Inspection on 08/01/08 for Holmer Care Centre

This inspection was carried out on 8th January 2008.

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

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.

Other inspections for this house

Holmer Care Centre 22/09/10

Holmer Care Centre 17/09/10

Holmer Care Centre 17/08/10

Holmer Care Centre 20/07/10

Holmer Care Centre 12/07/10

Holmer Care Centre 21/02/07

Holmer Care Centre 10/02/06

Holmer Care Centre 05/10/05

Holmer Care Centre 26/01/05

Holmer Care Centre 06/07/04

Holmer Care Centre 02/03/04

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

CARE HOMES FOR OLDER PEOPLE Holmer Care Centre Leominster Road Hereford Herefordshire HR4 9RG Lead Inspector Wendy Barrett Key Unannounced Inspection 8th January 2008 09:30 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 Holmer Care Centre DS0000027681.V352528.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. Holmer Care Centre DS0000027681.V352528.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holmer Care Centre Address Leominster Road Hereford Herefordshire HR4 9RG 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) 01453 455745 01432 342390 Mrs S Roberts Mr Jeremy Peter Ewens Walsh Mrs Susan Marshall Care Home 49 Category(ies) of Dementia - over 65 years of age (49), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (49), Old age, not falling within any other category (49) Holmer Care Centre DS0000027681.V352528.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1. Three named service users with dementia under the age of 65. Date of last inspection 21st February 2007 Brief Description of the Service: Holmer Care Centre is on the outskirts of the city of Hereford. It is owned and managed by The Holmer Partnership, Blanchworth Care. The Home was first opened in December 1991. It is a Victorian property that has been extended to provide a Care Home with nursing for a maximum of 49 older persons over the age of 65 years, of both sexes, who have dementia or a mental disorder. Twenty nine bedrooms are single occupancy, eighteen have en-suite facilities. The Home has a passenger lift. The Home operates a ‘locked door’ policy, as indicated in the Home’s Statement of Purpose and Service User guide. There is information literature describing the service displayed at the home and copies are available on the Provider’s website address. New residents receive a copy of this information and it also forms part of staff induction packs. Details of fees and additional charges are available from the Provider’s website address. Holmer Care Centre DS0000027681.V352528.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This report was written with reference to information about the service and held by the Commission, an annual assurance assessment report completed by the Care Manager for the Commission, a sample of relatives’, staff and visiting health care professionals’ survey forms and an unannounced inspection visit to the service. What the service does well: What has improved since the last inspection? A deputy manager has been appointed so that Mrs. Marshall will have support with the various management tasks. The staff are making additional efforts to keep and eye on each resident’s dietary needs and thereby protect them from the risk of malnutrition or becoming overweight. Holmer Care Centre DS0000027681.V352528.R01.S.doc Version 5.2 Page 6 Medication procedures have been strengthened to keep residents safe from errors. What they could do better: 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. Holmer Care Centre DS0000027681.V352528.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 Holmer Care Centre DS0000027681.V352528.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): 1,2,3 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information describing the service is made available to general enquirers and new residents although this may need to be more imaginatively presented so that the details are more easily accessed and remembered. Admissions are not made to the home until a full needs assessment has been undertaken and Mrs. Marshall has satisfied herself that the placement is likely to be successful for the prospective resident and the home. EVIDENCE: People who are considering receiving a service from the home can get copies of information literature from Holmer. This includes all sorts of details e.g. the fees and additional charges, the staffing arrangements, accommodation, complaints procedure. Blanchworth has also set up a web site and this is another way the information can be obtained. A Statement of Purpose Holmer Care Centre DS0000027681.V352528.R01.S.doc Version 5.2 Page 9 explains what sort of care needs can be accommodated, and every new resident receives a Service User Guide. Some relatives felt a little unclear about some things e.g. how to raise concerns and complaints. This is despite having a copy of the complaints procedure displayed at the home and every resident receiving a copy when they are admitted. This suggests that there is a need to do more work to present information in a way that helps residents and/or their relatives make best use of it e.g. use of pictures, videos, regular promotion of the material. Mrs. Marshall makes sure she finds out a great deal about prospective residents before she agrees to admit them. This involves a visit to meet them and their relatives, discussions with any other care professionals who may know them, and writing a full account that paints a picture of the individual e.g. their life history, current care needs, interests, preferences regarding the way they spend their days. All the information helps Mrs. Marshall to decide if the home will suit the individual, and this knowledge reduces the risk of unsuccessful admissions. One recent example of this pre-admission assessment work involved extensive consultation with a consultant psychiatrist about a potential resident’s care needs and specific religious convictions. The way that staff provided the care would have to respect these religious beliefs and it was going to need careful planning to make sure the resident was cared for safely but in a way that respected his religion. An independent advocate had been appointed under the Mental Capacity Act because the gentleman was unable to make informed choices for himself and had no family or friends who could represent him. The advocate would be available to represent his best interests when important decisions about his life had to be made by the professional carers. Holmer Care Centre DS0000027681.V352528.