Inspection on 18/10/05 for Homeleigh

This inspection was carried out on 18th October 2005.

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

Other inspections for this house

Homeleigh 21/09/09

Homeleigh 04/11/08

Homeleigh 07/11/07

Homeleigh 10/01/07

Homeleigh 25/01/06

Homeleigh 17/03/05

Homeleigh 27/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Homeleigh Avenue Road Erith Kent DA8 3AU Lead Inspector Susan Hall Unannounced Inspection 18th October 2005 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 Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 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. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Homeleigh Address Avenue Road Erith Kent DA8 3AU 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) 01322 339691 01322 350291 Kent Community Housing Trust Mrs Claire Helen Evans Care Home 48 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (32) of places Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to six (6) placements may be for short term/respite care. These placements are to be on the ground floor and may not include the category DE(E). 17th March 2005 Date of last inspection Brief Description of the Service: Homeleigh is a large detached building situated in a pleasant residential area of Erith. It is near to local shops and facilities, and has bus routes and train stations within easy travelling distance. It is owned and managed by Kent Community Housing Trust (KCHT), which is a charitable (not for profit) Trust, and who have other care homes for older people within the region. The home is set into a hillside, and has four floors, of which 3 are for accommodation. The top (3rd) floor is used as the premises for KCHT’s Bexley Regional Office. The ground and first floors include bedrooms and communal areas for older people (not in any other category of registration), and includes up to 4 beds for respite or short term care. There are also 4 rooms kept on the ground floor for older people with a high level of visual impairment. The 2nd floor has bedrooms and a communal lounge/dining room, and is used specifically for older people with dementia. There are additional safeguards in place for their safety. All levels can be reached via a passenger lift. As the home is on a hillside, the gardens are accessed from the first floor at the rear of the building, and there is a spacious patio area, walkways, a lawn and mature shrubs. The home provides day care for several Service Users each day. Day care service is not inspected by CSCI, and so does not form a part of this inspection. However, the Inspector was able to ascertain that additional staffing is deployed if it is needed for additional persons in this category. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 09.30 and 15.30, and the Inspector was assisted during the day by the Registered Manager, an Assistant Manager and other staff. The home had a pleasant and friendly atmosphere, and the Inspector felt welcome in the home. She was able to talk freely with Service Users and staff, and chatted with 8 Service Users in different parts of the building, and met others briefly. Conversations were held with 8 staff, including Team Leaders and other care staff, the cook, a laundry assistant and a domestic assistant. Staff were seen to be carrying out their duties in a caring and efficient manner. The inspection included a tour of the premises, reading documentation (e.g. care plans, Service Users’ Guide, staff files and minutes of staff and residents’ meetings); examining medication procedures, and viewing food being served. What the service does well: What has improved since the last inspection? A large room on the ground floor was previously used as a designated smoking area. This room is on one of the main corridors, and the home does not usually have many residents who smoke. A smaller room, near to a rear door, has now been designated as a smoking room, and this provides a suitable, cosy room for smokers, and enables the larger room to be used as a non-smoking lounge. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 6 New procedures have been put into place in regards to taking phone calls after 5pm and at weekends. These changes were made in response to a complaint, and demonstrates how the management have put positive action into place to rectify the previous situation. What they could do better: Several rooms had been redecorated during the last few months, and the home was clean throughout. However, the building is showing many signs of general wear and tear, and décor is very old and basic in some areas. None of the bedrooms have en-suite toilet facilities. The Company have already met with residents and relatives to state that they are considering the possibility of a complete refurbishment of the premises, or even new building work. They have stated that they are committed to retaining a care home within this area. The Inspector has not made any requirements in this respect, as the premises were in a satisfactory state. However, continued consideration will need to be given to this concern. Medication was generally well managed, but there is a requirement to ensure that external medication is stored separately from internal (as per the guidelines from the Royal Pharmaceutical Society); and there is a recommendation to ensure that handwritten entries on medication administration records (MAR charts), are signed and dated in each space where they are written. This is so that the person transcribing the medication takes accountability for the medication written, and on which chart. A previous recommendation had been met in respect of signing for the numbers of tablets counted in. One of the staff files viewed did not contain all required documentation (no photo or confirmation of CRB check, and only 1 written reference.) This employee had been transferred from another care home within the Company. There is a recommendation to check that all staff files contain the required documentation as per Schedule 2 of the regulations. Fire extinguishers had not been serviced since September 2004, and so this was just outside the scheduled time for an annual check. There is a recommendation to follow this up with the servicing contractors. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 7 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. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 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 Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5 The home provides satisfactory information to enable Service Users to make an informed choice before deciding to stay in this home. Good assessment procedures prevent the Manager from admitting Service Users whose needs they are unable to meet. EVIDENCE: The home’s Statement of Purpose, and the Service Users’ Guide, contain the required information for prospective Service Users. The Statement of Purpose includes all the listed requirements in Schedule 1 of the Regulations, and is set out in a style which is easy to read. The complaints procedure is included. The Manager said that the Statement of Purpose was currently being updated to reflect some changes in staffing and in training achievements. The Service Users’ Guide is well produced, and includes details of terms and conditions of residency, fee charges, and what these cover. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 10 Service Users are usually assessed by the Manager or an Assistant Manager, and a Team Leader often assists with the assessment process. Service Users may be visited in their own home or in hospital, and whenever possible, the Manager arranges for the Service User to have a guest visit in the home, so they can seem how it functions. This also gives them the opportunity to view the room available, and meet some of the staff and other residents. If someone is admitted as an emergency, the Manager obtains as much information as possible via joint assessments and information from Care Manager, relatives or hospital staff. These Service Users would have a review within a few days to assess the suitability of the home for them. Service User admitted with normal proceedings have a 4 –week trial period, which is then followed by a review. A set format is used for the assessment process, and this includes taking details in regards to medical history, mobility, personal hygiene and continence needs, skin care, communication needs and dietary needs. Additional information is obtained for Service Users with dementia, to assess their behavioural needs, and management of any aggressive tendencies. The home provides up to 4 beds for respite care, and these Service Users have the same levels of pre-admission assessment. Specialist needs are taken into account, and include the provision of rooms on the ground floor for Service Users with poor vision. This enables these Service Users to find their way around more readily. Any other specialist needs are considered and discussed prior to any decisions being made, and would include discussions with the relevant health professionals, and CSCI if the person was out of the registration category. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Care planning systems are well established, and show specific data for managing each Service User’s care. There are good links with health professionals, to meet assessed needs. Medication is administered well in this home, and procedures just need some slight adjustments. Service Users’ personal needs are met in privacy, and their dignity is protected. EVIDENCE: The Inspector examined 4 care plans for 4 Service Users receiving residential care, and 2 plans for Service Users with dementia. Care plans are set out in an individual folder for each Service User, and have detailed information in respect of personal and medical history. Assessments made on admission include a moving and handling assessment, assistance needed with personal care, dietary needs, medication, and social needs. Service Users with dementia have a more detailed assessment for mental health and management of their dementia. Care plans are discussed with the Service User (where possible), the Care Manager, the next of kin, a senior staff member and the allocated Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 12 keyworker. Reviews are carried out every 6 months (or sooner if indicated), and the care plan is signed and agreed by the reviewers. Care plans were seen to be detailed and individually applied, according to the needs of the Service User at assessment. Plans for personal hygiene care included information in respect of “prefers bath/shower; wears dentures; needs assistance with cleaning teeth; needs daily shave; requires assistance with using the toilet.” Specific risk assessments were in place for items such as smoking, self- neglect, mobility needs such as use of stairs or zimmer frame, and assistance with eating/drinking. Preferred daily routines and access to the community are in place, night routines and choice of activities. There are additional plans for Service Users with visual impairment, communication difficulties or for behavioural problems. The home is well supported by local GPs, District Nurses, Optician, Dentists, Physiotherapist and other health professionals such as Community Psychiatric Nurses. District Nurses visit the home to attend to any wound care, take blood tests and give insulin. Their records are kept in the home, and so can be viewed by visiting doctors when needed. The Manager has arranged for dentist, optician, and chiropodist to visit the home on a regular basis. The home was taking part in 2 projects set up by the Primary Care Trust (PCT). One of these is to speed up diagnosis and treatment for any Service User with a suspected urinary tract infection, and care staff have been taught how to recognise the signs, test the