CARE HOMES FOR OLDER PEOPLE
Genesis Care Home 76 Wimborne Road Bournemouth Dorset BH3 7AS Lead Inspector
Marjorie Richards Unannounced Inspection 15th March 2006 10:00 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 Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 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. Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Genesis Care Home Address 76 Wimborne Road Bournemouth Dorset BH3 7AS 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) 01202 515713 01202 762880 Genesis Care Homes Limited Miss Andrea Louise Mangold Care Home 13 Category(ies) of Dementia - over 65 years of age (13), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (13) Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. One named service user (as known to the CSCI) under the age of 65 but in the category Mental Disorder (MD) may be accommodated to receive care. 25th May 2005 Date of last inspection Brief Description of the Service: Genesis Care Home is a large, detached house, situated in the Winton area of Bournemouth. The home has ramped access and is a level walk away from nearby local shops, cafes and restaurants, churches and public houses etc. Local buses are available nearby to other parts of Bournemouth as well as Poole, Christchurch and beyond. Visitor parking for several vehicles is available at the front of the home and also on nearby streets. The front garden is mostly laid to lawn with flower borders and there is a more secluded garden with seating available to the rear of the property. The home is registered to accommodate up to thirteen older people with a mental disorder and/or dementia, within two double and nine single bedrooms. Accommodation is arranged on the ground and first floors, with a stair lift available to assist access between floors. Three rooms have en-suite facilities and there are sufficient communal bathrooms and WCs available on each floor. A comfortable lounge/dining room and adjoining sun lounge are available to residents. Twenty-four hour personal care is provided. Laundering of clothing etc is carried out on the premises. Activities are arranged on a daily basis and an inter-denominational religious service is held at Genesis every month. All meals are prepared and cooked within the home. Genesis is owned by Mrs Gene Mangold, trading as Genesis Care Homes Ltd and managed by her daughter, Miss Andrea Mangold. The Borough of Poole Social Services retains a block contract and makes the majority of placements at Genesis Care Home. Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4.5 hours on the 13th March 2006. The main purpose of the inspection was to see the residents living in the home were safe and properly cared for and to check on progress in meeting the thirteen requirements from the last inspection. A tour of the premises took place and a variety of records and related documentation was examined. Time was spent observing the interaction between residents and staff, as well as talking with four residents, Miss Mangold (Manager) and members of staff on duty. The majority of Standards assessed and found met during the previous inspection were not reassessed during this inspection; this report should therefore be read in conjunction with the report of the previous inspection of 25th May 2005. What the service does well:
The homes Statement of Purpose and Service User Guide ensures that prospective residents and their representatives have the information they require in making a decision about where to live. A Residents and Relatives Information File is also available within the home containing further information about the specialist nature of the home, (e.g., fact sheets about dementia) previous inspection reports etc. Visits are made to prospective residents, and residents and their relatives/friends/representatives are encouraged to visit the home prior to admission to enable them to assess the facilities and services provided. A trial period is also available before making any decision about whether or not to stay. There are satisfactory arrangements in place for managing medication and ensuring that the medication needs of residents are met. Visiting times at Genesis are unrestricted and visitors are made welcome. Residents are able to see their visitors in the lounge/dining room or their own bedrooms as they wish. Lunch on the day of inspection was gammon, with roast potatoes, roast parsnips, peas, sweetcorn and gravy. This was followed by stewed apple with custard. Residents clearly enjoyed their meal and there was very little wastage. Residents commented positively about the food provided, The food Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 6 isnt bad here, I enjoy my meals. We have plenty of food here, it is very good. The communal space comprises a lounge/dining room with a small adjoining conservatory. This room can be closed off from the rest of the lounge/dining room by means of a sliding door, providing additional space for activities or sometimes as a quiet room. Residents also have access to a rear garden, which is enclosed. There are paved areas where residents can walk. Patio tables and chairs are available and some residents enjoy sitting outside when the weather permits. Miss Mangold says it is the policy of the home not to have any involvement in the personal finances of residents. Therefore, all residents who are unable or do not wish to handle their own affairs, have a relative or other representative to deal with their finances etc. The home never handles residents monies but pays for services such as chiropody and hairdressing and then invoices relatives or representatives for payment every month. What has improved since the last inspection? What they could do better:
