CARE HOMES FOR OLDER PEOPLE
Genesis Care Home 76 Wimborne Road Bournemouth Dorset BH3 7AS Lead Inspector
Marjorie Richards Unannounced 25 May 2005 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 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 D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Genesis Care Home Address 76 Wimborne Road Bournemouth Dorset BH3 7AS 01202 515713 01202 762880 andreamangold@yahoo.com Genesis Care Homes Limited Telephone number Fax number Email 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 Andrea Louise Mangold CRH - Care Home Only 12 Category(ies) of DE(E) Dementia - over 65 (12) registration, with number MD(E) Mental Disorder -over 65 (12) of places Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 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. Date of last inspection 16 February 2005 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 twelve older people with a mental disorder and/or dementia, within two double and eight single bedrooms. Accommodation is arranged on the ground and first floors, with a stair lift available to assist access between floors. Two 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 service users. 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 D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over seven hours on the 25th May 2005. The previous inspection took place in February 2005. This inspection was brought forward following issues raised by a complaint about Genesis, investigated by the Borough of Poole Social Services. The main purpose of the inspection was to check that the residents living in the home were safe and properly cared for and also to check if previous requirements and recommendations had been met. A tour of the premises took place and a variety of records and related documentation was examined including the care records for three current residents and a deceased resident. Time was spent talking with four residents, as well as Mrs Mangold, Miss Mangold, the staff on duty and a visitor to the home in order to get a real feel of what it is like to live at Genesis Care Home. What the service does well:
Every resident has a care plan, which sets out in detail the individuals care needs and how these are to be met. Residents and their relatives are encouraged to contribute to assessments and care plans. Discussions with staff show they are aware of the wider needs of individuals and there is information in the care plan to support this, e.g. Likes to look smart and Likes talking about wartime experiences. Staff carry out regular reviews of care plans to ensure they are regularly updated as necessary. Residents confirmed they are well cared for and treated with respect and dignity. I like it here, they treat me very well and They make sure I look smart. Staff were observed throughout the inspection to be treating residents with courtesy, patience and kindness. Discussion with staff and the examination of care records for a deceased resident demonstrated the provision of appropriate care with a sense of compassion, sensitivity and respect. The home offers person centred activities, which focus on each resident, and their individual needs. To assist in this process, information about each residents past life, hobbies and interests etc is recorded and this usually involves input from relatives and friends. Some activities take place spontaneously, such as having a sing-along and some group activities are arranged, such as armchair football and skittles and armchair exercises to music. Residents can participate with tasks such as, laying tables, peeling
Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 6 potatoes etc, if they wish. A monthly communion service is held in the home and clergy also visit on request. Residents are encouraged to exercise as much control over their lives as possible and helped to make decisions about what they do each day. Residents commented, I can go to bed when I choose and I can go outside whenever I want to. Meals are varied and take into account the likes and dislikes of residents. Mealtime arrangements are flexible enough to accommodate individual preferences and any social activities etc. Snacks and drinks are available 24 hours a day. Residents speak highly of the meals provided, e.g. I had a lovely dinner, I really enjoyed it. Bedrooms are comfortably furnished and many contain the residents own personal items. Genesis is kept clean and there are no unpleasant smells, making daily life for all in the home more pleasant. The needs of residents are well met by the numbers and skill mix of the staff team. One staff member commented, I find the training here very helpful in understanding the people I care for. It helps me do my job better. The home seeks the views of residents, relatives, health professionals, care managers etc, as a means of making any suggestions for improvements and ensuring the home is run in the best interests of residents. In order to protect residents, it is the policy of the home not to have any involvement with their finances. All residents who are unable to handle their own affairs have a relative or other representative to deal with finances etc. Records confirm that equipment used in the home is regularly checked and maintained to ensure its safety. This includes proper maintenance of the fire warning system, emergency lighting and fire fighting equipment. What has improved since the last inspection?
