Inspection on 21/05/08 for Frinton House

This inspection was carried out on 21st May 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Frinton House 19/11/09

Frinton House 19/05/09

Frinton House 15/08/06

Frinton House 13/12/05

Frinton House 01/02/05

Frinton House 21/09/04

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 Frinton House 22 Buckhurst Road Bexhill on Sea East Sussex TN40 1QE Lead Inspector Caroline Johnson Unannounced Inspection 21st May 2008 09:50 Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 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 Frinton House DS0000060740.V365048.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 Adults 18-65. 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. Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Frinton House Address 22 Buckhurst Road Bexhill on Sea East Sussex TN40 1QE 01424 214430 01424 214431 frinton@consensushealthcare.org www.concensusupport.com Consensus Support Services Ltd 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) Miss Holly Robins Care Home 8 Category(ies) of Learning disability (0) registration, with number of places Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: 2. Learning disability - LD The maximum number of service users who can be accommodated is: 8 15th August 2006 Date of last inspection Brief Description of the Service: Frinton House is a detached property situated a short walk from Bexhill town centre and railway station. Bedroom accommodation is provided in eight single rooms situated on the ground and first floors. A shaft lift is fitted to assist access to first floor accommodation. The home is registered to accommodate eight adults with a learning disability; the registered owners are Aitch Care Homes Ltd. The fees charged start from £1,350 per week and include all day care provision and £250 towards the cost of a fully supported annual holiday. If residents require one-to-one support these costs would be negotiated separately. The cost of basic toiletries and chiropody are also included in the fees but residents pay themselves for hairdressing. Frinton House DS0000060740.V365048.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 that the people who use this service experience adequate quality outcomes. For the purpose of this report the people living at Frinton House will be referred to as ‘residents’. As part of the inspection process a site visit was carried out on 21/05/08 and it lasted from 9.50am until 5.25pm. The appointed manager facilitated the inspection. Over the course of the inspection there was an opportunity to meet with two of the residents. In addition time was spent with two members of care staff in private. With the exception of one bedroom all other areas of the house were seen during the inspection. A full examination was carried out of two care plans. In addition records seen included; staff recruitment and training, medication, menus, health and safety, quality assurance and leisure activities. Since the last inspection the registered manager has left her position as manager and the deputy manager took on the role in an acting capacity in October 2007. She was then appointed to the role of manager in January 2008. She has yet to submit an application for registration. At the time of inspection one of the residents was going through a health crisis and that was having an impact on the rest of the home. As a result the kitchen area was locked, but residents could use this area with staff supervision, ornaments and pictures had been removed from the ground floor and plastic cutlery was in use. Staffing levels had been increased by use of agency staff and the home had sought specialist advice and support to assist them in trying to meet the needs of this individual. The conclusion had been reached however, that the home were no longer able to meet the needs of this individual and arrangements were being made to have their needs reassessed. Following the inspection the home notified the Commission that the resident had been transferred to a more secure unit so that their needs could be assessed. What the service does well: Residents have opportunities to take part in a wide range of stimulating and interesting activities both through the week and at weekends. Staff attend regular training courses, which equip them to meet the complex needs of the residents accommodated. The home seeks specialist advice and support where necessary to meet the health needs of the residents and they work hard, despite the turnover in the staff team, to ensure that a consistent approach is Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 6 provided for residents. The building is well maintained and provides a spacious and comfortable environment and residents are encouraged to personalise their bedrooms. Residents’ meetings are held weekly and during these meetings residents are encouraged to make decisions about the food and activities to be planned for the following week. Although formal staff supervisions have decreased in frequency of late staff spoken with felt well supported and advised that whenever an incident occurs they are given an opportunity to talk and reflect on the incident. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 7 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. Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information available for prospective residents does not currently provide enough information to enable people to make an informed decision about accommodation. Current residents do not have a terms and conditions of residency and are therefore not aware of their rights and responsibilities. EVIDENCE: There is a statement of purpose in place but this needs to be updated to ensure that it includes all areas specified in the Regulations. The service user guide was available to view on the computer. The manager advised that although residents don’t have an individual copy, a copy was until recently on display in the home. It has been removed in the short-term to meet the individual needs of one of the residents. The guide provides detailed information but the manager agreed that it could be updated to make it more specific to the home. There was no written admission procedure in place at the time of inspection. However, the manager described a very thorough procedure. There have been no new admissions since the last inspection but for a variety of reasons four residents have moved on to alternative accommodation. Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 10 A requirement was made at the last inspection that prospective residents are given a contract/terms of residency and that existing residents be given a copy. This has not yet been achieved, although it was noted that the company has a document in place. The manager advised that she would need to read through it to make sure all areas are relevant to the service. At the time of inspection one resident was experiencing complex health problems and over the past few months their mental health had become their primary care needs rather than their learning disability. Following discussion with the manager and with staff on duty it become apparent that despite the best efforts of the staff team, this resident’s needs are not being met in this service. The manager was already in discussion with her line manager about calling an emergency review to discuss alternative suitable accommodation. Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans generally provide detailed information. Improved goal planning would however enhance the work carried out by staff. EVIDENCE: Two of the three care plans were seen during the inspection. The manager advised that the home is about to introduce a new format for care planning. Within the new format there will be a detailed pen portrait for each resident. Care plans seen were very detailed in advice and guidance about how to support residents. There were several goals in place that were generally very broad and it was not clear which aspects of each goal the resident could do and which areas the resident required support to achieve their goal. For example, in relation to one resident there was a goal for the resident to control their money. The action required was ‘needs encouragement to spend’ and a Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 12 weekly shopping session would be arranged. It was not clear how staff would support the resident to control their money. In one care plan there were twenty-four support plans. Most included guidance for staff rather than goals for residents and the manager acknowledged that perhaps separating guidance for staff and identifying a couple of goals to work on at any time might be more achievable. Residents have not yet signed their care plans but this will be addressed when the new format for care planning is introduced. Whenever a risk was identified there was a detailed risk assessment in place. In relation to reviews the manager advised that the last review had been held in November 2006 and the care manager didn’t feel another was necessary at this stage. The home has recently asked for a review to be held as a matter of urgency. In relation to the second resident, the manager advised that a review had been held but the notes of the review were not available. The manager agreed to track down the notes. Residents meetings are held weekly and minutes were seen. It was noted that residents make decisions about the food they want to eat for the coming week and the activities that they would like to participate in. Each resident is given a turn to speak and to share their views. One resident raised on more than one occasion that they are not happy about two of the residents continually fighting. There was no record of the action taken by staff to reassure this resident about this matter. Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a wide range of interesting activities on offer to those residents who choose to participate. EVIDENCE: One resident attends college five days a week and a second resident attends college two days and has a job doing voluntary work two mornings a week. In addition they attend an evening course at college one evening a week. The third resident has one structured day away from the home doing gardening activities and refuses other structured activities. Due to their current health needs the home respects their wishes. They offer an activity every day and whenever they can they encourage the resident to go out. Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 14 Residents also like having meals out, going to the pub occasionally and going to a disco. Weekends are spent going on shopping trips, cinema and bowling. Trips are also arranged to venues like the sealife centre and to museums. An aromatherapist visits the home every other week and all residents are offered a service. Two of the residents have their own computer and one resident likes playing on their play-station. At the time of inspection one resident was in the home all day and the other two residents were out for the majority of the day. One had college and the second was swimming. Two of the residents went out for their dinner. All residents have regular contact with their families, some relatives visit the home and some maintain contact by telephone. There is a rota on display in the home showing the household tasks that residents are expected to participate in such as helping with dishes, laying the table and cleaning duties. In order to meet the needs of one resident and to protect other residents and staff a decision was taken in the days prior to the inspection that in order to make the environment safe, the kitchen door would have to remain locked. Residents are able to use this area but only with staff supervision. In addition pictures and ornaments were removed from the walls on the ground floor and for the time being plastic cutlery was being used. Staff spoken with about this subject agreed it was necessary. They said that the home no longer looked homely and there was a tense atmosphere. One staff member advised that a staff meeting had been held to discuss how to explain to residents the necessary temporary changes and to provide reassurance. As stated previously menus are decided at the weekly residents’ meetings. The menus seen show that residents receive a varied and well balanced diet. One resident regularly refuses food and drink but at the time of inspection they were receiving a varied diet. When necessary support and advice is obtained from a dietician. Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good arrangements in place to ensure that residents’ healthcare needs are met. Some minor amendments to procedures will improve this further. EVIDENCE: Residents are supported to attend a variety of healthcare appointments as necessary to meet their individual needs. Where appropriate specialist advice and support is sought. There is detailed information recorded in relation to the management of residents who have epilepsy. The manager advised that all staff have received training on the subject. Staff seen during the inspection were courteous and treated residents with respect. Both male and female staff are employed so residents choose to have care provided by a person of the same gender. As there are only three residents routines can be flexible to meet individual needs. Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 16 One resident had particularly complex health issues at the time of inspection and the home were using whatever specialist advice and support they could obtain to assist them in managing this. This resident regularly refuses to eat and drink and this was having an impact on their health. There are detailed guidelines in place for the use of oxygen although staff have not had any formal training on the use of oxygen. It was recommended that the home check with their community nurse to see if the guidelines are sufficiently detailed. Record keeping in relation to medication was in order. A returns book is completed monthly. Following company advice, the home had requested that their gp remove the wording ‘as required’ from all prescribed medication. The Mar (medication administration record) chart now states `use as directed` but there is now no record of what the direction has been. The manager advised that following the last inspection they requested the gp to sign permission to administer a number of homely remedies when needed. This was achieved, however the signed document could not be located. All staff complete a medication proficiency assessment before administering medication independently. In addition staff complete a workbook assessment provided by their local pharmacy. Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place to enable anyone wishing to make a complaint to do so. However, the recording of complaints do not ensure that confidentiality is maintained. EVIDENCE: There are both detailed and simplified complaint procedures in place. It was noted that there had been three complaints received since the last inspection. Complaints are recorded in a hardbound book in chronological order. The action taken to address each complaint is not recorded in detail but the manager advised that more detailed information is recorded on the computer. A discussion was held about the fact that if staff are encouraged to record their complaint in the complaint book this does not offer confidentiality and could potentially deter people from making a complaint. Following discussion the manager agreed to record a chronological list of all complaints received in the hardbound book and to review how complaints and the action taken to address them would be recorded. There is a detailed procedure in place on the protection of vulnerable adults. In addition there is a flow chart in place and guidelines on the procedure should an allegation be made. Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 18 Since the last inspection there have been two adult protection alerts. Records for one of the alerts could not be located and the home was advised to contact the chair of the meeting to request a copy. In relation to the second alert, the home were found to have acted appropriately. Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a clean and comfortable environment where they are able to personalise their own rooms. The temporary alterations made to the environment mean that it is now less homely. EVIDENCE: A tour of the home was carried out and with the exception of one bedroom all areas were seen. As stated previously, within the past few weeks the home took the decision to remove ornaments and pictures to assist in meeting the needs of one individual who was experiencing mental health problems. This has unfortunately made the environment look bare and less homely. It was also noted that the kitchen is also being locked for safety reasons although residents can ask for the door to be unlocked and are able to use the room under supervision. Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 20 Communal areas consist of a large lounge area and a separate dining room. In addition there is a quiet room, which also has a computer available for residents’ use. In the garden area new garden furniture has been purchased and there is a new barbeque. A new water butt has also been installed. Staff are also encouraging residents to recycle. Two of the residents were happy to show their individual bedrooms and these areas were found to be very homely, had been personalised and reflected the individual tastes and hobbies of the residents. It was reported that the carpet in the hall, stairs and landing has just been replaced. There is a lift in place and it was noted that one of the residents uses the lift independently. Most of the bedrooms have ensuite shower and toilet facilities although two have ensuite facilities without the shower. There is separate bathroom available with a bath and a separate shower. Residents are encouraged to attend to their own laundry with support where necessary from staff. All areas seen during the inspection were clean. Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are provided with good training opportunities. The turnover in the staff team and the high use of agency staff makes it difficult to ensure consistency in approach but staff work hard to achieve this. Staff would benefit from more regular supervision. EVIDENCE: There has been a very high turnover in the staff team since the last inspection but this has slowed down in the last few months. The manager advised that the turnover was for a variety of reasons. At the time of inspection there were vacancies for one senior, one support worker and three full time waking night staff. The manager advised that they were having difficulty recruiting to the waking night shift. The rotas provided for inspection were not very clear and it was not always possible to identify who had been on duty on a particular day. Additional staff (agency or bank) were being used at the time of inspection to ensure residents’ safety and to provide a greater number of activities. Staffing levels Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 22 had been increased so that there was one waking and one sleep-in member of staff at night. It was reported that all agency staff used have worked in the home regularly over the past year. Two staff recruitment files were examined and it was noted that the procedures followed had been thorough. A member of staff spoken with stated that the induction period was very good. They had a week where they were supernumerary and within this week they had their medication assessment and regular opportunities to read through care plans, risk assessments and the key policies and procedures. It was also an opportunity to work along-side other care staff to get to know the residents and their individual routines. Mandatory training is covered during the first three months by e-learning on line. In relation to staff training the training matrix showed that out of nine staff, eight have completed training in moving and handling and epilepsy, seven in fire safety, four in first aid, seven in pova, and two in food safety. The matrix showed that there were no staff trained in infection control but some of the staff spoken with advised that they have completed this training in previous employment. One member of staff completed a course on mental health but that was in 2005. Another member of staff spoken with stated that they have attended a course on mental health issues via their previous job. One of the two staff spoken with advised that they have not had regular supervision although they were aware that this was being arranged. They also stated that whenever there is an incident there is an opportunity to talk through the incident with the manager and colleagues so they felt very well supported. The manager advised that formal supervisions over the past few months have not been as regular as they should be and they hoped to get back on track in this area in the near future. Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The operation of this home does not fully safeguard residents and staff and the manager needs additional support to resolve some of the current problems. EVIDENCE: Since the last inspection the registered manager has left her position as manager. The deputy manager was promoted to acting manager in October and she became the appointed manager in January 2008. She has yet to apply for a CRB check via the Commission and submit her application for registration. The manager is currently working towards the Registered Manager’s Award (RMA). Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 24 The manager advised that she has not had a formal supervision session since taking on the role of manager. However, her line manager is always contactable by phone and she felt well supported. The manager and deputy manager provide clear leadership to staff. However due to the changes in the staff team and the complex management issues that are being dealt with it is imperative that additional support be provided to assist the home in getting through this difficult period. A staff member spoken with stated that although a young team they are strong and work hard to give a consistent approach to the residents and to limit the impact of any disruption to their lives. The registered provider or a representative on their behalf should visit the home on a monthly basis and write a report of the findings. This has not been happening. It was noted that the manager completes a monthly audit and this is submitted to her line manager. The monthly audit does not include all the areas that would be expected to be covered in a Regulation 26 visit. The company carries out an audit every 12-16 months. The last audit for Frinton House was in January 2008 when the home scored 80 . In each section a number of recommendations were made but it was not clear what action had been taken as a result of each recommendation. The AQAA (annual quality assurance assessment) was completed by the previous manager and sent to the Commission prior to her departure, so some of the information is now out of date and not relevant to this inspection. In relation to quality assurance the manager advised that she has recently received a format for satisfaction questionnaires from the head