Inspection on 14/09/07 for Healey House

This inspection was carried out on 14th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Healey House 24/02/08

Healey House 27/03/07

Healey House 07/12/05

Healey House 06/07/05

Healey House 01/02/05

Healey House 03/09/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Healey House 3 Upper Maze Hill St Leonards-on-sea East Sussex TN38 0LQ Lead Inspector June Davies Key Unannounced Inspection 14th September 2007 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Healey House Address 3 Upper Maze Hill St Leonards-on-sea East Sussex TN38 0LQ 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) 01424 436359 01424 436359 Hastings and Rother Voluntary Association for the Blind Mrs Christine Smith Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is twenty-eight (28) Residents on admission will be visually handicapped Service users will be older people aged sixty-five (65) years or over on admission. 27th March 2007 Date of last inspection Brief Description of the Service: Healey House is owned and managed by the Hastings and Rother Voluntary Association for the Blind, a registered charity. The Home is not purpose built but enjoys the advantages of being a detached property set in its own grounds some distance from the road. The Home provides twenty-six single bedrooms and one double room, currently used as a single. Twenty-four of the rooms have en-suite facilities. The Home has level access throughout the building, with a passenger lift to all floors. There are handrails to accommodate visually impaired residents. Two sitting rooms, a music room and dining room provide communal space. The Home has its own dedicated activity centre adjacent to it and structured weekly activities are organised in-house. Fees are £330.14 per week to £425.00 for residents and £450.00 for respite care residents. Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place over a period of seven hours. Evidence was gathered from resident surveys, inspection of documents relevant to the standards inspected, and discussion with members of staff and residents. A tour of the home was carried out. Soon after this key inspection an issue occurred in the home, and the inspector has also included information gathered from this incident. What the service does well: What has improved since the last inspection? What they could do better: Contracts and statements of terms and conditions must inform residents as to what room they will occupy and give information relating to the fees they will be expected to pay. Residents and or their relatives/representatives must sign their contracts and their care plans. Each resident should be properly assessed as to their needs both physical and social to ensure that the home can meet these needs prior to the resident coming to live in the home. Residents’ medication must be properly managed by the home in accordance with the Royal Pharmaceutical Society’s guidelines for residential care homes. Personal clothing belonging to residents should be treated with respect, by staff. Where issues occur in the home, which could place residents’ at risk these must be reported to the appropriate authorities including CSCI. Decoration and maintenance in the home must be maintained to ensure that the residents live in a homely and pleasant environment. There must be Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 6 sufficient bathrooms that provide suitable equipment and adaptations to meet the assessed needs of frail elderly residents. Residents must be provided with call bells that are accessible from the beds in their bedrooms. The home must be sufficiently staffed by managers, care staff and ancillary staff to meet the needs of the residents. Care staff must receive Skills for Care induction, mandatory health and safety training and work related training to ensure that they have the skills and knowledge to meet the assessed needs of the residents in the home. A good quality assurance system needs to be put in place that seeks the views of the residents, relatives/representatives and all external stakeholders, as well as regular monitoring of all systems used in the home, to ensure that the residents are receiving a high standard of care. Staff must be supervised to check their knowledge and skills and to ensure that they are able to meet the philosophy of the home in providing care to the residents. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 7 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 Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,2 and 3 Quality in this outcome area is poor. The homes statement of purpose and service user guide at the present time is not accessible to prospective residents who have sight impairment. The residents’ contracts and statements of terms and conditions do not give sufficient information. Sufficient evidence is not gathered prior to the resident moving into the home to ensure all their care needs are being met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Healey House provides care for older people who are blind therefore their Statement of Purpose and Service User guide have been recorded onto tapes, which they were able to play on the talking newspaper machines, many of these machines have now been replaced by disc playing machines and therefore residents are no longer able to play the tapes on these machines. Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 9 This was discussed with the Manager who will arrange to have the Statement of Purpose and Service User Guide recorded onto disc so that service users are able to access these documents. The inspector noted that in two new care plans the residents contracts and statements of purpose do not state what room number the resident will occupy nor did it state the weekly fee and by whom it will be payable. While the home has a comprehensive pre-admission assessment, this could have been completed in more detail to give clearer guidelines as to the care that the residents would wish to receive. It was noted that neither of the two care plans viewed had pre-admission assessments or plans of care, written by the respective residents’ Care Managers. The homes pre-admission assessments did not include information relating to the prospective residents religious beliefs or their wishes on death. These pre-admission assessments did not include activities that the prospective residents might be interested in. The prospective residents and or their relative/representative had not signed the pre-admission assessments. Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 Quality in this outcome area is poor. Care plans adequately provide staff with information they need to meet the needs of the residents. The health needs of the residents are well met with evidence of good multi disciplinary working taking place on a regular basis. The system for medication administration needs to be improved to ensure that residents are not placed at risk. Personal care is offered in way to protect the resident’s privacy and dignity, but staff need to show respect for residents’ belongings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector viewed that care plans of the two residents who had moved into the home within the last seven months. The care plan had been based on what information had been obtained on the resident’s pre-admission Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 11 assessment, and evidenced via the daily report sheets that staff were acting on plans of care. Both care plans had risk assessments in place and these included risk assessments on mobility. There was evidence that the care plans are reviewed by the key worker but is was noted that this is not always monthly. When the care plan is reviewed occasionally the resident signs up to agree any changes that are made. The registered manager also reviews and signs the care plans every six months. The manager must ensure that all residents and or their relatives/representatives sign up to each resident’s plan of care. Each care plan has a personal care matrix and these were seen to be regularly and fully completed by the care staff, although there was no written evidence to show that tissue viability is checked regularly. None of the residents in the home at the present time have any pressure sores. The manager and a staff member stated that should concerns arise about tissue viability they would report this to the district nurse immediately. Where residents have continence problems the service of the continence nurse are sought. The continence nurse then carries out a thorough assessment of the resident’s needs and ensures that the appropriate aids are provided. It was noted in one care plan, that a bowel chart had been provided but staff are not completing this on a regular basis. For this particular resident it was very important that this bowel chart was kept up to date, due to medical condition. If the manager or head of care have any concerns regarding the psychological health of a resident this will in the first place be referred to the G.P. who in turn will write a referral letter to the consultant psychiatrist. Each care plan had a list of activities that were on offer in the home, this included daily exercises. Due to staffing numbers at the present time, these daily armchair exercises are not always carried out and were not evident on the day of this key inspection. Care plans clearly stated when a resident has contact with any health care professional, and there was evidence that residents have access to a variety of specialists – anti coagulant clinics, ophthalmologists, physiotherapists, chiropodists and Alzheimer’s society. An optician visits the home every year, and residents can also choose to use their own optician if they wish to do so. The Manager has recently changed the pharmacy for prescribed medications. The home has medication policies and procedures, which should be reviewed at least annually. The inspector did note that the home does not have an up to date list of staff that are medication trained. This list should also have the signatures and initials of staff. Eye drops and ointments were not dated on the bottle/tube on the day of opening, and there was evidence that if some eye Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 12 drops had been opened on the prescribed date their opening life of 28 days would have been exceeded. Some MAR sheets had not been initialled, but on checking these medications on the bubble pack there was evidence that the medication had been given. Staff must ensure that they initial every medication administered. Where medication is brought into the home mid cycle, these medications must be entered properly onto the MAR sheet, with the quantity of medication received, the date the medication is received and the signature of the member of staff checking the medication in. Where medication is written onto the MAR sheet two members of staff should sign to show that it has been properly recorded onto the MAR sheet. Controlled drugs are well managed. The inspector carried out an audit of controlled drugs and found that they corresponded with the drugs written into the Controlled Drugs Register. This register also had the signatures of two members of staff when the drug was administered. During this inspection it was noted that staff treat the residents with respect and ensure that their privacy and dignity is adhered to. Toilets doors are kept closed when in use, bathroom doors are shut when being used. Resident’s personal care is discussed quietly and out of hearing of the other residents. Residents are able to entertain visitors in their own rooms if they wish, and are able to have professional visitors in their bedrooms. Residents are able to have telephones in their own rooms if they wish to. There is a call box phone provided in the main hallway that residents can use if they wish to. Some residents did express concerns regarding their laundry, some said that they clothes were not ironed properly, while others said that their laundry goes missing. Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. Quality in this outcome area is good. People who use the service experience good outcomes in this area. Residents are able to choose from a small variety of activities on a daily basis. Links with the community are good and enrich the residents’ social lives. The meals in the home are good offering both choice and variety and catering for special diets. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager said that as far as possible and within the staffing levels in the home at the present time, residents are given choice in regard to their daily lives. The home does have an activities programme, which consists of daily armchair exercises Monday to Friday, Bingo, Quiz, Sing-along to tapes and afternoon poetry reading. Four residents attend the John Taplin Day Centre. which is attached to the home, two residents go on a daily basis, while one Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 14 attends every Thursday and another attends occasionally. Two to three residents go to a club called the Undaunted. This club gives talks and plays board games with the residents. Two to three residents go to ‘The dominoes club’. Two residents go to St Matthews’s church on a regular basis and one resident goes to bowling for the blind. Two residents said that they like the activities in the home. While those residents who are able to go outside the home to access social clubs there is a wide variety of choice, there is very little activity that goes on in the home to enhance the social lives of the more frail residents in the home. The visiting policy has been reviewed and up dated and specifically states that should visitors wish to visit after 8.00 p.m. in the evening then they must ring the home first, this is to ensure security for the residents in the home. Visitors from the local church visit the home on a regular basis, just to talk with the residents and give bible readings and prayers. None of the residents in the home manage their own financial affairs this is done by their relatives or their nominated solicitor. The home does have information regarding contacting a local advocacy group, and it was noted from evidence in one care plan that a relative is arranging advocacy for her mother. During a tour of the home the inspector noted that residents are able to bring their own personal items into the home with them – pictures, photographs, ornaments, televisions, radios, and small items of furniture. All personal information relating to residents’ is kept on their individual care plans. Residents are able to have access to their own care plans on request. Through discussion with residents and from resident surveys the inspector was told that meals in the home are on the whole good. Two residents said that the meals are ‘variable in quality.’ The inspector was shown menus and evidenced that meals are varied and nutritious, meals are well presented with a variety of choices being offered to the residents. The home caters for diabetic diets at the present time, and would also cater for other specialised diets should they be requested to do so. Healey House DS0000021131.V351406.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is poor. The home has a satisfactory complaints system with some evidence that residents feel their views would be listened to. The manager and staff do not have good knowledge of adult protection issues and this leaves the residents vulnerable to abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints policy and procedures has now been reviewed and includes timescales in which a complaint will be investigated and dealt with. The inspector did note that this new policy is not displayed in the home. There have been no complaints since the last inspection. From surveys the residents stated they would know how to make a complaint. There have been two incidents involving staff to staff, and could have involved residents, in the home since the last inspection, both of these issues were dealt with by head office. There is no evidence that these issues have been reported for investigation to the East Sussex Social Services Adult Protection Unit. The home does have policies and procedures in place for the POVA and Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 16 staff are aware of these policies. The home also has policies and procedures in place relating to whistle blowing, residents finances and gifts to staff. Since the last inspection 63 of the staff have received POVA training. Since this key inspection there has been another serious incident in the home, which was not reported by the home to CSCI but is resulting in an Adult Protection referral. Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 21, 22 and 26 Quality in this outcome area is poor. There has been no change in décor or furnishing in the last 12 months and although this does not pose a risk to the residents’ it does not create a pleasant and pleasing environment to live in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection the home was clean and tidy and free from odours. The communal rooms in the home are in need of decoration and new carpets/flooring. In one communal lounge wallpaper was coming off the wall and the carpet was worn and grubby. The dining room walls were chipped with paint missing and the flooring needs replacing. The grounds of the home are neat, colourful and tidy and well cared for. Access to the garden is via a rear patio area with a ramp leading off. Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 18 All doors have now been fitted with magnetic door closures to ensure that they shut should the fire alarm go off. Bathrooms had an institutional appearance and were dull and dark with poor lighting, two bathrooms are provided with specialised baths and the residents’ cannot use the third bathroom, as no aids are available for them to safely get into the bath. The communal toilets in the home are clean and are in close proximity to the communal areas and bedrooms. Call bell cords have now been replaced and are distinguishable. It was noted that in one bedroom the call bell cord is not accessible from the bed. The home is free from offensive odours. The laundry room is situated in the basement of the home. On the day of the inspection this room was in need of cleaning. The registered manager explained that as the laundry person has left and has not at the present time been replaced, care staff need to do the laundry, and this is why the laundry room is not kept as clean as it should be. One of the washing machines has now been replaced with an industrial washing machine that has a sluicing facility. The laundry room floor is impermeable to water. All communal toilets and bathrooms now have paper hand towels and liquid soap in place. The home has policies and procedures in place to tell staff how to prevent the risk of cross infection. Clinical waste in the home is managed appropriately. Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Quality in this outcome area is poor. The staff morale is low with high levels of staff turnover. This situation is having a detrimental impact on the standard and consistency of care offered within this home. Recruitment practices are good ensuring the residents are receiving care from well vetted staff. Staff training needs to improve to ensure that residents are receiving care from staff who are knowledgeable and have had the appropriate training to meet their assessed needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection staffing levels were low and residents were not offered their armchair exercises. Both the staff and the manager confirmed that while staffing levels should provide one senior carer and five carers on the morning shift and one senior and three carers on the p.m. shift with two waking night carers on duty, this was not always the case. Staff and the Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 20 manager confirmed that this is a regular occurrence due to staff annual leave and sickness. Since this key inspection evidence has also become available that the home has not been able to retain its staffing levels and is operating below the minimum recommended levels according to the Residential Staffing Forum. There is also a shortage of ancillary staff in the home – 1 chef has resigned, 2 domiciliary staff have left including the laundry assistant and 1 domestic is about to retire. The deputy manager has also resigned. Six out of twenty-one of care staff have NVQ level 2 and above, and the manager said that 4 staff are waiting to enrol on a NVQ course and one member of staff is in the process of completed her NVQ. It is envisaged that in the next year 11 staff will have achieved there NVQ level 2 or above. The inspector viewed the staff personnel files of three of the newest recruited staff. All staff files contained application form with a full employment history, CRB checks, two written references, Home Office work permits, two forms of identification, terms and conditions of employment and staff training certificates. All CRB checks had been received prior to the new employee starting work in the home. The inspector viewed the training file for staff and found that not all staff have completed their mandatory training. None of the staff have been trained to work with people who have a sensory disability, while all the residents in the home are either blind or sight impaired. Some staff have received dementia care training. The manager showed the inspector the new induction package related to ‘Skills for Care Induction’ this has not been put into practice yet. All staff have completed a health and safety induction into the home. Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 and 38 Quality in this outcome area is poor. The home is not well managed having a detrimental impact on all aspects of the residents’ care and support. Quality assurance systems need further development to ensure that the residents receive a high quality of care. Staff do not receive regular formal supervision, which in turn has an impact on the standard of care that the residents receive. While some aspects of health and safety have improved, not all staff have received training in health and safety issues, and this leaves residents in a vulnerable position. This judgement has been made using available evidence including a visit to this service. Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 22 EVIDENCE: The registered manager has a RGN qualification but has not obtained her registered manager award. The manager has attended her interview to be enrolled onto the RMA course, but Trustees of Hastings and Rother Voluntary Association for the Blind this have not supported this. All staff spoken to stated they have a good working relationship with the registered manager and found her to be approachable and open in the running of the home. The manager is included in the care staff duty rota, and does spend time working in the home with the care staff. The registered manager has tendered her resignation because she does not feel supported by the trustees. Since this key inspection evidence shows that the home has been very short of management hours, which has placed the residents at risk. The quality assurance system for the home is still in the process of being developed, resident and visitor questionnaires have been given out, questionnaires have been sent out to G.P.’s but no other stakeholders in the community have received these questionnaires. The manager is not aware that the home has an annual development plan. Fire Safety and Health and Safety checks have been carried out for all internal rooms in the home. The manager does carry out monitoring checks for Care Plans but other monitoring of systems used in the home are not recorded. The Head of Care carries out medication monitoring again this is not recorded. The manager deals with the personal allowances for ten of the residents, the relatives bring in monies for the residents personal expenditure, these are recorded into individual accounts books, any expenditure is also recorded and receipts kept and two members of staff sign for money going out. Each resident has their own personal plastic wallet in which their personal allowance is