Inspection on 22/07/08 for Korniloff

This inspection was carried out on 22nd July 2008.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Korniloff 09/09/09

Korniloff 18/01/08

Korniloff 16/01/07

Korniloff 15/06/06

Korniloff 30/09/05

Korniloff 12/04/05

Korniloff 10/11/04

Korniloff 06/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Korniloff Warren Road Bigbury-on-Sea Kingsbridge Devon TQ7 4AZ Lead Inspector Andrea East Unannounced Inspection 12.45p 22nd July 2008 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 Korniloff DS0000003732.V364744.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. Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Korniloff Address Warren Road Bigbury-on-Sea Kingsbridge Devon TQ7 4AZ 01548 810222 01548 810222 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) Mrs Georgina Suzanne Phillips Mrs Georgina Suzanne Phillips Care Home 17 Category(ies) of Dementia (17), Old age, not falling within any registration, with number other category (17), Physical disability (17) of places Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 2008 Brief Description of the Service: Korniloff is situated in Bigbury on Sea and has extensive sea views. Bigbury on Sea is a small coastal village with limited facilities. The home is registered to provide care for seventeen older people who may have physical disabilities or dementia. The accommodation comprises of eleven single and three double rooms. All of the rooms are currently used as single accommodation. The property is a detached three storey building with the bedrooms situated on the lower ground floor and the first floor. These can be accessed by two chair lifts. There are three spacious lounges and a dining room. Fees are charged weekly; at present fees range between £372 and £475 per person. The homes service users guide including the last inspection report was available on request and stored in the homes office. Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality services. The inspection site visit was carried out over a day. A range of documents including staff and individuals’ files, policies and procedures were examined. People were spoken to in the homes lounge and in private rooms and members of staff were also spoken with. The homes owner/registered provider and acting manager was (who is not yet registered with the Commission) was present throughout the inspection. Feedback about the home was also received by post in survey questionnaires, and in the homes Annual Quality Assurance Audit. What the service does well: People were well cared for and people said that they received care and attention, throughout the day from the staff on duty. Staff offered support to people who needed assistance and helped people at a pace that suited them in a kind and patience way. There was a good system of medication administration in place and medicines administration records were up to date and in good order. This ensured that people received medication safely. Routines in the home were flexible so that people were able to choose how they spent their time, what time to get up and what time to go to bed. This also extended to open and flexible visiting arrangements so that visitors were always made welcome and could visit at any time. There were positive links with the local community outside of the home in regular coffee mornings, visits from relatives and church representatives. People enjoyed the contact with the local community and felt “as if we still belong”. There was a good meal service that one person described as “excellent”. People said that they enjoyed the meals provided and were able to eat meals in their rooms or in the homes dining room. Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 6 A written complaints procedure was available to staff and was included in the service users guide. This meant staff and the people using the service had access to information about the Commission and how to raise concerns. People said that they knew how to raise concerns and complaints with staff, the registered provider and the new acting manager. People said “I complain verbally” and just talk to somebody” The home presented as bright, clean and tidy. Large parts of the home had been redecorated and refurbished, including large lounge areas that had been redecorated, fitted with new heaters, additional lighting and new carpets. People were pleased with improvements to the environment and said that they enjoyed using these areas. There was a good recruitment system in place for the recruitment of new staff. This ensured that people were protected from those who are unsuitable to work with vulnerable people. People were positively supported to deal with their own finances, through relatives and outside advocates such as solicitors. Any finances dealt within the home were fully recorded, including receipts and records showing purchases made on behalf of the person living in the home. What has improved since the last inspection? A number of documents had been updated including a pre admission form and new formats for care planning and assessments. This had been more fully implemented and provided detailed information to staff to help them care for people safely and meet peoples’ needs. The newly developed assessments gave much more information to staff on peoples needs and were focused on how the person wished to be cared for. The assessments were more detailed, made clear that they were completed prior to people moving in and kept on individuals’ files. A new system for recording complaints had been introduced and clearly showed what concerns had been raised, how the home had dealt with concerns and how the concerns had been resolved. At the previous inspection, when measured the water temperatures from the hot tap in this bathroom and wash hand basin exceeded 43 degrees. Since then the bath in the upstairs bathroom had been fitted with a water regulator