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Inspection on 27/06/06 for Heston House Care Home

Also see our care home review for Heston House Care Home for more information

This inspection was carried out on 27th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Pre-admission assessments are well completed. Staff were observed to interact with service users sensitively and respectfully. Service users and visitors spoken with expressed their satisfaction with the home. Complaints and Adult Protection issues are well managed. The meal provision is satisfactory and affords choice. The home meets service users individual, cultural and religious needs. Staff have an understanding of the service users` religious, cultural and communication needs. The home provides a good rehabilitation service for a small group of service users. Staff were observed to be respectful and courteous in their interactions with service users and their representatives.

What has improved since the last inspection?

The patio area has been refurbished. Two kitchens have been refurbished. The review of meal provision by the Registered Manager has taken place.

What the care home could do better:

Shortfalls with some areas of the service user care plans were identified. Reviews were not always taking place and the records did not detail whetherthere had been any changes to the service user plan. Personal care records were not always up to date. Risk of falls assessments were general and not specific to the service user. No assessments had been undertaken in relation to nutrition, skin care and continence. Training records were available, however, these were not always up to date. Duty rosters did not accurately reflect the staff that were on duty. The staffing levels need to be reviewed in line with service users dependencies. Shortfalls were identified with the environment, and some areas of the home are institutional in appearance. The resource planner should detail the members of staff on shift who have undertaken First Aid training.

CARE HOMES FOR OLDER PEOPLE Heston House Care Home 201-209 Vicarage Farm Road Heston Middlesex TW5 0AH Lead Inspector Mrs Rekha Bhardwa Key Unannounced Inspection 11:00 27th June 2006 and 5th July 2006 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 Heston House Care Home DS0000032606.V300655.R02.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. Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heston House Care Home Address 201-209 Vicarage Farm Road Heston Middlesex TW5 0AH 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) 020 8570 3040 020 8570 6099 London Borough of Hounslow Mrs Belinda Jane Calen Care Home 60 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (52) of places Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. A maximum of six service users may be accommodated in the Intermediate Care Unit situated on the ground floor. There shall be a minimum of two suitably trained care staff on duty in the Intermediate Care Unit during daytime hours. New staff recruited to work in the Intermediate Care Unit are provided with appropriate training within three months of employment. Any proposed reduction in staffing levels must be discussed with the allocated Inspector and agreement given prior to any such proposed reduction being made. The proposed Dementia Unit must not become operational until the outstanding environmental works are completed. The areas to be completed are: * Redecoration of the proposed dementia unit. * Area of garden to be sectioned and secured for the safety of the dementia unit service users. 15th December 2005 5. Date of last inspection Brief Description of the Service: Heston House is owned and managed by the London Borough of Hounslow. This very large home is sub divided into eight smaller units. Each unit has a dedicated kitchenette, dining area and lounge. Three units are dedicated to Asian Elders. The home has an intermediate care unit, which provides a rehabilitation service for up to six service users. The home also has an eight bedded dementia unit on the ground floor which has a secure garden. All meals are served from the main kitchen. The Registered Manager has demonstrable experience in working with older people. Diversity is recognised when recruiting staff. Heston House is set back slightly from Vicarage Farm Road which runs through Heston. The home is conveniently located for local amenities and bus routes. Heston House is situated in a large plot of land, most of which is lawned. The home provides a service for elderly frail people, who for what ever reason, can no longer live at home with support. The home aims to support service users in maintaining their independence for as long as possible. A Porto cabin has been erected in the grounds of the home for use by the Social Work Team for Older People. Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken over a period of two days. On the second day of the inspection the Pharmacy Inspector from the CSCI undertook a full Pharmacy inspection. A total of 21 hours were spent on the inspection process. The Inspector carried out a tour of the home, and inspected service user plans, maintenance records, training records and staff files. A number of service users on all units, 12 staff and 5 relatives were spoken with as part of the inspection process. At the time of inspection there were fifty one service users accommodated at the home. The Registered Manager was not available on the first day of the inspection and on the second day of the inspection she was on annual leave. The Standards in relation to the Registered Manager were not assessed at this inspection. On the second day of the inspection there were three Assistant Resource Managers on duty. Two of these Managers assisted the Inspector and Pharmacy Inspector on the inspection. The pre-inspection questionnaire, given to the home at the time of inspection, was also used to inform this report. It must be noted that it is sometimes difficult to ascertain the views of service users with dementia care needs What the service does well: What has improved since the last inspection? What they could do better: Shortfalls with some areas of the service user care plans were identified. Reviews were not always taking place and the records did not detail whether Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 6 there had been any changes to the service user plan. Personal care records were not always up to date. Risk of falls assessments were general and not specific to the service user. No assessments had been undertaken in relation to nutrition, skin care and continence. Training records were available, however, these were not always up to date. Duty rosters did not accurately reflect the staff that were on duty. The staffing levels need to be reviewed in line with service users dependencies. Shortfalls were identified with the environment, and some areas of the home are institutional in appearance. The resource planner should detail the members of staff on shift who have undertaken First Aid training. 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. Heston House Care Home DS0000032606.V300655.R02.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 Heston House Care Home DS0000032606.V300655.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their representatives are provided with up to date information about the home, therefore they have an accurate view of the facilities provided. Service users are assessed prior to admission to ensure the home can meet their needs. Staff have the training and skills to meet any specialist needs of service users. EVIDENCE: The Statement of Purpose and the Service User Guide had been updated to include the dementia unit. All service users had been issued with a copy of the Service User Guide. The home accommodates service users for permanent placement and also for respite care. Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 9 Service users are referred via a Social Worker. A needs led assessment is received by the home. A further assessment may be carried out by the home whereby the service user is visited in hospital or in their own home by one of the senior staff working at the home. The Inspector viewed the needs led assessments in relation to the two service user files. The assessment process does not always apply to service users who are admitted to the home at short notice for respite care. Since the last inspection the home has opened a 8 bedded dementia unit on the ground floor. Staff working on the unit confirmed that they have received training in dementia care. Referrals to the intermediate care unit are received via the single point of access in Hounslow. This referral contains basic information about the potential service user. The Physiotherapist or Occupational therapist who is attached to the intermediate care unit undertakes the assessment of the service user. A maximum of six weeks is allowed on the unit. The Inspector met the Physiotherapist on the first day of the inspection and the Occupational Therapist on the second day of the inspection. Feedback obtained from the Physiotherapist indicated that staff on the unit were working well together and that any rehab programme is carried out by the care staff when they are not available. A dedicated area is available for exercise, making snacks and drinks. Heston House Care Home DS0000032606.V300655.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Service user plans were not always up to date and did not accurately reflect the condition and needs of the service user. Staff are courteous to service users and personal support is provided in such a way as to promote and protect the service users privacy, dignity and independence. EVIDENCE: The Inspector viewed a sample of service user care plans. Generally care plans followed the same format and covered the following headings personal care, aids and mobility, ancillary services, medical needs and social, emotional and cultural needs. The care plans viewed were not individualised. Some were not dated or signed. A box is available for the staff to sign and date when a review is undertaken. Some of the care plans viewed had not been reviewed for 2 months. No information on whether care needs had stayed the same or had changed was recorded. Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 11 No care plans were available on the social care needs of service users. Care plans are not drawn up with the involvement of the service user or their representative. There was no evidence that care plan audits were taking place. Moving and handling risk assessments were available. Some had not been reviewed for over a year. For one service user no moving and handling assessment had been undertaken. A generic risk assessment tool which recorded risk of falls is available, for two service users who had a fall the assessment had not been reviewed. One of the Assistant Resource Managers stated that falls are reviewed by the Registered Manager via the accident and incident forms. Further detail is required in the risk assessment on the prevention of falls for example is the service user confused, details on their gait etc. For one service user who had fallen the accident record sheet did not detail the most recent fall. Assessments