hairdresser visits once a fortnight. One person said, ‘Night staff bring me a drink if I cannot sleep”, another said they would like more fresh fruit and brown bread sometimes. The inspector discussed this situation with the manager and cook, and was informed that there were no restrictions on budgets and fresh fruit was available. There was evidence of this at the time of this inspection. It was suggested the manager might wish to be proactive and cut and prepare fruit, which can be offered alongside tea and cake in the afternoon. Unfortunately, they were unaware that one person prefers brown bread, which is offered occasionally. The manager said they would address this issue immediately. One person said ‘we have a meeting with the owners but no-one ever speaks up. I help to set the tables and go to my room to watch TV.’ Several people spoke about the lack of activities, although an activity that took place was displayed in the hallway. One person said, ‘There are not enough activities, the member of staff who used to do them has left.’ People were encouraged to access community facilities where possible. person said, ‘I knit for a charity and they provide the wool.’ One Esther House DS0000008554.V354038.R01.S.doc Version 5.2 Page 15 The inspector spoke to one person who had lived in the home for 18 months. They discussed the quality of life they had experienced and said, ‘I had last Christmas here it was lovely, just like being at home.’ And ‘As soon as I walked in I knew I was at home.’ Also, ‘You do not miss your home because you are home.’ Esther House DS0000008554.V354038.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. A satisfactory complaints procedure is in place and staff have access to protection of vulnerable adults training, ensuring protection for people in the home. EVIDENCE: There is a complaints procedure on display in the hallway of the home. A complaint, compliments and concerns book is also in the entrance of the home for people to comment if they so wish. Neither CSCI nor the home had received any complaints since the last inspection. One person said, ‘If I weren’t happy I would see staff.’ People interviewed all said they had no complaints but felt comfortable in raising any complaints they may have. Protection of vulnerable adults training is arranged through Stockport social services for those staff that are not undertaking National Vocational Qualification. Esther House DS0000008554.V354038.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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Esther House is clean and well maintained with a warm welcoming atmosphere. Bedrooms reflect the personal choice of people and promotes a feeling of well-being. EVIDENCE: Esther House provides a clean, homely and well-maintained environment, which is free from odours and welcoming. Rooms were individually decorated and designed. Many had been personalised. One person said, ‘I brought in some of my furniture; a chair and a table.’ Esther House DS0000008554.V354038.R01.S.doc Version 5.2 Page 18 Grab rails had been provided where people may need assistance, which also includes bedrooms. There is one large lounge with a TV, and a dining room, which also provides a seating area overlooking the garden. A small quiet room where people can take their visitors is also available or they may just use it for personal space. The gardens are well maintained with seating areas. The lack of a lift does limit the choice of this home to some people; however there are three stair lifts to each level of the home. As mentioned previously in this report, some people choose to self-medicate but, unfortunately, no lockable piece of furniture was available the rooms. The manager said this was mainly because it was individual people’s furniture. They said they would look into this matter on how medication can be kept safe in people’s rooms. Esther House DS0000008554.V354038.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. This judgement has been made using available evidence, including a visit to this service. The lack of ancillary staff has had an impact on managerial work and activities in the home. Failure to obtain appropriate Criminal Record Bureau checks may pose a risk to people in the home. EVIDENCE: Examination of the duty rota for week commencing 19th November 2007 showed that the manager and two carers are on duty up to 12 o’clock. The cook does not start duty till 9am so staff are responsible for early breakfasts, as well as delivering personal care and laundry. These staffing levels remain until 3.45pm when numbers drop to two staff on shift, one of whom is the manager. Staff on the evening shift are responsible for preparation of teas, which are left out by the cook, serving meals, cleaning, laundry and personal care. The home has been without a domestic for approximately nine months, with staff having to undertake all cleaning duties and laundry. Esther House DS0000008554.V354038.R01.S.doc Version 5.2 Page 20 One person said, ‘there are only three staff on duty a.m., no cook till 9am and five people need a lot of help, also there is no cleaner.’ Another said, ‘There are not enough activities now the member of staff who used to do them has left.’ It has been identified throughout this report there have been areas the manager has failed to address, although outcomes for people remained positive. The manager said this was due to time constraints and that they needed to be hands-on and part of the care team. Supernumerary hours for the manager would enable them to address issues identified in this report. There was evidence that staff training had been accessed through Stockport Social Services that included staff inductions, first aid, and moving and handling. The inspector interviewed two staff members, one of whom did regular bank work for the home. Both knew people’s care needs well and gave detailed accounts of what personal care was needed. The manager reported that 50 of staff were trained to NVQ level 2. Night duty starts at 7.45pm through to 7.45am and there is only one member of staff and one person who sleeps on the premises. The person who sleeps on the premises was not reflected on the duty rota. Staff who had recently been employed had undergone Criminal Record Bureau checks. Unfortunately, the two people who covered sleeping-in duties had not been police checked. The manager said they would address this matter right away. They said confusion had arisen because one person was a family member and both people who undertook the duties had separate self-contained apartments attached to the home. People in the home were very positive about the care staff provided. Comments included ‘Staff are all very nice, no rudeness or anything, they treat me very well.’ The owners and manager had also failed to detail their procedure for recruitment, including Criminal Record Bureau checks, on the AQAA. However, they had recognised the need for a detailed staff training and development plan to be implemented. Esther House DS0000008554.V354038.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, 33, 35, 36 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Although positive outcomes remain, the management of the home does not fully promote the health, safety and well being of all residents. However, there is evidence that people are consulted about the service provided. EVIDENCE: The manager is qualified to NVQ level 4 and is near to completing the registered manager’s award. A deputy manager is also in post to ensure the presence of senior staff on duty. Esther House DS0000008554.V354038.R01.S.doc Version 5.2 Page 22 The manager operates an open and inclusive atmosphere where people’s views in the home are sought. Meetings were held for people to air their views, last minutes taken in August 2007. These stated that all were happy with the food and that a request had been made for a Christmas outing. Formal staff meetings were held on a less frequent basis, the last being recorded on 11th July 07 with issues of laundry; staff must ensure that people’s clothes are returned appropriately. Also, when any call bells are activated, they must be addressed immediately. No quality assurance systems were in place to gain the views of professionals or relatives. The home does not hold finances of people living there; these were, in the main, managed by families or advocates. Formal staff supervision did not take place. The small home environment allowed for effective communication systems and ensured positive outcomes for people remained. However, this needs to be a formal process to ensure positive outcomes remain and staff have development opportunities. A number of issues in this report relate to poor recording systems. It was noted that the information supplied in the AQAA demonstrated that there was an absence of policies and procedures, for example, physical intervention and restraint in dealing with crises and emergencies. The manager forms part of the care team, including duties of cleaning and laundry. The lack of supernumerary hours for the manager has impacted on the recording systems in the home. Health and safety was addressed by regular checks on equipment in the home. Weekly fire tests have been undertaken and staff had received fire drill training. Further fire drill training for staff was organised for January 2008. First aid and a moving and handling course were also scheduled. The owners visit on a regular basis and record such visits. Unfortunately, the process used for monitoring the home was not recorded. Regulation 26 of the Care Standards Act 2000 requires that the owner of the home must prepare a written report each month on an unannounced visit the provider has made to the service. They must interview, with consent and in private, people who use the service and their representatives and staff working in the home. The report must include an inspection of the home, its record of events and records of any complaints. Esther House DS0000008554.V354038.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 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 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 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 X 3 3 2 2 2 Esther House DS0000008554.V354038.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 OP3 Regulation 4/5 Requirement Timescale for action 31/12/07 2 OP7 15 3 OP9 13(2) 13(4c) 4 OP29 19 Complete a detailed assessment of need for those people who are self funding with a professional assessment of need being obtained for people funded by the local authority. Care planning must be 31/12/07 completed in line with people’s assessment of need and reflect risks involved, providing detailed instructions to staff on care delivery in order to ensure people’s needs in the home are met. Timescale of 31/10/06 not met. Risk assessments must be 31/12/07 completed for people who wish to self medicate. Any changes to medication recording must be signed and dated to ensure people’s health and safety needs are met. A Criminal Record Bureau check 31/12/07 must be obtained for people working in the home before commencement of duty to ensure the protection of people in the home. Esther House DS0000008554.V354038.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard OP24 OP27 OP36 OP37 OP38 Good Practice Recommendations A lockable piece of furniture should be provided for people who wish to self-medicate and store medication within their rooms. Review staffing levels in line with people’s needs and ensure all people working in the home are reflected on the duty rota. Staff supervision should take place a minimum of six times a year in order to recognise training needs and aid personal development. Recording systems in the home need to be reviewed for example, quality assurance, care planning and assessments. Regulation 26 of the Care Standards Act 2000 requires that the owner of the home must prepare a written report each month on an unannounced visit the provider has made to the service. They must interview, with the consent and in private, people who use the service and their representatives and staff working in the home. The report must include an inspection of the home, its record of events and records of any complaints. Esther House DS0000008554.V354038.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Manchester Local Office 11th Floor, West Point 501 Chester Road Old Trafford Manchester M16 9HU 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 Esther House DS0000008554.V354038.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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