Inspection on 11/09/07 for Ivy Leaf Care Home

This inspection was carried out on 11th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Ivy Leaf Care Home 15/11/08

Ivy Leaf Care Home 15/04/08

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Ivy Leaf Care Home 29 Geddling Road Carlton Nottingham NG4 3EX Lead Inspector Linda Hirst Unannounced Inspection 11th September 2007 10:30 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 Ivy Leaf Care Home DS0000070390.V348311.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. Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ivy Leaf Care Home Address 29 Geddling Road Carlton Nottingham NG4 3EX 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) 0115 961 6785 Mauricare Ltd Position Vacant Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider may provide the following category of service only:Care home only - Code PC To service users of the following gender:Either Whose primary care needs on admission to the home are within the following category:Old age, not falling within any other category - Code OP The maximum of service users who can be accommodated is 14. 2. Date of last inspection New service Brief Description of the Service: Ivy Leaf is an adapted residential property situated in the heart of Carlton, a busy area on the outskirts of Nottingham. The home is situated less than a five minute walk away from shops, cafes, public houses and places of worship. There are very good public transport links to the home and a small car park to the rear of the building. The service is registered to accept up to 14 people within the category of old age only. Nursing care is not provided at the home. The accommodation comprises two lounges, a dining room with a conservatory and there are 10 single and 2 double bedrooms, none of these rooms have en suite facilities but there are sufficient toilet and bathing facilities available. There is a small garden to the rear. The new proprietor informed us that he has plans to upgrade and improve the accommodation. There is a new statement of purpose and service user guide being developed at the moment and the manager intends to give this to every potential resident. The proprietor informed us that he intends to have the most recent inspection report available in reception for residents and their relatives to read. The current fees range from £325 to £400 per week. This fee does not include hairdressing, chiropody services or newspapers. Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This inspection involved one inspector; it was unannounced and took place in the day, including lunchtime. The main method of inspection used is called ‘case tracking’ which involves selecting three residents and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. There are no people living at the service currently from minority ethnic groups, although there are staff who can speak both Hindi and Punjabi if this were the first language of any resident. We observed some residents receiving help from the staff over lunchtime and some judgements in this report come from these observations. We spoke to two members of staff and asked for the views of another resident who was not part of the “case tracking” to form an opinion about the quality of the service. We read documents as part of this visit and medication was inspected to form an opinion about the health and safety of residents at the home. We did a partial tour of the building, including all communal areas and a sample of bedrooms to make sure that the environment is safe and homely. This service is under new ownership and was registered in June this year. The proprietor and manager highlighted to us a number of areas which they want to improve in the coming year. Some of these areas are identified in this report. We have reviewed of all the information we have received about the home since it was registered and considered this in planning the visit and deciding what areas to look at. Due to the short notice of this inspection, no surveys were sent out to residents and relatives but the quality assurance questionnaires which have been returned to the providers have been looked at and the comments have been added in to this report. Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The manager could make sure that the assessment of potential residents is more thorough and that there is a care plan in place as quickly as possible for people who are admitted in an emergency to make sure the staff can meet their needs properly. The care planning system could be much better to make sure that the residents’ needs being met in a positive way by the staff. The residents or their relatives could be involved in planning their care to make sure they know how staff intend to help them. The arrangements for medication are not safe and place residents at risk of taking medicine which is not meant for them. Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 7 Some staff could treat residents who need a lot of help, with more respect for their personal dignity and help them in a more sensitive and caring manner. They could also show respect for the personal choices of the residents and provide care in a more flexible way in line with their needs and wishes. The activities which are being provided could be reviewed with the residents to ensure these are in line with their wishes and expectations and that they are properly engaged and entertained. A record of all complaints, their investigation and outcome could be kept to make sure there is evidence that the concerns raised by residents are heard and addressed. The staff and manager could have a better understanding of their responsibilities if allegations of abuse are made to make sure they properly protect the vulnerable residents in their care. The new owner and manager needs to make sure that all of the information and documents required by Law have been provided on every staff member so they can be sure they are suitable to work with vulnerable people. The needs of the residents are such that the owner needs to make sure that there are enough staff to help support them. The manager and owner need to formulate a plan to address the areas needing improvement from this inspection to make sure the service provided to residents is safe and that the service provided is in their best interests. The manager needs to make sure the fire safety risk assessment is accurate and up to date and needs to do regular checks on fire doors to make sure they shut fully and will stop smoke and flames travelling through the home. 