Inspection on 15/09/06 for Inver House

This inspection was carried out on 15th September 2006.

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

Inver House 15/04/09

Inver House 28/04/08

Inver House 26/01/06

Inver House 12/07/05

Inver House 03/03/05

Inver House 17/08/04

Inver House 11/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Inver House Foreland Road Bembridge Isle Of Wight PO35 5UB Lead Inspector Liz Normanton Unannounced Inspection 15th September 2006 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 Inver House DS0000012502.V310056.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. Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Inver House Address Foreland Road Bembridge Isle Of Wight PO35 5UB 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) 01983 872312 01983 875814 Islecare `97 Limited Mrs Joanne Debora Bennett Care Home 35 Category(ies) of Dementia - over 65 years of age (9), Old age, registration, with number not falling within any other category (35), of places Physical disability over 65 years of age (12) Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th January 2006 Brief Description of the Service: Inver House is a care home providing personal care and accommodation for 35 older people. The home offers a day care service for up to four service users per weekday. An area of the home has been developed to accommodate and meet the needs of those individuals with mental frailty, and illness associated with dementia. The home is a large three storey detached property set in its own grounds and situated in a residential road in Bembridge village, a few minutes walk from a range of local shops and the nearby beach. There is a large car park to the front of the building from which there is level access into the home. The accommodation offers a range of single rooms on all three levels, accessible to residents via a passenger lift. There is a large enclosed garden, which is mainly laid to lawn with flowers, shrubs and seating for service users. The company who own the home are proposing to re-develop the site with the addition of a further 15 bedrooms. It is believed that building works will commence in January 2007. Weekly Fees: £365 .40 up to £472 .50 Inver House DS0000012502.V310056.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 and focussed on what the Commission considers to be core standards for a care home for older adults as defined in the Department of Health (DOH) National Minimum Standards. Information was gathered from a variety of sources, which included data being sent to the Commission prior to the site visit, discussion with several service users, three visitors, discussion with three staff, the manager, deputy manager and the viewing of staff and service users’ files. This information was then triangulated to access outcomes for people living at the home. A small number of concerns were raised about poor care practice at the home, which are detailed in the main body of the report. The overall outcome is that the home is well managed and sufficiently staffed with the majority of residents being very satisfied with care provided by the home. What the service does well: Prospective residents can visit the home and will be provided with written information to enable them to decide if the home will meet their expectations. The home will only admit people following a needs assessment being undertaken prior to admission to ensure that the home can meet an individual’s needs. Residents are able to maintain relationships with relatives and friends and visitors are always welcome at the home. There are opportunities for residents to exercise autonomy and choice on a day-to day basis. The home employs a cook who offers residents a wide variety of meals having taken people’s preferences in consideration. Residents are provided with warm homely surroundings, which are accessible and enable people to be as independent as possible. The home is managed by a competent, experienced management team who are supportive to the residents and staff. Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 6 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. Inver House DS0000012502.V310056.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 Inver House DS0000012502.V310056.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 &3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information needed to choose a home, which will meet their assessed needs. They have their needs assessed and a contract which clearly tells them about the service they receive. EVIDENCE: In discussion with the deputy manager they explained that prospective residents are sent out a colour brochure, which gives details of Inver House. A statement of purpose and service user guide is available on request and is usually given to residents following admission. A copy of the colour brochure was viewed and provides prospective residents and their relatives with information to make an informed judgement as to whether the home would meet their needs. People are able to visit the home as part of the decision making process. Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 9 In discussion with one resident they were not sure how they came to be living at Inver, however the manager explained that the person had been received as an emergency and that a relative had acted on their behalf and had visited the home to ensure it was suitable for their sister. Privately funded residents are provided with a contract including the terms and conditions of the placement. Those funded through social services have a separate contract, which is between the home and the local council. Prior to admission prospective residents’ care needs are assessed either by the manager or deputy manager. Five residents’ files were viewed and were seen to contain comprehensive needs assessments. In discussion with the deputy manager they stated that consideration would be given to a person’s needs and the staff experience to meet those needs. If it was believed that the home could not meet a person’s needs the home would not admit them. Inver House DS0000012502.V310056.