Inspection on 03/09/07 for Hornchurch Nursing Centre

This inspection was carried out on 3rd September 2007.

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

Hornchurch Nursing Centre 21/02/07

Hornchurch Nursing Centre 16/02/06

Hornchurch Nursing Centre 04/11/05

Hornchurch Nursing Centre 11/03/05

Hornchurch Nursing Centre 01/07/04

Hornchurch Nursing Centre 03/12/03

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 Hornchurch Nursing Centre 2a Suttons Lane Hornchurch Essex RM12 6RJ Lead Inspector Harbinder Ghir Unannounced Inspection 6:45 3 & 4th September 2007 rd 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 Hornchurch Nursing Centre DS0000015596.V349373.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. Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hornchurch Nursing Centre Address 2a Suttons Lane Hornchurch Essex RM12 6RJ 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) 01708 454 422 01708 445 456 baldockc@bupa.com ANS Homes Ltd Ms Carol Baldock Care Home 55 Category(ies) of Dementia - over 65 years of age (17), Old age, registration, with number not falling within any other category (38), of places Physical disability (5) Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2007 Brief Description of the Service: Hornchurch nursing home is a purpose built fifty-five bed home, which is owned and operated by BUPA. The home caters for three categories of service user: up to 16 people over the age of 65 with a diagnosis of dementia, up to 34 people over the age of 65 who have age related physical illnesses/ disabilities and up to 5 people between the ages of 18-65 who have physical disabilities / complex needs. The home is managed and staffed by registered nurses, care assistants and support staff. The home offers administrative, catering and laundry facilities on the ground floor and care accommodation on the further three floors. Each floor operates as a separate unit with staff allocated to each floor with bedrooms, lounge/ dining room, small kitchen area, bathrooms and toilets situated on each floor. The Home itself is situated within two minutes walk of the railway station and is easily accessed by car from the A13, A127 and M25. Hornchurch shopping centre is approximately twenty minutes walk or a short bus ride away. The current weekly cost of a placement is £800 for self-funding residents and fees can vary between £590 - £750 for local authority and primary care trust funded residents. Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken by Regulation Inspector Harbinder Ghir. The inspection took place on the 3rdth August 2007 between 6.45pm and 7.30pm and on the 4th August 2007 between 1.20pm and 5.15pm The manager of the home was available throughout the second day of the inspection. During the inspection the inspector was able to talk to the residents residing at the home, staff and relatives who were visiting during the inspection. The Continuing Care and Macmillan nurses were also spoken to. The London Borough of Havering who is the host authority for the service was contacted, inviting their comments on the service they are commissioning, which have been included in the report. As part of the inspection the inspector toured the home, read records of people who use the service and examined documents in relation to the management of the home. At the end of the inspection the inspector was able to provide feedback to the manager. The inspector would like to thank everyone involved in the inspection process. What the service does well: The service has a comprehensive activities programme, to ensure they can meet all the needs of residents. There is a good selection of meals provided at the home and residents benefit from a “nite bite” menu, where a selection of hot and cold food is available throughout the night. Pre-admission assessments are completed before prospective residents move into the home, ensuring that the service will meet their needs. All residents could be assured that at the time of their death, staff would treat them and their family with care, sensitivity and respect. The home has a clear complaints procedure, which includes timescales within which a complaint is to be investigated The health and safety of staff and residents is promoted by the home’s policies and procedures. The service achieves good outcomes for meeting the needs of those residents with a diagnosis of dementia. Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 6 Trial visits are offered to all prospective residents, to ensure residents have information on the services and facilities provided at the home. The service has robust recruitment procedures ensuring the safety of residents. What has improved since the last inspection? 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. Hornchurch Nursing Centre DS0000015596.V349373.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 Hornchurch Nursing Centre DS0000015596.V349373.