Inspection on 09/09/09 for Korniloff

This inspection was carried out on 9th September 2009.

CQC found this care home to be providing an Adequate service.

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

Korniloff 22/07/08

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 25/11/2009.

Key inspection report CARE HOMES FOR OLDER PEOPLE Korniloff Warren Road Bigbury-on-Sea Kingsbridge Devon TQ7 4AZ Lead Inspector Andrea East Key Unannounced Inspection 9th September 2009 10:40 DS0000003732.V376725.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Korniloff DS0000003732.V376725.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 Manager post vacant 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.V376725.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd July 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. A service users’ guide (including the last inspection report) is available on request from the home. Korniloff DS0000003732.V376725.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. Several weeks before this inspection took place we asked the provider to complete an Annual Quality Assurance Assessment (this document is referred to as an AQAA). The completed form was returned when we asked for it and it provided us with some useful information about the home and the way it has been managed. We also sent some survey forms to the home and asked them to distribute these. We received two completed forms from people living in the home and one from a health care professional. Their responses have helped us to form the judgements we have reached in this report. Our visit to the home began at approximately 10.40am and finished at approximately 6.40pm. On the day of this inspection there were 10 people living in the home. On arrival at the home the provider was present, plus 2 care staff and 1 cook. Later in the day the person who has recently been appointed as manager of the home (not yet registered) arrived. During the day we carried out a tour of the home. We looked at four care plan files to find out how the home had assessed people’s needs before they moved in, and how they had met those needs in the last year. We also looked at other records the home is required to maintain including medications, staff recruitment and training records, and records relating to people’s health and safety. We talked to the owner, the new manager, two care staff, a cook, and four people who live in the home to find out what it is like to live at Korniloff. What the service does well: Any person who may be thinking about moving will be given information about the home and opportunities to visit or have a short stay before any decision to move in permanently is made. They have thorough assessment procedures in place to help them find out about their health, mobility, social network, and about their preferred daily routines. This means that people will not be admitted unless the home is confident they will be able to provide the care and services the person needs. There are clearly written care plans in place that give staff good information about the tasks they must carry out each day to support people with all their personal and health care needs. The home has also considered any possible health risks people may face and any actions they can take to reduce those risks, including provision of specialist equipment. Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 6 The home has followed safe procedures for the storage and administration of medicines. Good records have been maintained to show medicines received into the home and administered. Staff have received training on medicine administration. People are offered a varied and healthy range of home cooked meals to meet individual dietary needs, likes and dislikes. There are good procedures in place to make sure people can raise any concerns or complaints and feel confident they have will be listened to and acted upon appropriately. What has improved since the last inspection? What they could do better: People should be fully consulted when drawing up a care plan to make sure the information is correct. Where possible, either the person or their representative should sign and date the document to confirm it is correct and to show that they agree with the content. We were uncertain that the storage facilities and record book for controlled drugs met with current legislation and we advised the home to check this with their pharmacist. Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 7 There is a timetable of activities displayed in the home but this has not been regularly followed so we recommended that a new programme should be drawn up after consulting with each person to make sure the programme covers all individual interests. The home does not give people a menu to show what meals will be provided each week. We suggested that people should be consulted about the meals regularly offered and menus should be drawn up to meet people’s preferences and dietary needs While many areas of the home appeared bright, clean and comfortable a few areas showed signs of wear and tear, including the carpet on the first floor corridor. Any furniture that is showing signs of wear and tear should be repaired or replaced. The home must improve their recruitment procedures to make sure vulnerable people living in the home are not placed at risk of harm or abuse. At least two satisfactory written references and a criminal records bureau (CRB) check and protection of vulnerable adults (POVA 1st) must be received before new staff are confirmed in post, and before new staff begin working directly with vulnerable people. We also recommended that an overview of staff training should be completed so there is clear evidence to show what training had been completed, when and by whom, and to show when future training and updates should be completed. A new manager has recently been appointed. An application to register her should be submitted to the Commission so that we can check her qualifications and experience and be satisfied that she is fit to manage the home. Further improvements to the home’s quality assurance system should be made to take into account the views of everyone who lives or works in the home, and also relatives and professionals who regularly visit. Where cash or valuables are held on behalf of those people who do not want to, or are unable to hold this for themselves the home should follow careful recording systems that include methods for checking and double checking the balances to ensure they are correct. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Korniloff DS0000003732.V376725.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 Korniloff DS0000003732.V376725.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4, 6 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given good information and opportunities to visit and get to know the home before any decision to move in is made. The home follows good assessment procedures so that they can confidently assure people that their care and support needs can be met. EVIDENCE: The new manager had recently reviewed and updated the statement of purpose/service user guide and the document had been updated in large print so that people could read it easily. We heard that this document will be offered to anyone thinking about moving in. Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 10 We talked to one person who had moved in since our last inspection. We were satisfied that the home had gathered good information about the person before they moved in. The care plan files contained assessment information received from Social Services and the home had also used their own comprehensive assessment form that guided them to gather information on a wide range of health and personal care needs for each person. Where people had moved to the home straight from hospital there were copies of the patient transfer documents giving information about the treatment they had received and any health or personal care needs they had, including skin care and the risk of pressure sores. There was also good information about any infections they may have had. The care plan files we looked at contained letter the home had written to the person after their assessment to confirm the home would be able to meet the person’s needs. People have been offered respite or short stays at the home in the last year. This has given people opportunity to stay at the home for a short period to help them get to know the home and decide if they want to move in permanently. We talked to one person to find out about the way they were admitted into the home. They told us they had lived in several other homes before moving to Korniloff and said “This is the best one I’ve been in”. The home does not provide intermediate care. Korniloff DS0000003732.V376725.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have been given good information in clearly written individual care plans about the personal and health care support each person needs every day. The home has followed safe procedures for the storage and administration of medicines. EVIDENCE: We looked at the four care plan files and looked at the other records held by the home relating to the care of these people, including medications an daily reports. We found the files contained a very thorough risk assessment section covering a wide range of possible health risks including skin care, mobility, Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 12 mental health problems, and nutrition. Where possible risks had been identified this information was transferred to the care plan section to explain the person’s care needs and the tasks the staff should carry out. The files contained important information about the person and key people in their lives including family and friends, and legal and health professionals. There was also evidence of agreements relating to self medication, and whether the person wanted a lock on their bedroom door. There was a page containing an overview of the person’s usual daily routine including getting up/going to bed, when they wanted a bath or shower, and when their bed should be changed. There was also a page that provided useful information to staff about the medication the person was on and any aids or equipment needed to assist with mobility. There were clear and detailed instructions on stoma care for one person. Another person received daily visits from the district nursing team for insulin injections. The main care plan documents covered a wide range of care needs and clearly explained the tasks people needed assistance with. The plans guided staff to offer people choice in all aspects of their daily care. The plans contained review sheets that showed that they had not been reviewed since March 2009. The new manager told us she had recently introduced a new keyworker system. Staff had been given some instructions and they were aware that they would be responsible for reviewing the care plans in the future. None of the plans had been signed by the person to show that they had been fully consulted when the care plans were drawn up – this is recommended. We talked to each of the four people whose care plans we had read. They assured us that they were very happy with the support they received from the staff. We heard that staff were available to help them whenever they wanted assistance. One person said that the staff answered the call bell promptly whenever they needed assistance and they were always cheerful and kind. We looked at the way the home stored and administers medicines. There is a ‘treatment room’ where medicines are stored. This room is locked when not in use. Medicines are stored in a trolley and separate cupboards. Stocks had recently been checked and any medicines no longer required had been returned to the pharmacy. The home used a monthly monitored dosage system supplied by their local pharmacy. People who wanted to hold their own medicines had been supported to do so safely by the home. Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 13 Records of medicines administered had been well maintained and there were good accounting and checking procedures for medicines received into the home, and any still held in the home at the end of each month – these amounts were carried forward to the next month. Staff confirmed that they were in the process of completing training on the safe administration of medicine. Controlled drugs were stored in a metal locked cupboard but we were unsure if the cupboard met current legal requirements for security and asked the home to check this with their pharmacist. The controlled drugs record book did not contain numbered pages and we asked the home to talk to their pharmacist about safe recording methods. Medicines that must be kept cool were stored securely in a refrigerator supplied specifically for medicines. Temperatures were checked regularly. Korniloff DS0000003732.V376725.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. While the level of activities offered to people has increased over the last year the home could do more to ensure people’s individual interests and social needs are met. People are offered a varied and healthy range of home cooked meals to meet individual dietary needs, likes and dislikes. EVIDENCE: There was a plan of activities displayed in the hallway but we heard this had not been regularly followed in recent months, although the level of activities has increased in the last year. Some of the activities that have been provided recently included bingo, musical entertainment, quizzes, dancing, and Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 15 handicrafts. The staff told us the emphasis is on people enjoying themselves and they said there is always lots of fun and laughter. The day before this inspection professional musicians called ‘Tranquil Moments’ visited the home. They have also had visits from a harpist. A new large screen plasma television has been installed in the main lounge and people often enjoy watching films of their choice on DVD. A coffee morning is held in the home on the first Wednesday of every month and we heard that these have been very popular and successful and have raised money for charity. We suggested that the home consults with people about the activity plan so that people have good information about the regular activities offered, and to make sure that the home regularly offers activities to meet all individual interests. We asked about how the home met people’s spiritual needs. We heard that some people used to go out regularly to church but none do so currently. Holy Communion is held in the home regularly for those people who want to participate. One person who completed a survey form before this inspection told us “The staff are always patient, respectful, very helpful and kind. The home is very comfortable and always welcomes visitors who come to see their relatives and friends.” Another person told us they would like the home to offer more outings. We heard that the providers are considering purchasing a vehicle that can be used to take people out it. The home employs two cooks who work on a part time basis to provide the main meals over seven days a week. We talked to the cook who was on duty on the day of this inspection to find out about the meals provided. The cook told us she has a record of each person’s likes and dislikes, and of any special dietary needs. She said that she plans the menus each week and records of meals actually provided were seen in a daily diary. The records showed that people were offered a good variety of fresh and frozen vegetables. We also saw that people who did not like the main meal offered had been given an alternative of their choice. No printed menus had been drawn up and we suggested this is done so that people know in advance the meals that will be offered. We also recommended that people are consulted about the menus. Both cooks make home made cakes on a regular basis. This includes low sugar cakes for people who are diabetic. Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 16 We asked four people who live in the home about the food offered and they told us it was always good, and always something they liked. The dining room appeared bright and homely. Tables had been attractively laid with matching table cloths. The dining chairs did not match and some appeared old. One chair with torn padding was replaced during our visit by the provider as soon as it was pointed out to her. . Korniloff DS0000003732.V376725.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that any concerns or complaints they have will be listened to and acted upon appropriately. The home has good procedures in place to reduce the risk of people suffering harm or abuse. EVIDENCE: The home’s complaints procedure was clearly displayed in the entrance hallway and the new manager said she was about to make sure people are given a copy in the recently updated service user guide. The people we talked to, and the people who completed a survey form before this inspection, said they knew who to talk to if they were unhappy about anything, and they knew how to make a complaint. The home has kept a record of all complaints received in the last year. No serious concerns have been received by the Commission about the home in the last year. Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 18 At the last inspection we found that the provider and staff had not received training on adult protection issues. During this inspection we saw evidence to show that all staff have received training on adult protection and safeguarding issues Korniloff DS0000003732.V376725.