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care a resident receives is based on their individual needs. The principles of respect and dignity are generally put into practice, however at this inspection staffing standards had slipped and as a consequence of this residents’ dignity and respect was being compromised. EVIDENCE: Four residents’ files were viewed and contained comprehensive care plans and risk assessments, which had been drawn up using the information provided in the needs assessment. In discussion with care staff they stated that the information provided was very useful and enabled them to understand a person’s care needs. There was evidence that care plans are reviewed monthly and alterations are made as required. Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 11 Care assistants were observed in practice operating equipment to aid transfers from a wheelchair to a comfortable seat. This was done in a caring and professional manner at the right pace for the residents. One resident confirmed that they always felt safe and in good hands. In discussion with the deputy manager they explained that residents are involved in the reviewing of care plans if they so wish, however most prefer not to get involved. The home operates a key worker system, this enables staff to develop a one to one relationship with residents and enables them to get to know them as individuals. Details of residents’ health needs are also part of the care plan. All residents are registered with a GP and benefit from a surgery being sited conveniently next to the home. There was evidence of behaviour management, nutritional, and pressure sore assessments. District nurses visit the home on a daily basis, to attend to residents who require medical attention and are also able to offer support and advice to the staff team. A community psychiatric nurse also supports residents with dementia care needs. Residents were observed to be wearing hearing aids and glasses and have access to dentists, opticians and a chiropodist. The home has a robust medication policy and procedures, which are followed by those staff that have responsibility for the administration of medication. Five staff currently have responsibility for the administration of medication and have had training in this area. Prescribed medication is received in to the home on a monthly basis and is booked in against the Medication Administration Record (MAR) sheets. A sample of MAR records were viewed and there was evidence that medication administration is always signed for. The procedure for the administration of controlled drugs was robust with medication administration being witnessed and a separate log in the controlled record book being double signed. The controlled drugs were checked against records and amounts were accurate. Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 12 The home currently stores controlled drugs in a separate locked cabinet within a locked cabinet. Although it is not required in an older persons’ home a separate storage facility bolted to the wall is considered to be more appropriate for the storage of controlled drugs and would be evidence of good practice. Non-prescribed medication (PRN) is ordered in bulk and is stored in a separate locked cabinet. The cabinet was disordered and oral preparations were being stored with external preparations. Records of PRN administration are kept. In discussion with several residents they all said that they got their medication everyday and always on time. Residents right to dignity and respect are part of the home’s induction training and are a major part of the home’s philosophy of care, as detailed in the Statement of Purpose, although at this inspection visit there were three areas of concern where residents’ dignity was compromised. One gentleman was observed to be wearing trousers which were obviously too big for him and these fell down whilst he stood up to leave the dining table, exposing his bottom and thighs to all those in the dining room. Care assistants acted immediately to rectify the situation and a member of staff explained why the person was wearing trousers which were too big. This matter was discussed with the manager who agreed the incident should not have occurred and will speak to the staff member responsible to ensure that nothing like this happens again. Secondly a member of staff from oversees was heard to be calling every resident he spoke to as “Darling” this form of address is not acceptable unless residents wish to be called darling. All staff should learn the names of residents, and the name they prefer to be called as stated in their care plan. This matter was discussed with the deputy manager who agreed to speak to the member of staff in question. Thirdly one carer spoke to a resident who they were assisting to eat in a patronizing manner. This was reported to the deputy manager who agreed to look in to the matter. Medical treatment is provided in residents’ own bedrooms or in the quiet room. Residents are able to meet visitors in the privacy of their own rooms. In discussion with several residents who were consulted individually they all confirmed that they are treated with dignity and respect at all times. Inver House DS0000012502.V310056.