Inspection on 30/04/07 for Memory House Care Centre

This inspection was carried out on 30th April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Memory House Care Centre 24/06/09

Memory House Care Centre 29/04/08

Memory House Care Centre 08/08/06

Memory House Care Centre 16/12/05

Memory House Care Centre 11/07/05

Memory House Care Centre 09/03/05

Memory House Care Centre 05/08/04

Memory House Care Centre 22/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Memory House Care Centre 6-9 Marine Parade Leigh On Sea Essex SS9 2NA Lead Inspector Carolyn Delaney Unannounced Inspection 30th April 2007 11:00 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 Memory House Care Centre DS0000015512.V337636.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. Memory House Care Centre DS0000015512.V337636.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Memory House Care Centre Address 6-9 Marine Parade Leigh On Sea Essex SS9 2NA 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 478245 01702 711168 www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Manager post vacant Care Home 45 Category(ies) of Dementia - over 65 years of age (45), Old age, registration, with number not falling within any other category (45) of places Memory House Care Centre DS0000015512.V337636.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Personal care to be provided for older people aged over 65 years. Personal care to be provided to no more than forty-five service users who have dementia and are over the age of 65 years. The number of persons for whom personal care is to be provided shall not exceed forty-five. 8th August 2006 Date of last inspection Brief Description of the Service: Memory House provides accommodation for up to forty-five older people, over the age of sixty-five years who have a diagnosis of dementia or Alzheimer’s disease. Accommodation is provided in a large older style, which over looks the Thames estuary and is situated within a short walk of Leigh Broadway and Old Leigh Town. Memory House has thirty-three single bedrooms and six shared bedrooms. There are three dining areas and two lounge areas. The range of fees for accommodation and personal care at the home range from £352.72 - £410.49 for social services purchased beds & £510.00 £650.00 for privately funded beds. Memory House Care Centre DS0000015512.V337636.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced Key inspection carried out on 30th April 2007. Lead inspector Carolyn Delaney carried out the inspection. As part of the inspection process a number of the Commissions ‘ Have your say about..’ service users questionnaires sent to the home to be distributed to residents so as to obtain their views about the home. The relatives of fifteen residents at the home were contacted by post so as to offer them the opportunity to make comments about the services provided by the home. At the time of completing this report only two of these people had responded. Any responses received after this date will be included within the next inspection report. The comments and views of residents and those people who responded to questionnaires have been used in conjunction with the findings of the inspection visit so as to make a judgement about the level of services provided by the home and have been included throughout the report. Records including assessments, care plans, daily care notes, and medication records and risk assessment documents in respect of a number of people living at the home were examined. Four members of staff including the homes acting manager were spoken with and a number of records including duty rota’s and staff recruitment files were examined. A tour of the premises was carried out. Key standards as identified in the intended outcomes sections of this report are inspected at each key inspection. Key standards are identified for each section of the report. Where other standards have not been assessed these will have been assessed at previous inspections. Reports in respect of previous inspections may be accessed via the Commissions website www.csci.org.uk. Memory House Care Centre DS0000015512.V337636.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Staff must ensure that a detailed assessment of needs is carried out and recorded before a person is offered a place at the home. Where there are changes to a persons needs, the care, support or treatment they are to receive the plan of care must be revised and amended so as to Memory House Care Centre DS0000015512.V337636.R01.S.doc Version 5.2 Page 7 ensure that all staff working at the home have the information they need to provide consistent and proper care. Staff at the home must ensure that they take steps to ensure that there are sufficient medicines at the home so that residents receive the medicines, which have been prescribed for them. More attention could be given to ensure that the needs of the more dependent people living at the home are met. Some people living at the home are frail and are dependent upon staff to assist them to wash and dress. A small number of people who were observed on the day of the inspection were noted to be wearing soiled and stained clothing and their nails were dirty. Meals should be served in accordance with the planned menu and the meals provided should be reviewed regularly so that they meet the nutritional needs and preferences of the people living at the home. Where it is identified that a person is at risk of weight loss staff should record food and fluid intake in order to determine what action should be taken. The home is in need of repair and redecoration in some areas and residents who spend most of their days in the lounge area must be provide with suitable tables to take meals, snacks and to hold any items they may require during the day. All staff working at the home must receive training and supervision so n that they can carry out their duties and support residents according to their individual needs. A system for assessing the effectiveness of training and the competency of the person should be implemented as part of the training programme so a to ensure that staff work in accordance with they way they have been trained. 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. Memory House Care Centre DS0000015512.V337636.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 Memory House Care Centre DS0000015512.V337636.