Inspection on 18/07/06 for Little Heaton Care Home

This inspection was carried out on 18th July 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Little Heaton Care Home 25/09/07

Little Heaton Care Home 30/01/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Little Heaton Care Home Little Heaton Walker Street Middleton Manchester Greater Manchester M24 4QF Lead Inspector Jenny Andrew Key Unannounced Inspection 18th July 2006 08.30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Little Heaton Care Home DS0000064013.V296215.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. Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Little Heaton Care Home Address Little Heaton Walker Street Middleton Manchester Greater Manchester M24 4QF 0161 655 4223 0161 654 0200 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) Little Heaton Care Limited Sandra Beatrice James Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25), Physical disability (2) of places Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 25 service users to include:up to 25 service users in the category of OP (Older People); up to 1 male service user in the category of (PD) Physical disabilities under 65 years of age). The service should employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. The homes manager must be supernumerary to the rota for at least 20 hours per week in a management capacity. 30th January 2006 2. 3. Date of last inspection Brief Description of the Service: Little Heaton is a converted church building situated in a quiet street off the main road into Middleton and Manchester. It is registered to provide personal care for up to 25 elderly persons in 13 single and 6 double bedrooms. The home is on a main bus route with easy access to the motorway network. Local shops are situated close by. Disabled access was provided by ramps and a passenger lift. The home did not provide nursing care. There was one lounge/dining area and a separate smoking lounge. Whilst there was no garden, residents could sit outside in the car parking area or in the church grounds. The weekly fee, as at July 2006, was £326.00. Additional charges were made for private chiropody, hairdressing and newspapers. The provider made information about the service available upon request in the form of a Service User Guide and Statement of Purpose, which was given to new residents. A copy of the most recent Commission for Social Care (CSCI) inspection report was held in the office. Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit took place over 6 hours with one Inspector. The inspector looked around parts of the building, checked the records kept on residents to make sure staff were looking after them properly (care plans) and other records the home needed to keep, to run its business. The inspector also spent time watching how staff cared for and spoke to the residents. The manager was at the home during the inspection. In order to obtain as much information as possible about how well the home looked after the residents, the manager, assistant manager, cook, domestic, 2 care assistants, 6 residents and one relative were spoken with. In addition comment cards were sent out before the inspection to relatives, residents and professional visitors to the home. Of these 4 resident and 6 relative/visitors questionnaires were returned. Other information, which had been received about the service, over the last few months, has also been used as evidence in the report. What the service does well: What has improved since the last inspection? The staff were still offering activities to the residents each day and making sure they included the mentally frail people also. A new hoist had been fitted in the ground floor bathroom, which meant that residents could now choose to use this bathroom instead of having to go to the one on the first floor. Also some new non-slip flooring had been fitted in two of the toilets. Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 6 The cleanliness all around the home was much better as more cleaning hours had been given to the domestic staff. The manager had changed the hours worked by some of the staff so that during the evenings, there were more staff working to make sure that residents were looked after properly. When new staff started work, there was a good training programme in place which made sure they were shown the right way to do their job. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The admission process was good with residents being assessed before coming into the home to ensure their needs could be satisfactorily met. EVIDENCE: The Statement of Purpose and Service User guide had been updated to reflect the change in ownership of the home in November 2005. A copy of the service user guide was given to new residents but the manager said sometimes the relatives would keep this document. One resident said he thought he had a copy of the guide. The files for the 2 most recently admitted residents were checked and each contained a full care management assessment. The Social Services Department had funded the placements for both these residents and the care managers had done detailed assessments, which gave the reader a clear picture of the persons needs. In addition the manager had done her own preadmission assessment to ensure all the details were correct. Once the resident Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 9 had been in the home for a few days, another assessment was done which included a social history of that person. The care plans were then written using all the assessment information. The manager was good at making sure the home could meet the assessed needs of residents and when she felt they could not, she would not accept the person into the home. She also ensured that staff received the right training and records showed that 8 staff had done training in dementia care, 5 had done Parkinsons disease and 2 had completed loss and bereavement training. Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. Residents’ health and personal care needs were being met but this was not always reflected in the documentation, which could result in staff being inconsistent in their approach. Personal support was offered in such a way as to promote and protect residents’ privacy, dignity and independence. EVIDENCE: Three care plans were checked. They were of the pre-printed type with boxes to tick to indicate the persons’ needs. Problems could be experienced when staff were unable to find a section, which related specifically to an individual. With this type of care plan, staff should ensure that where the person’s needs do not fit one of the printed statements, that their care needs are recorded in full on the care plan, using additional sheets. The current plan also limited the recording space to expand on care and support needs. One example of this was where a person’s needs had changed due to a medical reason and he was no longer able to have a bath. The care plan did not record that staff should give a bed bath daily, as they were doing. In two instances, additional sheets had been used to give more information on personal care needs. All residents Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 11 spoken with felt they were being well cared for by the staff team and said their needs were being met. The 3 care plans had been signed by the individual residents and had been reviewed monthly. Residents’ bathing and foot care records were kept in a separate file but staff were not always recording when residents had received a bath. Two of the records showed the residents had not received a bath since 6th and 8th June respectively although the manager said this was incorrect and that both people were bathed weekly. Any records relating to residents personal care needs must be accurate and up to date and rather than being recorded in a bath file, should be recorded in the care plan file. All 3 care plans contained some social history details. This information was obtained as part of the assessment process, when the resident had been in the home for a few days. Whilst risk assessments were being done for nutrition, falls, general risks and skin care (Waterlows), when the outcome of the assessment was found to be medium or high risk, the care plan did not always show how the risks were to be managed. An example of this was where a nutritional assessment showed medium to high risk because a resident had lost a considerable amount of weight over a period of 2 months. The care plan did not record that the resident was to be supervised at mealtimes in order to be encouraged to eat more or that small snack meals throughout the day should be offered. The manager said the advice of the visiting dietician had been taken, but the advice had not been recorded. Another example was where a resident had been assessed at medium risk with regard to skin. Whilst a pressure relief mattress had been provided and turning charts completed by the staff, this information had not been included in the care plan. Moving and handling assessments were in place but these could be expanded upon to show how a person should be lifted e.g. if they have had a stroke, which is their strong side etc. The staff had recently had hoist training, due to a new sling having been bought for a resident. The staff were willing to support residents to take some risks, providing that a risk assessment was in place. A good example of this was where one resident liked to go out unaccompanied to the pub and local bookies, which he did very regularly. The manager and 5 care staff had received training on 15 July 2006, by a dietician, in the use of the new Malnutrition Universal Screening Tool (MUST). The manager was just about to start re-assessing the residents, using the tool and said she would be implementing the care plans for nutrition, which were Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 12 part of the MUST pack. Residents’ weight was being regularly checked and the home had the provision of sitting scales. All residents spoken with felt their health care needs were well met and said that if they felt ill, the staff would request a visit from their Doctor. The visiting District Nurse was spoken with. She said the manager and staff cooperated with her when she visited and followed any instructions given. A medication policy/procedure was in place, but one recommendation made in October 2005, by the pharmacist inspector for a homely remedies policy to be written had not been done. The morning medication round, done by the assistant manager, was observed during the inspection. She administered the drugs in accordance with the home’s procedures, except she did not obtain a second signature when giving out controlled drugs. Also the storage of controlled drugs was unsatisfactory. The controlled drugs of a resident on respite were in a blister pack, which would not fit into the night time, small double locked cabinet. Only the manager and assistant manager had keys to the larger medication units. The manager said this person had very recently been made permanent and she was in the process of liaising with the chemist for all future drugs to be sent in a bottle so they would fit in the night time cabinet. All staff, responsible for the administration of medication, had received training. The aims and objectives of the home reinforced the importance of treating residents with respect and dignity. Residents interviewed were all complimentary about how staff assisted them with personal care tasks and felt their privacy and dignity was respected at all times. This was also observed during the inspection. Residents were taken to the toilet without having to wait, toilet doors were closed and staff knocked on bedroom doors before entering. One resident, who came down for breakfast inappropriately dressed was persuaded to go back to their room, with a care staff to change. When the district nurse visited, the residents being seen were escorted to their bedrooms so they could be seen in private. The relative spoken to said he was more than satisfied with the way his mother was cared for and that she had lived there for many years and had always received good care from the staff. The returned relative/visitor questionnaires also confirmed satisfaction with the way the residents were looked after. Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 13 The induction training programme, which is now done by all new staff, included how to treat residents with respect and dignity. Residents were also encouraged to remain as independent as possible and this was observed during the inspection. Residents who were becoming less mobile were being encouraged to continue to walk, with the aid of their zimmer frames or walking sticks. The home was adequately equipped with necessary aids and adaptations, which promoted people’s independence. At mealtimes, whilst assistance was given where needed, residents were prompted by staff to continue to eat their meals themselves. Little Heaton Care Home DS0000064013.V296215.