Inspection on 26/10/07 for Karam Court Care Home

This inspection was carried out on 26th October 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

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Heathlands

Aston Court Nursing Home

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Ravenhurst

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Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Karam Court Care Home Mallin Street Highbury Road Smethwick West Midlands B66 1QX Lead Inspector Ms Linda Elsaleh Unannounced Inspection 26th October 2007 1:00 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 Karam Court Care Home DS0000069175.V342924.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. Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Karam Court Care Home Address Mallin Street Highbury Road Smethwick West Midlands B66 1QX 0121 558 8007 0121 558 8008 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) Minster Care Management Ltd Mrs Valmy Flores Ms Nicola Dawn Hope Care Home 44 Category(ies) of Dementia - over 65 years of age (44), Old age, registration, with number not falling within any other category (44) of places Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide personal care (excluding nursing) and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category (OP) 44 dementia over 65 (DE)(E) 44 The maximum number of service users who can be accommodated is 44. 26th February 2007 2. Date of last inspection Brief Description of the Service: Karam Court is a purpose built three-storey care home. The home is registered to provide accommodation and personal care for up to 44 older people. It is situated on the corner plot of a residential road near to the A457, Smethwick and is easily accessible by public transport. There is limited parking at the frontage of the home, with additional off-road parking available on the plot of land opposite to the premises. The home as 44 single en-suite bedrooms located on the ground floor and first floor. Each floor has three lounges, two dining rooms and toilet and bathing facilities. Kitchen and laundry facilities are on the ground floor. The second floor comprises of training rooms and staff accommodation. All floors can be accessed via passenger lifts or stairways. The home is suitable for wheelchair service users. The staff structure comprises of two registered managers, team leaders, senior care officers and care assistants. The home also employs catering, domestic and administrative staff, an activity co-ordinator and a handy person. The home should be contacted directly about the range of fees charged for this service. Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over two days commencing the 26th October 2007. The purpose was to assess the home’s performance against the key standards in the National Minimum Standards for Care Homes for Adults and report on the progress made to address the requirements made at the previous inspection. The inspector’s findings are based on information received by the Commission for Social Care Inspection (CSCI) and examination of relevant records and documents kept at the home. The files of three service users and four staff were examined in detail. Interviews were conducted with the managers, staff and service users. Comments were also received from some relatives. The atmosphere within the home was relaxed and friendly. The managers have continued to identify areas for improvement and address issues raised at the previous inspection. Service users were complimentary about the home and the following comments are some of their quotes; “I’m happy to be here” and “I get on well with all staff and enjoy the activities. The food is usually very good.” Positive comments were also received from relatives; “My [relative] says s/he is always treated with respect and kindness” and “I haven’t been able to fault it [the service].” What the service does well: The home provides service users with information about its facilities and the service it provides, in suitable formats. Individual arrangements are made with service users to visit the home and move in on a trial basis. Good environmental standards are maintained and appropriate checks are carried out on appliances and equipment. Service users are provided with nutritious and well-balanced meals. Health care needs are met and arrangements are made to enable service users to consult with relevant healthcare professionals. The home provides a wide range of activities and support service users to access community-based clubs and events. Arrangements are made to consult with service users on an individual basis and regular house meetings are organised by the members of the service users’ committee. Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 6 Care staff are supported to carry out their duties through meetings with senior staff and training. What has improved since the last inspection? What they could do better: The home should review its assessment of the needs of self-funding service users and the recording format used to ensure their care needs and personal preferences are fully explored. Service users plans should be amended whenever changes are made to their care. Individual behaviours that challenge the service should be fully detailed with clear guidance for staff about how this is to be managed. Information for administering “as required” medication should be included in service users plans. The actual time medication is administered must be recorded on the medication administration records (MAR) sheets. The home has systems in place for assessing and evaluating the competencies and practices of staff in specific aspects of their work, such as fire safety and managing medication. The managers should ensure these are completed in a timely manner and include assessment of the individual’s understanding of their responsibilities for protecting service users from abuse. Training is provided to support staff to carry out their duties. However, they would benefit from a more planned approach to meeting their individual training needs. For example, to improve the quality of the information kept on Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 7 service users records staff should be provided with training to improve their recording skills. 