to ensure that water temperatures did not exceed 43 degrees. This had minimised the risk of scalding from full body immersion in hot water At the previous inspection the home had been cold so that people were sat wrapped in blankets and wearing additional knitwear. On this inspection it was a summers day so that the heating was not on. The registered provider and Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 7 acting manager said that had introduced a system of checking if the heating was on and people were asked if they were comfortable. What they could do better: Care plans and assessments did not always make clear if people had been involved in their care. The acting manager was aware of the need to encourage all staff to record in more detail the choices and involvement people have had in their care. The recording of formal and informal activities, while improved continues to need to be more detailed. To show how people have been involved in their care including how they spend social time and made decisions. Staff training could be improved. The acting manager and registered provider were unable to confirm that staff had received the planned training in safeguarding adults. This training should be completed as planned. Staff training in the use of medicines continues to be in need of updating for some staff. There remains a minimised risk of people being scalded. The registered provider said that water regulators had not been fitted to hand wash- basins. Risk assessment based on individual needs had been completed for each room and they included hand wash- basins. Risk assessment informing staff of potential hazards to the risk of scalding from hot water has reduced this risk. However the risk remains while hand wash- basins continue to be un-regulated. The registered provider said that the risks would be considered on an individual basis per person, per room. Water- valves should be fitted to wash-hand basins. Locks should be fitted to all private doors and it should be clearly recorded that they had been offered the choice of having a lock on their private doors. The staffing arrangements including the role of the manager must be reviewed and staffing increased to ensure that people’s needs are fully met. This would also enable the manager to complete management tasks, as management tasks such as; ensuring staff had supervision and training Staff records must show that members of staff receive updated training in key areas such as adult protection, health and safety and manual handling. There should be an overview of training for staff so that it was difficult to be sure what training had been completed, when and by whom. Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 8 Mrs Phillips was aware that the home needs a registered manager with the qualifications and skills to run the home. So that Mrs Phillips must either obtain the qualifications or register a manager for the home. Members of Staff must be supervised. The new system of supervision should be introduced consistently across all staff. A quality assurance system that measured the quality of the services provided and had taken into account peoples’ views should be fully introduced, as planned. 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. Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 9 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 Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 10 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people using the service were confidant that their care needs had been assessed and that their needs could be met, right from the start of their stay in the home. The services provided did not include intermediate care. EVIDENCE: The service users guide and statement of purpose had been updated at the last inspection. The acting manager said that they would be continuing to review and update the service users guide to include more photographs and give more details about the services provided. Three files holding a range of information on peoples needs were examined. Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 11 One file held information on the last person to move into the home. This file held information about the care needs, likes, dislikes and medical history of this person and had been completed prior to the person moving in. A new more detailed pre admission form had been created. This document was completed prior to someone moving into the home. The document on file for the new person moving into the home had been fully completed. The newly developed assessments gave much more information to staff on peoples needs and were focused on how the person wished to be cared for. The assessments were more detailed, made clear that they were completed prior to people moving in and kept on individuals’ files. Letters confirming that the home could meet people’s needs were now routinely sent out before people moved in. Copies of the letters sent were on each persons file. Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 12 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 good This judgement has been made using available evidence including a visit to this service. People’s care needs were clearly set out in an individualised plan of care. People using the service had their health, personal and social care needs met. People were protected by the policies and procedures in the home for dealing with medication. Staff training in this area could be improved. People were involved in decisions about their lives, and did play an active role in planning the care and support they received. This was not always as well recorded as it could have been. EVIDENCE: Three files holding a range of information including care plans were examined. The registered provider and the acting manager had introduced, as planned a new system of care planning and assessment. Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 13 Information in care plans and assessments were much clearer, showing peoples needs and how the home was addressing peoples’ needs. Care plans and assessments need to be clear so staff have the information they need to meet peoples’ needs. Care plans and assessments did not always make clear if people had been involved in their care. The acting manager was aware of the need to encourage all staff to record in more detail the choices and involvement people have had in their care. The acting manager was aware that this continues to be an area of development, as people were involved but this was not always recorded. The new assessment and care- planning format replaced a diary system and pulled together a range of information from previous care plan and assessment formats. Care Plan reviews of peoples care and assessments were more specific. Reviews made clearer if the persons care had been considered and changed. People said that they felt well cared for that they received care and attention throughout the day. There was a good system of medication administration in place. For example, people were administering all or some of their own medication, risk assessments had been completed a lockable storage area was available for medication in the individuals rooms. In addition a treatment room was available to staff, in which medication were securely stored. A separate refrigerator was available specifically for medicines requiring cool storage. The medication administration records were up-to-date and in good order. Staff training in the use of medicines continues to be in need of updating for some staff. Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People’ s lifestyle in the home met their expectations and satisfied their needs. People who used the services were able to make some choices about their life style, and were supported to develop life skills. Social, educational, cultural and recreational activities met individual’s expectations. EVIDENCE: People said that the routines in the home of flexible, so that they were able to choose how they spend their time, what time to get up and what time to go to bed. People individual routines had been recorded in more detail, in care plans and assessments, so that it was clearer how people had chosen their routine. People said that visiting arrangements were open and flexible and that their visitors were always made welcome and could did it at any time. People Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 15 received visits from relatives and friends in their private rooms and in the Homes lounge areas. The registered provider and acting manager said that if they had not been able to introduce formal activities into the home, as planned. The registered provider described activities in the home as continuing to be informal and on a one-to-one basis. Such as discussion over newspapers, chatting while attending to nail care and speaking to relatives and visitors. More organised activities included a monthly relaxation class, slide shows twice monthly and communion monthly. Contact from the local community was good with monthly charity coffee mornings and a steady stream of visitors. The recording of formal and informal activities, while improved continues to need to be more detailed. Peoples’ choices of foods and drinks had been made clearer in assessment and care planning information. Nutritional assessments had been more consistently completed. This information had also been passed to catering staff, who clearly described peoples preferences, likes dislikes and any special dietary needs. People said they enjoyed the food provided and were observed choosing to eat in the homes dining room, or one of the homes lounges. People said that they felt a choice of menu was available. Staff were observed, assisting people with food or drink and they helped people, at a pace that suited them, with humour and patience. Korniloff DS0000003732.V364744.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): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People who used the service were able to express their concerns, and complaints and suggestions from those using the service, relatives or other visitors to the home were treated seriously. People were protected from abuse. Training for staff in safeguarding the adults in their care could be improved. EVIDENCE: People said that they knew how to raise concerns and complaints. People felt comfortable in talking with staff, the registered provider and the acting manager. The complaints procedure was available to staff and was included in the service uses guide. This meant staff and the people using the service had access to information about the commission and how to raise concerns. A new system for recording complaints had been introduced and clearly showed what concerns had been raised, how the home had dealt with concerns and how the concerns had been resolved. Recording complaints and concerns continue to be important, so that the acting manager and registered provider can look at the concerns and how they have been resolved. This gives an overview to enable the manager and Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 17 provider to address any reoccurring problems and helps to maintain the quality of service provided. The acting manager and registered provider were unable to confirm that staff had received the planned training in safeguarding adults Staff said that they were aware of potential abuse issues and how to report any concerns they may have. Staff said that informal discussion about safeguarding sometimes took place. Korniloff DS0000003732.V364744.