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, bright and comfortable environment. The providers are undertaking a programme of upgrading that should bring the home up to a good standard when complete. EVIDENCE: Korniloff was previously hotel and it still retains some of the features of it’s former use, including a bar area. There is a large lounge with panoramic views over Bigbury Bay. There are also smaller sitting areas and a dining room providing plenty of places people can sit, and where they can entertain visitors if they choose. Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 20 In a tour of the home we found that all areas were clean, bright and comfortable. Contract gardeners have been employed to keep the gardens neat and tidy. In recent years some new carpets have been laid in many areas of the home and some bedrooms have been refurbished to provide en suite facilities. At the time of this inspection the owners were in the process of refurbishing another bedroom and had plans for more rooms to be upgraded in the future. The work already completed has been of a good standard and has resulted in rooms appearing bright, modern and attractive. However, there were some areas that would benefit from some attention to the decoration and carpets to bring the home up to the same good standard throughout. This included the carpet in the first floor corridors that needed to be stretched to remove wrinkled areas, or replaced. Some furniture was showing signs of wear and tear. Some windows have been replaced in recent years and these were in good order and provided people with a good outlook. However, some windows had double glazed units where the seals had broken and the windows had become misted. These needed replacement so that people can have uninterrupted views. We heard that the owners have plans to address these windows in the future. People have been offered a lock on their bedroom door if they want one – evidence of this was seen in the care plan files. All areas of the home were clean and there were no unpleasant odours in any areas. Staff have received training on infection control. The provider told us that carpets have been regularly shampooed. A new carpet washer has recently been purchased. The laundry was in good working order, clean and tidy. The washing machine had a sluice facility. People told us they were happy with the laundry service. The home told us they had taken action to comply with the report completed following a recent inspection of the kitchen by the Environmental Health Officer. This has included re-painting the kitchen walls and ceiling and providing a fly screen for the windows. Korniloff DS0000003732.V376725.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing levels have improved in the last year and at the time of this inspection they were sufficient to meet the needs of the people living in the home. Staff training has also improved and there was a programme of training that ensured staff had the skills they needed to meet people’s care needs. EVIDENCE: When we arrived at the home there were two care workers on duty, one cook, and the provider. There were 10 people living in the home and none of those were seriously ill or needing high levels of care. The staff were relaxed and cheerful and routines were carried out in a timely way. People told us they felt there were sufficient staff on duty at all times. The providers live on the premises and provide sleeping-in cover. They also employ one member of staff at night. Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 22 We looked at the recruitment files of four staff employed since the last inspection. We found that one member of staff had started work before satisfactory references and a criminal records bureau check had been received. Another person had been employed with just one written reference and a criminal records bureau check at least two satisfactory references are recommended as a minimum). It was unclear if the one reference received was from the person’s most recent employer. The third file we looked at showed the home had received on reference that had some areas that were unclear and should have been followed up to clarify the comments made. The actual start date for this person’s employment was not clear and therefore we were unable to check if the references and criminal records bureau check had been received before the person began work. The fourth file we looked at showed that two satisfactory references and a Protection of Vulnerable Adults (POVA 1st) check had been received before the person began work. However, care had not been taken to make sure that one reference had been obtained from the person’s former employer. We talked to the provider about the need to take good care when employing new staff to make sure they are entirely suitable for the post before they are offered the job, and before they begin work. (See also Management and Administration section). We looked at the training offered to staff since the last inspection. The new manager told us about the work she had recently undertaken to gather information on the training needs of the staff team. We heard that staff have received training on Parkinson’s disease, safe administration of medicines, infection control, and dementia (some staff were still in the process of completing these courses). There was also evidence of training on health and safety related topics including food hygiene, moving and handling, first aid and fire safety. We could not see if every member of staff had received all required training topics but the new manager assured us she was just about to complete a matrix that will provide this information. The home employed 12 staff, and of these 5 held a nationally recognised qualification known as NVQ’s. 4 staff were in the process of obtaining NVQ level 3 and 1 person was close to finishing NVQ level 2. This meant that, although the home did not meet the recommended level of 50 of staff to hold a relevant qualification, we could see they were close to achieving this, and when all staff have completed their training the home will have a high ratio of qualified staff. Staff meetings and staff supervision sessions have recently resumed since the new manager began working at the home and she told us she plans to hold Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 23 these regularly in future. She also plans to introduce annual appraisals for all staff. Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can feel confident that the home is well managed and safe, and their opinions will be valued and acted upon. However, people have not been fully protected by the some management procedures. EVIDENCE: At the last inspection the provider told the Commission that she did not want to actively manage the home on a full time basis and she had appointed a person to manage the home. It was intended that an application to register the Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 25 person as manager would be submitted. However, this person resigned several months ago and the owner retained responsibility for the day to day management of the home. At this inspection a new manager had been appointed and we heard that an application will be submitted to register her. When we receive an application for her registration we will check to make sure that she is suitably experienced and qualified for the position. A health professional who completed a survey form before this inspection took place told us “New manager recently appointed who is making positive changes. Care, communication and overall service has improved over the last month.” We saw evidence of a number of improvements in the management of the home since the new manager has been employed including care planning, staff training and staff supervision. However, staff recruitment that had been carried out by the provider and previous manager were poor and potentially placed people at risk. We looked at the way the home looked after money for those people who did not want to hold their own cash to pay for personal items such as hairdressing, toiletries or newspapers. The home had a separate cash wallet and paper record for each person they held money for. We checked two records and found two errors had been made when calculating the balances. We talked to the manager and provider about systems for checking and double checking all transactions and balances to ensure the records are always correct. At the last inspection we recommended that the home introduces a comprehensive quality auditing system. The home told us in their AQAA they have various methods for checking the quality of the services provided, including a complaints/suggestions and compliments book. They also send or give questionnaires to people’s families. However, they recognised that they need to improve their quality assurance systems. This could be achieved by holding resident’s meetings or giving questionnaires to people who live in the home, to staff, and to health and social care professionals. The new manager has spent considerable time updating all of the home’s policies and procedures. This has included policies relating to health and safety. In the last year a new fire log book has been introduced. The home told us in their annual quality assurance assessment that all equipment has been regularly serviced and repaired. Staff have received training on all health and safety related topics. Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 26 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 x 3 3 x N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 X x 3 Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 27 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 OP29 Regulation 19 Requirement At least two satisfactory written references and a criminal records bureau (CRB) check and protection of vulnerable adults (POVA 1st) must be received before new staff are confirmed in post, and before new staff begin working directly with vulnerable people. This is to make sure that new staff are entirely suitable for the job, and to ensure vulnerable people are protected. Timescale for action 01/10/09 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 OP7 Good Practice Recommendations The home should have evidence to show that they have consulted with each person when drawing up their care plan, and where possible the person (or their representative) should sign and date the care plan to DS0000003732.V376725.R01.S.doc Version 5.2 Page 28 Korniloff 2 3 OP9 OP12 4 5 OP15 OP19 6 7 8 9 OP27 OP31 OP33 OP35 confirm that the plan is correct. The home should seek specialist advice to ensure that their facilities for storing and recording any controlled drugs held in the home are safe. The home should consult with people about their social, recreational and educational interests and check that the plan of activities covers all interests. They should also make sure that the timetable is correct and people can be confident that they know what activities will be provided, and when. People should be consulted about the meals regularly offered and menus should be drawn up to meet people’s preferences and dietary needs. The owners should continue their programme of updating the home to bring all areas up to a good standard of decoration, furniture and flooring. Attention should be paid to carpets that are showing signs of wear. Any furniture that is showing signs of wear and tear should be repaired or replaced. 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 measures the quality of the services provided and takes into account peoples’ views should be fully introduced. Where cash or valuables are held on behalf of those people who do not want to, or are unable to hold this for themselves the home should follow careful recording systems that include methods for checking and double checking the balances to ensure they are correct. Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 29 Care Quality Commission Care Quality Commission South West Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Korniloff DS0000003732.V376725.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!