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to choose their lifestyle, social activity and keep in contact with family and friends. Social, cultural and recreational activities are limited and residents would prefer more to be available to them. Residents receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: Information sent prior to the visit indicated that the home offered limited activities and this was confirmed in discussion with several residents, who felt that there was not much going on at all to keep them occupied. Current activities are various games including Bingo and a visiting musician once a month. There were no activities taking place at this inspection. In discussion with the deputy manager they stated that the home has a designated employee who is now responsible for co-ordinating activities within the home. This was confirmed in later discussion with the manager, who also explained that Islecare are aware of the limited activities available across the homes in the Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 14 Islecare group and are focussing their attention on this area in consultation with an occupational therapist. There are no restrictions on visitors and several were observed visiting relatives and friends. In discussion with three visitors they confirmed that they are always made welcome and are offered refreshments. The home has the occasional coffee morning throughout the year and relatives are welcome to attend. Residents are able to access the local community if they have the capacity, and one resident had been out to visit their wife who is in another home and was observed announcing their return to the deputy manager. One resident is supported by family to attend church, and a Church of England minister visits the home the first Thursday of every month to give communion. With regard to residents’ autonomy and choice the home has two lounges and a quiet room in which residents can choose where they wish to sit. Evidence was seen that one resident has responsibility for their own finances and chooses how they wish to manage their money. In discussion with the deputy manager they stated that three residents choose to be responsible for cleaning their rooms and bed making. Whilst touring the home it was evident that residents are able to personalize their rooms to their liking and in some rooms people had brought their own furniture. In discussion with residents they confirmed that they are able to make choices. Residents, dietary needs are written on to care plans, the cook is made aware of specialist dietary needs. Meals can be taken in the dining room or in residents’ own rooms. A range of cereals was available for residents to help themselves at breakfast. There is a five weekly rotating menu, which offers a wide variety of meals available. The main meal is served at lunchtime. In discussion with several residents they confirmed that they were offered an alternative choice if they did not like what was on the menu. All those consulted felt that the meals provided at the home were very good. The lunchtime meal served at the inspection visit was observed to be well presented and looked appetizing. Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 15 Residents were offered additional refreshments mid-morning and midafternoon. Inver House DS0000012502.V310056.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to a robust, effective complaints procedure, are protected from abuse and have their legal rights protected. EVIDENCE: The home has a complaints policy and procedure, which was reviewed and implemented in 2005. The complaints procedure is provided with the home’s Statement of Purpose and a copy of this procedure was also on display in the hall. Information on how to contact CSCI is available in the complaints procedure. There have been four complaints to the manager/providers since the last inspection. The details of these complaints are confidential, however the home investigated the complaints using the home’s complaints procedure and all matters were looked into with a satisfactory resolution except for one. In discussion with several residents and three relatives they were all satisfied with the service and had no complaints. All knew how to make a complaint. The home has robust recruitment procedures to ensure that residents are not put at risk of abuse. There is an adult protection policy and procedure in place, which now correlates to the Isle of Wight Adult Protection Policy Guidance. In discussion with three care assistants they were able to Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 17 demonstrate that they understood what abuse was and would use the “whistle-blowing” policy if needed. In discussion with the manager they explained that there has been an incident at the home in which there were concerns about a member of staff’s practice. This matter was dealt with using the organization’s disciplinary procedure and the member of staff was dismissed. Abuse incidents, which occasionally occur between residents are always reported to the Isle of Wight Adult Protection Team. Inver House DS0000012502.V310056.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The physical layout of the home enables residents to live in a safe, well maintained and comfortable environment, which encourages independence, however there were some maintenance issues which need addressing. A number of issues regarding staff’s attitudes to the upkeep of residents’ bedrooms will also require further investigation. EVIDENCE: Islecare ‘97 Ltd has plans to redevelop the home with the addition of fifteen bedrooms. Plans for the alterations are on display in the residents’ dining room. Planning permission has now been granted and building works are believed to commence in January 2007. Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 19 A full tour of the home was undertaken which included the garden. The communal areas were clean, tidy, well lit and ventilated and provided comfortable seating and a pleasant environment. Over all the environment was kept clean and tidy and was free from offensive odours, however there were three bedrooms in the main house and three in the EMI unit, which had a strong odour. In discussion with the cleaner they explained that every effort is made to eliminate odours in rooms which are cleaned daily and when necessary carpets are washed. The three rooms in the EMI unit had a strong odour, which led to the inspector having a closer look at bedding, and three beds had been remade although they were urine soaked. This matter was raised with the deputy manager who was surprised as the home has a system in place for the checking of rooms. Records of daily room checks were evidenced, however