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): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each resident has an up to date plan of care so that staff know about current care needs and how to meet them in a way that will suit the individual resident. The plans are based on risk assessment exercises that help staff identify when residents may need extra support to keep safe and healthy. There may be more work needed to be sure that all staff familiarise themselves with the plans and to help relatives know who they can talk to about everyday care issues. There are arrangements in place for the management of medicines. These have been strengthened through attention to most requirements arising from the last inspection. However, the written guidance should be revised because it doesn’t reflect the procedures that are particularly relevant to the home. EVIDENCE: Holmer Care Centre DS0000027681.V352528.R01.S.doc Version 5.2 Page 11 Mrs. Marshall and her staff work closely with other care professionals because the home accommodates residents who have significant needs arising from dementia or mental health conditions. They need regular support from specialist social and health care workers as well as from the home’s staff. This combined approach strengthens the residents’ safety and comfort. A consultant psychiatrist who works with the service commented that the staff ‘look after residents’ best interests within meaning of Mental Capacity Act’. The purpose of this relatively new legislation is to make sure that people who can’t make their own decisions are protected so that any decisions taken on their behalf by others are based, as far as possible, on the individual’s best interests. There is annual instruction for nursing and care staff in abuse awareness, restraint and dementia care as part of the overall training programme. This is good because it recognises the special skill and knowledge that staff need at this home. Sometimes residents are unable to understand what is going on around them or they misunderstand what they see or hear. At these times they may become frightened or intolerant of others and staff may have to intervene to protect everyone. When incidents do occur Mrs. Marshall informs the Commission as she is required to do. She explains what happened and that action was taken to try and avoid similar problems e.g. risk assessment undertaken and care plan revised. There does need to be more detail to demonstrate that relative representatives and other professionals are being consulted in these reviewsparticularly when there is an emerging pattern of incidents involving specific residents. Every resident has a written plan of care and any risk areas are carefully monitored so that staff can change the way they work if need be e.g. a recent incident led to a decision that staff would always work in pairs with a resident. The records show how staff work hard to respect each resident’s situation. One record contained the following entry –‘at all times respect his beliefs and offer him choices. Take into account there may be a need to negotiate at times due to dementia illness’. The residents’ physical care needs are also carefully monitored with written action plans put in place to tell staff how to work with each individual. A sampled record showed very careful attention to a resident’s diabetic dietary needs. Staff were checking regularly to make sure a healthy, balanced diet was being taken. Mouth and dental care was being addressed so any problems could be picked up quickly. Other aspects of physical well being e.g. skin care, are also managed in much the same way. Most comments from relatives reflect a lot of confidence in the staff and satisfaction with the care and attitude of staff. One or two relatives commented that they don’t always feel they are kept sufficiently well informed by staffthey don’t always know who to speak to about issues arising e.g. wanting to request nail care for their resident. Four relatives admitted that they didn’t Holmer Care Centre DS0000027681.V352528.R01.S.doc Version 5.2 Page 12 know the name of their residents’ key worker although they were benefiting from regular support meetings with the home’s activities co-ordinator. A staff survey response commented that ‘the care staff could be better informed about the residents and their needs’ but another response referred to ‘good handovers and information’ so the picture is unclear on the basis of this limited feedback. The Commission’s pharmacy inspector participated in the last inspection and a number of requirements were identified as a result of his inspection of medication management at the home. Most of these shortfalls had been rectified when the current inspection took place. For example, medication is now carried around the home in a lockable trolley so that staff can administer drugs direct from the trolley rather than carry it through the home to each resident. The Provider’s representative had undertaken an audit of medication in April 2007 although more regular internal audits would help staff to quickly identify discrepancies in stock or recording. There hadn’t been any action to update the medication policy and procedure. This was required at the last inspection but the staff still had a version written in 2006 and this hadn’t been amended from the corporate approach to reflect the specific situation at Holmer. Holmer Care Centre DS0000027681.V352528.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): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are well supported in following a lifestyle of their choice despite their limited abilities. The catering service is well managed by a competent cook who understands what each resident needs and enjoys. The staff are always looking for new ways to be sure that every resident’s nutritional needs and preferences are well addressed. EVIDENCE: The residents are highly dependent on others to help them retain their dignity and individuality. This means that relatives have an important role because they have a lot of information that will help staff to respect each resident. They receive support from the home’s staff through regular meetings of a relatives’ support group run by the activities co-ordinator. Four relatives who attend this group agreed that it was helpful and informative. The activities co-ordinator provides various activities during the week and there are records kept of this work. Sometimes the activities will be for groups Holmer Care Centre DS0000027681.V352528.R01.S.doc Version 5.2 Page 14 of residents but time is also spent on a one to one basis when this seems best for the individual resident e.g. hand massages. At the end of last year the staff did some more work on the way they make sure each resident gets a well balanced diet. This includes more attention to monitoring weight fluctuations. Milk shakes have also been introduced as a way of offering extra nutrition. The activities co-ordinator helps residents get the most pleasure out of their meals through showing them various fruit and vegetables and talking to them about them. When residents are able to say which type of meal they particularly enjoy the staff try to make sure this is included in a future menu e.g. a resident said he liked rabbit stew-and a rabbit stew was prepared for him. Holmer Care Centre DS0000027681.V352528.