kept in a safe place in the home. The manager monitors the personal allowances on a monthly basis and signs each accounts book to say that she has done this. Care staff do not receive formal supervision six times per year. As mentioned previously not all staff have received mandatory training in Health and Safety issues and this has been referred to earlier in this report. The inspector did view up to date certificates for the maintenance of appliances used in the home. Since the last inspection window opening restrictors have been fitted to all windows on the first and second floor, and water control thermostatic valves Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 23 have been fitted to hot water outlets. Hot water temperatures are taken weekly and recorded. Fire points are checked on a weekly basis and this is recorded. The home has up to date policies and procedures relating to health and safety issues. All residents’ accidents are recorded appropriately into a HSE accident book and are in most instances well recorded. Healey House DS0000021131.V351406.R01.S.doc Version 5.2 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 1 2 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 2 X 1 2 X X X 3 STAFFING Standard No Score 27 1 28 2 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 1 X 3 1 X 1 Healey House DS0000021131.V351406.R01.S.doc Version 5.2 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 OP2 Regulation Schedule 4(8) Requirement The registered provider must ensure that all residents are given a contract and terms and conditions of residency, these must include the number of the room that the residents will occupy and the fees payable and by whom. Timescale for action 05/11/07 2. OP3 14 (1)(a) Schedule 3 05/11/07 The registered manager must ensure that prospective residents have a fully completed and informative pre-admission assessment, and where the prospective resident is funded by a local authority a pre-admission assessment must be obtained from the care manager. Residents should be involved in the drawing up of their care plan, and agree to any changes made in monthly reviews. This requirement was made at the last two inspections and timescales of 31/03/06 and 02/07/07 have not been met. 05/11/07 3. OP7 15(1)(2)( a)(c)(d) Schedule 3 (1)(b) Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 26 4. OP9 13(2)(4) 17(1)(a) Schedule 3(3)(i) 1. The manager must 20/11/07 produce a list of medication trained staff, together with their signatures and initials. 2. Eye drops/ointment and liquid medications should be dated on the bottle/tube on the day of opening. Medication that has an opening life of 28 days should not be used after the opening date. 3. Any mid cycle medications must be entered correctly on to the MAR sheet, with quantity of medication, date the medication is received into the home and the signature of the member of staff checking the medication in. 4. Where medication needs to be handwritten onto the MAR sheet, this should be done accurately and signed by two members of staff. 5. Staff should receive regular annual medication training with competency being checked by the registered manager. The registered manager must ensure that residents’ personal clothing is always returned after laundering, and that it is returned in a presentable manner. The registered provider must ensure that any incidents in the home that could place residents at risk are reported to the relevant authorities immediately. The registered provider must ensure that the home is kept in a DS0000021131.V351406.R01.S.doc 5. OP10 12(4)(a) 07/11/07 6. OP18 12(1)(a) 13(6) 07/11/07 7. OP19 23(2)(b) (d) 28/01/08 Healey House Version 5.2 Page 27 good state of repair and refurbishment. This includes communal rooms, bathrooms and the residents’ bedrooms 8. OP21 23(2)(j) The registered provider must ensure that there are sufficient bathrooms in the home (one bathroom for every eight residents) that are adapted to meet the needs of the frail elderly residents. The registered provider must ensure that the call bell cord in one bedroom is placed close to the resident’s bed so that they may call staff in the case of an emergency. The registered provider must ensure that there are sufficient numbers of staff (both care and ancillary) to meet the assessed needs of the residents. The registered person must ensure that all staff receive induction training to Skills for Care standards. This requirement was made at the last inspection and timescale of 03/08/07 has not been met. The registered person must ensure that all staff receive mandatory and job related training to meet the assessed needs of the residents. This requirement was made at the last inspection and timescale of 03/08/07 has not been met. 13. OP31 9 (1)(2)(b) The registered provider must 07/11/07 make provision for the registered DS0000021131.V351406.R01.S.doc Version 5.2 Page 28 28/01/08 9. OP22 23 (2)(n) 07/11/07 10. OP27 18(1)(a) 19/12/07 11. OP30 18 (1)(c)(i) 07/11/07 12. OP30 12 (1)(a)(b) 28/01/08 Healey House (ii) manager to enrol on and complete her Registered Manager’s award. This requirement was made at the last inspection and timescale of 03/08/07 has not been met. The registered provider must ensure that the home develops and effective quality assurance system. This requirement was made at the last inspection and timescale of 03/08/07 has not been met. The registered manager must ensure that staff receive formal supervision at least six times per year. 19/12/07 14. OP33 24 (1)(a)(b) (2)(3) 15. OP36 18(2) 07/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP7 OP16 OP19 Good Practice Recommendations The key workers must review residents’ care plans every month. The complaints policy should be displayed in a prominent place in the home. Chiming clocks in the home should be put back into use, to ensure that residents have a good indication of the time. Healey House DS0000021131.V351406.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Local 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. 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