Inspection on 25/05/07 for Home Close

This inspection was carried out on 25th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Home Close 20/05/08

Home Close 05/06/06

Home Close 07/12/05

Home Close 17/05/05

Home Close 22/11/04

Home Close 25/05/04

Home Close 08/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Home Close Cow Lane Fulbourn Cambridgeshire CB1 5HB Lead Inspector Lesley Richardson Key Unannounced Inspection 25th May 2007 12:25 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 Home Close DS0000015159.V339521.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. Home Close DS0000015159.V339521.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Home Close Address Cow Lane Fulbourn Cambridgeshire CB1 5HB 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) 01223 880233 01223 881728 Home Close Ltd Nicola Malthouse-Hobbs Care Home 68 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (68) of places Home Close DS0000015159.V339521.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated at any one time who require nursing care must not exceed 42. One named person in the category DE(E) Date of last inspection 5th June 2006 Brief Description of the Service: Home Close is a purpose built home situated in grounds in a quiet lane close to the centre of the village of Fulbourn. Accommodation is arranged in flats, and each flat has a kitchenette and lounge area. There is a large communal lounge/dining room on the ground floor. Individual accommodation is on two floors with the upper floor being accessed by a passenger lift or stairs. The home provides care for older people with both social and nursing care needs. There is a day centre on site and the home has ambulance bus transport available for outings. The home built an extension, which was registered with CSCI in January 2007. This increased the number of places they can provide by 20 to 68 people, of which, a maximum of 42 can also have nursing needs. The home is situated approximately 1 mile away from the centre of Fulbourn and 5 miles from the centre of Cambridge. There are local shops, pubs and a post-office in Fulbourn, and a full range of shopping and entertainment facilities in Cambridge. Fees for the service range from £590.00 to £740.00 a week. Extras are charged for additional items such as chiropody and hairdressing. Copies of the latest CSCI inspection report are available in the manager’s office or at the reception desk for people wishing to read them. Home Close DS0000015159.V339521.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection of this service and it took place over approximately 9 and a half hours as an unannounced visit to the premises. It was spent talking to the manager and staff working in the home, talking to people who live there and observing the interaction between them and the staff, and examining records and documents. Information obtained through returned questionnaires from people who live in the home, and relatives and visitors. Thirty-two questionnaires were returned from relatives and visitors, 5 from people living in the home. Two requirements from the last inspection have not been met. There have been a further 2 requirements and 3 recommendations made as a result of this inspection. This is an adequate service. What the service does well: There were some positive comments about the home from people who live there and others who visit. These include, “the home treats the residents with respect & good humour. I have never heard a voice raised in anger. Everyone is an individual & is cared for as such”, “the home is much improved over the last few years and especially under the new owners” and “(they) make my mother feel at ‘home’ and secure”. The manager or deputy manager visits people before they move into the home. An assessment is carried out to see what help the person needs and to make sure the home has the staff that can properly care for the person. Assessments from health and social care teams are also obtained, so that the home has as much information about the new person as possible. One person said the manager was able to give her a lot of information about the home during this visit. There is a very dedicated activities co-ordinator at the home who makes sure there is always something for people to do, if they want to. There was nothing but praise for her in comments from people living at the home and visitors to the home. One comment made was, “encourages them to do things. Takes them out for trips, i.e. music concerts, plays, picnic, even the pub for coffee!” and many other people said the activities co-ordinator is excellent and her work helps stop people becoming isolated. People living at the home are able to choose what they do during the day, and this includes staying in their room if they want. The home helps people keep in touch with their relatives, at least 2 people said ‘phones had been put in their relatives rooms, so they could make private calls when they wanted to. Home Close DS0000015159.V339521.R02.S.doc Version 5.2 Page 6 There have been improvements made at the home since the last inspection, and there are more changes being planned. People living there think the home is clean and fresh smelling and it was during the inspection, although some people visiting say there is an unpleasant smell at the front entrance. The home has got an amount of money to spend on improving the garden and hopes this will be finished by the end of the summer. The manager is a registered nurse and has other qualifications in management and dementia care. She has been working at the home since December 2005. Records are kept to show health and safety checks, equipment maintenance and servicing are carried out at the required intervals. Records are also kept to show money kept by the home on behalf of people living