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. Karam Court Care Home DS0000069175.V342924.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 Karam Court Care Home DS0000069175.V342924.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): 1, 2, 3, 4 & 5 Quality in this outcome area is good. Prospective service users receive information about the service and are invited to visit, and move in on a trial basis, to enable them to make an informed choice about where to live. The needs of prospective service users are assessed and the home provides written confirmation that it is able to meet their needs. Each service user has been provided with a Contract/Statement of Conditions. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s Statement of Purpose and Service User Guide is produced in different formats, for example large print and pictures. These documents provide information about what the prospective service user can expect from Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 10 the service such as the accommodation and facilities, qualifications and experience of staff, activities and how to make complaint. These documents are available in the reception area, together with additional information such as the home’s newsletter and a copy of the Commission for Social Care Inspection (CSCI) report. Service users and their relatives reported they received detailed information about the home, were given the opportunity to visit and provided with a written contract specifying the statement of terms and conditions of residency. A review meeting is held after the first six weeks with the service user, their relative/s and relevant professionals. The random selection of files examined contained a copy of the funding agency’s Care Management Assessment/Care Plan and the assessment carried out by the home prior to admission. The home follows the same assessment process for self-funding service users. The managers are advised to review the process and formats used for these service users to ensure a full and indepth assessment is being carried out on their needs and personal preferences. The discussions held and records examined show there are relevant skills and experience within the staff team to meet the assessed needs of the service users. The home has provided staff with training to meet the increased number of service users assessed with dementia and a member of staff is on duty to meet the communication needs of service users whose first language is not english. Karam Court Care Home DS0000069175.V342924.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): 7, 8, 9 & 10 Quality in this outcome area is adequate. A care plan is produced by the home for each service user. However, the home’s system for care planning, monitoring and review needs to be developed further to ensure detailed information is provided about the specific care needs and how these are to be met. The home has developed good working relationships with health care specialists and has suitable systems for ensuring service users health care needs are appropriately met. There are suitable facilities in the home for the safe storage of medication. Some improvements need to be made to recording practices to ensure the well-being of service users is fully protected. Service users feel they are treated with respect by staff. Systems have been introduced to ensure the quality of the recordings made by staff reflect this and is age-appropriate. This judgement has been made using available evidence including a visit to this service. Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 12 EVIDENCE: The home produces care plans for service users based on their assessed personal, health and social needs. Service users have access to all local health care services, such as dentist and opticians, and they are able to choose their own GP. Consultations take place in the privacy of the service user’s bedroom. The home has systems for monitoring the health of service users and relevant health care specialists are contacted where any concerns are raised. The inspector observed the sensitive approach taken by staff towards a service user who was expressing feelings of anxiety and arrangements were made on her/his behalf for their community nurse to visit the next day. Staff demonstrated, through discussions, an understanding of the behaviours presented by service users with dementia. However, the examples of how staff provide care and support to these service users varies. The managers were advised to ensure service users care plans include detailed information about presenting behaviours and responses to ensure service users receive an appropriate and consistent approach from all staff. As previously stated a review is held with the service user and other significant people after they have had an opportunity to settle in. Monthly monitoring of care plans is out by senior staff. Staff stated reviews had been held for two recently accommodated service users. There was a copy of the minutes of the meeting on one service user’s file. No record of the meeting was available on the other service user’s file. The monthly monitoring records of the care plans for the previous six months for other service users identifies no change to their care needs. However, discussions with staff show some changes have taken place. For example, the way personal support is provided to one service user differs from the information provided on her/his care plan. The omission in recording the outcome of a service user’s review and the quality of monitoring care needs indicate plans are not being amended in a timely manner. This was brought to the attention of the managers. Senior members of staff are responsibility for the safe handling and administration of medication. Accredited training is provided to staff and the home has a system for the periodic assessment on the competency of individuals. There are suitable arrangements for ordering, storing and disposal of medication. The inspector was informed regular meetings take place with the local pharmacist. Staff gave an example of a recent discussion that led to an improvement in how some medication is dispensed to the home. Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 13 Details of prescribed medication are kept on service users files and in the medication folders. Allergies and any other medical conditions are clearly stated. A photograph of the service user is attached to her/his medication administration record (MAR) sheets for identification purposes. A selection of service users MAR sheets were examined and showed these are being completed. Handwritten entries were seen for newly prescribed medication. These should be witnessed by a second member of staff and signed and dated by them to reduce the risk of errors being made in recording. The home’s “New Admission of a Resident Policy”, requires the booking-in of all medication to be checked, signed and dated by two members of staff. The managers are advised to re-visit this policy with senior staff and monitor practice to ensure this procedure is also followed for additional medication prescribed to service users who are already being accommodated. The inspector observed staff following good practice guidelines when handing over responsibility for the medication keys. Discussions with staff identified that prescribed medication is being administered to a service user later than the time being recorded. This change is at the request of the service user and does not have an adverse affect on her/his health. However, the home is required to maintain accurate records and this includes recording the correct time when medication is administered. At present the manager reports no “as required” medication is prescribed to sedate or calm service users. However, the record of a recent GP’s visit shows an update instruction for previously prescribed “as required” medication to be administered at regular times throughout the day. Although the service user’s MAR sheet shows this instruction has been followed, the information was not recorded on the service user’s file until three days later. Care plans must be amended in a timely manner to ensure accurate information about service users care needs are available to staff. The inspector observed staff using service users preferred names. Some service users sought advise from staff about their appearance. Staff described how they support service users, who require assistance, to choose the clothes they wish to wear. At the time of this visit service users appeared well groomed and suitably dressed. All bedrooms are single occupancy and have en-suite facilities. Support with personal care is provided in private. Service users can make their own arrangements to have a telephone installed in their bedroom, if they wish. Alternatively, service users are able to use the home’s handset to make and receive calls in their bedroom. Two service users have their own mobile phones. The files examined showed occasions when age inappropriate language has been used to describe the behaviour of some service users. The managers stated this matter had been addressed by the introduction of a new protocol for maintaining service users daily records. The senior member of staff on Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 14 duty is responsible for ensuring this protocol is followed. However, some examples of recent recordings show closer monitoring and support is needed. It is advisable for training in effective recording is provided to these staff to enable them to develop their skills. Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 15 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 good. Service users are able to participate in activities of their own choice and are supported to develop and maintain outside interests. The majority of service users continue to maintain regular contact with family and friends. Menus provide service users with a balanced and varied selection of food that meets their dietary needs and personal preferences. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are supported to follow their own daily routines. A weekly programme of in-house activities is displayed on the notice boards. Activities include bingo and chair aerobics. The activity co-ordinator is responsible for producing programmes and is supported by care staff in providing activities. Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 16 Individual activities are also encouraged. One service user was observed playing the organ for her/his own pleasure. Other service users said they like to spend some time alone watching television or listening to music in their own rooms. Transport is arranged for service users who wish to access communitybased activities, such as social clubs. Two service users have recently started to attend a local Caribbean centre. The individual service user meets the cost of these external activities. The home operates an open visiting policy that allows service users to receive visitors at a time of their choosing. Visitors were observed arriving at different times of the day throughout this inspection. Comments from relatives were positive about the welcome they receive from staff. The majority of service users consider mealtimes to be a social occasion and choose to take their meals in one of the two dining rooms. The home employs dining room assistants to support care staff during mealtimes and to provide service users with snacks and drinks throughout the day. Service users are able to help themselves to a selection of cold drinks available in the lounges. The minutes of service users house meetings show regular discussions take place about meals. The inspector was informed menus were being reviewed with service users and catering staff to reflect the change in the season. All service users, who expressed an opinion, were complimentary about meals provided and particular mention was given to the choice of food provided at breakfast. The home seeks advice from the community dietician about any nutritional concerns. House meetings are organised by the service users committee. It is chaired by one of the service users and they produce their own minutes. These are included in the home’s newsletters along with other regular features such as quizzes, details of forthcoming events and any of information of interest to service users and their relatives. Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 17 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. Service users and their relatives are provided with a copy of the home’s complaints procedure and are confident any complaints they make will be appropriately addressed. All staff must be familiar with safeguarding policies and procedures to ensure service users are fully protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The information provided by the managers prior to this inspection states no complaints have been made to the home about the service it provides. It is co-operating with the local authority’s investigation into a complaint recently received by them. No reports have been made under the Safeguarding Vulnerable Adults procedures. Details of the home’s complaints procedures are included in the Statement of Purpose and Service User Guide and, as previously reported, these are produced in large print and pictorial formats. Service users stated they were aware of the home’s complaint procedure and knew which staff member they would approach to discuss any concerns they may have. Service users meet on a regular basis to discuss the day-to-day running of the home. Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 18 Some staff demonstrated a good understanding of different forms of abuse and identified the person/s they would report any concerns or allegations to. However, some appeared less familiar with how to report any suspicions they may have. A discussion was held with the managers about the need to ensure each member of staff is fully aware of the issues and their individual responsibilities for reporting any concerns or allegations. The inspector was informed that staff had received training in the Protection of Vulnerable Adults. However, there was no evidence of this training on the staff files examined. The inspector has been provided with an amended copy of the home’s Procedure in the Event of a Missing Service User. Details of the agencies who should be notified of any such event is now included in this procedure. The managers report there have been no incidences that have required physical intervention by staff. The home has a written procedure for the use of physical intervention. Some staff have attended training in managing challenging behaviour and the use of restraint. Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 19 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 Quality in this outcome area is good. Service users live in a safe, well-maintained environment with appropriate aids and adaptations fitted to maximise their independence. All communal areas are accessible to service users and they are able to personalise their bedrooms. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Karam Court is a purpose built care home with 44 single en-suite bedrooms. There is a lift providing access to the communal areas and bedrooms on the first floor. The ground and first floor have sufficient toilets and bathing Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 20 facilities. Appropriate aids and adaptations are fitted to enable service users with limited mobility to manoeuvre safely around the home. The handy person carries out regular safety checks on the building, appliances, equipment and aids and adaptations. However, the corroded clinical waste in the ground floor bathroom has yet to be replaced. Bedrooms are personalised with photographs and ornaments and some service users have brought small pieces of furniture with them. An inventory of personal possessions is kept by the home to enable any mislaid items to be returned to the service user. The housekeeper and ancillary staff are provided with relevant training. The home has adequate infection control measures in place and issues raised in the Environmental Health Agency’s report have been addressed. Staff are provided with protective clothing to wear, where required. A programme for re-decoration is taking place. The managers reported planned improvements include more attention to meeting the needs of service users with dementia. There is off-road parking available for visitors. The garden at the rear of the premises has a selection of flowerbeds and plants. Furniture is provided for service users to sit out during fine weather. Karam Court Care Home DS0000069175.V342924.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. Service users are cared for by a team of staff who have a mix of skills and experience and are sufficient in numbers to meet the individual needs of the current service users. Robust recruitment procedures are followed to ensure the well-being and safety of service users are protected. Staff would benefit from a more planned approach to training and development to support them more fully to meet the needs of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was not fully occupied at the time this inspection. Suitable numbers of care staff were on duty to meet the needs of the service users being accommodated. Additional staff, such as the activity co-ordinator and dining room assistants, is provided at core times. Three care officers are on duty during the night. A suitable person is designated ‘in charge’ of the shift. Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 22 Support and guidance can be sought from the ‘on call’ manager in the event of emergencis. There is a range of skills and experience within the staff team. Four staff files were examined in detail. One staff member holds the National Vocational Qualification (NVQ) Level 3 and two hold the Level 2 certificate. The home is in the process of recruiting to vacant posts. Staff files show appointments are not made until satisfactory safety checks have been received, such as written references and Criminal Record Bureau Checks. This demonstrates the home follows robust recruiting procedures to ensure welfare and safety of service users are fully protected. Also available are copies of the conditions of employment and relevant job descriptions. The home provides an induction programme for newly appointed staff based on their previous experience and qualifications. Staff reported they were satisfied with the induction they received. This included practical support of working under the supervision of an experienced worker. An induction workbook for a member of staff employed by the current managers in January this year is in the process of being completed. The managers are advised to monitor progress and ensure the induction