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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives are given information to help them raise any concerns about the service. When this happens the staff respond appropriately. There does need to be more work to help relatives and staff understand how to communicate effectively so that residents get the best care. There may also need to be more work done by the organisation to encourage feedback in a constructive manner. The residents are protected from abuse by staff who are given training and guidance to help them work safely with residents. Mrs. Marshall demonstrates an open approach in working with other professionals in investigating any relevant issues but the other staff should be familiarised with local safeguarding arrangements. EVIDENCE: The home has only received two complaints about the service since the last inspection and these were resolved quickly. The Commission hasn’t received any complaints or allegations about the service since the last inspection. The survey responses included a few comments that indicate a need to give more help to relatives and other interested people who want to raise concerns on behalf of residents. Some relatives don’t know which staff to talk to and one said they contact their social worker if they have a complaint. Another Holmer Care Centre DS0000027681.V352528.R01.S.doc Version 5.2 Page 16 comment suggested that the provider organisation could work harder to encourage feedback and offer a more constructive response to issues raised about the service. A written complaints procedure is displayed at the home and each resident receives a copy when they are admitted. Relatives met at the home felt that staff deal well with any questions they raise. The information is passed onto senior staff and a response is received. When complaints are made there is a record kept of the details, including any action taken to investigate and respond. The staff receive annual training to make sure they understand how to recognise any abusive practice and report any related concerns to senior staff. This instruction should include local safeguarding protocols because this offers staff an independent route to raise any concerns they have about the residents’ safety. Mrs. Marshall has demonstrated her willingness to work with other care professionals in investigating any allegations of abuse so that residents are protected. Holmer Care Centre DS0000027681.V352528.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): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in accommodation that is designed and equipped with their special needs in mind. The everyday maintenance and cleaning systems keep the environment safe and hygienic and there is ongoing investment to continue improving the quality of the residents’ accommodation. EVIDENCE: The premises are designed and equipped with the special needs of the residents in mind. Fittings and furnishings are chosen to make it easier to keep the residents’ accommodation clean and fresh e.g. some rooms are carpeted and others have hard flooring. There are plans to provide a sensory garden next year and Mrs. Marshall had already made arrangements for a new Holmer Care Centre DS0000027681.V352528.R01.S.doc Version 5.2 Page 18 concrete ramp to improve access to the gardens from the building. This will please relatives who said they would like to be able to take residents into the garden during summer months but felt access was not good enough at the moment. An occupational assessment has recently been undertaken and can be seen on the company website. When residents can benefit from having personal possessions in their room the staff encourage relatives to organise this e.g. provision of double bed, card table and television from home has been seen in one resident’s bedroom. The premises are kept in good condition through day-to-day maintenance and an ongoing programme of decoration. A schedule of works has been devised during the past year to make sure everywhere is kept clean. This addresses daily and deep cleaning tasks. The Environmental Health Officer made a routine check of the kitchen on the same day as this inspection visit. The report of the visit confirmed a generally satisfactory situation with only a few minor pieces of work to do e.g. repairing cracked plaster in one area of the kitchen. A nurse felt happy with the provision of aids and equipment at the home. She also said there was always a supply of protective clothing to help staff to work in a hygienic manner. Staff were seen using this equipment appropriately as they went about their work in the home. Holmer Care Centre DS0000027681.V352528.