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. Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5, 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The assessment and care planning systems are not robust and responsive enough to ensure that residents’ needs can be met at the home. EVIDENCE: The manager and provider were not clear about the registration category for the home and the manager was about to admit a person who needed a specialist service for people with Dementia to the home. When it was pointed out that this was an offence she cancelled the admission. We looked at the file of the person who was most recently admitted to the home. We found evidence that the person has been properly assessed before being admitted and that her needs can be met at the service. The manager explained she had not assessed her personally, as she was admitted in an emergency. The staff confirm that it is normal practice for the manager to go Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 10 out to assess people before they are admitted and she then gives them verbal feedback. There was no care plan in place for this person, four days later and the daily records contained minimal information to guide staff on how to meet the resident’s needs. None of the residents who spoke to us said they had been visited before coming to the home though one person said he had chosen the home himself. Intermediate care is not provided at the home and the standard is not applicable. Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The arrangements for health and personal care are insufficient to ensure that residents get the care and support they need in a way which supports their personal dignity and maintains their wellbeing. EVIDENCE: The provider has intentions to overhaul the care planning systems to bring them into line best practice. The evidence we saw indicates that this is needed and must be given priority. The current care plans are of poor quality, they contain out of date information, crossings out and do not reflect the current needs of the residents selected for “case tracking.” There is no evidence that the residents have been involved in the development of their care plans and they confirmed this when we interviewed them. The review of care plans and risk assessments are not meaningful and are just a list of dates. The staff said that they complete daily record sheets and they think the care plans are detailed enough to guide them. Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 12 The residents said that the staff are very good at looking after their health. They said they keep a close eye on residents and call the Doctor or Nurse if they have any concerns. One person said he does not want any further health investigations, but these wishes are not recorded anywhere and there is no evidence that these preferences have been passed on to his Doctor. There is good evidence in records of support being provided by the District Nurse and an Occupational Therapist was visiting during this inspection to assess a resident. The residents told us that they have special cushions and mattresses to prevent pressure areas developing. The staff told us that they keep a close eye on residents’ health and they said the manager will always contact the Doctor if they have any concerns about residents. We observed a medication round. The manager popped residents’ tablets out into her hand and then put the tablets into pots for residents to take. She also left the medication trolley open and unattended whilst she went to various areas of the home to give residents their tablets. This is not safe practice. When we looked at the medication being held in the home we found some eye drops which were out of date but which were still in use. These were disposed of during the inspection. Some residents did not have a current supply of medicine prescribed for them. When we looked at the records however, staff had signed to say the medication had been given indicating that another person’s supply may have been used. This was pointed out as inappropriate practice. The residents who spoke to us said that the staff leave their tablets for them to take later because “they know they can trust us.” The dangers of doing this were pointed out to the manager. The medication policies are being rewritten at the moment and were not available for inspection. The staff who were interviewed gave clear accounts of safe practice when giving out medication but the evidence indicates that this is not necessarily being put into practice. An immediate requirement was left during this inspection to make sure that medication is being handled safely. The policy on privacy and dignity was being updated and was not available for us to look at. The residents told us that the staff are “great” and treat them with respect for their dignity. They said they can have privacy if and when they want it, and one person said he likes to have a lie down after lunch. The staff said that they try and make sure the residents are comfortable and clean and they said they show them respect by listening to what they want and meeting their needs. There were some concerns about how staff supported people to eat during this inspection (see OP12). Ivy Leaf Care Home DS0000070390.V348311.