urine, and fax the results through to the GP. The other project had just been commenced, and is for a “Rapid Response” team. Prescribing nurses are requested to visit the home at short notice, if the GP is unavailable. These nurses are also able to admit Service Users directly to the medial admissions unit at the hospital, which prevents Service Users from having to go through Accident and Emergency departments. Daily reports are written 3 times per day by the care staff, and were suitably signed, timed and dated. Service Users said that they are well cared for and that staff are “always there” for them. The medication is stored in a locked clinical room. There was no overstocking, and items were all in date. Eye drops and creams are dated on opening. The temperature of the drugs fridge is recorded daily. Most medication is administered via the Boots monitored dosage system. A separate storage cupboard and trolley are used for the dementia unit. A written risk assessment is carried out for any Service User who wishes to self medicate. Controlled drugs are stored appropriately, and a controlled drugs register is used. The Inspector noted that external creams and lotions were stored next to tablets, and there is a requirement to store these separately, in accordance with the guidelines from the Royal Pharmaceutical Society. Handwritten entries on Medication Administration Records (MAR charts) were not signed and dated, and there is a recommendation for this. The MAR charts were otherwise well completed. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15 The home provides an excellent choice of daily activities and opportunities for outings. All food is prepared in-house, and a nutritional and well balanced diet is provided for Service Users. EVIDENCE: The home employs 2 activities assistants, who work together to provide a continually varied programme of activities. They are assisted by care staff when possible. The home has a large activities room, and 10 Service Users were seen happily playing bingo together during the morning. The activities room was unusually stacked with boxes of goods, which were items donated for a bring and buy sale. A daily programme of activities had been prepared, but this is flexible, according to the wishes of residents on that day. the home has it’s own minibus, and if the weather is pleasant, Service Users may decide they wish to go out to local shopping centres, parks or places of interest. Specific outings are frequently organised for theatre trips, outings to the coast (e.g. Folkestone, Herne Bay, Southend), or for lunches out, strawberry picking etc. There had been 6 organised trips in each of June and July, and 2 for August and September. These were apart from impromptu trips arranged on the day. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 14 The Activities Assistants ensure that all Service Users are given the opportunity to take part in outings, and not just a “first come, first served” routine. The Home has 2 large lounges on the ground floor, as well as the activities room and the smoking room. One of the lounges is designated as a “quiet” lounge, which does not have a television, and so enables Service Users to talk more freely. There is a large television in the other lounge, and a huge television screen in the dining room. This venue is often used for Service Users to watch sport or films together in the afternoons/evenings, and armchairs are brought in for comfortable viewing on these occasions. In–house activities ranged from items such as music and movement, arts and crafts, gardening and sing-alongs. Photographs on display included an afternoon tea dance, karaoke afternoon, and a picnic outing. Aromatherapy and reflexology sessions are available every 2 weeks from visiting therapists, and Service Users pay for this as an extra service if required. There is a large library area, and the library books are changed every month. Service Users are able to stay in their own rooms, sit in the lounges or go out, according to choice. The Activities Assistants also visit the dementia unit and arrange separate activities in the lounge/dining room on the second floor. The Inspector did not see activities taking place in this area, as the Service Users were about to have lunch. The menus are discussed with the Manager, cooks, and Service Users, ensuring that they reflect the current likes and dislikes of Service Users. A choice of main meals is always available, and a record is kept of each person’s nutritional intake. Home made soups, salads, and snacks such as jacket potatoes are always offered if Service Users do not want a full meal. The Inspector saw that meals were well presented, and were individually prepared in respect of the choice of meal and the size of the portion required. The cook on duty had completed an Intermediate Food/Hygiene certificate, and catered for special diets as well as overseeing individual choices. Home-made cakes and desserts are supplied, and fresh fruit is made available every day. The Inspector viewed the kitchens, which are extremely spacious, and have extra rooms for office space, washing up, and storage. The kitchens and equipment were very clean, and there is a controlled daily programme for cleaning. Fridge and freezer temperatures are recorded daily, and meat temperatures and re-heating temperatures are recorded. A designated carer is allocated to the kitchen for each shift, and is required to wear a blue disposable apron and head covering. Only this carer is permitted to enter the kitchen, and carries out the tea/coffee rounds and cold drinks for Service Users. The designated carer does not carry out personal care until all kitchen duties are completed, and this is a good infection control policy. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The home has a clear complaints procedure in place, which is easily accessible to Service Users and visitors. Staff training in adult protection safeguards Service Users from the risk of abuse. EVIDENCE: The complaints procedure is set out in a style which is easy to follow, and encourages anyone with concerns to voice these to the staff on duty, or the Manager, as soon as possible. The procedure is included in the Service Users’ Guide, and in the Statement of Purpose. Some updating was required for the wording in the Statement of Purpose, and this matter was already being addressed. A record is kept of any complaints, and one formal complaint had been made since the last inspection. The record showed that appropriate action had been taken to resolve the matter. No complaints had been made to the Commission for Social Care Inspection. Small issues are dealt with on an individual basis, and recorded in Service Users’ files. These are discussed a care management reviews, ensuring that the concern has been properly reviewed and addressed. Staff training records included training in understanding and recognition of adult abuse, and how to prevent this. There were also detailed records of how Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 16 to manage situations where Service Users may show aggressive behaviour (on the dementia unit), and how to deflect and manage these situations. Good procedures were in place for staff recruitment, with detailed interviews, records of previous work, and Criminal Record Bureau (CRB) checks in place. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19-26 The building is in a good location, and meets Service Users’ needs in a homely environment. Routine maintenance is adequate, but the premises are becoming generally run down and look worn and old in places. However, the wide corridors, and varied communal areas still make this home a good facility for it’s purpose. EVIDENCE: The premises have private car parking spaces at the front, and gardens at the rear of the property. The entrance hall has protected doorways with security codes for the safety of Service Users. Wide corridors and a passenger lift enable easy access for wheelchair users. Emergency lighting is in place throughout the building, and all external doors are alarmed for additional security. One of these door alarms sounded during the inspection, and proved to be due to a Service User having accessed a door to go outside for a cigarette. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 18 The home has very good communal areas on the ground floor, including 2 large lounges, a smoking room, an activities room and a large dining room. There is a small quiet area on the first floor, with 4 armchairs, and this is a cosy area where some Service Users like to meet. There is only one communal lounge/dining room on the second floor. This enables staff to easily view Service Users with dementia, and to provide activities for them together, but any considerations for altering the premises could include possible extra communal space for these Service Users. The Providers have stated that they are considering a complete refurbishment of the premises, or possible new build. Most bedrooms are for single use, but there is one shared room which could be used for 2 people sharing if they wished (e.g. a married couple). Bedrooms were personalised with Service Users’ belongings, and were adequately decorated. Some had been redecorated since the last inspection. There are no bedrooms with en-suite toilets or bathrooms. There are many shared toilet, bathroom and shower facilities, and these include toilets near to communal areas. These are basic and functional facilities, and included suitable hand washbasins, liquid soap and paper towels. Some of the baths are fitted with integral hoists, and showers have mobile shower chairs or seats. There are additional mobile hoists, which may be used for helping Service Users transfer from chair to bed etc. or to lift Service Users from the floor if they have fallen. Service Users are assessed on admission for their mobility, and the Manager would expect minimal need for the use of hoists. The home is suitably fitted with grab rails, and other aids such as raised toilet seats. Pictures on doors in the dementia unit enable these Service Users to easily find the toilets. Wheelchairs are mostly allocated to individual Service Users after referral by the GP. The home has some spare wheelchairs, which may be used for Service Users who cannot walk far, and are going on outings. The Manager stated that these are appropriately serviced. The Home has 2 separate rooms for laundry facilities. There are 2 commercial washing machines, and a special sluice for dealing with any soiled items. A separate drying room contains 2 tumble dryers, and space for individual baskets for clean clothing. A Laundry Assistant is on duty every day, and ensures that all clothing items have name labels, and irons all personal clothing as needed. Linen cupboards were viewed, and towels and bed linen were seen to be of good quality. The Home was clean in all areas. There was a slightly offensive odour of urine in one area of the dementia unit, but not in any other areas. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27-30 Staffing levels are assessed in accordance to the numbers and dependency levels of Service Users, and were seen to be satisfactory. The home has good policies in place for recruitment procedures, and a high percentage of care staff have NVQ training. There is a suitable skill mix of staff, and good ongoing training records. EVIDENCE: The Manager is as sited by 2 Assistant Managers, and Team Leaders take charge of care duties on each floor. Team Leaders carry extra responsibility for ensuring that personal care, medication and nutrition are properly administered. Medication training is carried out via a college course, and staff are assessed for competency over several weeks before being allowed to administer medication alone. Random audits are carried out be the Manager or assistant Managers to check procedures. Service Users are allocated with keyworkers, who are responsible for ensuring details of care and documentation are carried out. Different duties are assigned to care staff each day, such as working alongside the kitchen staff, or ensuring baths /showers are given. The home has 5-6 Service Users in for Day Care on Mondays to Fridays, and this is considered when planning the staff rota. Approximately 80 of care staff had completed NVQ 2 training, and this is commendable. The Inspector could see that this had a positive effect on the home, as care staff were clearly aware of Service Users’ needs, and were carrying out their duties efficiently, and in a caring manner. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 20 Recruitment procedures were satisfactory, and are based on equal opportunities. Applicants are asked to complete details of previous training and experience on application forms, and any gaps in employment are discussed. Interview records are retained, and successful applicants are required to provide 2 written references, and complete a health declaration form. Criminal Record Bureau (CRB) checks are applied for. If these are taking a long time to be processed, new staff may be commenced after a satisfactory POVA First check, but only working under direct supervision until a satisfactory CRB check is received. The Inspector examined 4 staff files, and these were mostly completed according to the required standards. However, 1 file was viewed for a staff member who had been transferred from another Company home, and this file did not include a confirmation of CRB check, a photograph or proof of identity. There is a recommendation to review all staff files and ensure they contain the documentation required (as listed in Schedule 2 of the Regulations). The home had 3 volunteers taking part in the life of the home, and these had all been CRB checked. Staff training records are held on individual files, and in a comprehensive training schedule. Induction and foundation training are completed in accordance with the required standards, and include an induction period over 3 days initially and a further 4 separate days. The Inspector viewed one of the completed induction records. Foundation training is completed in the first 6 months, and includes mandatory training in moving and handling, first aid, infection control, health and safety, fire awareness and basic food hygiene. Additional training is given in adult protection, dementia care and in management of aggression. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,36,37,38 The Manager provides a strong sense of leadership and is well supported by Assistant Managers and an Administrator. The staff demonstrate an understanding of the needs of older Service Users, and provide friendly and efficient care. Service Users know that their views will be taken into account. EVIDENCE: The Manager has completed required training, and has many years of experience in caring for Service Users in these categories of care. She is available throughout the week for individual conversations with Service Users and relatives, and provides strong leadership and encouragement to staff. Assistant Managers have completed a Certificate in Management Studies, and have carried out additional Assessors’ courses, enabling them to assist in training of care staff. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 22 Care staff have clearly defined roles, and are able to share ideas for change or matters of concern at regular staff meetings. These are all minuted, so that staff who are unable to attend can read the content of the meeting. One to one formal supervision is delegated to different senior staff, and a set format is used to ensure that all staff have equal supervision opportunities. Residents’ meetings are chaired by the Activities Assistants, as the Manager has recognised that Service Users relate differently to this category of staff, and often express themselves more freely. Any issues involving care are passed directly to the Manager. The Inspector read the minutes for the last 2 meetings, and participants had discussed items such as forthcoming events, outings, and food. The Inspector viewed documentation which included some policies and procedures, care plans, daily reports, medication charts, kitchen records and staff files. These were generally well maintained and up to date. Records are stored to maintain confidentiality of Service Users and staff. Staff training records confirmed that mandatory safe working practices are carried out, and there was a general awareness of health and safety procedures (e.g. use of security keypads for doors, and fire drills). COSHH leaflets had been obtained for different chemicals used on the premises. Fire extinguishers were in place throughout the building, but had not been serviced since September 2004. There is a recommendation to ensure that the contracted servicing Company carry out annual checks. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 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 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 2 Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 (2) Requirement To ensure that external medication is not stored alongside internal medication. Timescale for action 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP9 OP29 OP38 Good Practice Recommendations To ensure that all handwritten entries on Medication Administration Records are signed and dated for accountability. To ensure that all staff files contain the required documentation as per Schedule 2 of the Regulations. To check that the contracted Company for servicing fire extinguishers carries out these checks on a yearly basis. Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Homeleigh DS0000006793.V256978.R01.S.doc Version 5.0 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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