there. This means that there is information to show when money is spent and what it is spent on, so that people can feel safe in having the home take care of it. What has improved since the last inspection? What they could do better: The way medication is stored and given is satisfactory but records to show how creams are given must be clearer. Staff must sign medication records when they administer medication, even if the medication is a cream. Temperatures in a storage room for controlled drugs are not taken, the room is very warm on a cool day, which may mean it is too hot for medication to be safely stored. Arrangements have already been made for an air-conditioning unit to be put in this room, but it is important this is done so that medication is stored at the manufacturer’s recommended temperature. There were some issues about dignity for people at the home, although most people feel staff are polite, kind and friendly. Information about individual people’s dietary needs and preferences should not be on public display. The main meal of the day is at lunchtime and there is a choice of two alternatives. Comments from people at the home and visitors were that they like the meals, but that the evening meal should improve as there are a lot of sandwiches and convenience foods, like turkey drummers. Home Close DS0000015159.V339521.R02.S.doc Version 5.2 Page 7 Everyone at the home said they know who to speak to if they’re not happy with something, and about ¾ of people said they know how to make a complaint. 2 people said the home did not answer their complaint properly, that they felt ‘fobbed off’ with answers and were not taken seriously. Not all staff members have adult protection training, and although there have been no adult protection issues in the last 12 months, it is important that staff are able to recognise possible abuse. The staffing levels are adequate, but there were many comments about low staffing levels from visitors to the home. This is mainly in the evenings and at weekends and staff rotas show there is a slight drop in staff numbers in the evenings. Even though there are occasions when staffing levels are satisfactory, there have been occasions when levels have dropped to unacceptably low. The amount of training given to staff must increase. This must be for all types of training, including required health and safety training, as not all staff know the correct way to move people. The checks that are carried out before new staff members start work must be completed properly. This was identified at the last inspection and even though the specific issues found then have improved, other checks are not always done. These checks must be done properly before new staff start working to make sure it is safe for them to do so. 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. Home Close DS0000015159.V339521.R02.S.doc Version 5.2 Page 8 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 Home Close DS0000015159.V339521.R02.S.doc Version 5.2 Page 9 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): 3 and 6 Quality in this outcome area is good. Pre-admission assessments ensure the home has adequate information about people before they live there. This means the home is able to make a decision about whether it can properly care for a person moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Assessments of people who have expressed a wish to live at the home are carried out by the manager or deputy manager before that person moves into the home. Further assessments are obtained from health and social care teams and provide additional information so the home is able to say whether it has the staff with the skills and experience to properly care for that person. The home does not provide accommodation specifically for intermediate care or for rehabilitation purposes. Home Close DS0000015159.V339521.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. Care records generally provide the information needed to guide staff in meeting care needs, staff are polite but other areas of the home are such that privacy and dignity is not met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person at the home has a plan that guides staff in how to care for them. There has been an improvement in the way care plans are written, especially those plans that give information about specific care, like dementia or medical conditions. These are written in detail and give clear advice about how the care should be given. Risk assessments are completed and identify the actions that must be taken to reduce the risk, although not all of this information is written in care plans. For example, one person’s moving and handling risk assessment shows they need to be moved using a hoist and sling, and gives clear information about the type of sling to be used. However, there was no care plan to show staff how to safely move this person and the only reference to moving and handling was in a plan for maintaining a Home Close DS0000015159.V339521.R02.S.doc Version 5.2 Page 11 safe environment. Similarly, another person who can become aggressive when personal care is given has a brief comment about mood changes in a plan specifically for this, although it does not mention a trigger activity and none of this information is written in the plan for personal hygiene. There is information in care records to show people living at the home have access to a range of health care professionals, including dieticians, speech and language therapists, and specialist medical practitioners. Information provided since the inspection says that the families of people who live at the home are involved in their care records, and any contact with family about changes to medical conditions is also recorded. However, a number of relatives have also said they have not been informed at all