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): 3, 4, 5, 6 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The service completes comprehensive pre-admission assessments, to ensure they can meet the needs of residents. Trial visits are offered to all prospective residents, to ensure residents have information on the services and facilities provided at the home. The service does not provide intermediate care. EVIDENCE: Four pre-admission assessments were closely examined. Records showed that comprehensive pre-admission assessments are completed before a prospective resident is admitted to the home. Assessments comprehensively covered the Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 9 personal, healthcare and social care needs of residents. For residents with a diagnosis of dementia, their mental health needs were identified in detail and the care plan was devised accordingly. For example, a pre-admission assessment viewed identified a resident’s challenging behaviour and the risks posed to staff and other residents. Strategies and ways to calm the resident down were clearly recorded in the care plan. For Local Authority funded residents, the service had obtained care management assessments from the placing authority and the above pre-admission processes were also followed for any residents admitted for a respite stay at the home. All prospective residents and their relatives and family are given the opportunity to visit the home prior to being admitted. During the inspection one family was seen visiting the home and were given a tour of the home and the registered manager spent time talking to the family about the services and facilities provided at the home. A relative also spoken to stated “I looked at the home for my friend and she settled in very well.” Residents and relatives spoken to during the inspection, spoke positively about the care provided by the service. A relative spoken to stated, “The home is lovely. My dad looks a lot better since being admitted to the home. We have been really impressed by the quality of care provided.” Another relative informed, “The care provided here is excellent. Staff always listen to me, they have all been extremely helpful and caring. I think they are wonderful and have admiration for the staff.” A resident spoken to stated “The care here is very good, they are always there, if you want someone. I can’t fault the home, I am very happy here.” The London Borough of Havering contract department was contacted as part of the inspection process and also gave good feedback regarding the home. A contracts monitoring officer spoken to informed “Hornchurch Nursing Home is a very good home, we cannot fault the home and we have no concerns regarding the service.” Hornchurch Nursing Centre DS0000015596.V349373.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, 10, 11 People using the service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs are set out in individual care plans. Care plans are detailed, to ensure the needs of residents can be met effectively. There are clear medication policies and procedures to follow. However, there are some inconsistencies in the management of medication, which may result in unsafe practices. All residents can be assured that, at the time of their death, staff would treat them and their family with care, sensitivity and respect. EVIDENCE: Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 11 Four care plans were closely examined and case tracked. Care plans were comprehensive, and clearly sets out residents’ health, personal and social care needs. Information covered the comfort and safety of residents, their communication needs, their nutritional needs, personal care, mobility and their hobbies and leisure. One care plan identified a resident’s like of knitting. The resident was seen knitting throughout the inspection. Care plans effectively detailed the level of care each resident required and adopted a person approach, focusing on promoting residents independence instead of creating a dependency on care staff. One care plan viewed stated, “X is able to wash own hands and face but needs assistance with other areas of personal hygiene.” This information informed staff of the individual’s abilities and the level of care required. Care provided for residents with a diagnosis of dementia focused on meeting their specialist care needs. A care plan viewed for a resident who had a diagnosis of dementia and had difficulty in communicating, clearly recorded that staff are to talk slowly and clearly to the resident, to ensure her communication needs were met. All members of staff were wearing their name badges and large signage was displayed around the unit. Staff were observed to be interacting positively with residents, talking to residents, maintaining eye contact, talking slowly and in a manner which was appropriate to the communication, needs of residents. The documentation/ health records relating to pressure care areas; management of diabetes, falls were examined. The records for these were found to be detailed and were adequately maintained. There was evidence that care plans were being reviewed at least monthly. Risk assessments are routinely undertaken for all residents around nutrition, manual handling, continence, falls and pressure care areas and are reviewed on a regular basis. Monthly weight checks were undertaken for all residents and appropriate action being taken where necessary. Records indicated other health professionals such as the tissue viability nurses, Macmillan nurses optical, dental and chiropody services saw residents. The continuing care nurse visiting the home was spoken to as part of the inspection. She spoke very highly of the home and stated, “The home always notifies us of all admissions, there have never been any problems, staff are always very helpful, they always give us their time. The documentation of records is good and on the whole is updated. Feedback from residents is very positive, we have never had any cause for concern.” A Macmillan nurse was spoken to who is involved in the process of admitting patients to the home who are terminally ill, commented very positively about the care provide at the home and stated “They are very good at phoning us, we have had no problems placing individuals who are terminally ill at the home. The staff are very good and willing. They are very receptive and always listen to our suggestions.” Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 12 A relative spoken to stated, “Since my dad has been here they have asked us everything, we have really been involved in his care.” The home has implemented the Liverpool care pathway and the end of life scheme. The scheme focuses on agreed practices to support people when they are terminally ill or who are at the end of their life. The main premise of this is to involve the resident and establish their needs and wishes and to ensure these are met by the service. The home is to be commended for implementing these programmes. The accident and incident book was reviewed. Accidents were recorded in full, and residents received follow up checks to ensure there were no further health-associated risks. The Commission for Social Care Inspection, in line with Regulation 37, and the Care Homes Regulations 2001, has been informed of these accidents. All care plans viewed contained information on the end of life wishes of residents and the contact details of relatives and representatives where appropriate. There are policies and procedures for the handling and recording of medicines. An audit was undertaken of the management of medicine within the home and a random sample of Medication Administration Records (MAR) charts were examined. The medication files on each floor included the registered nurse identification signatures of staff with permission to administer medication. Each resident medication file included a photo card, and a drug description of all their prescribed medication. However the following issues were highlighted and discussed with the manager of the home. Medication administration records (MAR Chart) were not completed in full. Some entries were missing. On completing an audit for some of these medications, it was identified that the medication had been administered but the MAR chart had not been signed to confirm the administration of medication by that member of staff. It is Requirement 1 that medication practices are reviewed to ensure the safety of residents. Hornchurch Nursing Centre DS0000015596.V349373.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, 15 People using the service receive excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is a varied programme of activities available and residents are given the opportunity to take part in a variety of activities, which meet their recreational needs. There is a wide choice of meals in the home, to ensure they meet the needs and choices of all residents. Visiting times are flexible and people are made to feel welcome in the home, so that residents are able to maintain contact with their family and friends as they wish. EVIDENCE: The service employs a full time activities co-ordinator, to ensure activities meet the needs of people living at the home. The service has a comprehensive Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 14 activities programme and the programme is displayed on each floor and in the reception area of the home. Activities included reminiscence therapies, gardening, hand massage and manicures, games afternoon, movement and exercise, quizzes and for those residents who are bed bound or are unable to participate in group activities, one to one sessions were provided by the coordinator where she would, chat, sing a song, read books with residents and provide activities of their choice. Daily case recording sheets evidenced this. Other activities included theme days, such as a Caribbean day, which was being organised by the co-ordinator and included Caribbean entertainment and Caribbean food for the day. The home had just had a Hawaiian theme day, which included staff dressing in brightly coloured grass skirts and hula-hoops and entertainment. The co-ordinator also provided a fortnightly shopping service, where residents could give her their personal shopping lists, which the co-ordinator would go out and purchase. Outings included trips to the pub and day trips to Southend, which residents had just been on. The activities organiser has completed her NAPA training for implementing further activities with elderly frail and dementia care residents. The service has also built a sensory garden, which residents go out into on a daily basis, where they can have their tea. The home has also organised garden parties of which photos are displayed of in the reception area. There is also a library service available and a variety of books, music CD’s accompanied by a record player were found around the home. On the day of the inspection residents were going to watch an ‘old’ time favourite movie, which they had requested to watch. Residents and relatives spoken to all commented on how much they enjoy the activities at the home. A relative spoken to stated, “My dad is doing activities everyday. He is always doing something in the mornings. I have seen staff take out residents into garden and we can also take out our relatives.” A resident spoken to informed “We went to Southend recently and it was very nice, we get to go out here. I go out into the garden, I do the exercise classes, and we have our tea in the garden, I can’t fault the home”. The continuing care nurse further stated, “The activities co-ordinator is excellent”. There is a four weekly menu and a “nite bite” menu available from 6.30pm and 6.30am offering a variety of hot and cold snacks throughout the night. The menu was seen which included a variety of fresh fruits and vegetables and a choice of two meals at lunchtime and at suppertime and snacks throughout the day. Records were seen of residents’ choices of meals for each day that they had chosen when consulted with by carers. On speaking to the chef, he was able to demonstrate his knowledge of those residents requiring special diets, for example diabetic and pureed diets. Residents and relatives spoken to spoke very highly of the meals provided at the home. One relative stated “We have been really impressed with the quality of food and they always offer Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 15 my dad more.” Another relative stated “My loved one has always spoken very highly of the meals here.” Visiting times were flexible and visitors could visit at any time convenient to residents. Relatives, family and friends were seen to visit residents throughout the time of the inspection and were made to feel welcomed by the staff at the home. Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 16 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, 18 People using the service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users can be assured their views are listened to and acted on. However, the service needs to broaden its way of recording complaints to include concerns to ensure any dissatisfaction is recorded and acted upon regardless of source. All staff have received up to date training in safeguarding adults, which ensures the protection of residents. EVIDENCE: The complaints procedure is clear and easy to follow and was displayed in the entrance of the home. Timescales within which a complaint would be investigated were stated on the complaints procedure and included the contact details for the Commission for Social Care Inspection. A complaints logbook is kept by the home, which was viewed. There was one recent written formal complaint logged, the service investigated the concerns highlighted satisfactorily. The Commission for Social Care Inspection has not been informed of any complaints. The home also holds regular residents’ Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 17 meetings and records seen demonstrated that all concerns raised by residents were listened to. However, evidence was not seen of verbal concerns recorded by the service or how they are actioned. It is Recommendation 1 that all concerns about the care of service users, regardless of source or how they are made, are recorded and responded to. All staff attend POVA training and adult protection is comprehensively covered in the induction programme. The service has comprehensive safeguarding adults procedures and protocols in place. The service has obtained safeguarding adult protection procedures devised by The London Borough of Havering. Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 18 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, 20, 21, 22, 23, 24, 25, 26 People using the service receive adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable environment and décor is of a good standard and provides a homely and pleasant living environment enhancing residents’ comfort, but further environmental safety checks would minimise risks presented to residents. EVIDENCE: The premises were comfortable, bright, airy, clean and free from offensive odours. Furnishings and fittings in communal areas were of good quality, domestic and unobtrusive. The home provides a homely environment to meet the needs of service users. The home has three floors; each has a lounge, dining room and kitchen area and has sufficient bathrooms and toilets. The Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 19 grounds around the home were well maintained and were equipped with suitable garden furniture. Some residents’ rooms were seen during the inspection, which were comfortable with adequate furnishings and was also personalised by residents with personal family photos and furniture. All rooms were lockable and can be overridden by staff in an emergency. The service provides suitable aids and adaptations where required. There were hoists and other aids available at the home. At the last inspection a requirement was made that all service users are provided with a height adjustable bed. The service is in the process of providing these and evidence was seen of BUPA Care homes prioritising Hornchurch Nursing Home to have these beds in order to meet the National Minimum Standards. Not all residents have been provided with the equipment and therefore the requirement will be repeated at this inspection as Requirement 3. During the tour of the premises, it was identified that bathrooms stored residents’ personal toiletries communally and were not labelled in regards to whom they belonged. One bathroom floor required maintenance work as the tiles from the floor had come away, presenting a health and safety risk to residents and staff. Bath water temperatures had not been consistently taken when residents were bathed. All parts of the home to which residents have access to must be so far reasonably practicable made free from hazards to their safety and unnecessary risks to residents are identified and so far as possible eliminated, this will be stated as Requirement 2. The main kitchen is situated on the ground floor, which was inspected. The kitchen was clean and was equipped with suitable cooking appliances and kitchen equipment. There was a wide range of fruit and vegetables and meats. Fridge, freezer and food temperatures were taken daily and food was correctly labelled with date of opening. Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 20 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, 30 People using the service receive good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Recruitment practices are robust and ensure residents are in safe hands at all times. Adequate staff training is provided to all care staff, to ensure they are equipped with the skills and are competent to do their jobs. There is good skill mix of staff to meet the needs of residents. EVIDENCE: The staffing levels at the home consist of a qualified nurse on each floor at all times and three carers on each shift on each floor. There are four waking night staff on duty during the night shift. Staffing levels were satisfactory and relatives and residents spoke very positively about the staff team. The continuing care nurse spoken to stated “The staff support one another, the staff work very well as at team and always very helpful.” A relative spoken to stated “Staff attitudes are very good, they always listen.” Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 21 Three staff files were closely examined, which were all in good order. References and Criminals Records Bureau checks had been obtained for all three members of staff. Staff had been on induction programmes and all received ongoing training. Training received included training in equality and diversity, introduction to quality to dementia care, fire training, manual handling, basic food and hygiene, elder abuse, health and safety, use of hoists, flocare/nutricia, five members of staff has been trained in phlebotomy including the registered manager and two members of staff has completed training in tissue viability. Although staff had received training in an introduction to quality to dementia care, this is not sufficient in understanding the complex needs of people with dementia. It is Recommendation 2 that receive further in-depth training in dementia to ensure staff are equipped with skills to meet the needs of residents with dementia. The service has a permanent staff team and use pool of bank staff when there are staff shortages. Staff qualifications evidenced that the service has a ratio above 50 of NVQ qualified staff. Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 22 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, 38 People using the service good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from an experienced manager who recognises their needs and adequately manages the home. Systems for service user consultation have been implemented, to ensure residents’ views underpin all self-monitoring, reviews and developments by the home. Residents can be confident that the staff team who care for them benefit from regular supervision. Service users’ financial interests are safeguarded. The welfare of staff and residents is promoted by the home’s policies and procedures. EVIDENCE: Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 23 The registered manager is a registered nurse with experience of managing services for this client group and has undertaken a certificate in management studies. Through discussion and observation it was evident that the manager has the qualities and experience necessary to manage the home. The service does not manage residents’ finances; these are managed by families, representatives or the residents themselves. A service does maintain a petty cash float, which is used for residents if they require it. A clear recording system was in place to evidence all monies received and spent on the service users behalf and how that money had been spent. All amounts were accounted correctly and were in order. There is an annual quality assurance programme. The results of the resident customer satisfaction survey completed in December 2006 were viewed. These results were compiled into a report and chart format, which were available at the home. The registered manager had also devised an action plan to action any dissatisfactions with the service, which had been implemented. The home also held regular resident meetings ensuring residents had the opportunity to further express their views on the daily running of the home. Staff supervision records evidenced that staff were supervised at least six times a year, ensuring staff are provided with the skills, training and knowledge to perform the tasks required by their employment role. Health and Safety records were inspected. All documentation was in order and appropriately completed. Evidence was seen of water temperatures checks completed at all outlets throughout the home on a monthly basis. The London Borough of Havering contract department also commented on the quantity of training provided to staff maintaining the home. A contracts monitoring officer from the department stated, “When I last visited the home, I was very impressed with the training and knowledge of the individual in charge of the maintenance of the home. The procedures they follow are the best I have come across.” Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 Requirement Timescale for action 30/11/07 2 OP19 13 (4) (a) 3 OP22 16 The registered persons must ensure Medication Administration Records are recorded correctly to ensure the safety and protection of people using the service. The registered persons must 30/11/07 ensure that all parts of the home to which residents have access must be so far reasonably practicable made free from hazards to their safety and unnecessary risks to residents are identified and so far as possible eliminated. It is a requirement that within 12 01/04/08 months all service users are provided with an adjustable bed. Requirement partially met. Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP16 OP27 Good Practice Recommendations It is recommended that all concerns about the care of service users, regardless of source or how they are made, are recorded and responded to. It is recommended that receive further in-depth training in dementia to ensure staff are equipped with skills to meet the needs of residents with dementia. Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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 Hornchurch Nursing Centre DS0000015596.V349373.R01.S.doc Version 5.2 Page 28 - 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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