Miss Mangold is always looking to make improvements that will enhance the lives of residents within the home. New bedside tables have been ordered for all bedrooms and delivery of new outdoor tables and chairs is awaited. New signage has been ordered for toilet and bathroom doors. Conversion work is in progress to provide an additional single bedroom on the first floor. Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 7 What they could do better:
Although residents receive visitors, there is no detailed record available to evidence this, in the form of a visitors book. The complaints procedure is in need of amendment. Complaints are not always handled objectively or documented in full, which means that residents and their relatives cannot be confident that their complaints will be taken seriously and dealt with appropriately. The Adult Protection policy is out of date and is not in line with the Department of Health No Secrets guidance, therefore any allegations of abuse cannot be managed effectively. Not all staff have received training in adult protection issues to ensure a proper response to any suspicion or allegation of abuse, although this is now being rectified. Miss Mangold had plans to make bath times more pleasurable for residents and enhance the environment in communal bathrooms as well as toilets. Work commenced before the last inspection in February 2005 when bathrooms were redecorated, but plans to add pictures, transfers, mobiles etc have still not been completed. A low wall situated in front of the small greenhouse in the rear garden is potentially hazardous as residents sometimes sit on this and could fall backwards into the glass. At the last inspection in February 2005, Miss Mangold said she had completed a risk assessment and decided to dismantle the greenhouse, but this has still not yet been achieved, leaving residents potentially at risk. The home has a detailed recruitment policy, but this needs amendment to ensure Criminal Records Bureau checks are carried out prior to employment commencing, for the protection of residents. A staff induction and training programme is in place, however the home is not meeting the target of having 50 trained staff at NVQ level 2 by 2005, therefore residents cannot be fully confident that they are in safe hands at all times. It is important that all records are kept in the care home, available at all times for reference, as well as inspection by authorised persons. Staff employment, supervision and training records were not all available in the home at the time of inspection. Staff say that fire training and drills are taking place at the required intervals, so they are fully aware of what to do in the event of fire. Fire records confirm this, except in the case of new members of staff who are receiving only one fire training session in their first month of employment, rather than the recommended two.
Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 8 Although not assessed on this occasion, two requirements and a recommendation from the last inspection report are carried forward. No scores or outcomes have been allocated in respect of these. (Requirements, Standards 25 and 31 and Recommendation, Standard 36.) 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 D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 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 standard(s) No Standards were assessed during this inspection. (Standard 6 is not applicable as Genesis does not offer intermediate care.) EVIDENCE: Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10 and 11 A care planning system is in place, which ensures that staff have sufficient information to meet the needs of residents. The health needs of residents are also well met, with evidence of good support from the community health professionals. Residents are treated respectfully and care is offered in a way that protects the resident’s right to privacy and dignity. At the time of death, residents and their relatives are treated with consideration and respect. EVIDENCE: Each resident has a care plan that details their care needs and how these are to be met. A key worker system is in place, with care staff having particular duties for the individual residents that are their responsibility, including reviewing their care, updating their records and life histories and monitoring their physical and mental health. Discussions with staff show that they are also aware of the wider needs of individuals and there is detailed information in the care plan to support this, e.g. Likes to look smart, Likes talking about wartime experiences and Has a very good sense of humour. Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 12 The three care plans examined show that professional advice is sought appropriately and visits by the GP, District Nurse, dentist etc are recorded. Staff were observed to be treating residents in a respectful manner and carrying out personal care tasks with due regard for privacy and dignity. One resident commented, I like it here, they treat me well. Residents wear their own clothes and these are named to prevent any confusion. Clothing is arranged neatly in drawers and wardrobes. Residents are well presented and commented, They ask me what I want to wear, and They make sure I look smart. Discussion with staff and examination of the care records for a deceased resident demonstrated that appropriate care had been provided, with support from the District Nurse and GP. Relatives had been kept informed and were able to visit. The home has a policy on the care of the dying and also a document entitled If I were dying I would want, which includes statements such as: • I would wish to be cared for in my own room. • I would want my friends and family around me. Miss Mangold spoke of the additional care and support given to residents and relatives at this difficult time, and of the home s policy to attend funerals as a mark of respect. This information is not currently recorded, but Miss Mangold says it is now her intention to do so. Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 The home satisfies recreational and religious needs and a range of social activities provide variation and interest for the residents. Visits from family and friends are encouraged but only limited opportunities are available for contact with the community. A flexible approach is taken to the running of the home and residents are helped to have a choice over their lives. The home provides a balanced and varied selection of food that meets residents’ tastes, choices and special dietary needs. EVIDENCE: The home provides person centred activities, which focus on each resident and their individual needs. To assist in this, information about each residents past life, hobbies and interests etc is recorded and this often involves input from family and friends. Group activities also take place, such as armchair football and skittles, singing and a weekly movement to music session. Sensory materials are used, such as coloured lights, sand, water and ice. Some residents like to assist with small tasks around the home, such as laying the tables for mealtimes or peeling potatoes, helping with laundry or in the garden etc. During the inspection, residents were seen enjoying picture book colouring, a sing-along, armchair football and going for a walk with staff.
Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 14 Miss Mangold says that at present, no residents have expressed a wish to go to church but a Church of England clergyman visits the home on a monthly basis for a communion service and all are welcome to attend. A Catholic priest will also visit on request. Most residents receive visitors on a regular basis but these are not routinely recorded in a visitors book. 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. Visiting times at Genesis are unrestricted and a visitor confirmed, We have visited at all different times of the day and have always been made welcome. Residents are helped to exercise as much control over their lives as possible and are encouraged to make decisions about what they do each day, what they wear, when they get up or go to bed. Residents commented, I get up early, which I like. I go to bed at 9 p.m. but I can go when I like, I can choose. Do you like my dress? I chose this to put on this morning. I like walking in the garden. I can go outside whenever I want to. Lunch was served in the dining area, in a relaxed, unhurried atmosphere. Residents may choose where they eat and times are flexible. Snacks and drinks are available from staff 24 hours a day. Staff commented, They eat very well here and enjoy their food. We make sure they have plenty to eat and drink to help them stay well. A visitor said, I have been here at breakfast, lunch, tea and suppertime. The food always looks good, with good sized portions. Lunch on the day of inspection was shepherds pie, with mashed potatoes, cabbage, peas and cauliflower. This was followed by stewed apple with cream or ice cream, or yoghurt. Menus are based around the known likes and dislikes of residents, who confirmed they only have to ask and any personal preferences are accommodated by staff. I like everything here except liver, but I have something different. Residents commented positively about the food provided, I had a lovely dinner, I really enjoyed it. Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 15 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 standard(s) 16 and 18 Complaints are not always handled objectively, therefore residents cannot be confident that their concerns will be taken seriously or acted upon. Procedures for responding to suspicions of abuse are not carried out in accordance with Department of Health guidance, therefore any allegations of abuse cannot be managed effectively. Not all staff have received training in adult protection issues to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a complaints procedure in place but this is in need of amendment as some information, such as the timescales for investigation and response to a complaint, is missing. Two complaints have been made about the home in 2005 and both are currently being investigated by the Borough of Poole Social Services; one of these as an Adult Protection matter. This complaint was made by a resident but was not fully documented in the care notes or in the complaint file. Action taken in response to the complaint did not demonstrate an impartial approach and investigation records were muddled and not in chronological order, making them difficult to follow. (The outcome of the Adult Protection investigation was subsequently found to be not proven.) The Adult Protection policy was out of date and in need of amendment. This policy does not make reference to the Department of Health No Secrets document and is not in line with this guidance, therefore any allegations of abuse cannot be managed effectively. This was clearly demonstrated when appropriate action was not taken immediately in response to the allegation of abuse, with the potential to leave all residents in the home vulnerable and at
Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 16 risk. Both Mrs Mangold and Miss Mangold are seeking to address these shortfalls and have held a meeting with all staff to discuss Adult Protection issues. Not all staff have received Adult Protection training, to ensure a proper response to any suspicion or allegation of abuse. Miss Mangold says she will update the complaints and Adult Protection policies and follow this through with individual staff supervision sessions. Adult Protection training for all staff is being arranged over the coming weeks. Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 24 and 26 Continuous investment in the upkeep of the home results in a well-maintained, comfortable and safe environment for residents, where standards are constantly improving. Residents have access to indoor and outdoor communal facilities, although the siting of the garden greenhouse is potentially hazardous. Bedrooms are comfortably furnished and individually personalised to suit residents. The home is kept clean and there are no unpleasant smells, making daily life for all in the home more pleasant. EVIDENCE: Miss Mangold confirmed ongoing maintenance of the home and her intention of always seeking to improve facilities for residents. New bedside tables have been ordered for all bedrooms and delivery of new outdoor tables and chairs is awaited. New signage has been ordered for toilet and bathroom doors to allow easier identifcation of these facilities. Conversion work is in progress to provide an additional single bedroom on the first floor. Hot radiator surfaces are guarded to ensure the safety of residents. A stair lift is available to assist access between floors.
Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 18 At the last inspection it was noted that communal bathrooms had been redecorated and Miss Mangold was in the process of adding pictures, mobiles etc, in order to make bathing a more welcoming and pleasurable experience for residents. This work has still not been completed. Residents have access to a comfortable communal lounge/dining room on the ground floor, with a small adjoining sun lounge providing additional space for activities or sometimes as a quiet room. Residents were seen to be enjoying walking and sitting in the rear garden, which is easily accessible from the lounge. Comments included, I like the garden very much, and I enjoy walking round the garden sometimes, it is good exercise. A low wall situated in front of the small greenhouse is potentially hazardous as residents sometimes sit on this and may fall backwards into the glass. This hazard was first noted in the inspection report dated July 2004, following a minor accident. At the last inspection in February 2005, Miss Mangold said she had completed a risk assessment and decided to dismantle the greenhouse, but this has still not yet been achieved. Miss Mangold promised immediate action to ensure resident safety. Bedrooms are comfortably furnished and many contain the residents own personal items. Some rooms are carpeted but others have floor coverings that are more suited to the needs of the individual. Residents commented, I have a very nice room, and I like my room. I have two bedspreads, a winter one and a summer one which is cooler. An external laundry service is used for the laundering of sheets, pillowcases, duvets and towels etc, but all personal items are laundered within the home. Genesis is clean throughout and there are no unpleasant odours. Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 The numbers and skill mix of staff are sufficient to meet the needs of residents. The home has a detailed recruitment policy, but this needs amendment to ensure Criminal Records Bureau checks are carried out prior to employment commencing, for the protection of residents. A staff induction and training programme is in place, however the home is not meeting the target of having 50 trained staff at NVQ level 2 by 2005, therefore residents cannot be fully confident that they are in safe hands at all times. EVIDENCE: Good staffing levels at Genesis allow the home not only to meet the present needs of residents but also permit more time to be involved in person centred care, as well as group and individual therapeutic activities. Staffing rosters confirm that four care staff are on duty throughout the day, two working from 8 a.m. until 6 p.m. and two from 8 a.m. until 7 p.m. Two night care staff are on duty from 7 p.m. until 8 a.m., one wakeful and one sleeping but on call. In addition, a domestic assistant carries out cleaning duties from 9 a.m. until 12 p.m. on a daily basis. Care staff share responsibility for cooking, laundry and other domestic tasks. Residents commented, There are enough people here to look after us, and They (staff) look after me very well. At present, no staff have National Vocational Qualifications (NVQ), although one is studying for NVQ level 3 and two will commence training in September
Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 20 2005. 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. The home operates a thorough recruitment procedure based on equal opportunities, to ensure the protection of residents. 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 etc. Criminal Records Bureau (CRB) checks have been obtained, but Miss Mangold needs to update the policy and ensure that, unless there are very exceptional circumstances, CRB and Protection of Vulnerable Adults (POVA) checks will be carried out before staff starting work in the home. Genesis has a detailed staff induction system in place. However, not all induction training is completed within the first six weeks and records are not always fully up-to-date. 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. Staff commented, I am new to this work, but since starting here I have done a lot of training, about 10 courses. I find the training here very helpful in understanding the people I care for. It helps me do my job better. I enjoy the chance to learn many new things. Staff confirmed that recent training included moving and handling, first aid, basic food hygiene and health and safety. It is important that all records are kept in the care home, available at all times for reference, as well as inspection by authorised persons. Not all staff employment, supervision and training records were available in the home at the time of inspection. Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 38 The home is reviewing its performance through a programme of consultations, which include seeking the views of residents, staff, relatives and other visitors to Genesis to ensure the home is run in the best interests of residents. Residents are assured of sound management of their financial interests. Systems are in place to promote the health, safety and welfare of residents, ensuring they are protected. EVIDENCE: Miss Mangold says that she and her staff speak informally with residents everyday in order to gain their views and ensure their needs are being met. At present, any relevant comments are not formally recorded. A resident said, They ask me if I want anything, but I have everything I need. Staff commented, Residents are at the heart of all we do. Genesis is their home. We staff are here to make sure residents can do whatever they want, whenever they want to.
Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 22 Quality Assurance questionnaires have recently been sent to relatives, GPs, District Nurses, Community Psychiatric Nurses and Care Managers and a questionnaire for staff is currently being prepared. Feedback from these questionnaires will help to ensure that the home is meeting its aims and objectives and provide opportunities to make any suggestions for improvements to the running of the home. Miss Mangold says that, in order to protect residents, it is the policy of the home not to have any involvement in their 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. Residents are encouraged not to bring items of value into the home. The home pays for services such as chiropody and hairdressing and this is then invoiced to residents, relatives or representatives for payment. Records confirm that equipment used in the home is regularly checked and maintained to ensure its safety. Hot water temperatures were tested and found to be close to 43C, to prevent any risk of scalding. Policies and procedures are available to guide staff in health and safety issues, Control of Substances Hazardous to Health, infection control, fire safety and moving and handling etc. Most staff have received training in these matters and further training is planned. Records demonstrate that appropriate maintenance and checks of the fire warning system, emergency lighting and fire fighting equipment are taking place to ensure resident safety. Staff confirm that fire training and drills are also taking place at the required intervals, so they are fully aware of what to do in the event of fire. However the fire record shows that new members of staff are receiving only one fire training session in their first month of employment, rather than the recommended two. A letter from Dorset Fire and Rescue Service dated 24/3/05 confirms that the fire precautions are being maintained satisfactorily. Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 2 14 3 15 4
COMPLAINTS AND PROTECTION 3 1 x x x 3 x 3 STAFFING Standard No Score 27 3 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x 1 x x 3 3 x x x 2 Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 24 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. 2. Standard 13 16 Regulation 17(2) Schedule4 22 Requirement It is required that a record of all visitors to the care home be maintained. The registered persons must develop a complaints procedure to be fully in line with Regulation 22 and National Minimum Standard 16. A detailed record must be kept of all complaints and the action taken by the registered person in respect of any such complaint. It is required that all staff receive training in Adult Protection issues, to ensure a proper response to any suspicion or allegation of abuse. The registered persons must ensure that residents are safeguarded from any form of abuse. Existing policies must be updated in line with Department of Health No Secrets guidance and made accessible to all staff. The registered persons must ensure that the rear garden is safe for residents. The registered persons must ensure that the heating in communal bathrooms meets the relevant health and safety Timescale for action 31/8/05 31/8/05 3. 16 17(2) Schedule4 13(6) 31/8/05 4. 18 31/10/05 5. 18 13(6) 31/8/05 6. 7. 20 25 23(2)(o) 23(5) 31/7/05 31/10/05 Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 25 8. 9. 28 29 18(1)(c) 19(1) Schedule2 10. 30 17(2) Schedule4 11. 30 18 12. 31 7 and 9 13. 38 23(4)(d) requirements and the needs of individual residents. (Previous timescale of 30/10/04 not met.) A minimum of 50 of care staff employed by the home must have NVQ level 2 or equivalent. The registered persons must ensure that all staff are properly checked before being employed. The recruitment policy must reflect changes made regarding CRB and POVA checks since 26/7/04. The registered persons must ensure that all staff records are at all times of available for inspection by authorised persons within the care home. The registered persons must ensure that detailed records are maintained, to demonstrate that staff are receiving appropriate training. It is required that Mrs Mangold furnish documentary evidence of her own Criminal Record Bureau check to the Commission for Social Care Inspection. (Previous timescales of 30/5/04, 31/10/04 not met.) The registered persons must ensure that fire training for new staff is carried out at appropriate intervals, i.e. two half hour sessions within the first month of employment. 31/12/05 31/8/05 31/8/05 31/8/05 31/8/05 31/8/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 36 Good Practice Recommendations It is recommended that evidence of formal supervision sessions for staff is retained securely within the home and
D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 26 Genesis Care Home available for inspection. Repeated Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Bournemouth Dorset BH17 0NF National Enquiry Line: 0845 015 0120 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 Genesis Care Home D55 S3942 Genesis Care Home V230133 250505 Stage 4.doc Version 1.30 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
