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Inspection on 03/07/08 for Maranatha Rest Home

Also see our care home review for Maranatha Rest Home for more information

This inspection was carried out on 3rd July 2008.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People live in a small home where their individual needs are understood. There is a stable core group of staff working at the home. This provides consistency and stability for the people living there. Staff were observed to interact in a kind and caring manner with people during the site visit.People are happy with the level of care offered. One person said "I am happy with the care given to my relative." People are provided with good healthcare support. Referrals are made to relevant professionals such as falls prevention, or the community mental health team. Staff also work well with people`s families providing them with support and information. When people are ill or at the end of their life, they and their families will receive good care and support from management and staff. People know that their friends and families will always be made welcome, and that there will be no restrictions about when they can visit.

What has improved since the last inspection?

Further improvements have been made to the home to provide a more pleasant environment for the people living there. Re-decoration has taken place in parts of the building and some carpets have been replaced. The refurbishment of the kitchen is has been completed. Work to improve people`s private accommodation and replace old and worn furnishings is due to commence soon. The use of consultants to support management is starting to improve the standard of organisation and documentation within the home. Policies and procedures have been reviewed to help ensure that staff are working with up to date information to guide their practice. Since the previous inspection the manager and staff have attended further training courses to enhance their knowledge and skills. Training undertaken has included care planning, and infection control. Some staff have also undertaken medication training, so, people can be confident that this aspect of their care will be well managed.

What the care home could do better:

Management and staff with the assistance of consultants and a new shareholder have made steady progress and are achieving a good level of improvement at the home. This needs to continue in line with information given verbally at the site visit, and in the Annual Quality Assurance Assessment (AQAA) submitted by the manager. This includes consulting with people as to their activity needs and encouraging their involvement in the running of the home.As no new staff have started work at the home since the previous inspection, management have yet to show that they have robust recruitment and induction processes in place. Management are keen to promote good levels of training and ensure that people are looked after by skilled staff. Training should include key areas such as moving and handling and food hygiene.

CARE HOMES FOR OLDER PEOPLE Maranatha Rest Home 211 York Road Southend On Sea Essex SS1 2RU Lead Inspector Ms Vicky Dutton Unannounced Inspection 3rd July 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Maranatha Rest Home DS0000038290.V367836.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. Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maranatha Rest Home Address 211 York Road Southend On Sea Essex SS1 2RU 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) 01702 467675 01702 600884 Syed@smh.demon.co.uk AMA Generic Ltd Mrs Rosemary Gay Bodley Care Home 15 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (15) of places Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Training in the care of older people with dementia to be arranged for care staff three months from date of registration. Radiators within the establishment to be made safe, by ensuring both covers and thermostats are fitted where required. 17th January 2008 Date of last inspection Brief Description of the Service: Maranatha Rest Home is an established private home providing personal care and accommodation for up to fifteen older people. Within this number the home is registered to care for up to five people who have a diagnosis of dementia. Maranatha is a detached property comprising of eleven single and two double bedrooms. There is a choice of two communal lounge areas, a dining area and a conservatory. Bedrooms are provided on the ground and first floor, with the first floor being accessed via a passenger lift. There is a small garden for people to use and on street parking for visitors. The home is situated close to Southend town centre and to the seafront. Maranatha has both a Statement of Purpose and Service Users Guide available. The previous inspection report was available to residents or other interested parties in the homes entrance area. It was confirmed that the current fees at the home are £370.58 to £460.13 There are additional charges for chiropody, hairdressing, taxis when required and newspapers/magazines. Maranatha Rest Home DS0000038290.V367836.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 outcomes. This was an unannounced ‘key’ site visit. At this visit we (CSCI) considered how well the home meets the needs of the people living there, how staff and management work to provide good outcomes for people, and how people are helped to have a lifestyle that is acceptable to them. The level of compliance with requirements made at the previous inspection was assessed. The site visit took place over a period of seven hours. A partial tour of the premises was undertaken, care records, staff records, medication records and other documentation were selected and various elements of these assessed. Time was spent talking to, observing and interacting with people living at the home, and talking to staff. The home’s Annual Quality Assurance Assessment (AQAA) was sent in to us (CSCI.) The AQAA was fully completed, and outlined how the home feel they are performing against the National Minimum Standards, and how they can evidence this. Before the site visit a selection of surveys with addressed return envelopes had been sent to the home for distribution to residents, relatives involved professionals and staff. Only two surveys were returned to us. The views expressed at the site visit and in survey responses have been incorporated into this report. We were assisted at the site visit by the manager, and other members of the staff team. Feedback on findings was provided to the manager throughout the inspection. The opportunity for discussion or clarification was given. We would like to thank the manager, staff team, residents, relatives and visiting professionals for their help throughout the inspection process. What the service does well: People live in a small home where their individual needs are understood. There is a stable core group of staff working at the home. This provides consistency and stability for the people living there. Staff were observed to interact in a kind and caring manner with people during the site visit. Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 6 People are happy with the level of care offered. One person said “I am happy with the care given to my relative.” People are provided with good healthcare support. Referrals are made to relevant professionals such as falls prevention, or the community mental health team. Staff also work well with people’s families providing them with support and information. When people are ill or at the end of their life, they and their families will receive good care and support from management and staff. People know that their friends and families will always be made welcome, and that there will be no restrictions about when they can visit. What has improved since the last inspection? What they could do better: Management and staff with the assistance of consultants and a new shareholder have made steady progress and are achieving a good level of improvement at the home. This needs to continue in line with information given verbally at the site visit, and in the Annual Quality Assurance Assessment (AQAA) submitted by the manager. This includes consulting with people as to their activity needs and encouraging their involvement in the running of the home. Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 7 As no new staff have started work at the home since the previous inspection, management have yet to show that they have robust recruitment and induction processes in place. Management are keen to promote good levels of training and ensure that people are looked after by skilled staff. Training should include key areas such as moving and handling and food hygiene. 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. Maranatha Rest Home DS0000038290.V367836.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 Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know that will gather information and assess their needs to ensure that the home is suitable for them. EVIDENCE: We looked at the files of two people who had recently moved into the home. Both had been admitted on an emergency basis following a family or medical crisis. We saw that information from Social Services was available, and that the manager had completed some pre-admission assessments on the day of admission to ensure that the home would be able to meet their needs. Other assessments had been completed following admission. The manager said that information had also been gathered from families who had been encouraged to visit. For another person admitted the previous day an initial care plan was in place to assist staff in caring for them. Information was passed over at a staff handover, to help staff to be aware of the person’s needs. During the site visit a family member of the person visited. Observations showed that staff were Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 10 working with the family and person to ensure as smooth a transition as possible. The person themselves was unable to comment on the move, but the family member was pleased with arrangements made, and the accommodation provided. Another relative of someone who had recently moved in said, “I visited the home on numerous occasions prior to my [relative] going to Maranatha. I visited at different times and unannounced, and was always greeted with a friendly and warm manner.” Other documentation associated with admissions such as ‘Admission Checklist,’ designed to ensure people are settled in and given relevant information were not always completed on files viewed. Intermediate care is not provided at Maranatha. Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive good care and healthcare support to meet their individual identified needs. EVIDENCE: People living at Maranatha and their families told us that they are happy with the care and support given to them. Relatives said, “My [relative] gets all the support they need and the family as well.” Another said “My [relative] always tells me that they are well looked after, and have received all the help I have asked for. So far I am happy with the care given to my [relative].” People living at the home made comments such as, “I can’t praise them enough,” and “Marvellous people.” To see how well staff understand people’s needs and plan for their care we viewed a number of care files, staff were spoken with and practice observed. The manager and staff had a good awareness of people’s individual needs and were observed to give people the care and assistance they needed. Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 12 Since the previous inspection the manager and deputy manager have undertaken training in care planning. Care plans viewed showed that staff had continued to try and develop a person centred approach to care planning. A consultant is also currently working with management to implement further changes and improvements in this area. Care plans viewed would enable staff to be aware of people’s needs and assist them with day to day living in ways that they prefer. For people being cared for in their rooms, care planning and other information was available there, so that staff have access to relevant information when delivering care. Some shortfalls were discussed with the manager. These included a person identified in assessments as having diabetes, but this not being mentioned in care planning, to alert staff to any dietary needs. The manager said that it had not yet been determined if they did have diabetes. In some instances care plans needed to be more detailed to ensure people receive safe care. For example, one person was using a safety system in