they had not been checked at this inspection. The deputy manager stated that the matter would be reported to the manager and fully investigated. There was evidence that bed making was done in a slovenly manner with many beds having bottom sheets on inside out and not completely covering the mattress. One bed had been remade with a top sheet which was holed and threadbare. Several bedrooms had badly hung curtains due to broken curtain hooks. In discussion with one member of staff they felt that standards had slipped in the home and that they felt up against a constant battle with other staff. These issues were discussed with the manager who explained that the home has been short staffed, and care assistants and herself are having to work additional hours to meet the needs of the residents, and that the conditions in the home at the time of the inspection did not reflect a true picture of the general running of the home and that this was a particularly bad day. One bedroom requires a new headboard as the existing one is worn and has holes in. One bedroom has damage to the plaster and wallpaper on an external facing wall, which suggests, water is getting in. It was noted that the decoration in one room was poor, the cleaner stated that it had recently been redecorated. The standard of workmanship was very poor with areas of paint having been missed. There was a hole in the wall outside room 5 which looked unsightly. The bathroom in the EMI unit was being used to store a carpet cleaner, mop buckets and an ironing board. This was raised with the deputy manager who arranged for them to be moved. Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 20 The laundry is situated away from food preparation areas and has an impermeable floor covering. All staff have received infection control as part of the home’s induction training. The washing machine is fitted with a sluice programme. The laundry is not fitted with a wash hand basin. In discussion with the deputy manager they explained that all staff wear gloves when handling laundry and that they are provided with a pocket sized liquid hand cleaning dispenser. Residents’ laundry is labelled and clothing is washed separately from bedding etc. Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of the residents, however greater consideration should be given to providing care from at least one experienced staff member to those residents with dementia care needs on the day and afternoon shifts. EVIDENCE: In addition to the management team the home employs 17 care assistants, 2 seniors, a clerical assistant a cook and a cleaner. The skills mix of the team is varied and both male and female staff are available to provide care. The staffing list provided prior to the inspection visit showed that the home had three staff vacancies. The pre-inspection questionnaire indicated that the home has used several agency staff over the past eight weeks. In discussion with the manager they explained that in addition to one staff having been dismissed a month ago, two full time staff have recently left her employ and as of yet she has been unable to fill the vacancies. This has led to employing agency staff and she and existing staff are working additional hours to ensure that the shifts are covered to meet the residents’ needs. Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 22 Samples of the staffing rosters for the period July/August were sent prior to the inspection and evidenced that there are sufficient members of staff to meet the needs of the service users. In discussion with residents and relatives they were happy with the levels of staff and the care provided. At the inspection visit there were sufficient numbers of staff on duty and residents’ needs were observed as being attended to. The two staff on duty in the EMI unit were recently employed and had not had experience of working with people with dementia, one had not worked with older people before. This was discussed with the deputy manager who explained that there are plans to train the new staff in dementia. In further discussion with the manager they explained that the residents with dementia did not have nursing needs and felt that they were well cared for and that there was sufficient support available to new staff from the senior staff on duty if they required help. Information provided on the pre-inspection questionnaire detailed that 10 staff have completed the National Vocational Qualifications (NVQ) in care at level 2 or above which means 62 of the staff team have qualifications. Four staff files were viewed for evidence of robust recruitment practices. None of the files held evidence of Protection of Vulnerable Adult (POVA) first checks. There was no photographic identification in three files and no work permits for three overseas staff. There was a record that Criminal Record Bureau (CRB) checks had been undertaken. A visit to the Islecare ‘97 Ltd was undertaken to access staff files which were found to contain evidence, which was missing at the home. In discussion with the secretary she explained that plans were in place to ensure that all Islecare Homes held the relevant documents for inspection. Application forms and two references, one being from the last employer, were in situ at the home. Islecare ‘97 Ltd are equal opportunities employers and the home employs a mixed staff group which includes male and female staff, and staff from overseas. There was evidence of staff training in the following areas, induction training which includes: fire safety, manual handling, health and safety, and food hygiene awareness. There was evidence of induction training in staff files. Islecare have a probationary period of 22 weeks and this is initially reviewed at six weeks. In discussion with care staff two had found the training beneficial, whilst one felt that it had been rushed and felt “thrown in at the deep end” and was different to what other people had received. This was discussed with the manager, who was surprised to hear that a member of staff had not felt that the training had been sufficient, and agreed to look into the matter. Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 23 Additional training includes: Dementia Care, which is provided by the deputy manager. Seven staff hold a First Aid Certificate. Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 24 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, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems, which are implemented by a competent, qualified manager. Attention needs to be paid to fire safety procedures to ensure the ongoing safety of residents. EVIDENCE: The manager has ten years’ experience of working at the home and has been the registered manager for just over two years. The manager has completed the NVQ level 4 in care and will go on to undertake the Registered Managers Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 25 Award. The manager is supported in the day to day running of the home by a deputy manager and two assistant managers. There is a clear line of accountability, and the management team who provide regular supervision, annual appraisals, along with training and daily guidance, supports all staff. Residents are consulted about the quality of the service they receive, this is done by way of daily contact, annual questionnaires for long stay residents, questionnaires for respite residents, questionnaires for relatives/ representatives and residents’ meetings which are held between 3-4 a year. Five copies of the residents’ questionnaires were viewed and all thought the service was good, and in some areas people felt the home was excellent. Minutes of the February residents’ meeting indicated that this is used as a forum for the home to provide information to residents and for residents to raise issues or make requests. An Islecare representative visits the home monthly to monitor the conduct of the service, and a representative of the company from the mainland continues to undertake periodic audits. Residents are encouraged to maintain their own finances to maintain as much independence as possible. In the event that residents cannot manage their financial affairs, this duty is undertaken by relatives, solicitors and power of attorney. In discussion with the deputy manager they explained that the registered manager is an appointee for one resident’s finances and the clerk collects three people’s pensions. There are facilities for the safekeeping of residents’ monies and personal allowances are all kept separate, records of financial transactions are held and receipts are kept. Three residents’ monies were checked against records and the amounts were correct. There are policies and procedures in place for the health and safety of residents and staff, these are regularly reviewed and updated as required. There was evidence provided prior to the inspection visit that the home has electrical and gas appliances serviced regularly and that electrical installation is serviced every five years. At this inspection there was a fault with the call bell system a maintenance person arrived just after lunch to repair the system. Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 26 All staff had received health and safety, health and hygiene, moving and handling, basic first aid, and fire safety during their induction to the home. There was evidence that fire systems are checked weekly. In discussion with two staff they demonstrated that they understood the fire procures. Two residents’ room doors were wedged open, the deputy manager explained that both residents are very independent and wedge the door open only for the purpose of going to the bathroom. The deputy manager stated that due to these two residents limited mobility they are not able to activate a self-closing door mechanism, and would be having their independence taken away if this was to be a requirement. The general view is that doors should never be wedged open, and the home should consult with the fire safety officer for advice in respect to this matter. The fire exit door in the EMI unit had been blocked by a stool; this was mentioned to staff present who were asked to remove it. The home had safe storage for substances considered harmful to health (COSHH) and all cleaning materials are locked away following use to prevent potential injuries to residents and staff. There was a COSHH risk-assessment in place. The cook kept records of fridge and freezer temperatures and the kitchen was clean. Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 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 x x 3 Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 28 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 (2) Requirement You are required to tidy up the PRN medication cupboard and ensure that oral and external preparations are not stored on the same shelf. You are required to ensure that care staff treat residents with dignity and respect at all times, including the way in which their bedrooms are maintained. You are required to make repairs to damaged walls as listed in the report. You are required to consult with the fire service with regards to self-closing door mechanisms which could be used by physically disabled residents to maximise their independence. Timescale for action 15/12/06 2 OP10 12 (4) (a) 15/12/06 3 4 OP19 OP38 23 (2) (b) 23 (c ) (i) 15/12/06 15/12/06 Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 29 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 OP9 OP27 Good Practice Recommendations The home should consider installing separate controlled drugs cabinet, which is bolted to the wall, to ensure robust safekeeping of controlled drugs. Residents with dementia care needs would benefit from at least one experienced, trained member of staff being on duty during the two day shifts to ensure their care needs are fully met. Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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 Inver House DS0000012502.V310056.R01.S.doc Version 5.2 Page 31 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!