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): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Mrs. Marshall regularly reviews the situation to make sure there are always enough staff to meet the residents’ needs. There are, however, differing views in the staff group about the adequacy of staffing arrangements and this discrepancy should be explored as part of Mrs. Marshall’s regular reviews. New staff are carefully selected to be sure they will be safe to work with vulnerable adults. When they start work new recruits receive the support and instruction they need to work safely. All staff receive good training opportunities so that they can develop their skills and keep their knowledge up to date in those areas that are particularly relevant to the residents’ care needs. EVIDENCE: There are enough nursing and care staff employed to meet the needs of the residents although there is some reliance on agency staff to cover absences. Sometimes agency staff are not available and this means that the staffing level falls a little short e.g. by one staff member on a particular shift. Mrs. Marshall doesn’t feel this situation affects the care received by residents and a staff survey referred to ‘usually’ being enough staff at work. Another staff survey referred to ‘often being short of staff’ and also commented that it makes it difficult working alongside agency staff who may not be familiar with the Holmer Care Centre DS0000027681.V352528.R01.S.doc Version 5.2 Page 20 residents and routines. One of the staff interviewed at the home mentioned occasional staff shortages that reduce staff morale. Another interviewed member of staff said ‘workers are brilliant here. We cope with any staff shortages’. Mrs. Marshall reviews staffing levels weekly so that she can identify and deal with any difficulties. The staff are offered good training opportunities. Over half of the staff involved in care have obtained a national vocational qualification and most of the rest are working towards this qualification. There is also regular attention to the type of training that is relevant to the residents e.g. annual instruction in dementia care and dealing with challenging behaviours. Nurses are offered training in areas such as wound care and verification of death, so that they can keep their skills and knowledge up to date. A nurse was interviewed at the home and she was very happy with the training opportunities she was being offered –‘I’ve learnt the most here from all my placements’. A care assistant described an initial induction programme that included a 3 day course in Gloucester. He had received essential health and safety instruction e.g. fire safety and food hygiene, although a planned manual handling course had recently been cancelled. Senior staff had, however, instructed him in use of the hoist when he started work. New staff are carefully selected to be sure they will be suitable to work with vulnerable adults. Recruitment procedures include obtaining references and criminal records checks. This was confirmed by two staff who have been employed since the last inspection. All new staff receive induction training that is in line with nationally recognised specifications. Holmer Care Centre DS0000027681.V352528.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): 31,33,35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is managed by an experienced Provider and Care manager. There are relevant policies and procedures in place although some of these may need to be written with more reference to the specific care service rather than a corporate approach. The Provider has implemented a quality assurance system as a way to monitor and measure the effectiveness of the service in achieving its aims and objectives. The recent appointment of a deputy manager is welcomed because Mrs. Marshall hasn’t had time to maintain a regular programme of supervision and support for junior staff. This should now be given priority as this is a demanding service with regular incidents of challenging behaviours that staff have to cope with. The service is run with attention to the particular needs of the resident group to ensure their safety and welfare and to allow them as much choice as possible. Holmer Care Centre DS0000027681.V352528.R01.S.doc Version 5.2 Page 22 EVIDENCE: Mrs. Marshall is a competent care manager who has considerable relevant training and experience to help her fulfil her responsibilities. She understands the organisation’s financial and planning systems and she follows these with a high regard for the best interests of each resident and the home as a whole. The organisation supports Mrs. Marshall by providing policies and procedures, computerised recording systems and regular visits to the home to audit the everyday management situation. Sometimes there should be more emphasis on reflecting the individuality of the service because the corporate approach does not allow for the inevitable differences between services e.g. in writing policies and procedures. The organisation also provides meetings and seminars that are a way of keeping Mrs. Marshall up to date with new legislation and good practice guidance relevant to her role. The annual quality assurance assessment form that Mrs. Marshall was asked to complete prior to this inspection demonstrates her management ability to evaluate and plan ahead. There is an annual quality assurance plan. The results of these exercises were seen on the notice board at the home. Mrs. Marshall was due to attend a managers’ meeting where the results of quality assurance exercises and future development plans would be discussed. Residents’ personal money is not held at the home. When there is any expenditure the relatives or financial representatives receive separate invoices. This approach is considered good practice because staff should have as little involvement in managing residents’ financial affairs as possible. There is a programme of annual appraisal for staff but the programme of one to one supervision meetings has not been fully met due to demands on Mrs. Marshall’s time. A deputy manager has recently been appointed to help Mrs. Marshall with this and other management tasks so the situation should improve. Holmer Care Centre DS0000027681.V352528.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 4 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 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 2 17 x 18 2 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 2 3 3 Holmer Care Centre DS0000027681.V352528.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 OP1 OP16 OP9 OP9 Good Practice Recommendations The way that information about the service is presented may benefit from a more imaginative approach because sometimes relatives don’t remember the details. The corporate medication policy and procedure should better reflect the particular situation in this home. There should be regular internal checks of medication stock and records to make sure residents receive their medication correctly and accurate records are being maintained. All staff should receive information about the local safeguarding protocols for protecting vulnerable adults. 4. OP18 Holmer Care Centre DS0000027681.V352528.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Holmer Care Centre DS0000027681.V352528.R01.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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