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are only offered a place at Memory House once they have received information about the home and a detailed assessment of the individuals needs has been carried out so as to ensure that the home is suitable. EVIDENCE: Memory House has a detailed statement of purpose, which clearly sets out the aims and objectives of the home and describes the care and services provided. This document needs to be updated so as include the cost of a place at the home. There is a copy of the statement of purpose kept in the foyer at the home and the homes acting manager said that residents are not provided with a copy of the service users guide, as they would not be able to utilise it. Instead people who move into the home rely on information provided by staff about the routines etc within the home. However at least two people living at the home on the day of the inspection would be capable of reading and Memory House Care Centre DS0000015512.V337636.R01.S.doc Version 5.2 Page 10 understanding the information in this document. The service users guide is also available on audio cassette. Each of the five residents and two relatives who completed ‘Have your say about..’ surveys said that they had received enough information about the home so they could decide it was the right place for them. Wherever it is possible people are invited to visit the home before deciding whether it will be suited to their needs. One of the five residents who completed a survey said that they had made a visit to the home prior to making a decision about moving in. Senior care staff working at the home usually carry out an assessment of a persons care needs before they are offered a place at the home. The assessments for four people who had recently moved into the home were examined. Three of the four were complete and included detailed information about the persons care needs. The other was incomplete and areas of the assessment in relation to the persons risk of developing pressure sores, nutritional needs and level of dependency in respect daily activities of living such as washing and dressing, mobility etc had not been completed. It is the policy of Southern Cross that a pre-admission draft care plan is formulated for each person based upon the information obtained at the time of the assessment. This is to ensure that when a person moves into the home that there is recorded information in order that staff working at the home will be able to provide care to the person during the first days of admission until such time as more detailed care plans are devised. These draft care plans had not been devised for three of the four people whose records were examined. Resident’s relatives are given a copy of the homes contract of terms and conditions and sign these in agreement on behalf of residents and copies of these were available for inspection. Each of the five residents who completed surveys said that they had received a contract. Memory House does not provide intermediate care to those people requiring a period of rehabilitation before moving home or a permanent place in a care home. Memory House Care Centre DS0000015512.V337636.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 adequate. This judgement has been made using available evidence including a visit to this service. People living at the are generally well cared for however more could be done to support the more dependent people living at the home. People living at the home do not always receive medicines prescribed as part of their treatment. EVIDENCE: There have been improvements made in the way that staff record information about residents care and general needs. The care plans for three people living at the home were assessed. These were generally well written and included details of each person’s preferences for how they wish to be supported by staff and the person’s capabilities in respect of daily activities of daily living. There was evidence of the resident’s involvement in the planning of care where the person was capable of doing so. Each of the two residents relatives who completed ‘Have your say about..’ surveys said that they felt that the home meets the need of residents, that Memory House Care Centre DS0000015512.V337636.R01.S.doc Version 5.2 Page 12 they are kept informed of any important issues affecting residents and that the home provides the support and care to residents that they expect. Where risks to a person’s health and safety have been identified such as risks of falls or weight loss there were care plans and risk assessments in place. However for a number of people whose care notes were sampled these care plans and risk assessments had not been updated when there had been changes to the level of risk or to the care and treatment the person was to receive. For example one resident sustained five falls over a period of twenty days. There was no evidence that the plan of care or risk assessments had been revised in light of the frequency of these falls. The home has a twentyfour hour monitoring form, which staff should complete when a resident has a fall. This is to monitor for any signs of injury, which may note be apparent at the time of the incident. This monitoring is consistently carried out by staff in line with the homes policy. Where it was identified that residents were losing weight and the plan of care indicated that the person’s nutritional intake should be monitored and there is a dedicated form to record this information. However this was not done in a consistent manner and there was no evidence that where a person refused a meal that alternative food was offered at that time or later. The home has a policy for the safe receipt, administration, storage and disposal of medicines. BOOTS supply the home with medicines and provide training to staff who work at the home. At the time of this inspection each of the seven senior staff who are responsible for the administration of medicines had received basic training. Four of the seven had completed a more advanced level of training and the remaining three were undertaking this training. The home has a system for regularly auditing the practices for storage, administration and disposal of medicines in the home. Records, which were assessed on the day of the inspection, were generally well maintained and the issues, which had been identified at the last inspection in