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lifestyle residents at the home experience is not flexible enough to make sure care is delivered in line with their needs and wishes. EVIDENCE: The manager said that activities such as skittles, cards and quizzes took place and one of the people who was “case tracked” was seen helping with various chores around the home during the visit, such as washing up and folding the washing. She said she likes to be involved in household tasks. Other residents said they used to do movement to music and enjoyed trips out but they said these appear to have stopped now. The staff said they try and do activities such as BINGO, sing-along and ball games when they can with the residents. The owner told us that professional entertainers have visited the home twice and that birthdays and entertainmen events are opened up for relatives and friends to attend. Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 14 The residents who were interviewed said their family and friends can visit when they like, there are no restrictions and they said they can see people in private if they want. Some said they would like to get out more into the community, shopping, going to the pub or garden centre visits which they have enjoyed in the past. The staff confirmed that relatives can visit when they like. The residents said they have not voted since being in the home, the manager has supplied evidence that residents are registered to vote and said she intends to enable people to use their votes. The manager said that some relatives vote for residents and under the Mental Capacity Act the manager will need to assess whether residents are competent to vote, record her findings and take action appropriately. The staff who were interviewed said that some residents get up early but if they are asleep they are left undisturbed, however when residents were interviewed they said they do not get the chance for a lie in as the staff take the bed clothes off them to wake them up. This is inappropriate and undignified and the matter has been referred to the proprietor and manager for investigation. They said they have a “bath day” but said this had been chosen for him, the staff confirmed they bathe two residents a day but said people can have extra baths if they wish. The manager felt that residents may not have realised that there have been changes in the home since the new owner took over and that people can bathe when they choose and she will discuss these matters with residents and staff. Lunch was observed. The manager was doing the cooking on the day of the visit, although the proprietor told us that a person has been appointed to do the cooking and is awaiting Criminal Records Bureau checks. The stocks of food in the home appeared low, the proprietor said that this was because the shopping was delivered every few days from the supermarket. The staff said that there was enough food in the home to prepare drinks and snacks for the residents and the residents who were interviewed said they get enough to eat and drink. The food looked and smelled appetising but there was no choice of menu and no alternatives were provided. The meals came out pre plated and none of the residents were asked what they would like on their plate. One person complained about the size of the portion, saying there “is not much here is there?” We watched a staff member assist one person to eat. The staff member put an apron over her without explaining what she was doing or why, she also stood to assist her to eat rather than sitting beside her so she could talk to her properly. The staff member did not tell the resident what was for lunch and did not check the temperature of the food before putting it in the resident’s mouth. She was seen tapping the resident’s lip with the spoon and pushing the food against her mouth to get her to open it. When the resident opened her mouth Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 15 to protest the staff member put the food in which startled and distressed her. The staff member was also seen to offer food before the resident had finished eating. She asked the manager for advice, but despite being told to “leave her for a minute,” the staff member continued as before. This was a very poor example of practice and the matter was referred to the provider and manager for investigation and to take appropriate action. The staff who were interviewed demonstrated that they know how they should support a resident who needs help to eat but the evidence indicates that this is not necessarily put into practice. Ivy Leaf Care Home DS0000070390.V348311.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The arrangements for recording complaints and reporting safeguarding issues are not robust enough to make sure that residents are properly protected from potential harm or abuse. EVIDENCE: We could not find a complaints procedure on display in the home and the Law requires that there is one, but this matter was addressed before the end of the visit. There have been two complaints about the service since registration. One was received by the Commission, referred to the provider to investigate, and appropriate action has been taken in response to the issues raised. The other came to light when we interviewed a resident who said he had complained and the owner had taken quick action to address his concerns. There was, however no record of this issue in the complaints log, it had only been recorded in the care plan, nor was there any record of the outcome of the complaint. The residents we spoke to said they would feel able to complain to the manager or the owner and they felt confident that any concerns would be taken seriously. The staff had not dealt with any complaints but they knew what action they should take if one was made. Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 17 There have been no safeguarding allegations made since the home was registered, and the company policy was not available to view as this is being rewritten. The manager did have a copy of the local procedures but these were not up to date and the manager needs to download new guidance following the link www.nottsadultprotection.org. The staff understood the different types of abuse and said they would report allegations to a social worker, “if they were true.” It is clear that they do not understand the procedures to be followed in the event of allegations and this could result in inappropriate action being taken, training for all staff including the manager is needed. The residents at the home said they feel safe there and have never seen or experienced the staff acting in a way they felt was inappropriate. Ivy Leaf Care Home DS0000070390.V348311.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, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The accommodation is clean, tidy and the residents feel it is comfortable and homely. EVIDENCE: The accommodation is generally clean and tidy and the owner said he has plans to upgrade and improve the physical standards of the home, and is in the process of doing this. The bath on the ground floor has been damaged and has sharp jagged edges, and although the owner has plans to replace this with adapted bathing, steps need to be taken more immediately to prevent injury to residents or staff when using the facility. The owner said he would attend to this with immediate effect. Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 19 The staff who were interviewed had no concerns about the accommodation and said they felt there were enough cleaning hours to keep the home clean and odour free. The residents said the home is clean, comfortable and homely and they have the facilities they need and want. Some of the bedrooms seen were very personalised. Ivy Leaf Care Home DS0000070390.V348311.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): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The numbers of staff on each shift are not adequate to ensure that residents’ needs are fully met and the recruitment practice is not robust enough to protect residents from harm or potential abuse. EVIDENCE: Day shifts are currently staffed with two care staff and the manager, although she sometimes covers the cooking. The manager’s hours are not reflected on the rota and nor are those of another member of staff who is covering the role of the cook temporarily. The owner said that he knows he needs to increase his staff complement and has employed two new staff who are waiting for all of the pre employment checks. The residents who were interviewed said there are not enough staff around to meet the needs of people living at the home and they describe the staff as “rushed off their feet.” The staff who were interviewed felt there were enough staff to provide care to residents, but the observations we did during this visit did not support this view. There were not enough staff at lunchtime to help the residents with their needs, and some people who needed help were rushed, as the staff were too busy. (See OP15). Only one member of staff currently has achieved National Vocational Qualification Level 3 and one Level 2. The new owner has now enrolled all staff on National Vocational Qualification Level 2. The staff who were interviewed Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 21 confirmed that this is the case. The residents said the staff seem competent and are very helpful. Five staff files were inspected and these did not contain the documents and information required by Law to make sure that staff are suitable to work with vulnerable people. The owner said he knew they were not adequate and has plans to use a staff file checklist to make sure that all of the required documents are present. This matter needs urgent attention. The staff who were interviewed confirmed that they had not completed application forms, though they said they did have Criminal Records Bureau checks before starting work. The previous owner employed them. The manager said there has been training on First Aid, Dementia, Moving and Handling Health and Safety, Basic Food Hygiene, Fire and she said Infection Control training is pending. The owner said the manager would use a company form to identify all of the training needed by the staff to bring them up to standard. The staff who were interviewed said they understood more training is planned. Ivy Leaf Care Home DS0000070390.V348311.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, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management of the service needs to address the areas of weakness highlighted from this inspection to ensure that the service is run in a safe manner and in the best interests of the people who use it. EVIDENCE: The manager has just completed the process of applying to become registered with the Commission and is awaiting the outcome of this process. She has started doing her National Vocational Qualification Level 4 and will then start doing the Registered Managers Award. She acknowledges that she needs to improve her knowledge and understanding around the Law. The residents who Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 23 were interviewed said the manager seems to run the home well but needs more staff to do this properly and the staff said the manager is “better than the one before,” she is approachable, is always there to help us and will listen to our ideas.” The new owners have already started doing quality assurance