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Residents were able to follow their chosen lifestyles both in and outside of the home and varied and nutritious meals were provided. EVIDENCE: The provision of social activities continued to be addressed by the manager and staff team. Many of the residents living at Little Heaton were mentally frail but they were encouraged to join in with simple floor and ball games and staff spent one to one time with them. An activities book was kept where staff recorded what activities had taken place. Examples were as follows: going out for walks, music, reminiscence, “play your cards right”, bingo, cards, ball therapy, gardening. An outing to the theatre had been arranged and the Queen’s birthday had been celebrated with a party. On the afternoon of the visit, a quiz was organised, at the request of a resident and several were seen to enjoy this session. Feedback from 2 returned resident questionnaires commented “I enjoy taking part in the activities” and “activities are arranged but I choose not to join in”. Residents meetings were arranged and from the minutes, it was evident they were fully included in the planning of the outings and activity programme. A Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 15 request had been to re-introduce bingo and this had been done. A summer outing to Knowsley Safari Park had also been requested and the manager was in the process of arranging the trip for sometime in August. Residents religious needs were recorded on file and during the inspection, the local Vicar was visiting the home to give communion. He said sometimes the more able residents were able to come across to the church, which was only a few yards away and that they also sometimes went to the church fairs and coffee mornings. Feedback from the returned relative/visitor questionnaires indicated they were made welcome at the home at any time, were kept informed of important matters affecting their relative/friend and were satisfied with their overall care. Residents spoken to said they were able to make choices in their daily routines such as times to get up and go to bed, what to wear, where to sit and use of their rooms. Residents’ finances were handled mainly by their relatives. However, money was held by the home for some of the residents who could request this money whenever they wanted to. The finance records of one resident showed they had money on an almost daily basis as they enjoyed going out into the community. The manager had recently drawn up new four weekly menus and these were seen during the inspection. She had consulted with the residents, both on a group and individual basis, before changing the menus. They had requested more trifles, cream cakes and beef burgers/hot dogs and for liver and ordinary sausages to be taken off the menus. This had been done. Cream cakes were now being offered over the weekend and trifle was offered twice over the four week period. Hot dogs had been added as a teatime meal. The new menus were to start on 31 July 2006. A large wall mounted board, outside the kitchen, displayed the daily menus. The current menus were varied and offered a good selection of fish, meat, fresh and frozen vegetables and fruit. Whilst an alternative meal was not offered either at lunch or teatime, there was a large sign on the dining room wall, next to the serving hatch, stating what daily alternatives residents could have. A returned resident questionnaire commented “I am usually offered something different if I don’t like what’s being offered”. The cook said both she and the other cook knew the residents likes/dislikes and would offer them something else when they knew they did not like what was on the menu. The residents spoken with all felt the meals were good but one questionnaire said the meat was sometimes tough. The inspector sampled the lunch time meal of lamb casserole, boiled potatoes and carrots/swede. The meat was very tender and tasty and the vegetables were not over cooked. A fruit crumble was the dessert offered. At teatime the menus offered sandwiches several times a week or snack type meals such as beans/egg/cheese on toast but home baked cakes or a dessert were also offered at teatime. A substantial supper such as Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 16 crackers, sandwiches, toast, biscuits or cake was available to residents, which many enjoyed. Staff offered residents second helpings at lunchtime and also asked if they wanted more to drink. The special dietary needs of the residents were being met with soft/liquidised and high fibre food being given. At both breakfast and lunch, it was observed that the more dependent residents were being taken to the dining tables far too early and were waiting for long periods for their meals to arrive. This had in fact, been brought up by a resident during a resident meeting but clearly, the practice was continuing. The manager said she would speak to the staff about this. Little Heaton Care Home DS0000064013.V296215.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. An effective complaints system was in place which residents were familiar with and staff training and good recruitment practices ensured that residents were protected from abuse. EVIDENCE: A clear, easily understandable complaints procedure was in place which was included in the service user guide and statement of purpose. It was also displayed in the entrancehall of the home and a copy was in all of the bedrooms. A complaints log book was in place but no complaints had been recorded over the last 12 months. Neither had the Commission for Social Care Inspection had cause to investigate any complaints. Rochdale Social Services Department had been involved in the investigation of a complaint but had decided this was not a protection issue. However, the manager had not logged it as a complaint but had recorded it in a non-compliance book. This was discussed during the inspection and it was agreed that in future, all complaints would be appropriately logged in the correct book. The residents spoken with all felt they could speak to any staff about problems and that they would be listened to. The returned questionnaires also indicated that they knew who to complain to. Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 18 More than half of the staff had already completed NVQ level 2 training which included units on elderly abuse. In addition, the training records showed that all but the newest care assistant had attended the Rochdale MBC Protection of Vulnerable Adult course. Staff files showed that Criminal Record Bureau checks had been done before any new staff started work so as to ensure that the staff were suitable to work with vulnerable people. The Rochdale MBC Protection of Vulnerable Adult policy/procedure was kept in the office so it was available to all the staff. Little Heaton Care Home DS0000064013.V296215.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home was clean, well maintained and provided a comfortable and homely environment for the residents. EVIDENCE: Since the new owner had taken over in November 2005, it was evident he had prioritised work on the environment. The manager had recently written a maintenance and renewal programme which was in the process of being implemented. A new bath hoist had been fitted in the ground floor bathroom and an extractor fan fitted in the smoking lounge. Also two of the toilets had new non slip flooring which had really improved their appearance. Redecoration work had also been done in communal areas and some of the bedrooms. The next priority was to have the electric storage heaters replaced and have gas central heating fitted throughout the home. This work was to be done before Winter. Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 20 Whilst the residents were able to sit outside the home, there was no safe enclosed garden area. The new provider was in negotiation with the local Vicar to see if they could lease some of the church land so that a small safe garden could be created. The majority of the residents spoken with were satisfied with their bedrooms and said they had brought personal items in with them. However, one resident did say she really did not like the colour of her carpet as it depressed her and she would like a different colour. Whilst the carpet was clean and in good condition, the provider may wish to consult with her and arrange to have a carpet fitted which is to her taste. Residents said they could get around the home fairly easily and appropriate aids and adaptations were fitted in bathrooms, toilets and corridors so that residents could remain as independent as possible. The manager said one resident was now able to move around the home better, as her walking stick had been replaced with a zimmer frame. An Environmental Health Officer had visited in February and left the cook a Safer Food folder which contained risk assessment documentation. A follow up visit had taken place in March and the Cooks were completing the necessary documents. At the last inspection, which took place in January 2006, several areas around the home were in need of cleaning. Since this time, the manager had employed another cleaner and the housekeeper had also been allocated some additional hours. She had also introduced a recording system, whereby the domestics signed when they had completed their cleaning tasks whether daily or weekly. This enabled her to monitor the home was being cleaned thoroughly. The cleanliness around the home was much improved and there were no malodours. Infection control policies/procedures were in place which staff were adhering to. All staff, including the domestics and housekeeper had received infection control training. At mealtimes, staff were seen to wear blue protective aprons or wear cloth tabards for serving food. Liquid soap and paper towels were supplied in toilets and bathrooms. Adequate laundry facilities were in place and individual baskets supplied for each residents clothes. Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 39 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. There was a good match of well trained and qualified staff offering consistent care to the residents. EVIDENCE: The home had 16 people living there with one respite stay resident, just having returned home. The manager said they regularly had people on respite visits and several had chosen to come in on a permanent basis. For this number of residents there were 3 staff covering the morning and afternoon shifts and two night staff. Following a requirement made at the last inspection, the late afternoon/early evening shift patterns had been changed to ensure that 3 staff were also on duty during the evening up to either 8.00 or 9.00 p.m. This cover depended upon the needs of the current resident group i.e. what time people wished to go to bed. This ensured the residents health and personal care needs could be met. The provision of ancillary staff was also satisfactory with cooks, domestics, handyman and housekeeper being employed. Residents spoken to were all very complimentary about the staff team and felt they were well cared for. One returned questionnaire commented “sometimes there is a shortage of staff”, but staffing levels were adequate at the time of the inspection. Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 22 Staff feedback indicated they felt they worked well together as a team and as a result, they gave good consistent care to the residents. There had been no change in staff, since the January inspection which meant they knew the residents individual preferred routines and likes and dislikes. The preinspection questionnaire showed that all necessary policies/procedures were in place, including equal opportunities. The team was small with 14 carers currently being employed. There was a good skill and age mix of staff. The team was all white which matched the ethnicity of the current resident group. There were 3 male carers, which ensured that the 4 male residents could choose to have the assistance of a male carer. Staff training was given a high profile, with the manager ensuring that staff were given opportunities to enable them to strengthen and develop their skills and knowledge. Eight of the 14 care staff had completed their NVQ level 2 training although 2 were still waiting to receive their certificates. A further 3 were to start the training in September 2006. One of the senior carers had also successfully completed level 3 training. The home had therefore achieved more than 50 of trained staff. In addition to the above, the team had all received training in fire, infection control, and with one exception all had done moving/handling training. Thirteen staff had done first aid, 10 had done food hygiene and 9 health and safety training In addition 8 staff had done dementia training, 5 Parkinsons disease and 2 loss and bereavement training. The evidence of staff completing training was seen in their personnel files where all certificates were kept. The manager was in