Miss Mangold carries out pre-admission assessments, to ensure that Genesis Care Home is the correct placement for prospective residents. At present, no written confirmation as to the outcome of the assessment is provided, so the prospective resident cannot be fully assured that his/her care needs will be met. Part of the kitchen is currently being used as office space. This is not considered best practice in relation to food hygiene. There was evidence that cigarette smoking had been taking place in the kitchen. More care must be taken with regard to stock rotation, to ensure out of date items are not served to residents. For example, a large quantity of cakes was found dated Best before 1st March and Best before 5th March 2006. Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 7 Since the last inspection, the complaints procedure has been amended and updated. However, the record of complaints is still not well maintained, so residents cannot be confident that their concerns will be fully investigated and appropriate action taken. The Adult Protection policy has also been re-written but needs a further small addition. Policies and Procedures offering guidance and support to staff are contained within three large files. It is recommended that these files be indexed to make access to the information much easier. It might also assist staff if related policies were grouped together, e.g., Adult Protection, whistle blowing etc. The home provides sufficient bathrooms and WCs to meet the needs of residents. However, the only heating in bathrooms comes from heated towel rails, which have potentially dangerously hot surfaces. Action must be taken to ensure more suitable heating is provided and vulnerable residents are protected from potential hazards to their safety. Genesis Care Home is not meeting the target of having 50 trained staff with National Vocational Qualifications (NVQ) level 2, therefore residents cannot be fully confident that they are in safe hands at all times. The home operates a thorough recruitment procedure based on equal opportunities, to ensure the protection of residents. At the last inspection it was pointed out that this procedure needed updating to reflect the changes brought about by the introduction of the Protection of Vulnerable Adults (POVA) list held by the Department of Health, but this has not yet been achieved. Examination of training files shows a variety of training has taken place, e.g., moving and handling, health and safety, Adult Protection, first aid, medication and basic food hygiene. However, some training took place a while ago and is in need of updating, e.g., first aid and basic food hygiene. All care staff should also receive training in dementia care, dealing with challenging behaviour etc., to ensure they have the skills and knowledge necessary to care for the residents. The manager is experienced in working with older people with dementia, but has still not achieved completion of the National Vocational Qualification (NVQ) level 4 in management and care, to ensure she has the necessary qualifications to carry out her responsibilities in full. A formal staff supervision system is now in place, but care needs to be taken to ensure it is being implemented at the recommended intervals of at least six sessions a year, to ensure continuing good practice within the home. Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 8 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. Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 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 Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5 The home does not provide intermediate care so Standard 6 does not apply. Detailed information is available to assist prospective residents and their relatives or representatives to make informed decisions about admission to the home. Pre-admission assessments are carried out to ensure that only those whose needs can be met by the home are offered places there. However, without written confirmation, prospective residents cannot be fully assured that their needs will be met. Prospective residents and their relatives or representatives are invited to visit the home prior to admission to enable them to assess the facilities and services provided. A trial period is also available before making any decision about whether or not to stay. Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 11 EVIDENCE: The homes Statement of Purpose and Service User Guide ensures that prospective residents and their representatives have the information they require in making a decision about where to live. This includes information on the specialist nature of the service provided. A Residents and Relatives Information File is also available within the home containing further information and fact sheets, previous inspection reports etc. Where Borough of Poole Social Services makes a placement, contracts are put in place between the placing authority, the home and the resident. For these residents, terms and conditions are issued by Borough of Poole confirming the arrangements. For privately funded residents, the home also issues it’s own terms and conditions. It was noted that there are differences between the homes own terms and conditions and that of the Borough of Poole, e.g., a trial period of four weeks for privately funded residents and six weeks for Borough of Poole funded residents. The Borough of Poole Social Services has a block contract arrangement with Genesis Care Home and makes the majority of placements in the home. Where the local authority is involved, Miss Mangold receives a copy of their assessment and care plan. She speaks with relatives and relevant professionals, such as the GP, Community Psychiatric Nurse etc, to obtain further information. Miss Mangold then carries out her own pre-admission assessment to ensure that Genesis Care Home is the correct placement. At present, no written confirmation as to the outcome of the assessment is provided, so the prospective resident cannot be fully assured that his/her care needs will be met. Visits are made to prospective residents, and residents and their relatives/friends/representatives are encouraged to visit the home, to look around and assess the facilities etc, prior to admission. These visits allow the prospective service user/relatives to meet with other residents and staff and give an opportunity to ask questions. The visits also help to inform the home about the prospective residents needs and assist in making the decision to offer a place or not. The information gained also helps in the development of the care plan. Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 (Standards 7, 8, 10 and 11 were found met at the previous inspection) There are satisfactory arrangements in place for managing medication and ensuring that the medication needs of residents are met. Records indicate that residents receive their medicines as prescribed. EVIDENCE: Medication is stored securely within the home. There is a separate cupboard available for Controlled Drugs if necessary. A monitored dosage system is in use. Staff sign to record that medicines have been given as prescribed or record the reason for non-administration. A sample of Medicine Administration Record (MAR) charts was checked and found to be well maintained. No residents are currently looking after their own medication. Only staff members that Miss Mangold considers to be competent and confident in administering medication carry out this task. Staff receive training about Giving medication safely.
Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 13 Information on the medicines used is available for the resident or their representative and also for staff reference. Miss Mangold says that residents medication is reviewed regularly by their GPs in line with recommendations in the National Service Framework for older people. Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 15 (Standards 12 and 14 were found met at the previous inspection) Visitors are made welcome at the home and can come whenever it suits them and the residents. A balanced and varied selection of food is available, that meets residents’ tastes, choices and special dietary needs and is served in pleasant surroundings. However, more care must be taken to ensure smoking is banned from the kitchen and out of date food items are not available to residents. EVIDENCE: Most residents receive visitors on a regular basis but these are still not being recorded in a visitors book. Regulation 17, Schedule 4, requires that a record be maintained of all visitors to the care home. This was brought to Miss Mangolds attention following the last inspection, but has still not been actioned. One resident regularly goes out alone and a programme for accompanied walks has been developed, so that all residents have the opportunity to go out of the home if they wish. Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 15 Visiting times at Genesis are unrestricted. Residents are able to see their visitors in the lounge/dining room or their own bedrooms as they wish. Most residents are visited by family members and some go out with them on trips. Where residents do not wish to be in contact with their families the home support them in this. Lunch was served in the dining area, in a relaxed, unhurried atmosphere. Residents may choose where they eat and times are flexible. Lunch on the day of inspection was gammon, with roast potatoes, roast parsnips, peas, sweetcorn and gravy. This was followed by stewed apple with custard. Residents clearly enjoyed their meal and there was very little wastage. Menus are based around the known likes and dislikes of residents, who confirm they only have to ask and any personal preferences are accommodated by staff. If you dont like what is for dinner, they will give you something different. Residents commented positively about the food provided, The food isnt bad here, I enjoy my meals. We have plenty of food here, it is very good. Part of the kitchen is currently being used as office space. This is not considered best practice in relation to food hygiene. Cigarette smoking should also not be permitted in the kitchen. More care must be taken with regard to stock rotation, to ensure out of date items are not served to residents. For example, a large quantity of cakes was found dated Best before 1st March and Best before 5th March 2006. Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The complaints procedure has been amended and updated. However, the record of complaints is still not well maintained, so residents cannot be confident that their concerns will be taken seriously, fully investigated and appropriate action taken. The Adult Protection policy has also been re-written but needs a further small addition. Procedures for responding to suspicions of abuse are now carried out in accordance with Department of Health guidance, ensuring that any allegations of abuse can be managed effectively. EVIDENCE: Policies and Procedures offering guidance and support to staff are contained within three large files. It is recommended that these files be indexed to make access to the information within easier to find. It might also assist staff if related policies were grouped together, e.g., Adult Protection, whistle blowing etc. The home has amended and updated its complaints procedure in line with Regulation 22. However, the record of complaints shows insufficient detail regarding investigations. There are no recorded outcomes and no information about actions taken as a result of the investigation. Statements from staff regarding one complaint demonstrated inappropriate action being taken in response to an incident. Miss Mangold demonstrated her
Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 17 awareness of this, but the record did not evidence that any further action had been taken to ensure that such a situation could not arise again. At the last inspection it was noted that the Adult Protection policy was out of date and in need of amendment. This policy has been re-written and is now in line with the Department of Health No Secrets guidance, therefore ensuring that any allegations of abuse can be managed effectively. The policy should also make reference to the Public Interest Disclosure Act and Miss Mangold says she will now include this. All except two new staff have now received Adult Protection training, to ensure a proper response to any suspicion or allegation of abuse. Miss Mangold says Adult Protection training for the new staff has been arranged for March 17th. Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 and 21(Standards 19, 24 & 26 were found met at the previous inspection) Residents have access to pleasant indoor and outdoor communal facilities, providing space for leisure activities etc. The home provides sufficient bathrooms and WCs to meet the needs of residents. However, unguarded heated towel rails in bathrooms may potentially pose risks to the safety of residents. EVIDENCE: The communal space comprises a lounge/dining room with a small adjoining conservatory. This room can be closed off from the rest of the lounge/dining room by means of a sliding door, providing additional space for activities or sometimes as a quiet room. The front garden is attractively laid to lawn with flowerbeds. The rear garden is enclosed and offers more seclusion, also some shade from mature trees. There are paved areas where residents can walk around. Patio tables and chairs are available and some residents like to sit outside when the weather
Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 19 permits. The greenhouse has now been dismantled, following a minor accident in 2005. Miss Mangold is currently in discussion with her neighbours over the upkeep of their fencing. The current state of some fencing means that the rear garden is no longer secure. Miss Mangold says that, for the present, residents can only access the garden when supervised by staff to ensure they cannot wander off. Three single bedrooms have en-suite facilities. Commodes are also in use in some bedrooms. There are two communal bathrooms and three separate WCs situated on the ground and first floors. (The ground floor bathroom has an assisted bath). At previous inspections it was noted that the ground floor communal bathroom had been redecorated and Miss Mangold had added pictures, decorated tiles and mobiles etc, in order to make bathing a more welcoming and pleasurable experience for residents. Miss Mangold says she has similar plans for the first floor bathroom, but this work has still not been completed. Previous inspection reports have also highlighted the lack of heating in bathrooms/WCs. The only heating in bathrooms comes from heated towel rails, which have potentially dangerously hot surfaces. Miss Mangold says the heated towel rails have been switched off for safety purposes, whilst advice is taken about more appropriate heating methods. However, during this inspection, the towel rail in the first floor bathroom was found to be switched on. Action must now be taken to ensure vulnerable residents are protected from potential hazards to their safety. Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29 and 30 (Standard 27 was found met at the previous inspection) Genesis care Home is not meeting the target of having 50 trained staff with National Vocational Qualifications (NVQ) level 2, therefore residents cannot be fully confident that they are in safe hands at all times. The home has a detailed recruitment policy in place, but this needs updating to ensure the protection of residents. Staff training is carried out, but this needs auditing to ensure all staff have the skills and knowledge necessary to care for the residents. EVIDENCE: At present, only one member of staff has National Vocational Qualifications (NVQ) level 2, although it is hoped that more will commence training in later in 2006. Some staff are employed from abroad and Miss Mangold believes that several have qualifications that are more than the equivalent of NVQ level 3, but there is no documentary evidence to support this. She is hoping to encourage further interest among staff in NVQ training. The NVQ is a means of confirming an individual’s competence in actual work and a method for the manager to ensure that the care home has appropriately competent staff to deliver care. Without this assurance, residents cannot feel that they are in safe hands at all times. Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 21 The home operates a thorough recruitment procedure based on equal opportunities, to ensure the protection of residents. At the last inspection it was pointed out that this procedure needed updating to reflect the changes brought about by the introduction of the Protection of Vulnerable Adults (POVA) list held by the Department of Health. Staff can now only start working at the home once they have a Criminal Records Bureau (CRB) disclosure for Genesis Care Home or a POVAfirst check. The policy has not yet been updated. Two staff files were examined and these showed the required information to be in place, e.g. proof of identity, references, work history, details of qualifications CRB disclosures etc. Miss Mangold is mindful of the fact that new regulations regarding staff induction are now in place. The home’s induction programme will be updated to reflect these changes. (Information and guidance about the new Common Induction Standards can be obtained from www.skillsforcare.org.uk). Further training is delivered through in-house sessions as well as external courses and each member of staff has a training file where copies of certificates etc are kept. Examination of training files shows a variety of training has taken place, e.g., moving and handling, health and safety, Adult Protection, first aid, medication and basic food hygiene. However, some training took place a while ago and is in need of updating, e.g., first aid and basic food hygiene. All care staff should also receive training in dementia care, dealing with challenging behaviour etc., to ensure they have the skills and knowledge necessary to care for the residents. Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 22 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35, 36 (Standards 33 & 35 were met at the previous inspection) The manager is experienced in working with older people with dementia, but has still not achieved completion of the National Vocational Qualification (NVQ) level 4 in management and care, to ensure she has the necessary qualifications to carry out her responsibilities in full. Residents are assured of sound management of their financial interests. A formal staff supervision system is now in place, but this is not always being implemented at the recommended intervals to ensure continuing good practice within the home. Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 23 EVIDENCE: The inspection report dated 6 July 2004 states, The registered manager, Miss Mangold, has experience of working with older people with dementia and mental disorder and is currently undertaking her National Vocational Qualification (NVQ) level 4 in management and care. Miss Mangold has still not achieved her NVQ level 4 in management and care and says she finds it is not always easy to fit course work in with her management role. She has also had to make changes in her choice of training course, which has caused delays beyond her control. Miss Mangold should discuss her concerns with the registered person, Mrs Mangold, so that sufficient time can be set aside for completion of both management tasks and course work. In order to protect residents, Miss Mangold says it is the policy of the home not to have any involvement in their personal finances. Therefore, all residents who are unable or do not wish to handle their own affairs, have a relative or other representative to deal with their finances etc. The home never handles residents monies but pays for services such as chiropody and hairdressing and keeps a record of what is owed. This amount is then invoiced to relatives or representatives for payment every month. Care staff should receive formal supervision at least six times a year, as a means of ensuring good practice, emphasising the philosophy of care within the home and looking at individual career development needs etc. Examination of supervision records shows supervision is not always taking place the recommended six times a year. Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 24 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 2 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 2 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 2 X 3 1 X X X X X STAFFING Standard No Score 27 X 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 3 2 X X Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 25 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 14 Requirement Following assessment written confirmation must be given to prospective residents that Genesis care Home is able to meet their assessed needs. It is required that a record of all visitors to the care home be maintained. (Previous timescale of 31/08/05 not met.) The registered persons must ensure that satisfactory standards of hygiene are maintained. Cigarette smoking must not take place in the kitchen. The registered persons must ensure that food, which is past its best before date, is not available to residents. A detailed record must be kept of all complaints and the action taken by the registered person in respect of any such complaint. (Previous timescale of 31/08/05 not met.)
DS0000003942.V274770.R01.S.doc Timescale for action 01/06/06 2 OP13 17(2) Schedule4 01/06/06 3 OP15 16(2)(j) 01/06/06 4 OP15 16(2)(i) 01/06/06 5 OP16 17(2) Schedule4 01/06/06 Genesis Care Home Version 5.1 Page 26 6 OP25 23(5) 7 OP28 18(1)(c) 8 OP29 19(1) Schedule2 9 OP30 18(1) 10 OP31 18 (1) (c) (i) The registered persons must ensure that the heating in communal bathrooms meets the relevant health and safety requirements and the needs of individual residents. (Previous timescales of 30/10/04 and 31/10/05 not met.) A minimum of 50 of care staff employed by the home must have NVQ level 2 or equivalent. (Previous timescale of 31/12/05 not met.) The registered persons must ensure that the recruitment policy is updated to reflect changes made regarding CRB and POVA since 26/7/04. (Previous timescale of 31/08/05 not met.) It is required that an audit of staff training be carried out, to update records and ensure all staff are receiving the training they need. Where necessary, training must be updated, e.g., first aid. It is required that the registered person ensures the manager receives suitable assistance, including sufficient time for the purpose of obtaining the NVQ level 4 in management and care. 30/06/06 31/12/06 01/06/06 30/06/06 31/12/06 Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 27 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 Refer to Standard OP2 OP18 Good Practice Recommendations It is recommended that the homes own terms and conditions and the Borough of Poole contract should have the same time allowed for a trial period. It is recommended that Policies and Procedures offering guidance and support to staff are indexed and related policies grouped together, e.g., Adult Protection, whistle blowing etc., to assist staff in accessing this information. It is recommended that the Adult Protection policy also contain reference to the Public Interest Disclosure Act. It is recommended that formal staff supervision be carried out at two monthly intervals. 3 4 OP18 OP36 Genesis Care Home DS0000003942.V274770.R01.S.doc Version 5.1 Page 28 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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