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): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People lived in a clean bright pleasant environment. Health and safety issues related to the environment could be addressed more fully. EVIDENCE: All areas of the home were toured. This included the large lounge conservatory and dining areas, peoples’ private rooms and bathroom and toilets. The home was clean and tidy. Large parts of the home had benefited from recent redecoration and refurbishment. This included lounge areas hat had been redecorated and fitted with new heaters, lighting and carpets. Risk assessments identifying and addressing potential or existing hazards in the home environment had been started. Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 19 Risk assessment concerning un-regulated hot water supplied to hand wash basins had been completed. A risk assessment for the upstairs bathroom and hot water temperatures had been completed. This was displayed on the back of the bathroom door so that staff could refer to it. It also instructed staff to carry out water temperature checks and record them, which staff were completing. At the previous inspection, when measured the water temperatures from the hot tap in this bathroom and wash hand basin exceeded 43 degrees. Since then the bath in the upstairs bathroom had been fitted with a water regulator to ensure that water temperatures did not exceed 43 degrees. This had minimised the risk of scalding from full body immersion in hot water. The registered provider said that water regulators had not been fitted to hand wash- basins. Risk assessment based on individual needs had been completed for each room and they included hand wash- basins. Risk assessment informing staff of potential hazards to the risk of scalding from hot water has reduced this risk. However the risk remains while hand wash- basins continue to be un-regulated. The registered provider said that the risks would be considered on an individual basis per person, per room. Locks had not been fitted to all private doors. People said that they did not mind not have a lockable room and that they had been asked if they would like one fitted. At the previous inspection the home had been cold so that people were sat wrapped in blankets and wearing additional knitwear. On this inspection it was a summers day so that the heating was not on. The registered provider and acting manager said that had introduced a system of checking if the heating was on and people were asked if they were comfortable. Korniloff DS0000003732.V364744.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. Staff, had not been consistently trained, so people could not be sure that the staff were skilled and competent. Staff had been subject to rigorous recruitment checks. The low numbers of staff employed in the home sometimes affected the care people received. EVIDENCE: The registered provider and acting manager described the staffing numbers as “usually two care staff through out the day and two staff sleeping in over night. In addition there is one carer between eight in the morning until eleven in the morning”, depending on peoples’ needs”. The Registered Provider (who lives on the premises) and one member of staff sleeping in, provide the care at night. The registered provider said that waking night care staff, were provided when required (for example, when people were ill). Staff rosters showed that the numbers of staff on duty sometimes fell to two care staff on duty to care for up to twelve older people, with a variety of physical frailties and needs. Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 21 The numbers of staff on duty remain unchanged since the last inspection, when feedback from relatives and staff expressed concern about the numbers of staff on duty. Six out of six surveys from staff highlighted their concerns at the low numbers of staff on duty and how this affected peoples’ care. Surveys said “we have only two carers on shift day and night and we do laundry and cleaning” “We don’t have time to spend with the service users” “not enough staff for service users” “not enough staff to give correct care to service users. One survey from a health professional said that ‘the home could be improved’ by “more staff on duty”. One survey from a relative said ‘that they could be improved’ “by having more staff”. Recent surveys from staff, requested by the home, said that it would be “an advantage to the home and care team to have waking night staff ”. People said that most of the time staff were “lovely, helpful and tried hard but were often very busy”. The acting manager and registered provider were also working as part of the staff team. Due to continued staff sickness the acting manager was working as part of the care staff. This meant the acting manager was unable to complete management tasks, such as planning and delivering training, appraisals and supervision for staff. Care staff completed a range of tasks including domestic, catering, laundry, medication administration and caring. The arrangements for staffing the home both at night and day may place people at risk; Staffing at night did not take into account possible risks to people in the event of a fire and moving people. Staffing at night also does not take into account of peoples needs if they are taken ill suddenly. Since the last inspection one member of staff had been recruited. This persons files was examined and included recruitment information including staff roles and responsibilities a job descriptions, interview checklists and questions, references and police checks and identity checks. Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 22 The registered provider was in the process of recruiting staff to cover a member of staff who had been off sick for some time. This would release the acting manager from working hours as a carer. The acting manager and registered provider said that some staff had received training in first aid and that all staff had received fire training. Training in adult protection/ safeguarding people had not been completed. There was no overview of training for staff so that it was difficult to be sure what training had been completed, when and by who. The acting manager had been unable to proceed with planned training due to staff shortages and working as a carer. People said that they had no concerns about the skills and knowledge of staff as they said “staff seemed to know what they are doing”. Korniloff DS0000003732.V364744.