bed. The care plan recognised this, but provided no guidance to staff as to how to position and use the equipment safely. There are still some consistency issues with documentation such as a ‘review sheet’ being available and completed in one file and not in others, and moving and handling plans not being present in all files. Although kept separate from individual care plans, it was seen that good daily records are maintained. Care records, observations and discussions during the day indicated that people are offered a good level of healthcare to meet their needs. People can access all appropriate services, and when health issues arise staff are proactive in ensuring people are assisted, with appropriate referrals being made. A district nurse who is familiar with the home said that staff, “Do a fantastic job.” They confirmed that most of their work at the home is with people coming out of hospital with problems such as pressure sores. As part of care planning people’s nutritional and tissue viability needs are assessed. Nutritional and fluid records are maintained, although there were some gaps in recording on those viewed. At the moment only stand on scales are available. This means that frailer people will not be able to have their weight monitored to provide a useful tool in monitoring their well being. The manager said that plans are in hand to provide sit on scales. Medication is managed mostly through a monitored dosage system. Records were well maintained, and suitable procedures were in place to make sure help assure people that their medicines will be managed safely. Since the previous inspection some staff have completed medication training and it was identified that other staff are to attend on future dates. The manager showed us a competency monitoring form that is in use with staff. During the site visit staff treated people with care and respect. Doors were kept shut when personal care was taking place. Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 13 The manager felt that a strength of the home was the way it managed end of life issues and provided care and support for people and their families. A recent letter was received by us, (CSCI) which supported this. It said, “The level of care our [relative] received, particularly over the last two months of [their] life was second to none. We cannot praise the staff and management highly enough for the way they looked after both [relative] and the family.” Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are supported to have a lifestyle that suites their preferences, and will maintain contact with friends and family. EVIDENCE: In the AQAA completed by the manager it was stated that the home hoped to improve within the next twelve months by, ‘In discussion with the owner to look at the provision of an activities co-ordinator to provide training for staff to provide them to embrace activity throughout the day as a team and as part of good care. To support people to do the things they would enjoy.’ A first newsletter just produced said, ‘we are circulating an activity survey to the residents and waiting for feedback to organise the new activity schedule.’ We saw a sample of this survey. Discussion took place with the manager relating to the individual needs of some people. These things show that management and staff are now considering to a greater degree how people’s individual social and occupational needs can be properly assessed and met, and plan to improve this area of care. The success of this will be considered at the next inspection. Currently people’s preferences relating to activities and routines are identified to a degree in care planning. This aspect has also improved since the previous inspection in the level of detail provided. Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 15 However, there is not always a robust approach to assessing and meeting people’s social or occupational needs. This is particularly relevant for people who have dementia care needs. From observations during the site visit it was clear that staff were aware of people’s preferred routines, and respected these. For example people preferring to remain in their rooms. Group and individual activity took place during the site visit. A relative said, “[Relative] chooses not to socialise, but activities are there if [they] want.” It was said that people’s spiritual needs are met on an individual basis, with a minister visiting for one person, and another being taken to church weekly by their family. People can be confident that they will be encouraged to maintain contact with their friends and family. Visiting at Maranatha is open with no restrictions. One person said, “My family visit whenever they wish, and are always made welcome.” A tour of the premises showed that people living there are able to bring in personal possessions to help them feel at home. Information on advocacy services was available so that people know that they can get independent support and advice. People are supported to retain or regain their independence and autonomy. One person was particularly happy that staff had supported them to, “get walking and going again.” People felt that the food provided at the home was good, but two people spoken with felt that they were not offered choice. One person said, “We just have what [member of staff] puts in front of us.” Menus are prepared on a weekly basis with no ‘alternative’ to the main choice being identified. The manager said that the weekly menus are prepared in discussion with people. They also said that people are offered choice, and that although no alternative is formally identified, salads, jacket potatoes or whatever people want can be provided as an alternative at any time. It was suggested that people living at the home be reminded of this, particularly one person whose care plan identified that they did not like red meat, and who in discussion, said that they did not really like any meat. Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are protected from abuse through clear complaints procedures and good practice. EVIDENCE: Since the previous inspection no complaints or concerns have been recorded by the home, or raised with us (CSCI.) Surveys indicated that people are aware of how to raise concerns. People spoken with said that they would speak to the manager or deputy manager about any concerns. There was a complaints procedure on display for people, but the version on display was not very user friendly in it’s language, was small print and placed quite high up on a notice board. The manager agreed to address this, so that people would be better able to see and use this information if they needed to. No safeguarding concerns have been raised. Information on staff training available indicated that staff have received training in safeguarding people. Since the previous inspection the manager has attended a ‘Safeguarding for Managers’ course to update their understanding and practice. A member of staff spoken with confirmed that they had undertaken safeguarding training, and understood safeguarding issues. The manager gave an example of a recent occasion when a member of staff had whistle blown on a colleague in relation to their practice. This shows that staff understand procedures and are prepared to act to maintain good and safe care. Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 17 Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People live in a homely environment, where there is an improving picture of cleanliness and facilities. EVIDENCE: Since the previous inspection people have seen a number of improvements to the environment. This has included redecoration of the main lounge, recarpeting to lounge hallway and stairs, the fitting of a new kitchen, a new large washing machine and the purchase of new dining chairs and beds. A schedule is in place to continue to provide the needed improved facilities for people, with choice being offered as to décor and new furnishings in their private rooms. One person spoken with confirmed, “[Manager] asked me if I would like my room decorated, but I am happy as I am at the moment, and couldn’t face the thought of all the upheaval.” They also said that when something goes Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 19 wrong, such as a recent problem with the water that it is sorted out as soon as possible. In spite of recent staffing issues, with the homes domestic staff needing to cover care shifts, the home appeared reasonably clean and was generally odour free at the time of the site visit. A comment on one survey said that the home was always “spotless.” Staff have received training in Infection control to enable them to work safely and follow correct procedures. Some people have undertaken this training since the previous inspection, with further dates planned for new staff currently being recruited. Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A small team of trained staff ensures that people are well supported. EVIDENCE: Staffing levels currently provided to meet people’s needs are: three staff on duty during the day until 20.00 when it drops to two staff. One person always in charge of each shift. At night there is one asleep and one awake member of staff. The sleeping in member of staff also works from 07.00 to 08.00 to assist in helping people to get up. Rotas viewed showed that these levels are being maintained. There is a stable group of core staff working at the home, but there has been a recent turnover of staff. This has led to some staff shortages which, very unusually for Maranatha, agency staff have been used to cover. There were some positive comments about staff. On surveys relatives said, “The staff couldn’t be more helpful,” and, “Again from the short time my [relative] has stayed at this rest home the staffs’ skills towards my [relative] have been good.” People spoken with said that, “most of the staff are very good,” and “I am very happy with the staff.” During the day there was a good rapport between people and staff. They felt that there was sufficient staff to assist them. One person said, “I can’t fault them, if I need help they are usually there.” Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 21 The AQAA said that there were ten care staff, of whom five had a National Vocational Qualification (NVQ,) at level two or above in care, and that three further staff were working towards this qualification. From information gathered at the site visit, out of six carers, a senior carer and the deputy manager, three have an NVQ at level two or above, two are undertaking NVQ training, and one has another health and social care qualification gained in 2002. With the current levels of staffing this means that the home is complying with the recommended level of at least 50 of staff being trained to NVQ level two or above. In the AQAA the manager said under their ‘plans for the next twelve months’ section that they wanted to, ‘make sure that the recruitment process is more robust.’ Since the previous inspection no new staff have been recruited, but three staff were in the process of being recruited. The information gathered so far on these staff was looked at. From this it appeared that management are following correct procedures to ensure that people living in the home are safeguarded. This will be fully assessed at the next inspection. On the day of the site visit a consultant was organising staff files to ensure that information about recruitment and training was recorded consistently, and could be accessed easily. As no staff have been recruited since the previous inspection it was not possible to assess if a proper staff induction process was now in place. Following the last inspection management was required to submit an improvement plan to show how procedures were going to be improved. The improvement plan said: ‘there is an induction process in operation and to ensure better documentation a checklist has been introduced. The manager was sent on another course, which shows how to set up induction courses, and in the light of this the procedure is being reviewed for any upgrade/changes.’ Again this will need to be reviewed at the next inspection. As part of this inspection a training matrix that was said to be up to date was provided. However on checking against information gathered at the previous inspection, the matrix was not up to date, and had not included some training that had been undertaken by staff such as an NVQ level three, and dementia training. The matrix and previous information showed that staff have undertaken a range of training that is relevant to the needs of people living at the home, including dementia care. Management have also tried to keep up to date with current trends and legislation by attending training on The Mental Capacity Act and employment law. Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People live in a home where there is a commitment towards improving standards, and seeking their views on the service so that improvements are in line with their views. EVIDENCE: Maranatha has an experienced registered manager in post, who has undertaken appropriate training for the role such as NVQ level four and the Registered Managers Award. The manager is well liked by staff, relatives and people living at the home, and has a hands on approach to the role. This report has identified improvements at Maranatha. However this has been achieved with the support of two consultants, who are helping to address longstanding management issues such as poor care planning and documentation, and poor organisation and maintenance of the required Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 23 records and documentation relating to the management of the home. It is also understood that a ‘trainee manager’ is soon to be appointed to assist the manager in achieving and maintaining good standards. Evidence from this site visit shows that good progress is being made but that there is still work to do to achieve a well managed and organised home. Formal meetings for people living at the home or their relatives have not up to now been held. Discussions have been held with residents, and brief notes made on specific issues such as the use of signage to assist people who have dementia, and putting up shelves in bedrooms. Issues have been discussed with relatives on a one to one basis. This does not demonstrate that people involved with the home have regular opportunities to express their views or feelings, and to influence the running of the home. However this may be starting to change. The AQAA said that the home was, ‘Looking at various ways of providing opportunities for relatives and visitors to offer suggestions, complaints, and compliments anonymously if they wish,’ and, ‘Given the client group we are currently caring for and their suggestions, we are going to start residents meetings bi-monthly to enable residents to have a stronger voice.’ The manager said that they were also going to have a relative’s coffee morning to encourage involvement, and offer the opportunity for discussion. Management have recently sent out surveys to people involved with the home. One response has so far been received. The registered provider has nominated a new shareholder to conduct regular monthly visits to the home to seek people’s views, and ensure that the home is being run in the best interests of the people living there. The AQAA completed by the home was briefly but fully completed. The manager confirmed that no monies are held on behalf of people living there. The AQAA completed by management showed that policies and procedures had now been reviewed and that systems and services are maintained. Since the previous inspection management have improved procedures to ensure that people are cared for safely. All staff have recently attended a fire training course to ensure that they follow safe procedures in the event of an emergency. Records seen showed us that regular fire drills are now taking place. Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 24 We saw that the deputy manager has recently been re-accredited to train the staff in safe moving and handling. Another member of staff has also completed this training on an earlier date. From training information given three of the home’s six care staff require update training in this important area. An environmental health officer has recently visited, and found food preparation arrangements to be satisfactory. Care staff are involved in food preparation but two staff are not identified as having undertaken training in food hygiene to ensure that their knowledge is good and practice safe. Maranatha Rest Home DS0000038290.V367836.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 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 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 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 3 X 3 X X 2 Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP29 Regulation 19 Requirement Staff recruitment procedures must be robust so that residents are properly protected. This refers to the issues raised in the body of the report including the need to obtain satisfactory written references and Criminal Records Bureau checks before people start work. This requirement could not be properly assessed at this inspection and is therefore carried forward. 2. OP30 18(1) So that people are cared for by staff that have good initial training to be competent and confident in their role, the home must be able to evidence that robust induction procedures are in place. This requirement could not be properly assessed at this inspection and is therefore carried forward. 01/11/08 Timescale for action 01/11/08 Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 27 3. OP38 18 Management at the home must ensure that staff receive appropriate training and are kept up to date in core areas so that they can care for people safely. This includes food hygiene and moving and handling This is a repeat requirement with previous compliance dates of 01/12/07 and 01/04/08 that have not yet been fully met. 01/11/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations People should be confident that staff have accurate and comprehensive information to assist them in delivering appropriate and safe care. Care plans should continue to be developed and monitored to ensure that they achieve this. Management at the home should continue to develop appropriate activities and occupation in consultation with people. In particular people with dementia should have their needs properly assessed, appropriate occupation provided, and outcomes recorded. Management at the home should be able to evidence that staff starting work at the home receive a robust induction programme that is in line with current skills for Care standards. 2. OP12 4. OP30 Maranatha Rest Home DS0000038290.V367836.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Maranatha Rest Home DS0000038290.V367836.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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