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 8th August 2006 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.V306325.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.V306325.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.V306325.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. 16th December 2005 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.V306325.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 8th August. 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 were posted to the home prior to the inspection visit and seven residents responded. In addition a further four residents living at the home were spoken with during the inspection visit. The relatives of sixteen 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 eleven of these people had responded. Twelve general practitioners who have patients living at the home were contacted for their views about the home. Four of the twelve responded. 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 five people living at the home were examined. Five members of staff including the homes activities coordinator and 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.V306325.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:
Up to date information about the home should be made available to residents or their relatives where this is more appropriate. A number of relatives have made comments about increases in fees at the home and the fee structure should be made clear to those people who may be affected. Some residents had moved into the home and the contract of terms and conditions had not been agreed with the resident or their relative / representative.
Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 7 Some of the information about residents care and treatment could be better written and should include any preference the individual has such as preferred times for getting up, and going to bed and any particular wishes they may have for how they spend their days. Some of the information is not updated in light of changes to a person’s condition, which means that the information is not accurate, and therefore care provided may not be appropriate for the individual. More attention could be paid to ensuring that the more dependent people’s personal care needs are met in a better way. A number of relatives commented that residents clothing went missing and that their loved ones were dressed in clothing belonging to other residents. Some relatives also made comments about residents having dirty fingernails. Some staff who were administering medicines at the home did not appear to have had training and the seriousness of this was discussed with the homes acting manager and the operations manager during the inspector. Some staff do not sign records when they have administered medicines and some records did not tally with the numbers of tablets available on the day of the inspection. While most of the residents felt that staff treated them in a way which promoted their dignity and respected their privacy one resident said that staff ‘barged into her bedroom without knocking on the door’ and one relative said that they were unhappy with the way in which some staff spoke to their mother and felt that staff do not take into consideration her mothers age. While the home employs an activities coordinator who tries hard to provide a good range of activities for residents there are a number of people who are not offered the opportunity for meaningful and stimulating activities. Those people who tend to wander were not provided with anything to do to keep them occupied and those who are confined to spending a lot of time sitting in their chairs were left for the most part without much in the way of interaction with staff or other residents. Some relatives commented that staff do not spend time with residents and that residents appeared bored. It was not clear that where people living at the home were capable of making choices that staff working at the home offered them the opportunity to do so. For example residents were given drinks without staff offering any choice and at lunchtime a decision had been made to provide sandwiches with no choice of a hot meal for some residents. Residents who are more capable were not provided with a choice of condiments to compliment their meal. Residents comments about the food provided by the home were mixed and a number of residents who were spoken with on the day of the inspection said that they did not enjoy their lunchtime meal. Many complained that ‘the meat was tough’. Some residents said that the food was not very good at weekends. Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 8 Some areas of the home are in need of redecoration and there are persistent odours in some places. While the levels of care staff employed at he home are in line with the minimum levels agreed when the Commission took over the responsibility for regulating care homes some residents and relatives feel that there are insufficient numbers of staff on duty at times for the needs of the residents. The shortages in domestic and laundry staff have impacted upon resident’s ad a number of relatives have said that the laundry service is not acceptable. At the time of the inspection some staff had not received training such as safe moving and handling and training in respect of the safe administration of medicines. This possible consequence of this was discussed with the homes acting manager and the organisations operations manager. In general the home is well managed and residents and their relatives are consulted on a regular basis so as to monitor the quality of care and to make improvements where necessary. Some areas of concern were raised at the inspection in respect of the arrangements for minimising the risks associated with any potential outbreak of fire at the home. Some records for the checks on fire safety systems including fire alarms were poorly maintained. The fire exit by the laundry area was obstructed and there was no evidence that the areas highlighted within a risk assessment carried out at the home had been addressed. The homes acting manager and operations manager undertook to deal with these issues as a matter of urgency. 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. Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 9 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.V306325.R01.S.doc Version 5.2 Page 10 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5 & 6 Outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. At the time of this inspection information about the home as required by regulation had not been updated so as provide up to date to prospective residents, their relatives or those who commission services, with up to date and accurate information. People are not offered a place at the home until a detailed assessment of their care needs has been carried out so as to ensure that these needs can be met by the home. EVIDENCE: At the time of this inspection the information in respect of the services provided by the home had not been updated in light of the recent changes in ownership. The homes acting manager had just recently forward details specific to the home to the organisations head office so that a new and up to date statement of purpose and service users guide could be compiled. While
Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 11 these were forwarded to the inspector following the inspection they were not readily available for residents and others at the time of this inspection. Two of the seven people who completed ‘Have your say about…’ surveys said that they had not received contracts in respect of their placement at the home and there were no completed contracts in place for those people who had recently moved into the home whose notes were examined. Each of the seven residents who completed ‘Have your say about…’ survey forms indicated that they had received enough information abut the Memory House before making a decision as to whether the home would be a suitable place for them to move into. Senior staff carry out a detailed assessment of each persons care needs prior to offering prospective residents a place at the home. There was no written confirmation to indicate that following the assessment that the home can meet the needs of prospective residents. During the inspection a number of people who were looking for a home for loved ones visited the home to look around. It was noted that these visitors were welcomed and provided with information they requested. Memory House does not provide intermediate or rehabilitative care. Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 12 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10 Outcome in this area is poor. This judgement has been made using available evidence including a visit to this service. Staff do not consistently record and update information about the people living at the home. The people who are most dependent upon the assistance of staff are not always cared for according to their needs. Medicines are not stored safely and securely. EVIDENCE: With the sale of Ashbourne homes to Southern Cross earlier this year there have been a number of changes including the introduction of new documents for recording care plans and risk assessments. At the time of this inspection staff at the home were in the process of transferring information about residents from the old care planning system to the new system. Some of the information about residents was very well recorded. However some of the care plans and assessments in respect of risks to residents were not sufficiently detailed so as to ensure that the persons needs could be met consistently by staff. For a number of residents areas of the care plan were incomplete and not
Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 13 kept under regular review. The assessment in respect of resident’s risk of developing pressure sores were not completed for a number of residents whose care plans were examined. It was very disappointing to note that there had been no care plan developed for one resident who had moved into the home some five days prior to the date of this inspection. Five of the seven people who completed ‘Have your say about…’ said that they always received the care and support they need. The other two said that they usually did. Six said that they always received the medical support they needed and the other one said that they usually did. Records indicated that staff acted so as to ensure that resident’s healthcare needs are generally met by the home. A number of general practitioners who have patients living at the home were contacted to give their views about the home. Three responded. Of these two commented that in their opinion the level of care provided by the home was ‘acceptable’. One general practitioner indicated that staff at the home communicated clearly and worked in partnership with the surgery and that staff had a clear understanding of the care needs of residents. However one general practitioner commented that the home seemed ‘very chaotic’ and that residents ‘were got up early and put to bed early’. While some residents looked well cared for others, particularly those who were less capable and dependent upon staff for assistance with personal care looked dishevelled with stained clothing and dirty fingernails. Two relatives commented that personal care could be better and one resident said that more attention could be paid to ensuring that resident’s fingernails were clean. One resident who completed the ‘Have your say about…’ survey said that some staff had ‘barged into their bedroom without knocking’. But generally residents felt that staff treated them with respect. On the day of the inspection it was noted that both the trolleys used for the storage of medicines were not secure. The one kept in the reception area of the home was not secured properly to the wall and the one kept in the dining room did not close securely. The homes acting manager undertook to address this as a matter of urgency and an action plan was implemented the day following the inspection so as to provide new and appropriate storage facilities for medicines. On assessing the Medication Administration Records (MAR) it was noted that there were a number of instances where staff had not signed to indicate that they had administered medicines. An audit of one resident’s medicines was carried out, which indicated that medicines may have been signed as being administered but that they were not given to the resident.
Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 14 Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15 Outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. The provision of activities does not meet the needs of all the people living at the home. Resident’s relatives are welcomed to the home at any time. Staff do not always help residents to exercise control over their daily lives. More could be done so as to ensure that meals are served in a congenial setting and meals meet the needs and wishes of residents. EVIDENCE: The home employs an activities coordinator for forty hours per week. When on duty this person provides a number of activities and opportunities for stimulation and occupation for some residents. However it was noted that the less able residents had little or no stimulation or activities during the day of the inspection and there are little or no activities provided in the evenings or at weekends. One of the seven residents who completed ‘Have your say about…’ surveys said that they did not wish to participate in activities provided by the home. Of
Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 16 the remaining six, two said there were always activities arranged by the home, which they could participate in, one said there usually were and the remaining three said that sometimes there were. Three of the eleven residents relatives who completed surveys commented that residents were often ‘bored’ and spent most of the day ‘just sitting in their chairs’. One relative commented that staff did not spend much time with residents and that residents often appeared to be bored. Each of the eleven residents relatives who completed ‘Relative / Visitors Comment Cards’ said that they were welcomed in the home at any time and that they could visit at any time. Nine of the eleven residents relatives said that if their loved ones were not capable of making decisions that they were consulted by the home on behalf of the residents. Four of the seven residents who completed ‘Have your say about…’ surveys said that staff usually listened and acted upon what they say. The remaining three said that staff always did. It was not evident that during the inspection that staff acted so as to maximise resident’s capacity for choice. For example staff did not offer residents a choice of drinks at lunchtime or when refreshments were offered. When questioned the member of staff serving drinks said ‘there is juice if they want it’ however staff did not offer residents the choice. One of the seven residents who completed ‘Have your say about…’ survey said that they always liked the meals provided by the home. Three said that they usually did and three said that they sometimes did. One resident commented that the meals ‘were not up to standard at weekends’ and another commented that they would wish for a more varied choice of vegetables. A number of residents who were spoken with during the inspection visit said that that they did not enjoy their lunchtime meal because the meat was too tough to eat. Other residents were given sandwiches at lunchtime without being offered the choice of sandwiches or a hot meal. It was noted that the more capable residents were not offered the choice of beverages and condiments to accompany their meal. Some residents sitting together were not served their meals simultaneously so as to provide a normal and congenial setting for the mealtime. It was also noted during the inspection that during the lunch period a member of domestic staff was vacuuming an area very close to the dining area and some residents complained about the noise this caused. Where staff was assisting the more dependent people at mealtimes there was very little in the way of staff interaction. Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 17 Despite it being discussed at previous inspections, some residents who spend their days sitting in their chairs and who cannot take their meals at the dining tables have not been provided with small tables so as to allow them to place drinks and plates etc and to encourage a level of independence. Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 18 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Staff practices do not generate a significant number of complaints. Residents and their relatives are satisfied that their complaints will be well received and dealt with in an appropriate manner. Staff working at the home are trained and supported so as to protect the people living at the home from harm and abuse. EVIDENCE: Memory House has a detailed policy and procedure for dealing with complaints. According to records there had been three complaints received since the last inspection. One complaint was in respect of an increase in fees, the other two were in respect of staff practices relating to care such as staff mislaying residents clothing. There was evidence that complaints were dealt with and responded to in a satisfactory manner. Records did not indicate the outcome of the complaints investigation in line with the homes policies and procedures and the Care Homes Regulations. Of the seven people living at the home who completed the ‘Have your say about…’ surveys six said that they always knew who to speak to if they were unhappy and that they knew how to make a complaint. One resident commented that the ‘people higher up’ did not always deal with complaints and issues.
Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 19 Eight of the eleven residents relatives who completed surveys said that they were aware of the homes complaints procedure. Three of the eleven said that they had made complaints about the home. No further information in respect of these complaints was provided. Memory House has a detailed policy and procedure in place in respect of the protection of vulnerable people who live at the home from harm, abuse and neglect. Staff working at the home had received training so as to have an understanding of the issues around abuse and dealing with aggression in older people. There have been no allegations of abuse, harm or neglect of people living at the home. Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 20 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. The home is in need of some redecoration and more needs to be done to dispel and eliminate the stale odours in some areas of the home. EVIDENCE: Some areas within the home are in needs of redecoration. Paintwork is scuffed and some carpeting is stained. On the day of the inspection some unpleasant odours were detected particularly in the vicinity of the dining room area. This has not been addressed following previous inspections. Of the seven residents who completed the ‘Have your say about…’ surveys two said that the home was usually fresh and clean, one said it sometimes was and the remaining four said that it always was. One of the eleven residents relatives who completed surveys said that ‘there is often a very strong smell of urine in the home’.
Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 21 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Outcome in this area is poor. This judgement has been made using available evidence including a visit to this service. While care staff levels are in line with the minimum levels agreed, staff do not always work so as to best meet the needs of the residents and the shortage of domestic staff has an adverse impact upon the quality of life of the people who live at the home. Staff are not recruited in a consistent manner and some shortfalls in the recruitment process are still evident, which may impact upon the care of people living at the home. Staff receive training according to a plan for the home. However some staff have not received training appropriate for the work they carry out. EVIDENCE: Eight of the eleven relatives who completed survey forms said that in their opinion there were always sufficient numbers of staff on duty at the home. However a number of relatives commented that staff did not engage or interact much with residents. Duty rotas indicated that staffing levels are maintained in line with the minimum levels agreed at the time of the Commission taking responsibility for the regulation and inspection of care homes in 2001.
Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 22 While there appeared to be sufficient numbers of care staff on duty some staff did not spend time interacting with residents. Some residents who tend to wander were not provided with any form of occupation and those less able and confined to spending much of the time in their chairs were also left for much of the day without any form of stimulation. It was of some concern to note that on some occasions there was no senior care cover for night duty. There was no evidence that staff on duty at these times had received training in respect of administering medication. While the homes acting manager and the operations manager said that if needed a senior member of staff would come into the home this is not acceptable practice. It was also noted that for some time where has been insufficient numbers of domestic and laundry staff employed at the home, particularly at weekends. Only 15 of the 40 hours in respect of domestic were covered for two consecutive weeks. There have been a number of comments made by both residents and their relatives about the poor quality of laundry services at the home. The laundry area was disorganised with a backlog of dirty linen and clothing to be washed. There have been improvements made since the last full inspection in respect of recruitment of people to work in the home. However for the two files for newly recruited staff at the home a number of shortfalls in the practice of making checks in respect of candidates past employment were noted. It was not clear that references were sought from previous employers. Where gaps were noted in employment histories there was no evidence that this had been explored and a satisfactory explanation sought for the gaps. There is a training programme in place for staff working at the home. However it was noted tat some staff had commenced work at the home without having undertaken training for the safe moving and handling of people. Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 23 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, & 38 Outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. Memory house is fairly well managed, however more could be done so as to ensure that residents needs are met. Staff and management need to do more so as to ensure that the welfare of residents and visitors to the home is protected. EVIDENCE: In general the home is well managed and the organisations operations manager supports the acting manager. Regular audits are carried out so as to identify shortfalls and to plan action so as to improve the services provided by the home. Nine of the eleven residents relatives who completed surveys said that they were satisfied with the overall care provided by the home.
Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 24 The records in respect of monies held by the home on behalf of residents were assessed. Records in respect of transactions were generally well maintained, however the system for managing receipts made it difficult to audit these records. The acting manager undertook to address and to introduce a more robust system for managing the documentation in respect of resident’s monies. The laundry area was accessible to those residents who tend to wander and this could pose a hazard as the area was cluttered with baskets of clothing all over the floor space. It was noted that the fire exit door was obstructed outside with road sign debris. The acting manager and operations manager said that this may have been ‘dumped’ there by passers by. However it is concern that staff who use the corridor leading to the fire exit had not reported its presence and taken action to clear the fire exit. Records in respect of the checks made for fire safety within the home were not well maintained and there was no evidence that the issues identified within the fire risk assessment for the home had been addressed at the time of this inspection. The acting manager undertook to deal with these issues as a matte of urgency. Memory House Care Centre DS0000015512.V306325.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 2 2 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 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 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 X 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 1 Memory House Care Centre DS0000015512.V306325.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 4&5 Requirement Timescale for action 30/11/06 2. OP2 4(1) (b) 5(a) 3 OP7 15 4. OP8 12 & 13(4)(C) The registered persons must ensure that there is up to date information made available about the services provided by the home in accordance with regulation 4 & 5 of the Care Homes Regulations. The registered persons must 30/11/06 ensure that each person who moves into the home is provided with a detailed contract of terms and conditions in respect of their placement, the facilities and services provided and the charges for these services. The registered persons must 30/11/06 ensure that information about each residents particular care and welfare needs is recorded clearly and accurately so as to ensure that all staff have sufficient information to enable them to provide good quality in a consistent manner. The registered persons must 30/11/06 ensure that staff complete the risk assessment documents and keep them up to date so as to ensure that any risks to
DS0000015512.V306325.R01.S.doc Version 5.2 Memory House Care Centre Page 27 resident’s health and welfare are assessed and managed. 5. OP9 13(2) The registered persons must ensure that the arrangements for the storage of medicines at the home are safe and that all medicines are stored in an appropriate place. The registered persons must ensure that staff meet the needs in respect of personal care for those residents who are less capable. The registered persons must ensure so far as it is practicable that a suitable range of stimulating and meaningful activities are provided for residents living at the home. 01/11/06 6. OP10 12(2) (3) 10/11/06 7. OP12 16(2)(n) 10/11/06 8 OP15 16(1) & 16(2)(n) 20/11/06 The registered persons must ensure that meals are provided and served in a manner which meets the needs and wishes of the people living at the home and that suitable facilities are made available so that residents can take meals and refreshments in a comfortable manner, which meets their needs and wishes. This is outstanding from the previous inspection and the timescale of 02/06/06 has not been met. The registered persons must ensure that all records maintained in respect of complaints received include details of the outcomes and response to complainant. The registered persons must ensure that so far as it is practicable that the home is maintained free from unpleasant
DS0000015512.V306325.R01.S.doc 9. OP16 22 11/11/06 10. OP26 16(2)(k) 30/11/06 Memory House Care Centre Version 5.2 Page 28 odours. This is outstanding from the previous inspections and the timescales of 28/02/06 & 30/05/06 & 30/06/06 have not been met. 11. OP27 18(1) The registered persons must ensure that sufficient domestic and cleaning staff are employed so as to meet the needs of the people living at the home. The registered persons must ensure that staff are recruited to work in the home according to a robust and consistent procedure so as to protect the people who live there. The registered persons must ensure that all staff working at the home are trained in respect of the work they are to perform and the needs of the people living at the home The registered persons must ensure that the home is maintained in a manner, which promotes the safety of persons working there. This with particular reference to the issues identified in respect of the laundry area, Fire Risk assessments and the use of fire exits at the home. 30/11/06 12. OP29 19 30/11/06 13. OP30 18(1) (c) 30/11/06 14. OP38 23 15/11/06 Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 29 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. Refer to Standard OP19 OP35 Good Practice Recommendations Communal areas would benefit from redecoration. Receipts in respect of purchases made by residents need to be better organised so as to keep clear records and minimise the risk of mishandling of residents monies. Memory House Care Centre DS0000015512.V306325.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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