for nutrition, continence and pressure sore risk had not been completed. From the records viewed it was clear that regular weights were not being undertaken. For the service users on the dementia care unit no mental state assessments had been undertaken. It was reported that there were no pressure sores at the time of the inspection. Any wounds are attended to by the District Nursing service. Health care needs were being met. Evidence of this was seen in the records viewed. The GP and a Clinical Psychologist from the West London Mental Health Trust were seen visiting on the first day of the inspection. The CSCI Pharmacist Inspector carried out an inspection on 05/07/06 and a separate report is available. Staff were seen caring for service users in a gentle manner, and conversing with them courteously. There was a homely atmosphere on each of the units and service users looked well cared for. Generally the service users and visitors spoken with expressed their satisfaction with the care provision at the home. Where concerns had been raised with the Inspector at the time of the inspection these were referred to the two Assistant Resource Managers on duty. Records in relation to personal care were not always up to date and one service user complained that they had not been bathed for over two weeks. When the Inspector viewed the personal care records for this service user there was no evidence that the service user had actually had a bath within this period of time. This was discussed with both Assistant Resource Managers on the second day of the inspection. Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 12 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): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Activities are provided to meet the service users needs. Visiting is encouraged and this enables service users to maintain contact with their family and friends. Food choices are available and service users dietary needs are catered for, to include meeting any specialist dietary needs or requests. EVIDENCE: There was evidence that the activities coordinator had been working to ascertain a full social history for some service users. Activities programmes for the current week were displayed. Details of service user’s religious observance and specific cultural needs had been identified, and multi-faith religious festivals are celebrated. The Inspector spoke with the activities coordinator on the first day of the inspection. She stated that she enjoyed her role and attempted to have Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 13 varying activities in the morning and in the afternoon. It was not clear what training she had undertaken in relation to her role. During the course of the inspection, relatives, friends and representatives of service users were seen visiting the home. Service users are able to receive visitors in private or in communal areas. Visitors who were asked said that they had been made very welcome at the home, and representatives said that they are kept up to date with any issues pertaining to their relative. Some service users choose to spend their time in their bedroom rather than in the lounge area. A choice of food is offered. Daily routines are flexible. The kitchen was clean and tidy. A six week menu is available for the English menu. A four week menu is available for the Asian units. There was evidence that the service users had been asked in advance of the meal their choice preference and this had been recorded. Where service users had special dietary needs, these had been recorded. Service users spoken with were generally satisfied with the food provision and were pleased to be offered a choice. One service user on Primrose Unit was not satisfied with the some of the food provision and this was an ongoing issue that was being addressed by the Registered Manager. Since the last inspection the Registered Manager has undertaken a meal survey as part of the quality assurance system in the home. Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 14 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): 16,17 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The systems for managing complaints and adult protection matters are robust, thus safeguarding service users. EVIDENCE: A complaints policy and procedure was in place. There had been one complaint recorded since the last inspection. Visitors who spoke with the Inspector confirmed that they were aware of the complaints procedure and would be able to raise any concerns with the Registered Manager or one of the Assistant Resource Managers. Service user’s finances are managed by the Civic Centre at the London Borough of Hounslow. The home has a small amount of money which is used on behalf of some service users. Three service users are able to manage their own finances. Receipts are kept and any expenditure is deducted from the running balance. A cash audit report was undertaken on the 19/4/06. Staff have received training in Adult Protection from the Protection of Vulnerable Adults Team in Hounslow. One incident which related to a service user prior to their admission into the home was currently being investigated by the Adult Protection coordinator. No allegations have been reported to the CSCI since the last inspection. Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 15 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): 19, 22 and 26 Quality in this outcome area is adequate, in relation to the environment. Quality in this outcome area for the other standards is good. This judgement has been made using available evidence including a visit to the service. Generally the home was well maintained, however some sections of the environment are in a poor condition, thus some areas do not provide service users with a homely environment to live in. Systems are in place for the management of infection control thus safeguarding service users. EVIDENCE: The Inspector undertook a tour of the premises. Generally the home was being maintained, but areas in need of redecoration and refurbishment were noted, and detracted from the homely environment. These were mainly the corridor areas which looked shabby and institutional and some of the communal areas. Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 16 Generally individual furnishings in the service users bedrooms were satisfactory. There is a five year redecoration and refurbishment plan, which identifies individual units that require refurbishment and furniture that needs to be replaced. At the time of the inspection one kitchen was being refurbished. Plans were in place to refurbish another two units. The lounge on Jasmine unit had radiator stains; the room was dark and uninviting. Any day to day maintenance issues are recorded in the diary. The home employs part-time and full time maintenance personnel. The Inspector suggested that the maintenance man have a maintenance book in place which should detail the day an issue was raised and detail when the issue had been addressed. The new dementia unit (Birchwood unit) has been pleasantly decorated. The garden is secure. Garden furniture was available for this unit but was not in use as further work was required to the lawn area in this garden. The ramp in the dementia unit garden has no handrails in place. The stairs within this unit are not secure and the lift has no key pads installed. No risk assessments were available for the stairs or the lift in this unit. All these areas were discussed with the Assistant Resource Manager on duty on the first day of the inspection. Grab rails and handrails were available throughout the rest of the home. All bedrooms are single. Some of the furniture in the bedrooms was worn and old, and again, this needs to be addressed. The home does have some adjustable beds for service users with moving & handling needs. There is a call bell system throughout the home and these were answered promptly. The main garden is well maintained and the patio area has been relayed. The home also provides a community laundry service. The laundry was viewed during the course of the inspection. Dirty laundry is dealt with in one area and clean laundry in another area. Both laundry staff on duty spoke with the Inspector. Both stated that they had received training in infection control and how to manage soiled and infected laundry. The laundry was well ordered and clean. The duty rosters indicated that house keeping staff are on duty. This ranged from six staff on duty to three staff on duty at the weekends. The home was generally clean. Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 17 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): 27,28,29 and 30 Quality in this outcome area in relation to staffing is adequate. Quality in this outcome area for the other standards is good. These judgements have been made using available evidence including a visit to the service. The home is appropriately staffed to meet the current needs of the service users. Staff training in the home provides staff with the skills and knowledge to meet service user’s needs. Robust systems are in place for the recruitment of staff, thus safeguarding service users. EVIDENCE: Duty rosters viewed did not always reflect the staff that were on duty. On the first day of the inspection the Registered Manager was shown as being on the roster when she was actually away. The resource planner used on a daily basis did not always reflect the staff that were shown on the duty roster. Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 18 It was not clear from the resource planner who had overall responsibility for the home in the absence of the Registered Manager. There was no evidence that the staffing was based on any service user dependency assessments. On Primrose unit which is on the first floor six service users are accommodated on the first floor and two service users allocated to this unit are on the ground floor. When the care worker is assisting the two service users on the ground floor the service users on the first floor are unsupervised. One Assistant Resource Manager stated that the care worker from Jasmine unit would cover for Primrose unit. The Inspector was concerned that the service users on Jasmine unit were then left unsupervised. There has been no increase to the night staffing levels with the opening on the dementia unit. It is essential that once the unit is fully occupied and fully functioning that the night staff arrangements be reviewed. The home has in place a programme for NVQ in care training. The preinspection questionnaire detailed that twelve care staff had completed their NVQ Level 2 or equivalent and that five care staff were waiting for final verification of their portfolios. The staff employment files viewed contained all the required information with the exception of one reference for one member of staff. The Assistant Resource Manager on duty on the first day of the inspection stated that a copy of this would be obtained from the Human Resources department at the Civic Centre. One Assistant Resource Manager informed the Inspector that the home has in place induction and foundation training to meet the Skills for Care standards. Each member of staff has a training record. Some records viewed were not up to date and there was no overall view of the training undertaken by staff and the training that had been planned. It was suggested at the time of the inspection that the home have in place a training matrix which would provide an overview of the training undertaken by the staff and the training that was required. Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 19 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): 33, 35, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Systems for quality assurance are in place, thus providing an ongoing process of review and feedback. Generally systems for the management of health and safety are in place, shortfalls have been identified and these should be easy to address. EVIDENCE: Records viewed indicated that a quality audit had taken place in July 2005. The results of this audit have been collated. The Registered Manager has also undertaken a meal review and has obtained feedback from each unit. Regulation 26 visits are undertaken monthly. An annual development plan was available. This detailed the major refurbishment required in the home i.e Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 20 kitchens and bedrooms. Service user and relatives meetings are held and feedback is also obtained from these meetings. Audits to include housekeeping, facilities, care planning and health and safety do not take place. Service users finances have been addressed under Standard 18. Records were being stored securely. Records required by regulation and for the efficient running of the business were not always up to date. Maintenance and servicing records were viewed at random. Those viewed were up to date. Fire drill records viewed showed that drills were taking place on a regular basis. The need to clearly identify the time of the drill was discussed. All senior staff including night staff and administration staff have undertaken the four day First Aid training. Details of which member of staff was to be a fire marshall was recorded on the resource planner. This should also record which member of staff on duty is responsible for the administration of First Aid in the event of an emergency. Regular health and safety audits are undertaken three monthly. Some representatives of a service user stated that they were concerned about trailing wires in their relative’s bedroom. This was reported to one of the Assistant Resource Managers at the time of the inspection. Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 21 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 X 3 x X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X x 2 X X x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x x x 2 2 Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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 OP7 Regulation 15,17 Requirement The service user care plan must accurately reflect all the individual needs of the service user. Including social and activity needs. They must be reviewed and updated monthly and whenever the service users condition changes. All service user care plans must be dated and signed. The service user care plan must be drawn up with the involvement of the service user and representative. Risk assessments for falls must be in place for all service users and must be updated following any falls. Moving and handling, continence, nutritional and skin assessments must be in place for all service users. Records in relation to service users must be accurate and kept up to date. The activities coordinator must undertake training relevant to her role. She must also undertake training in dementia DS0000032606.V300655.R02.S.doc Timescale for action 22/08/06 2 OP7 15 01/09/06 3 OP8 13(4) 22/08/06 4 OP8 13(4),13( 5) 17 18 22/08/06 5 6 OP8 OP10 OP12 01/08/06 01/11/06 Heston House Care Home Version 5.2 Page 23 7 8 9 OP22 OP22 OP27 23(2)(n) 12,13(4) 18 10 OP27 17(2) 11 12 OP30 OP37 17 17 care. Hand rails must be fitted to the ramp in the dementia unit garden. Risk assessments must be available on the stairs and the lift on the dementia unit. The Registered Manager must undertake a review of the staffing provision in line with the service users dependency levels, size and layout of the home. A copy of this review must be sent to the CSCI. The duty rosters must accurately reflect the hours actually worked by all staff working in the care home. The duty roster must accurately reflect the staff on duty this also includes the Registered Manager. Staff training records must be kept up to date. The Registered Manager must ensure that records required by regulation and for the efficient running of the business are up to date, available and accurate. (See details under Standards 7, 8 and 30) 01/09/06 22/08/06 01/10/06 01/08/06 22/08/06 01/08/06 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 OP27 OP30 Good Practice Recommendations The duty roster should identify the member of staff who has overall responsibility for the premises in the absence of the Registered Manager. The Registered Manager should have in place a training matrix. This should detail the training undertaken and the training that is required. DS0000032606.V300655.R02.S.doc Version 5.2 Page 24 Heston House Care Home 3 OP38 The daily resource planner should highlight the member of staff responsible for First Aid in the event of an emergency. Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West London Area Office 11th Floor West Wing 26-28 Hammersmith Grove Hammersmith London W6 7SE 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 Heston House Care Home DS0000032606.V300655.R02.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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