respect of the location and condition of medicine trolleys, had been addressed and all medicines were stored safely and securely. It was however noted with concern that one resident had not received the Isosorbide Dinitrate 10mg twice daily (a medicine for the management of angina) for four days, Metformin 500mg ( a medicine for the management of diabetes) for nine days, and Chlorpromazine (a sedative) had not been administered for four days. Staff said that these medicines had not been available at the home. There was no evidence as to what measures staff had taken so as to receive these medicines and there seemed to generally be a lack of awareness as to the importance of ensuring that there are sufficient medicines at the home for the treatment of residents. Most residents who were observed and spoken with during the inspection looked well cared for, well dressed and groomed. However some of the people Memory House Care Centre DS0000015512.V337636.R01.S.doc Version 5.2 Page 13 who are more dependent upon staff to support them in washing and dressing were noted to be wearing stained clothing and some residents were dirty and female residents had old chipped nail polish. Where residents wished to disclose their preferences for how and where they would wish to be cared for if they became unwell or as they reached their end of life these wishes were recorded so that staff could ensure that the care and support provided at this time will be suited to the residents wishes and needs. Where residents chose not to discuss this aspect of their care this was noted in their care records. Memory House Care Centre DS0000015512.V337636.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. The experiences of people living at the home regarding choices and lifestyle does not always meet their needs and wishes. EVIDENCE: The home employs an activities coordinator for 23 hours per week on Monday, Tuesdays, Thursdays and Fridays. There is a plan of activities provided each week. The range of activities provided by the home includes games, music and trips to local shops for those people who are more able bodied and mobile. Of the five residents who completed ‘Have your say about..’ surveys one said that the home always provides activities that they can participate in, two said that the home usually does and two said that they sometimes do. On the day of the inspection the activities coordinator and the homes deputy manager were noted to be actively involved in providing opportunities for residents to be occupied and stimulated. However while staff were observed to interact and engage with residents when carrying out care and providing support there was little in the way of activities provided for the less able Memory House Care Centre DS0000015512.V337636.R01.S.doc Version 5.2 Page 15 bodied people in the home. A number of people who sit in the front lounge were left for periods without any support or interaction from staff. It was noted that despite the warm weather that no residents were offered the opportunity to spend time in the garden. Residents had recently been consulted as to what activities they would like the home to provide and from this the plan was to be revised so as to include their preferences. Visitors were noted to welcomed into the home and wherever possible relatives may take spend time with residents out of the home. The home has a menu, which is displayed in the dining room. On the day of the inspection the menu displayed was not that for the days meal. When staff were made aware of this the correct menu was displayed. The planned meal for the day was the choice of Lancashire hotpot with potatoes and seasonal vegetables or ham omelette served with chips. The meal, which was served, was hotpot or ham omelette with chips and cabbage, which did not look particularly appetising. A number of residents did not eat their meal and some said that the food is not always good. There was no reason given as to why the meal provided was not as per the menu. It was positive to note that those residents who are more capable take their meals in the back dining room and that most of those who are more dependent upon staff for support were seated in the front dining room and were assisted according to their needs. However a small number of people took their meals in the lounge area. Three of these people were observed to struggle to feed themselves and staff were not available to assist them. The evening meal, which was served at 5pm, consisted of mushroom soup and a choice of shepherds pie or sandwiches. Where it has been identified that a person may be at risk of weight loss or malnutrition staff should record what food a person has eaten at each mealtime. Staff were noted to clear meal plates without making any note as to what food residents had eaten. Records for three people who had been identified as being at particular risk were requested. It is of concern to note that these were not completed. For each of these three people there were gaps of up to three days where staff had not recorded what the resident had eaten. Residents are provided with hot and cold beverages at designated times during the day. Some residents are not provided with appropriate tables to take their meals and beverages. Memory House Care Centre DS0000015512.V337636.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. Residents and their relatives feel that any complaints and concerns will be taken seriously and dealt with appropriately and that residents will so far as possible be protected from abuse, harm or neglect. EVIDENCE: Memory House has a policy and procedure for dealing with complaints details of which are included within the service users guide. The homes acting manager said that a copy of the policy is to be placed on each resident’s door so that they and their relatives will have access to it. Each of the residents and relatives who completed surveys said that they were aware of how to make a complaint and who to speak with of they were unhappy. Both relatives said that where complaints or concerns were raised that staff dealt with these in an appropriate manner. Records are kept at the home in respect of complaints made and the action taken so as to resolve where possible the issues of concern raised by complainants. Records indicate that there have been three complaints made since the last key inspection. One complaint received was made in respect of poor hygiene at the home – tables and chairs being dirty and staff not having enough time to spend with residents. This was investigated and the complaint was upheld. Memory House Care Centre DS0000015512.V337636.R01.S.doc Version 5.2 Page 17 The second complaint concerned the failure of staff working at the home to inform a resident’s relative when the resident sustained an injury following a fall. This was investigated and the complaint was upheld. The third complaint was made in respect of rainwater coming into a resident’s bedroom. This was investigated and the resident was offered an alternative bedroom while the cause was detected and rectified. This complaint was upheld. It is noted that the cause of this has not been identified and dealt with. Records kept regarding the complaints made were well maintained. Each of the five residents and two relatives who completed ‘Have your say about..’ surveys said that they knew whom to speak to if they were unhappy or needed to make a complaint. Both residents’ relatives indicated that where complaints have been made or concerns raised that these have been dealt with appropriately. The home provides training in respect of the protection of people who may be vulnerable and at risk of abuse. From the information provided by the home it was noted that twenty-five of the thirty-three staff (75 ) working at the home had received this training within the past twelve months. There have been no allegations of abuse, harm or neglect made since the last inspection. Memory House Care Centre DS0000015512.V337636.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. Areas of the home are in need repair & redecoration. Residents do not have access to furniture which is suited to their needs and there is a persistent problem with unpleasant odours in some parts of the home EVIDENCE: A number of people living at the home spend the majority of their day seated in the lounge area. The more dependent and less mobile people are seated in one area. It was identified at the last key inspection carried out in August 2006 that there were insufficient ‘over lap’ type tables for residents to place drinks and any other items they may require during the day. This was discussed with the homes acting manager who undertook to purchase tables for residents. However at the time of this inspection some residents were still without the use of tables, which made managing beverages difficult for some residents. Memory House Care Centre DS0000015512.V337636.R01.S.doc Version 5.2 Page 19 The property is old and in need of repair and redecoration in areas. One complaint made was in respect of rainwater coming into a resident’s bedroom during bad weather. The source of the leak has not been identified and repaired. Some areas of the home would benefit from redecoration and the homes acting manager said that there were plans for replacing carpets in some areas. It was noted that residents were not offered the opportunity to access the garden area despite the warm weather on the day of the inspection. There has been a persistent unpleasant odour in the lounge area for some considerable length of time. This has been identified at previous inspections but has not been dealt with. Both the residents relatives who completed ‘Have your say about ..’ surveys commented that the home would benefit from redecoration and one commented about the odour in parts of the home. Memory House Care Centre DS0000015512.V337636.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. The practices for recruiting, training and deployment of staff in the home is not consistent and does not ensure that residents receive the support they need. EVIDENCE: The staffing levels at the home at the time of this inspection were one senior member of staff and five care staff for the morning duty, one senior and four care staff for the afternoon/ evening duty and one senior and two care staff for the night duty. Staff duty rotas, which were examined, indicated that staff do not work excessive hours and all staff have a minimum of one day off per week. Three of the five residents who completed surveys said staff were usually available when needed. Some people who completed surveys and who were spoken with during the day of the inspection commented that sometimes staff were ‘too busy..’ when they asked for help. During the day of the inspection there were times when staff were not available when needed by residents. The homes acting manager said that she intended to increase the numbers of staff from six to seven in the morning and from five to six in the afternoon. With this in mind a regulatory requirement has not been made in respect of staffing levels at the home and this will be reviewed at the next inspection visit. Memory House Care Centre DS0000015512.V337636.R01.S.doc Version 5.2 Page 21 Three of the nineteen care staff (16 ) working at the home had undertaken National Vocational Qualification (NVQ) level 2 in care. The National Minimum Standards recommend that a minimum of 50 of care staff undertake this training. The staff files for four people who have been recruited to work at the home since the last inspection were examined so as to assess the procedures for staff recruitment at the home. One person had been recruited from another Southern Cross home. This person had been employed at Memory House as a deputy manager and had worked as a senior carer in the other care home. There was no evidence that this person had undertaken a period of induction or had received any training in respect of their new role as deputy manager. A reference had not been obtained from another person’s most recent employer. A reference had been obtained from a company where this person had not indicated they worked. There was evidence that they gaps in one persons employment history had been explored, however it was recorded that this person had been in college for a period of ten years and this was not explored fully. There was evidence that the homes manager had interviewed each person and that satisfactory PoVA First checks and Criminal Records Bureau (CRB) disclosures had been obtained and checks made in respect of each persons identity and where appropriate their eligibility to live and work in the United Kingdom had been carried out before a person commenced work at the home. All new staff who commence work at the home should undertake a