or quickly enough about medical issues involving their relatives. Generally, the procedures staff use for medication administration are acceptable, although there are some practices that should improve to make sure records clearly show medication that has been given. There were only occasional entries in medication administration records (MAR) that did not have a signature or key to show why it had not been given. Medicated creams are made available to people so they can apply these themselves, if the wish. However, one person’s MAR shows this has been the case, but this person is not physically able to apply the cream. The records must show which staff member has applied the cream if people are not able to do this themselves. Medication is stored in lockable trolleys that are also locked to a wall, or in a lockable room, which is where controlled medication is also kept. Temperature checks are taken and records kept for the medication fridge temperature, but not of the room temperature. The room was very warm on an overcast, but not cold day, which suggests that temperatures in this storage area may exceed the recommended temperatures for medication storage. The manager said plans have already been made to have an air–conditioning unit installed in the room. Most people living at the home and their relatives, and visitors to the home said staff are very nice and polite, although one person felt this was true of only some staff members. Staff members don’t always knock on doors or wait for an answer before coming into rooms, although the people who said this also said this didn’t concern them at all. There were generally positive comments about staff members from people who returned surveys. Although, there were two comments that suggest a staff member has exerted power over someone and another person had been left without being able to easily obtain help. Confidentiality of most personal information is kept securely, although details of specialised diets and individuals preferences were taped to the outside door of a kitchenette cupboard in one flat. There were many comments in returned surveys that show there is a significant problem with laundry at the home, clothes going missing and not returned. Although people living at the home didn’t specifically comment that they do not always receive their own clothes back, it would appear this is the case for a number of people. Home Close DS0000015159.V339521.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. People are able to participate in meaningful activities, choose how they spend their time and are assisted to keep in contact with their family. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs a full-time activities co-ordinator, who arranges games, entertainment, trips and spends time with people in group settings and on an individual basis. Her commitment to the job and to the people who live at the home is shown in the many positive comments received during the inspection and in surveys that have been returned. People said the activities are such that there is always something to do, they are encouraged to join in or the activities co-ordinator arranges something for them specifically. This reduces the feeling of isolation that can come with living in a large home. Several people also said they choose to spend time either in their rooms or in quieter areas of the home, doing what they want to do. One person, who is often unable to leave her room said staff, other than the activities co-ordinator, spend time with her when they have a few spare minutes. There is a good rapport in the main dining/lounge area, with some staff members giving Home Close DS0000015159.V339521.R02.S.doc Version 5.2 Page 13 impromptu entertainment by playing musical instruments when they have spare time. The home has an open visiting policy and people can have visitors at any time of the day. Almost half of the relatives and visitors returning surveys said the home helped their relative keep in touch, and almost ¾ said they are kept up to date with issues concerning their relative. A relatives meeting is held every 2 months, minutes are available and displayed in the reception area. Minutes are sent to relatives on request, although one person said these are not passed on to people if they are unable to attend. Any contact that is made with relatives is recorded in care records, although a number of relatives said they have either not been contacted quickly or at all when they felt they should have been. People at the home said they are able to choose how to spend their days, whether that is in their own room, in the main lounge/dining area reading the paper or participating in activities. Just under 60 of visitors returning surveys said the home supported their relative in living how they choose to live. Although it was recognised by many people living at the home and visitors that this would not be in a care home environment if they could manage in their own homes. Each ‘flat’ in the home is equipped with it’s own kitchen where residents and visitors can make their own drinks. Information provided before the inspection shows there is a choice of two main meals at lunchtime and a 4-week rotating menu, so that the same meal is not served to often. Although people living at the home said they like the meals that are provided, there were mixed reactions from people visiting the home. Some people said the meals are good and well prepared, while other comments identified that meals in the evening could be more varied with fewer sandwiches and easy-cook products, such as fish fingers and turkey drummers. The 4 week menu provided also shows that one evening each fortnight a savoury alternative is not available, with scones, doughnuts and fresh fruit being provided for the evening meal. Home Close DS0000015159.V339521.