questionnaires and said he has sent these out to relatives, residents and visiting professionals. He intends to send out the surveys twice a year to get feedback from the residents. Comments included, “I am extremely pleased with the care and service given. She is very well looked after in my opinion and I am very pleased with all aspects of the service within the home.” “Information is available when I ask. My father is well cared for and I keep in regular touch with him. I am aware of all issues affecting my dad. The support given to my dad is what I would expect. I do not feel there are enough staff employed with experience of dealing with old people.” “As always I am extremely pleased with the care my mother receives, all the staff treat her with kindness and respect.” “I was concerned at the change of ownership but sincerely hope that the excellent care offered to my father will be continued. The staff are always very welcoming and do an excellent job in my opinion.” The staff and residents who were interviewed did not know if any questionnaires had been done, they said they had not completed them. The owner and manager are not the appointees for any of the residents and they do not collect or receive the personal allowance for anyone. Only small cash amounts are held on the premises and the records all tally with the amounts remaining at the service. The staff said they have nothing to do with residents’ finances. Health and safety servicing and testing is undertaken at the required intervals to ensure the residents and staff are safe. There is a ramp to the exit from the lounge, and this is blocking the automatic self-closing mechanism on the fire door, but this matter is not covered on the fire safety risk assessment. The fire door leading from the small lounge is not closing on its rebates and presents a risk. The staff who were interviewed felt they have enough training, equipment and support to ensure their health and safety. Ivy Leaf Care Home DS0000070390.V348311.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 2 X 2 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 1 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? N/A 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 *RQN Regulation S24 Care Standards Act 2000 15 Requirement You must NOT admit residents whose needs are outside of the category of registration and whose needs the staff do not understand and cannot meet. Each resident must have a care plan which reflects his or her current needs in detail. This must be compiled in consultation with residents/their relatives and be kept under review to make sure staff know how to meet their needs. Good hygiene practices must be followed when administering medication to the residents to prevent cross infection. This is an immediate requirement Medication must not be left unlocked or unattended as this could result in residents taking medication which was not prescribed for them. This is an immediate requirement All residents must have an adequate stock of medication to ensure they can be given their medicines as prescribed. Staff DS0000070390.V348311.R01.S.doc Timescale for action 16/10/07 2. OP7 09/12/07 3. OP9 13(2) 20/09/07 4. OP9 13(2) 20/09/07 5. OP9 13(2) 20/09/07 Ivy Leaf Care Home Version 5.2 Page 26 6. OP14 12(2 & 3) 7. OP15 12(4) 8. OP16 22 9. OP18 13(6) 10. OP27 18(1)(a) 11. OP29 19, Sch 2 12. OP38 13(4)(a – c) must not use “shared” supplies of medication. This is an immediate requirement Residents must be able to rise, bathe and retire at a time of their choosing, not for the convenience of staff. Residents must be assisted to eat in a sensitive and caring manner and staff must demonstrate respect for their personal dignity. The provider must report to the Commission on the action taken in relation to the incident which was observed. All complaints must be fully recorded and must include the details of the investigation and outcomes to ensure residents concerns have been properly responded to. All staff must have training on local safeguarding procedures to make sure they know what action to take to protect residents in the event of allegations being made. The dependency levels of the residents must be reviewed and an assessment of the staffing levels needed to meet these needs must be undertaken to make sure there are enough staff to support residents at all times. Staff files must contain all of the information and documentation required by Law to make sure that all staff members are suitable to work with vulnerable adults. • The use of the ramp in the lounge must be incorporated into the fire risk assessment. • All fire doors must close fully on their rebates. DS0000070390.V348311.R01.S.doc 20/10/07 20/10/07 20/10/07 20/01/08 20/11/07 20/11/07 30/10/07 Ivy Leaf Care Home Version 5.2 Page 27 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 OP5 Good Practice Recommendations Residents who are admitted in an emergency should have a care plan and a contract in place within five working days. The development of the policies and procedures on the safe handling of medicines should be expedited to ensure staff know what the expectations are and follow safe practice. The development of the policy regarding issues of privacy, dignity and independence should be expedited to ensure that staff have clear guidance about the philosophy of care at the home and work in line with this. The activities provided at the home should be reviewed in consultation with the residents to ensure they have the chance to be purposefully engaged. The manager should assess resident’s capacity to vote under the Mental Capacity Act and record her findings appropriately. OP9 3. OP10 4. 5. OP12 OP14 Ivy Leaf Care Home DS0000070390.V348311.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. 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