period of induction to the home and complete an induction programme, which is in line with the Skills for Care programme. The acting manager said that this practice would be implemented with all new staff in the future. There is a programme for staff training at the home. A copy of the staff training matrix was provided and from this it was determined that 87 off staff working at the home have received moving and handling training, 70 have received basic health and safety training and 61 of staff have received training in respect of fire safety, basic food hygiene and training in respect of protecting people who may be vulnerable from abuse, harm or neglect. Sixteen members of staff have completed dementia awareness training. On the day of the inspection three senior members of staff received first aid training and there were plans for care planning and infection control training. There was not always evidence that when staff undertake training that there is a process for assessing the competence of the person in respect of the training. Memory House Care Centre DS0000015512.V337636.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, 35, 36 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well managed however there are a number of issues which must be addressed so that the home is run in the best interests of the people who live there. EVIDENCE: The home acting manager has completed the Registered Managers Award (RMA) training specific for people who wish to manage care establishments and her application to be registered as manager has been sent to the Commission. The day-to-day management of the home is generally good and residents and their relatives feel that they can approach the manager to discuss any issues Memory House Care Centre DS0000015512.V337636.R01.S.doc Version 5.2 Page 23 or concerns that they may have. There are regular audits carried out in respect of care planning, medication and food etc to determine where improvements can be made. Southern Cross have provided a system for managing monies held by them on behalf of residents. These monies up to a maximum of £500 are banked in a pooled non-interest bearing account. The Commission have been in discussion with Southern Cross to decide the best way to manage the handling of resident’s monies. At the time of this inspection the practices employed by the home had not been agreed. At the time of this inspection seven of the nineteen care staff working at the home had received supervision. The National Minimum Standards recommend that staff receive supervision at least six times per year. The home employs a dedicated maintenance person to carry out regular checks in respect of equipment and systems in the home including the systems and equipment for detecting and dealing with an outbreak of fire at the home, hoists and other lifting equipment, gas and electrical equipment. All staff working at the home receive regular fire drill exercises. Regular checks are carried for hot water temperatures so as to test the competency of the hot water regulation system. Memory House Care Centre DS0000015512.V337636.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 2 2 X 3 Memory House Care Centre DS0000015512.V337636.R01.S.doc Version 5.2 Page 25 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 OP3 Regulation 14(1) Requirement A full and detailed assessment of a persons needs must be carried out prior to them being offered a place at the care home. Care plans must be kept under review and revised at any such time where there is a change to a person’s condition or the care and treatment a person is to receive. Where risks to the health and welfare of residents are identified, plans to minimise these risks must be assessed and the assessments revised at any time where there is a change to the level of risk. Staff must ensure that so far as possible that residents receive medicines required as part of their treatment. A range of nutritionally balanced and appetising meals must be provided by the home, which meet the nutritional needs and preferences of residents. Suitable tables must be provided for residents who take their meals and beverages in the DS0000015512.V337636.R01.S.doc Timescale for action 30/07/07 2. OP7 15 30/07/07 3. OP8 13(4)(c) 30/07/07 4. OP9 12(1) 30/06/07 5. OP15 16(1) & 16(2)(n) 30/07/07 6. OP19 23 30/07/07 Memory House Care Centre Version 5.2 Page 26 7. OP26 16(2)(k) lounge area. So far as it is practicable that the 30/06/07 home must be maintained free from unpleasant odours. This is outstanding from the previous inspections and the timescales of 28/02/06, 30/05/06, 30/06/06 & 30/11/06 have not been met. 8. OP29 19 People must only be employed to 30/07/07 work at the home once all of the checks as required by regulation have been carried out. This is a repeat requirement and the previous timescale of 30/11/07 has not been met 9. OP30 18(1) (c) People working at the home must receive training in respect to their roles and the needs of the people living at the home. This is a repeat requirement and the previous timescale of 30/11/07 has not been met 30/08/07 10. OP36 18(2) (a) All staff working at the home must receive supervision. 30/08/07 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 OP2 Good Practice Recommendations A copy of the homes service users guide should be given to any residents living at the home who would be capable DS0000015512.V337636.R01.S.doc Version 5.2 Page 27 Memory House Care Centre 2. 3. 4. 5. 6. 7. 87. OP7 OP12 OP18 OP19 OP27 OP28 OP35 of using it. More attention should be given to the personal care needs of the more dependent people living at the home. More could be done to provide opportunities for activities and stimulation for residents. All staff working at the home should receive training in respect of the protection of people from harm, abuse and neglect. Communal areas would benefit from redecoration. Staffing levels should be reviewed and increased in line with the needs of the people living at the home. A minimum of 50 of care staff working at the home should undertake NVQ training. The arrangements for handling resident’s monies should be in line with those as agreed as being in the best interests of residents. Memory House Care Centre DS0000015512.V337636.R01.S.doc Version 5.2 Page 28 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. 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