Inspection on 30/07/07 for Maplin House

This inspection was carried out on 30th July 2007.

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

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

Other inspections for this house

Maplin House 16/07/09

Maplin House 14/05/08

Maplin House 05/12/07

Maplin House 21/06/06

Maplin House 09/06/05

Maplin House 20/04/05

Maplin House 10/02/05

Maplin House 29/09/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Maplin House 117/119 Church Road Shoeburyness Essex SS3 9EY Lead Inspector Trevor Davey Unannounced Inspection 30th July 2007 10:30 X10029.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 Maplin House DS0000015450.V346245.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 and Care Homes for Adults 18 – 65*. 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. Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maplin House Address 117/119 Church Road Shoeburyness Essex SS3 9EY 01702 297494 F/P 01702 297494 laycraftlimited@yahoo.co.uk 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) Mr Mohammud Yousouf Meeajun Mrs Oume Mahani Abdool Raheem Care Home 16 Category(ies) of Dementia - over 65 years of age (2), Learning registration, with number disability over 65 years of age (16) of places Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home may admit up to five persons (of the above 16) who are over 50 years of age. The home may admit two people (of the above 16) who have a diagnosis of Dementia and whose details are known to the CSCI. Date of last inspection Brief Description of the Service: Maplin House is a large detached care home set in a sought after residential area in Shoeburyness/Thorpe Bay. The home provides accommodation for up to sixteen older people with some degree of learning disabilities. At the time of inspection, one person was being cared for who had dementia. Accommodation is provided on two floors, the home has eight single and four double bedrooms. There is a two bed roomed flat provided for staff living accommodation which is situated on the third floor of the building. The home has adequate communal areas on both floors and a shaft lift has been provided. There is limited outdoor space; the garden surrounds the property and has small areas that are suitable for seating. The home has its own mini-bus that is used for taking out residents which includes trips to the beach, shops and local parks. There is a bus route within a short walk of the home which goes to Southend town centre. There is a car park at the rear to building. All prospective residents are provided with a Statement of Purpose and Service User Guide that supplies them with information on the home. The current range of fees is from £350 to £600 per week and there are additional charges for chiropody, magazines, newspapers, toiletries and day trips. Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Key Inspection site visit took place over a period of 9.00 hours and covered all key standards. The Registered manager was on leave and the Registered provider arrived at the home at 2:30 p.m. Staff and residents were also spoken with during the site visit. Their comments and contributions received were helpful in assisting the Inspector to compile the report. As part of the inspection process, survey forms were made available for residents, relatives and other health care professionals to give them the opportunity to comment about the service. Some of these have since been returned by or on behalf of residents. Comments received were mainly positive about the service. There was no information provided by the home in the form of surveys or quality assurance at the time of the inspection. At the time of the inspection, eleven residents were being accommodated in the home and two of these were out attending day centres. As part of the site visit, a tour of the premises took place and some of the personal care records and other official records within the home were also assessed. On arrival at the home, the senior care assistant on duty assisted the Inspector and later during the day, a detailed feedback was given to the Registered provider. What the service does well: The home carries out a thorough assessment of prospective residents prior to admission to ensure that individual needs can be met. The core staff team has a good knowledge of residents and delivers appropriate care providing individual support where this is required. The home is well furnished, decorated and provides homely, clean accommodation. Residents have good access to the local community and some attend local day centres and clubs. The home’s vehicle is used regularly for transporting residents to shops and local amenities. A variety of meals is made available which takes into account residents’ choice and diabetic needs. Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Following the last inspection, a requirement was made in the report for the Statement of Purpose and Service User’s Guide to be reviewed and updated. The Inspector was advised by the Registered Provider that copies had been given to residents but the latest versions have not been received by the Commission. The staffing structure for the home needs to be reviewed to ensure there are sufficient levels of staff available on duty at all times which takes account of residents needs as well as domestic/housekeeping and meal preparation. Although mentioned in the last inspection report, thorough recruitment procedures are not being followed which could place residents at risk. The Registered provider needs to take a more robust approach to ensure that health and safety issues are properly monitored and potential hazards are identified, to minimise the risk to residents and staff. Evidence of servicing and maintenance checks was not always available (e.g. gas safety certificate). Any incidents involving residents which could affect their safety and well-being, need to be dealt with promptly with appropriate action being taken. Records in the home had not always been regularly completed and there were gaps between entries. Although there were care plans available, these sometimes lacked specific detail, and had not been signed or dated. From the sample checks made, risk assessments had not been completed. One of the bedroom doors had not been fitted with a proper door handle and closing device which could infringe the privacy and dignity of residents. Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 7 Some areas require decoration with fixtures and fittings being replaced as required. It is understood that residents’ meetings take place but the last recorded minutes were dated the 17th of October 2006. Although referred to in the previous inspection report, there was no quality assurance system in place and evidence as to whether the outcomes had been included as part of an action plan for the home. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 & 6 People who use the service experience good quality outcomes in this area. The Statement of Purpose and a Service Users Guide need updating to reflect changes in the home. Pre-admission assessment details for care/health needs had been completed to give staff suitable information and to assure potential residents that their needs could be met. Intermediate care is not provided by the home. This judgement has been made using available evidence including a visit to the service. Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 10 EVIDENCE: The Registered Provider advised the Inspector that residents had been given copies of the Service User’s Guide. Copies of this document and the Statement of Purpose were not available during the inspection and the last copy received by the Commission for Social Care Inspection was dated February 2004. These documents had not been reviewed and updated to take account of changes in the home particularly since the new manager was appointed. Pre-admission assessment information was available which included details of visits to the home prior to admission, helpful photographs and easy to read captions which explained the potential resident’s experience and their responses to the initial visit. The key worker had also been involved in this process. A client profile had been prepared which included personal details and family information as well as contacts relating to health care professionals. A record was available showing preferences and dislikes, medical information (including allergies) and an occupational therapist assessment was included which had been carried out previously. An initial care plan had been completed prior to admittance to the home. Record of the community care review was also on file. The home does not provide intermediate care. Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 12 7,8,9 & 10 People who use the service experience adequate quality outcomes in this area. Basic personal care needs of residents were being met but greater input is needed for the more highly dependent residents. Care records had not always been fully completed or reviewed to reflect any changes in the support required. Medication administrative procedures were not always being followed to ensure the safety and protection of residents. Residents are treated with respect but privacy could be infringed. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A selection of care plans and other case records were examined. This also involved sampling various information relevant to individual cases. Since the last inspection, personal care records have been stored more securely in individual files. Personal information included social worker contact, family history and next of kin or advocate. Individual requests regarding funeral arrangements and wishes had also been recorded. The care plan structure identified the needs, strengths, weaknesses and action required. Some of the identified needs covered, took into account living safely in a free from harm environment, good healthy diet, reaching own aspirations, and medication. One of the identified needs was to be able to move freely and the action recorded included assessing the risks but there was no risk assessment available. None of the care plans sampled has signatures of the persons included in the plan of care, the reviewer involved or dates. Records of weight had been maintained but these had not always been signed, and some of the details had been omitted. Monthly reviews take place but in one of the samples inspected, the last entry was the 31st of March 2007. In the records inspected, community care reviews had taken place which had been signed by the resident or carer as well as the reviewing practitioner and team manager. Health-care appointments and doctors visits had been recorded. Daily log/care notes were being completed which normally consisted of one entry per day. Some of the care plans had more detailed information including action to be taken in dealing with agitated or aggressive behaviour but these had not been signed or dated by staff. In one of the samples inspected, a behaviour chart has been included which identified several incidents of verbal and physical aggression towards other residents and staff. The last entry was dated 28th July but there was no record of a similar incident which had occurred the Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 13 following day. Another sample of an incomplete care plan identified that a resident needed assistance with all transfers and mobilising but the specific action which staff needed to take and the manoeuvres involved, had not been recorded. Neither was there a risk assessment in place. Residents and staff could be put at risk of injury unless there is continuity in record-keeping which includes providing specific information to show staff how to meet identified needs safely. Some of the residents spoken with confirmed that staff are approachable and supportive. Some of them were aware of their key workers. Residents confirmed that they see their doctor and staff accompany them for other health care appointments. Staff were said to be supportive in assisting with personal care needs. On the day of inspection, two of the call bells were not working in one of the double bedrooms and in another case, the call bell was not accessible to the resident concerned which could place residents at risk if staff are not aware that assistance is required. The Registered Provider was made aware of this during the inspection and took remedial action to ensure all call bells were working properly. One of the bedroom doors on the first floor did not have a secure door handle or shutting device. This meant that the privacy of the resident could be infringed. When approaching this door there was no room number or name to indicate that this was a residents bedroom. A blue label on the outside of the door had a fire warning notice that the door must be kept shut. Medication administration records (M.A.R.) had been completed and entries had been properly completed. It was noted that transcribing of medication had taken place but these did not contain two staff signatures or confirmation from the local doctor. In the sample inspected, neither was there a protocol in place for P.R.N (to be taken as required) medication. The Inspector was advised that staff have received training in medication but the policies and procedures must be strictly followed to ensure there is no risk to residents. Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 People who use the service experience adequate quality outcomes in this area. People living at the home benefit from a range of activities to meet social, cultural and spiritual needs. Residents receive wholesome and an appealing variety of meals. This judgement has been made using available evidence including a visit to the service. Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 15 EVIDENCE: From conversations with residents, staff and observation during the inspection, residents are encouraged to pursue their own preferred lifestyle and daily routines. In the upstairs lounge, two of the residents were using colouring books but for much of the time they were left on their own and staff had very little time to engage with them in this or other activities. Three of the residents attend various day centre facilities during the week and one of the residents spoken with, confirmed that he attends every Thursday. Some residents are also able to visit and keep in touch regularly with their families. Residents confirmed that staff are supportive and communicate with them appropriately to ensure essential needs are met in accordance with their daily routines and individual preferences. One resident enjoys having meals in their bedroom and confirmed that there is opportunity to select meals of their choosing. In view of some of the disabilities of residents, it is recommended that specially designed cutlery could be useful in assisting residents to eat their meals more easily. Wherever possible, the right of residents to pursue a lifestyle of independence is respected and encouraged although this is limited by nature of the dependency levels of some of the resident group. Some of the residents who share rooms have formed good and supportive friendships. Other residents confirmed that staff take them out shopping and the home has its own vehicle which is regularly used to convey residents in and around the local community to the seafront and various clubs. Residents were also taken on holiday in May. On the day of inspection, two members of staff who normally drive the vehicle, were on annual leave and this transport could not be used. Menus and meal records were available but these were not always consistently completed . Some details of meals had been recorded and other information had been omitted. Not all breakfasts had been recorded and it was not possible to identify lunches which had been given to individual residents. There was no record to show the meals which had been given to residents with diabetes. There were also gaps in the records for fridge and freezer temperatures. There were considerable gaps for the month of June when temperatures had not been recorded. For July, there were gaps with entries being recorded for the 20th, 27th and 30th of the month. By not maintaining a consistent approach in the regular monitoring and recording of these records, contravenes food hygiene regulations as well as not being able to evidence that a nutritious, and healthy diet is being provided to individual residents. When speaking to the Inspector, some of the residents were unsure as to whether meetings had taken place for themselves as a group. The previous recorded minutes available for a residents’ meeting was dated 17th October 2006. There needs to be evidence available to show that residents are Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 16 regularly consulted and involved in decisions relating to daily routines of the home as well as social and recreational activities. Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience poor quality outcomes in this area. People who use the service are able to express their concerns but procedures are not sufficiently robust or effective to ensure residents are always protected. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Some of the residents spoken with found some of the staff were approachable and supportive. Concerns were also expressed that when raising issues, staff did not always respond appropriately with the result that some residents feel vulnerable because of the behaviour of other residents in the home. One resident told the Inspector that on the previous day they had been approached and hit hard on the back by another resident and when raised with staff, their response was this resident cant help it. There was also concern expressed about the rudeness of some residents to other people in the home. This issue was raised by the Inspector with the Registered provider who confirmed that he had been made aware of this incident by the resident concerned earlier Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 18 during the day. Although staff have received Protection of Vulnerable Adults training, some of the staff spoken with, did not have a clear understanding as to the reporting procedures which must be followed in relation to other agencies. These procedures must be clarified and reinforced to the staff team in order to promote the well-being of residents as well as minimising risk of harm. Such incidents must also be properly recorded and notified to the Commission for Social Care Inspection under Regulation 37 of the Care Home Regulations. The Registered Provider advised the Inspector that there had been no formal recorded complaints since the last inspection. Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 &26 People who use the service experience poor quality outcomes in this area. The premises are not sufficiently maintained to enable people who use the service to live in a safe, comfortable environment. This judgement has been made using available evidence including a visit to the service. Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 20 EVIDENCE: Since the last inspection, some decoration of bedrooms and other areas of the home have taken place. One of the ground floor double bedrooms is still in need of decoration. A number of the rooms are nicely furnished, homely and meet residents’ expectations. Some of the residents spoken with enjoyed their own private space and spending time in their rooms during the day. There are both lounge and dining room facilities on the ground and first floors together with communal bathrooms and toilets. There is limited grass areas adjacent to the car park at the rear of the building where some of the residents can sit. During the site visit a number of health and safety issues were identified which could place residents at risk . It was noted that when tested, some of the call bell alarms were not working (as previously referred to in this report). In one case, the call bell was not accessible to a resident who was in bed at the time. In addition when activated, the call bell was only audible in the office which means if staff are elsewhere in the building, it is not always possible to be aware when residents require assistance. The plastic protective screen in the ground floor communal shower room was broken and loose. The coating of the toilet seat was worn and the lavatory pan had not been cleaned. There were no disposable gloves or aprons in this bathroom and when mentioned to staff, further supplies were made available. One of the corridor areas on the first floor was dark and the light should be left on to assist residents and minimise the risk of falls. One of the residents had mentioned to the Inspector that they use the laundry chute, which is situated on the first floor, to dispose of dirty linen directly into the laundry room which is on the ground floor. The inspector found that the door hatch providing access to the laundry chute was unlocked and potentially dangerous to residents (particularly those with dementia), who could get inside and fall through to the ground floor. This was raised with the Registered Provider as a safety hazard with a request that immediate action be taken to make safe and withdraw this facility from use. Alternative procedures were suggested to the Registered provider for the collection of dirty laundry from residents. The Registered provider advised the Inspector that he would make this area safe and this would be completed by the end of the day. Sample checks were made of hot water temperatures in residents’ bedrooms and these were recorded 56° and 52.3° respectively. There could be a danger of scalding to residents unless risk assessments are in place and/or some thermostatic control device is installed to restrict the temperature to a safe temperature of 43°. Window restrictors had not been fitted to all bedroom windows which could place some residents at risk. Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 People who use the service experience adequate quality outcomes in this area. Staff in the home are trained but not in sufficient numbers to support people who use the service. Recruitment policies and practices are not being followed to ensure residents are adequately supported and protected. This judgement has been made using available evidence including a visit to the service. EVIDENCE: At the time of inspection, the manager was on leave and eleven residents were being cared for in the home. The staff rota was made available but there was Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 22 some confusion as to whether all staff would be working as shown or whether a day off had been agreed previously. This was resolved by telephone by the senior care assistant who was in charge at the time. There is an arrangement for two shifts to provide cover from 8 a.m. till 4 p.m. and 4 p.m. to 8 p.m. Two groups of three staff cover the waking day. Because there are staff vacancies, some staff work extra hours to provide cover which includes cooking and domestic duties. Although the rota includes the post of cook, care staff cover these duties on a rotating basis as there has been a vacancy for some time. Two of the staff live and have their own accommodation on the premises. They also provide sleep-in cover on a rota basis to support the wake night staff. On the day of inspection, one member staff covering the late shift, was also rostered to carry awake night duty from 8 p.m. to 8 a.m. The Inspector was advised that some staff are working 10 or 12 hour shifts and there is a particular need for bank staff. When the Inspector arrived at the home for the site visit, the senior care assistant, who was in charge, said that she had hurt her back at work on the previous Friday. An accident form had been completed. The Inspector advised that in the absence of the manager, she should notify the Registered provider of her injury and obtain medical advice. Another member staff later came in to provide cover. Some staff were on holiday but given the dependency levels of residents in the home at the time, staffing levels were not sufficient to enable staff to fully interact with residents, take them out as well as having to cover cooking and housekeeping duties. The homes allocation record book specified duties to be carried out each day which predominantly included housekeeping activities such as tidying kitchen cupboards, hoovering, washing and polishing. Staff recruitment records could not be inspected on this occasion as the manager was on leave and other staff, including the Registered provider, did not have access to this information. The senior care assistant in charge advised the Inspector that she had started working at the home six weeks ago having come from a previous residential care home. References had been provided but a new Criminal Record Bureau check had not been completed. The previous CRB was apparently dated April 2007. Where full recruiting procedures have not been completed for new staff including CRB and PovaFirst checks, could place residents at risk. Training records could not be inspected on this occasion as nobody on duty at the time had access to this information. Some certificates were available which included diabetes education including blood glucose monitoring and training in abuse procedures. The Registered Provider advised the Inspector that five or six staff are completing N.V.Q. Level 2 studies and three others are completing Level 3. As some residents in the home have medical conditions which include diabetes and Parkinson’s Disease, training courses should be arranged to ensure the staff team have an awareness in these areas as well as the necessary skills in providing appropriate care. Training in dementia care should also be maintained on a regular basis. Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 24 31,33,35 & 38 People who use the service experience poor quality outcomes in this area. The management, administration and quality assurance systems of the home are not effective to ensure the safety and well-being of residents. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The Registered Provider advised the Inspector that the manager was on the final stages of the N.V.Q. Level 4 Registered Manager’s Award. It is also understood that the manager has attended an approved Protection of Vulnerable Adults course. During the site visit, there was no evidence available of the home’s quality assurance system which still needs to be put in place and which was included as a recommendation in the previous inspection report. Monthly Regulation 26 visits are being carried out and reports are being sent to the CSCI. Individual care records are now being stored appropriately. The manager is the appointee for all residents as approved by the Department of health and Social Security. It was not possible to inspect the records of personal allowances but the Registered Provider advised the Inspector that he gives money as required and any documentation will be updated on the managers return from leave. The health, safety and welfare of residents and staff could be at risk because of insufficient monitoring and regular maintenance. A number of examples have been highlighted elsewhere in this report. There was no up -to -date gas safety certificate available although an electrical safety certificate was in place. Fire risk assessments had recently been completed and weekly testing of fire systems had been recorded on a regular basis. A certificate for the quarterly fire alarm maintenance was available but this had not been signed. It is understood that the last fire drill took place in June 2007 but this was not dated in the records. Some of the issues regarding ongoing maintenance and checks and the irregularity of these was also highlighted in the previous report following the inspection which took place at the home on the 21st of June 2006. Maplin House DS0000015450.V346245.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 2 x 3 3 4 x 5 x 6 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 1 ENVIRONMENT Standard No Score 19 1 20 x 21 x 22 x 23 x 24 x 25 x 26 2 STAFFING Standard No Score 27 2 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No Score 31 2 32 x 33 2 34 x 35 1 36 x 37 x 38 1 Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? 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 OP1 Regulation 6 (a) (b) Requirement Timescale for action 31/10/07 2. OP7 3. OP9 4. OP15 The Registered Person shall keep under review and revise the statement of purpose and the service user guide and notify the Commission and residents of any such revision within 28 days. (previous timescale 30/08/06 not met) 15(1)(2) The Registered Person shall 30/09/07 13(4) update & keep under review care plans to show how residents’ needs are to be met. This includes providing risk assessments to minimise potential hazards & promote the safety of residents. 13(2) The Registered Person shall 30/09/07 17(sched.3) make arrangements for the recording, handling, safekeeping & administration of medication in the home. This applies to clear dosage instructions & confirmation from health care practitioners. 17(2) The Registered Person shall 15/09/07 (Sched 4) maintain records of the food provided for residents in sufficient detail to determine whether the diet is satisfactory DS0000015450.V346245.R01.S.doc Version 5.2 Maplin House Page 27 5. 6. OP16 OP18 17(2) (sched. 4) 37, 13 (6) 7. OP19 OP38 13(4) 8. OP27 18(1) 9. OP29 19 10. OP33 24 in relation to nutrition & special diets. The Registered Provider shall maintain records of complaints received & the action taken. The Registered Person shall make arrangements, by training staff or by other measures, to prevent residents being harmed or suffering abuse or being placed at risk of harm or abuse. The Registered Person shall ensure that all parts of the home to which residents have access are so far as reasonably practicable, free from hazards to their safety. This includes work place risk assessments, servicing/safety certificates and safe hot water temperatures. (previous timescale 30/07/06 not met). The Registered Person shall ensure that at all times, suitably qualified, competent & experienced persons are working at the care home in such numbers as are appropriate for the health & welfare of residents. This includes supervisory, cooking & domestic staff. The Registered Person shall not employ a person to work at the care home unless the person is fit. This refers to the completion of all recruitment procedures including new C.R.B. checks. The Registered Person shall establish & maintain a system for evaluating the quality of the services provided at the care home. 15/09/07 30/09/07 30/09/07 31/10/07 30/09/07 31/10/07 Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 28 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP10 OP14 OP30 Good Practice Recommendations Arrangements should be made to provide suitable & secure door handle/shutting devices for bedrooms to ensure the privacy of residents is protected. There should be more consultation to ascertain the views of residents & for the outcomes of these discussions to be recorded. Arrangements should be made for staff to receive training in relation to diabetes & Parkinson’s medical conditions. Maplin House DS0000015450.V346245.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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. Maplin House DS0000015450.V346245.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. 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