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): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People live in an adequately managed home. Improvements could be made to make the home a more stimulating and safer environment. EVIDENCE: The registered provider retains overall control of the home, as the registered provider and manager. The acting manager had been appointed around the time of the last inspection. The registered provider said that the acting manager still intended to be registered with the Commission, as she no longer wished to actively manage the home on a full time basis. Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 24 The acting manager had a range of qualifications and skills in care and had been previously registered with the Commission for another home. The acting manager had not yet made an application to register with the Commission. At previous inspections another person had been acting as assistant manager with a view to registering as the manager. Mrs Phillips was aware that the home needs a registered manager with the qualifications and skills to run the home. So that she must either obtain the qualifications herself or register a manager for the home. Management tasks were shared between the manager and the registered provider. People were supported to deal with their own finances, through relatives and outside advocates such as solicitors. Any finances dealt within the home were fully recorded, including receipts and records showing purchases made on behalf of the person living in the home. Members of Staff were not properly supervised. The acting manager had developed a system of supervision, which had not yet been introduced consistently across all staff. This was also highlighted a the previous inspection (please also see staffing) Since the last inspection the protection of Peoples’ health and welfare have improved. For example people were no longer cold, complaints were dealt with formerly and risk assessments for the premises had been started. Management tasks such as; ensuring staff had supervision and training and documentation such as environmental risk assessments were up to date, had not been completed as planned. This appeared to be due to the acting manager working as part of the care staff so that she was unable to complete management tasks. A quality assurance system that measured the quality of the services provided and had taken into account peoples’ views had been partly introduced. The acting manager was working on a quality assurance system and a form had been devised to ask people what they thought of the service. A survey form for staff had been completed and some of the comments from those surveys have been included in this report. Health and safety issues such as reducing the risk of scalding had been partly addressed. Korniloff DS0000003732.V364744.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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 2 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 2 x 2 Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? YES 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 OP18 Regulation 13 Requirement All staff, including the registered provider must be aware of adult protection issues and how to safeguard the people who use the service and staff from harm. This relates to the lack of training on adult protection and safeguarding issues. 2 OP27 18 The arrangements for staffing the home both at night and day Must be reviewed and increased to ensure that peoples needs are fully met. 06/12/08 Timescale for action 06/12/08 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 Refer to Standard OP9 Good Practice Recommendations Staff should receive updated training on medication administration to ensure that medication continues to be DS0000003732.V364744.R01.S.doc Version 5.2 Page 27 Korniloff administered safely. 2 OP12 Peoples’ individual routines including social and recreational activities should be recorded, in detail, in care plans and assessments. People must have the opportunity to participate in and be consulted with regarding social, recreational and educational activities that suit them. Peoples should have the choice of rooms that have been fitted with locks and have been offered a key unless sufficient reasons for not offering this service are recorded in the care plan. Locks must be lockable from the inside and capable of being overridden in an emergency. Staff records must show that staff receive updated training in key areas such as adult protection, health and safety and manual handling. An overview of training for staff should be completed as planned so that it is clear what training had been completed, when and by whom. Mrs Phillips as the registered provider should either obtain the qualifications to manage the home affectively herself or register a manager for the home. A quality assurance system that measured the quality of the services provided and had taken into account peoples’ views should be fully introduced, as planned. Members of Staff should be supervised. The new system of supervision should be introduced consistently across all staff. Water valves regulating the water temperature should be fitted to hand wash- basins to minimise the risk of scalding. 3 OP14 4 OP19 5 OP27 10. OP27 11. OP31 12 OP33 13 OP36 14 OP38 Korniloff DS0000003732.V364744.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Korniloff DS0000003732.V364744.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. 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. 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