and foundation training for staff is completed within the required timescales. Staff stated they receive regular individual supervision and periodic training. The records examined show a range of training is arranged. The files examined show some staff have attended training for Basic Food Hygiene, Pressure Care Relief, Manual Handling, Fire Safety, Safe handling and Administration of Medication during the last twelve months. One staff member has attended training for Deaf/Blind Awareness and two have attended a course for Leading Teams. There is evidence on staff files to show assessments are carried out individual’s competencies in areas such as fire safety and medication. However, those examined had not been completed and/or evaluated. Staff would benefit further from being provided with a planned individual training and development programme that assesses their knowledge and skills and, where necessary, arrange for their needs to be met in a timely manner. Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 23 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, 37 & 39 Quality in this outcome area is adequate. Service users live in a home that is run by managers who are experienced in meeting their needs. There are systems in place to ensure the staff meet regularly and receive individual supervision. However, service users would benefit from staff being provided with practical guidance and support when implementing new practices to further the quality of the service being provided. The procedures for monitoring health and safety within the home promote and protect service users and staff. This judgement has been made using available evidence including a visit to this service. Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 24 EVIDENCE: Two managers have been registered by the Commission for Social Care Inspection (CSCI) and hold joint responsibility for the running Karam Court. Both managers are in the process of completing the Registered Managers Award. They have worked well together in improving practices within the home and have developed positive relationships with service users, relatives and multi-agency professionals. The home has systems in place for reporting accidents and significant incidences to senior staff. These are reviewed on a regular basis by one of the managers and, where appropriate, suitable risk assessments are carried out and strategies developed to address any areas of concern. The managers stated they receive good support from the responsible individual who visits regularly to assess the home’s performance. Reports for these visits were not inspected during this visit. Staff spoke positively about the changes that have been made to care practices and the positive affect this has had for service users, for example they appear more relaxed and the atmosphere in the home is calmer. Service users confirmed they are consulted about their care and the day-to-day running of the home. Service users are encouraged to maintain financial independence and are supported by their relatives. The home does not manage service users financial affairs. Records are kept of any service user’s money held in temporary safekeeping. The managers are continuing to work with staff in implementing a more person-centred approach to care planning. The records show changes in care practices are discussed at team meetings and individual supervision sessions. However, the inspection has raised some issues about care practices and recordkeeping. The managers are advised to review their own monitoring systems to ensure any concerns raised about practice are quickly identified, addressed and staff are supported to take a team approach to implementing changes. Suitable records are kept of the maintenance and servicing carried out on appliances and equipment. Environmental risks assessments are also undertaken and regularly reviewed. Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 25 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 2 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 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 2 2 3 Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 26 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 When medication is administered to service users it must be recorded accurately to ensure their healthcare needs are fully safeguarded. All staff must be trained for protecting service users from being harmed or suffering abuse or being placed at risk of harm or abuse. Timescale for action 21/12/07 2. OP18 13.6 15/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP3 OP7 OP7 Good Practice Recommendations Assessment process for self-funding service users should be reviewed to ensure all care needs are identified and details recorded of how these can be met. Care plans should include detailed information about known behaviours and appropriate responses to ensure service users receive a consistent level of care. Staff should be provided with training to improve their recording skills to ensure accurate monitoring and DS0000069175.V342924.R01.S.doc Version 5.2 Page 27 Karam Court Care Home evaluation takes place of service users needs and how these are met. Care plans should be amended in a timely manner to ensure service users needs are appropriately met at all times. Whenever “as required” medication is prescribed to sedate or calm a service user detailed information should be provided of the process to be followed before a decision is made to administer the medication. The corroded clinical waste bin in the ground floor bathroom should be replaced to reduce the risk of infection. A more planned approach should be developed to meet the individual training needs of staff. The system implemented to assess the competency of staff in specific aspects of their work should be completed in a reasonable timescale and the evaluation of their practice recorded on her/his file. The managers own monitoring systems should be reviewed to ensure any concerns raised about practice are identified quickly and addressed. 4. OP9 5. 6. OP26 OP36 7. OP36 Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 Karam Court Care Home DS0000069175.V342924.R01.S.doc Version 5.2 Page 29 - 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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