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. The home has a complaints system but evidence that not all complaints are listened to or acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager said the home has received two complaints in the last 12 months. Both complaints are still being dealt with by the provider organisation. Verbal complaints and issues that are raised are recorded in people’s care records. People living at the home who returned surveys said they knew how to make a complaint and most people said they knew who they would speak to if they were unhappy about something. 75 of relatives and visitors said they know how to make a complaint and all but one of these people said they usually received an appropriate response. However, 2 people said their complaints had not been responded to properly, saying they had felt as if excuses had been made and that the home was “not very good at getting some minor things done”. There have been no adult protection issues since the last inspection. Although staff gave appropriate responses to questions about adult protection and what they would do if they saw abuse happening, not all staff members have had training in how to recognise possible abuse or what to do if they see it. Home Close DS0000015159.V339521.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. The home is generally clean and provides a safe environment. This means the home is pleasant place to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is a large purpose built property situated in a suburban area in the village of Fulbourn and on the outskirts of Cambridge. People living at the home have access to a number of communal areas, including a garden at the back of the property. The general décor within the home is satisfactory, and it was clean and tidy, with no offensive smells. Everyone returning surveys said the home is usually clean and tidy. However, not everyone visiting the home felt the same way. There were many comments from relatives saying clothing is often lost or mixed with other residents’ clothing even though it is labeled. There were specific comments about an unpleasant smell at the front entrance and that individual rooms Home Close DS0000015159.V339521.R02.S.doc Version 5.2 Page 16 could be cleaned and decorated more regularly. One person said their relative had lived at the home for more than 5 years and had not had their room redecorated in that time. Information provided since the inspection shows that the offensive odour has since been resolved. The manager has been informed of these issues. One concern about the poor state of the garden that was brought to the attention of CSCI before the inspection was looked at. The manager said funding has been received to renovate the area behind the new part of the building and completion was anticipated by the end of the summer. Fencing has been put up on the boundary between the home property and the neighbouring property. Home Close DS0000015159.V339521.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. Staffing levels and staff training do not always ensure correct care practice is given, recruitment checks are not completed properly. This means people living at the home are placed at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information showing staffing numbers was supplied before the inspection. A 4-week period in April was looked at in detail and shows staffing levels provide an approximate ratio (with all 68 places filled) of one staff member to every 6 to 7.5 residents in the morning. Levels for evening shifts drop slightly to a ratio of one staff member to every 7 to 8.5 residents, and there are usually 4 members of staff on duty at night. There are occasions when staffing levels exceed these numbers and also occasions when there is fewer staff available. The staff rota shows this is usually in the evening and on one occasion there was as few as 4 staff members on duty. There were a large number of comments from people living at the home and relatives and visitors returning surveys about staffing levels, all but one was that staffing levels are not adequate. Particular times identified as being an issue were afternoons, evening and weekends and one specific issue mentioned is the length of time it can take for call bells to be answered. Staff members said generally staffing levels had improved, although there are times when staff members call in sick and staffing levels cannot be increased with agency staff, and at these times it can be difficult to answer bells quickly. The quality assurance survey Home Close DS0000015159.V339521.R02.S.doc Version 5.2 Page 18 completed by the home last year identified low staffing levels as an issue. The manager said recruitment of new staff is continuing as needed, and the home was recruiting at the home of inspection. New staff members complete induction training that includes mandatory health and safety training and gives them an introduction to care work at the home and their role in this. A training matrix was provided that shows when staff members have received training or had this training updated. Unfortunately, this shows there are significant numbers of staff who have not had moving and handling, infection control and health and safety training or updates of these within the last year. Information provided before the inspection shows that only 35 of care staff have a national vocational qualification at level 2 or above. ¾ of people returning questionnaires said they thought staff had the skills and experience to properly look after people at the home, although 10 felt this was the case only sometimes. Specific comments were made about some staff needing training and that some were more adept at moving and handling than others. During the inspection a staff member attempted to assist