the process of identifying courses for the remaining staff to undertake the mandatory training. Policies and procedures were in place for the recruitment and selection of staff. Two staff files were checked for the most recently recruited carers. The files were in order and contained all the required checks. Copies of the General Social Care Conference, “Code of Practice” were given to new staff as part of their induction process. The homes in-house induction training was to the National Training Organisation specification. As only one new staff had started work this year, their file was checked. It contained a full induction training record, which had been endorsed and signed by the manager. It cross-referenced the mandatory training that the employee had done and showed what training was still outstanding. This was being addressed. Regular staff meetings for night staff, day staff and ancillary staff took place as well as regular supervision. Little Heaton Care Home DS0000064013.V296215.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The manager provided good leadership, guidance and direction to staff to ensure residents received safe and consistent care. EVIDENCE: The manager had been in post for just over 12 months. In this time she had worked hard to improve the environment and care practices, which had, in turn, improved the quality of life for the residents. She was currently undertaking her Registered Manager’s award and had just 3 more units to complete. Some delays had been experienced due to the college assessor being off sick. She was hoping to have finished the course by September/October 2006. Although it was identified at the last inspection, that the home did not have internet facilities, the provider had not addressed this shortfall. In order to keep herself updated of best care practice, the Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 24 manager was having to use her own computer at home to access appropriate web sets including that for the Commission for Social Care Inspection. Residents knew who the manager was and felt they could speak to her if they had a problem. She sometimes covered a shift and worked alongside the staff, enabling her to monitor staff practice. The manager was in the process of completing assessment documents to register with Investors in People. Whilst some formal quality assurance monitoring measures were already in place, these could be further improved. Good practice was noted in that regular resident and staff meetings took place, questionnaires for relatives and residents were available in the entrance hall and compliment letters and cards were displayed. A staff training matrix had been drawn up so the manager could easily see which staff still needed to do training and she had also written a general maintenance plan for the years 2006-7. It was however, noted that the number of completed resident/relative questionnaires was low and the manager needed to devise a system whereby these could be completed more regularly. Staff and professional visitor questionnaires should also be formulated and circulated regularly. Results of surveys undertaken should be included in the service user guide and a copy forwarded to the CSCI. The systems in place for the recording of residents’ finances were in order with income and outgoings being recorded. The system had been improved since the last inspection, with the manager ensuring that podiatry and hairdressing receipts showed which residents had received the services. Secure facilities were provided for the safe keeping of money and valuables and receipts retained for any purchases made on behalf of residents. From information received on the pre-inspection questionnaire, it was identified that all the relevant maintenance health and safety checks had been carried out at the correct times. When randomly sampling some of the documents, it was noted that at the last lift service, several areas were identified which needed attention. These had not yet been done and the provider must provide a written account that the work is non urgent. Other health and safety records were in order, for example accident recordings and water temperatures. As stated in the staffing section above, the majority of the staff team, including ancillary staff, had attended the necessary health and safety training. The manager said she would send the remaining staff on the next available courses. Little Heaton Care Home DS0000064013.V296215.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 2 8 3 9 2 10 3 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 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Little Heaton Care Home DS0000064013.V296215.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 OP7 Regulation 15 Requirement The care plans must accurately reflect all the health and care needs of each resident. Where residents have been assessed as medium or high risk in relation to nutrition, skin care, falls etc. the care plan must record how the risk is to be managed. When controlled drugs are administered, 2 staff must sign the register. All controlled drugs must be safely stored as stated in the medication policy. The quality assurance and monitoring system must be improved. The recommendations made by the lift engineer must be implemented unless the provider can demonstrate that they are non urgent and do not compromise the safety of the residents. Timescale for action 30/09/06 2. OP7 13 30/09/06 3. 4. 5. 6. OP9 OP9 OP33 OP38 13 13 24 23 30/08/06 30/08/06 30/09/06 30/08/06 Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations As the existing care plans were pre-printed and did not have much space for additional comments, extra sheets should be kept with the care plans so that staff will be encouraged to expand on certain areas. Residents’ individual bathing records should be kept in their care plan file. Consideration should be given to the development of a homely remedies policy in agreement with residents’ GP’s and the supplying pharmacist. (This was a previous recommendation, which has not been implemented). Residents should not be assisted to the dining room until their meal is ready to be served. Internet facilities and a printer should be available within the home. 2. 3. OP7 OP9 4. 10. OP15 OP27 Little Heaton Care Home DS0000064013.V296215.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Little Heaton Care Home DS0000064013.V296215.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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