office but they have yet to be distributed to relatives and residents. The manager advised that they do not have a written annual development plan but that they have regular development meetings. The home are currently working on relaunching the service to attract more residents to the home. The home has very little involvement in supporting residents with the management of finances. One resident holds their own money, although their relative has recently relinquished appointeeship, and no one has as yet taken it on. Both of the other two residents receive support via their relatives in relation to managing money. A record is maintained of all accidents and incidents that occur in the home. The severity of incidents has increased of late and staff are working hard to ensure that residents are kept safe at all times. There have been occasions when staff have been injured in the process. It is recognised that some of the limitations imposed (previously referred to in this report), have all been necessary in the short-term to safeguard against the risk of injury, it is however, not in anyone’s interest if these measures were to be in place in the Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 25 long-term. The manager must be supported to make arrangements to reach a conclusion that is in everyone’s best interest. There is no policy in place on aggression towards staff and staff rights in such situations. The manager was unsure if all the required policies and procedures were in place and she was referred to the national minimum standards for advice on what policies and procedures are needed. There was an environmental risk assessment in place that was mostly up to date. In addition records showed that equipment is serviced on a regular basis and there is a monthly health and safety checklist in place. A recommendation as made at the time of the last inspection that the home contact the local Environmental Health Officer to obtain a copy of the new guidance in relation to the preparation of food in care homes. This had been addressed but the manager advised that it is not a working document yet. Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 1 3 X 4 2 5 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 3 2 2 X 3 X Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 27 YES 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 YA1 Regulation 4(1c), 6 Requirement The statement of purpose must be reviewed to ensure that it includes reference to all areas specified in schedule one of the Regulations. The home must ensure that arrangements are made to have the current needs of one of the residents reassessed so that a decision can be made as to whether the home can continue to offer a service and to ensure that the home remains within their category of registration. The home must provide all prospective residents with a written and costed contract/statement of terms of residency between the home and the prospective resident prior to them moving into the home. All existing residents must be provided with this information. [This was a requirement of the previous inspection –timescale given was 30/10/06]. Goals in care plans must be specific, measurable and achievable and residents must DS0000060740.V365048.R01.S.doc Timescale for action 31/07/08 2. YA2 14(2) 30/06/08 3. YA5 5(c)14(2) 30/06/08 4. YA6 15 31/07/08 Frinton House Version 5.2 Page 28 5. YA22 17(2) Schedule 4 para. 11 6. YA23 7. YA24 17(2) Schedule 4 para 12(b) 23(1)(2d) 8. 9. 10 11. YA33 YA36 YA37 YA39 18(1a) 18(2) 9 26 be encouraged to sign their care plans if they are in agreement with the content. The home must review the complaint procedure to ensure that a detailed record is kept of the outcome of all investigations. The revised procedure must ensure that confidentiality is not breached. Records must be maintained securely of any adult protection alert made by the home and the outcome of the investigation. The home must be suitable for the purpose of achieving the aims and objectives and all areas be reasonably decorated. Staff vacancies must be filled. All staff including the manager must receive regular supervision. The manager must submit an application for registration. The Responsible Individual or a representative on their behalf must visit the home once a month unannounced and write a report of their findings. Reports must be available for inspection. The home’s quality assurance system must involve seeking the views of residents and their representatives on the quality of the care provided. The outcome of such questionnaires must be published and made available to all interested parties. 31/07/08 31/07/08 31/07/08 15/07/08 31/07/08 31/07/08 30/06/08 12. YA39 24 15/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000060740.V365048.R01.S.doc Version 5.2 Page 29 Frinton House 1. 2. 3. 4. YA1 YA4 YA20 YA20 The service user guide should be updated to make it more applicable to Frinton House and a copy should be given to all current and prospective residents. The home should draw up a written admissions procedure to the home. Arrangements should be made to check the guidelines for the use of oxygen with an appropriately qualified person. That clear guidance is requested form GPs in respect of when and how frequently ‘as required ’ and/or homely remedies can be administered. The home should ensure that there is a policy in place on aggression towards staff. A review of all other policies and procedures should also be undertaken to ensure that they are applicable to the home. Reference should be made to those topics listed in the NMS to ensure that all areas are covered. 5. YA40 Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Frinton House DS0000060740.V365048.R01.S.doc Version 5.2 Page 31 - 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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