a person using an outdated and potentially damaging procedure. This is despite having a person trained to train others in safe moving and handling techniques. Staff members said the amount and type of training offered to them has improved since the last inspection. Information received before the inspection shows more than 28 staff members have a current first aid certificate, although the training matrix shows there are only 14 people with this training. Therefore, the training matrix is not an up to date record of training received by staff and although the amount of training given to staff has increased, this needs more improvement for all staff members to be able to care for people safely and with the proper skills. Staff records were seen for two recently employed staff members, and show that most of the required checks and documents were obtained before these staff members started working at the home. This is an improvement since the last inspection, although further improvement is still needed to make sure all the required information about new staff is obtained. All the references obtained were satisfactory, although neither of those for one person were from the manager of the care home that person was previously employed at, and one was a personal reference from a family friend. There was no information in one file to show why that person had stopped working in a care position. Employment dates are written in months and years only in both files, and in one case there were 2 gaps of between 2 and 5 months; there was no written explanation to show that gaps in employment dates had been explored. The manager said interview notes are now taken at all staff interviews and these were looked at in two other staff files to see if gaps in employment dates are explored and a written explanation obtained. This had not been recorded in either of these records either. Home Close DS0000015159.V339521.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Systems in the home ensure health and safety checks are carried out, money is kept safely and people are asked their opinion, ensuring people living at the home are able to contribute to it’s running. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has been at the home since December 2005 and is registered with the Commission for Social Care Inspection as manager. She is a nurse registered with the Nursing and Midwifery Council and has completed the registered managers award and the ENB N11 qualification in dementia care. A quality assurance survey was last carried out almost a year ago and the home is preparing to complete this year’s annual survey. A significant finding from last years survey from people living at the home and visitors to the home Home Close DS0000015159.V339521.R02.S.doc Version 5.2 Page 20 was about staff not always being available when needed. The views of people living in the home and visitors to the home are obtained on a more regular basis at separate residents’ and relatives meetings. These are recorded and minutes made available to people who attend the meeting, although not always to everyone else. One person said if meetings are missed they do not receive a copy of the minutes. Money is kept by the home on behalf of people living there; access can be gained through the administrator who maintains an accounting system for credits and withdrawals. Money and records for 2 people were checked, with one person having been credited by a small amount, as the home was not able to give the correct change. The administrator was advised records of transactions should have 2 signatures to show accountability and an audit trail. People living at the home are also able to keep money with them, if they wish. Information provided before the inspection shows health and safety maintenance and service checks are completed. Fire equipment seen was last checked within the required timescale. Home Close DS0000015159.V339521.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 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 2 STAFFING Standard No Score 27 2 28 2 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Home Close DS0000015159.V339521.R02.S.doc Version 5.2 Page 22 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 OP7 Regulation 15(1) Requirement Timescale for action 31/08/07 2 OP9 13(2) 3 OP29 19(1)(a), (b) 4 OP30 18(c)(i) Care plans must be written for identified needs, to make sure staff have guidance about how to meet all care needs. Medication records must identify 31/08/07 the person administering the medication and medication must be stored within the recommended temperature. This is to make sure medication is safely administered. Recruitment checks must be 31/08/07 completed before new staff start working at the home, to make sure it is safe for them to do so and to protect people living at the home. (Previous timescale of 05/06/06 not met.) Training must be given to all 31/08/07 staff to make sure they are able to properly care for people at the home. (Previous timescale of 30/07/06 not met.) Home Close DS0000015159.V339521.R02.S.doc Version 5.2 Page 23 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 4 Refer to Standard OP10 OP15 OP18 OP27 Good Practice Recommendations Laundry facilities should be improved to make sure people living at the home have their own clothes and clothing is not lost. Consideration should be given to replacing sandwiches and convenience foods at the evening meal. All staff should receive training in the prevention of abuse. Staffing levels should be reviewed to make sure care needs can be attended to promptly. Home Close DS0000015159.V339521.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Home Close DS0000015159.V339521.R02.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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