Inspection on 10/05/06 for Micron House

This inspection was carried out on 10th May 2006.

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

Micron House 05/03/08

Micron House 01/11/05

Micron House 21/06/05

Micron House 27/09/04

Micron House 19/04/04

Micron House 25/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Micron House Micron House 41 Halesowen Road Netherton Dudley West Midlands DY2 9QD Lead Inspector Mrs Cathy Moore Unannounced Inspection 10th May 2006 08:10 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 Micron House DS0000025033.V292884.R01.S.doc Version 5.1 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. Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Micron House Address Micron House 41 Halesowen Road Netherton Dudley West Midlands DY2 9QD 01384 230504 01384 230504 micronhouse@blueyonder.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Gail Benita Butcher Mrs Gail Benita Butcher Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user (female) identified in the variation report dated 6 July 2005 may be accommodated at the home in the category MD(E). This will remain until such time that the service users placement is terminated. 01/11/05 Date of last inspection Brief Description of the Service: Micron House is registered to provide personal care to a maximum of ten older people. It is located in Netherton,near Dudley. It is situated in a favourable position, as it has a number of amenities and facilities close by. Next to the home is a good sized park, a library and an arts centre. Further down the road are a number of shops including a supermarket, newsagent, butchers, a bakery and a post office. Nearby is an Age Concern centre and the main Netherton health centre where district nurses and local doctors are based. The home is on a main bus route leading to Cradley Heath in one direction and Dudley in the other. Micron House is a traditional, detached property. The ground floor houses the lounge, dining area, a conservatory, toilet, assisted bathroom, laundry, kitchen and bedrooms. The first floor houses the office, further bedrooms a toilet and a further bathroom that is not often used. The home provides six single bedrooms, four of which have en-suite facilities and two double bedrooms. There is a generous sized rear garden which is on two levels. Ramped access is available from the top to the bottom of the garden. The home has a small car park at the rear which can accommodate three cars; further car parking is available in a public car park opposite the home. The fee rate for the home ranges from £343-£400 per week. Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection was conducted by one inspector on one day between 08.10 and 16.10 hours. A Commission pharmacy inspector was present for part of the inspection to assess the medication systems. The inspection took place mostly in an area where general daytime activity could be observed. Seven residents were accommodated at the time of the inspection. Six of the seven residents, four relative/friends and three staff were spoken to. Two residents’ files were looked at to include; their assessment of need records, care plan, daily notes and risk assessments. A tour of the premises was carried out which included looking at; three residents’ bedrooms, the bathrooms and toilets, living areas, the kitchen and laundry. Staff files and training were assessed as were quality assurance systems and health, safety and maintenance records/certificates. Information for this key inspection was also gathered prior to the site visit by gathering intelligence of events that have occurred since the last inspection carried out in November 2005. This was aided by the registered provider/manager completing a pre-inspection questionnaire and questionnaires completed by five residents’/ or on their behalf. What the service does well: The registered person ( owner) is also the registered manager and is involved in the direct running of the home. On the day of the inspection she was working ‘ on the floor’. She is very much involved in providing direct care to the residents and the functioning of the home. Micron House is located in a favourable position next to a park and close to community facilities and amenities including; a library, shops, a main bus route, choice of doctors’ surgeries and an Age Concern owned facility. The home is well maintained. It is friendly and welcoming. Residents’ were happy to chat and share their experiences. Micron House has never received many requirements. Only one remains outstanding from previous inspection activity. Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 6 Residents’ in the home looked well cared for. They were all able to converse and confirm that they were content and satisfied with the home, staff and their care. Five of the eight staff members have achieved N.V.Q level 2 or above in care. The Senior carer has N.V.Q level 3. The medication charts are clear and well documented. Care staff have received accredited medication training to enhance medication safety. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4. Evidence was available to demonstrate that an assessment of need is carried out in respect of prospective residents’ and that information about the home is widely available. This section ‘choice of home’ is therefore assessed as being met to a ‘good’ standard. EVIDENCE: Two resident files were examined both included a contract which detailed their bedroom number and weekly fee. The manager confirmed that the residents’ contracts are updated annually to capture the correct weekly fees. Evidence was available to demonstrate that the contracts were in fact being updated. Five resident completed questionnaires were received by the Commission . All five confirmed that they had been issued with a contract. It was observed that the homes’ last inspection report, statement of purpose and service user guide were on display in the hallway of the home. A question included in the residents’ questionnaire sent out prior to the inspection asks if residents / relatives’ received enough information before moving into the home so they could decide if the home was the right place’. The response to this in all five completed questionnaires was ‘yes’. Further Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 9 comments on this subject included, “very helpful” and, “my daughter visited a few times and told me all about the home”. There was evidence of written assessment of need processes. New revised assessment of need documents revealed a section for residents’/relatives to sign to show that they were involved in this process. The manager confirmed that a letter is sent to all new residents’ confirming that the home can meet their needs. This evidenced further in the home’s service user guide which says, “...You will receive a copy of the assessment and a letter of confirmation if you are assessed as suitable to reside at Micron House”. General positive comments about the home were received for example, one resident said, “I am very happy here. It is a home from home. Like a family. I love it”. Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. Care plans and medication systems require further development all other areas are of a good standard. This section; ’Healthcare’ has therefore, been assessed as being ‘adequate’. EVIDENCE: It was pleasing to see that a care plan is in place for each resident. The care plans viewed had been signed by the individual resident that they had been produced for indicating, that they had been involved in their care planning process. It was identified that areas of risk that had been ascertained by using risk assessment tools for tissue viability and nutrition were not always included in the care plans and therefore vital instruction to staff on how to minimise tissue breakdown what to do if they were concerned, the encouragement of residents’ to stand or change position regularly to relive pressure, what to do if a resident looses weight as examples; were missing. This is vital as a number of residents’ had been assessed as being at risk or high risk of tissue breakdown and in respect of weight/nutrition. Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 11 There was a lack of ‘short term’ care plans for residents’ who had been ill, had an acute health care situation, or were prone to various illness examples being; urinary infections, cataract operations/ treatment, chest infection. Care plan reviews did not always reflect these ‘acute’ episodes. A concern had raised before the inspection about a former resident who it was identified whilst in hospital had a pressure sore. It must be highlighted however, that there has been no confirmation that the pressure sore in question was present on their admission to hospital or if it quickly developed whilst in hospital. However, better information in care plans would prevent questions being asked in the future. Whilst it is positive that written records were available to demonstrate services provided by external healthcare services examples being; the doctor, district nurse and chiropodist these are not being recorded consistently. There was a gap in records of 12 months in some cases between chiropody visits. Similarly, doctor visit records did not always reflect when the visit had been to undertake a specific ‘over 75 year old check’. It is positive that residents are weighed on a monthly basis and that risk assessment tools examples being; falls risk assessment and moving and handling assessments are in operation. It is also positive that five of the five completed questionnaire comments received all said that they felt that they;’ received the care and support they needed”. Three of the five completed resident questionnaires confirmed that they received medical support when needed. Two stated that they; ‘ usually’ did. Positive comments about the personal care provided by the home were received from relatives and residents’ during the inspection and included;” look I’m always clean and tidy” (from one resident who proudly, without prompting showed her clothes). “ I love having a bath here, “ .. is always clean and tidy”. Two relatives commented on the good communication regarding health issues. The nephew of one resident said;” They always phone me if .. is unwell”. Another said;” They always keep me informed and ring me at home”. Although provision was available on the documentation viewed for the preferred form of address of each resident to be recorded, this section on the two files viewed had not been completed. It was positive in that staff observed during the inspection showed respect to the residents; and gave them choices. One staff member commented; “ We know that the residents’ need to be looked after. We do however, encourage them to be independent where possible”. It is positive that all residents’ looked ‘well groomed’ and all but one who chose not to had leg coverings, socks or tights on. The last wishes of residents’ where possible are determined and recorded. A space was also available for recording any ‘ Special religious needs’ any resident may have. Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 12 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. Activity provision is in need of further development. Visiting arrangements, resident choice and control , meals and menus are all managed and provided to a good standard. This section ‘Daily Life and Social Activities’ is therefore assessed as being of a ‘good standard’. EVIDENCE: Activities are provided by the home and an activities programme is in operation. It is positive in that activity participation for each resident is recorded daily. One resident however, when asked what activities are provided was unable to answer. Five completed resident questionnaires revealed the following; two confirmed that; ‘ there are activities arranged by the home that they could take part in. One answered ‘ usually’ to this question and three answered ‘ sometimes’ to this question. Comments about activities varied. One resident commented;” Entertainment is provided inside the home and by people outside the home”. Another stated;” They have entertainment sometimes”. One said; “ I would like to do more activities like jigsaw puzzles and play bingo”. Visiting in the home is open. Visitors are however, encouraged to avoid mealtimes. Mealtimes to avoid any disturbance, are detailed within the visiting statement. Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 13 In total four visitors’ were spoken to during the inspection process. All confirmed that they can visit when they want to, but do avoid meal times. They said that they are made to feel welcome by the staff and are offered drinks. One resident said happily, “ I go out with my family”. Another resident confirmed that her husband visits her everyday. Residents are allowed to and do bring into the home with them a range of personal possessions. One resident said; “I have got my ornaments and photos on the windowsill in my bedroom”. These were actually seen when her room was viewed. Another resident had brought into the home her, her own television. A printed leaflet giving contact details of an external advocacy scheme was seen available within the home. Concern was raised early this year in that a resident from the home who was sent to hospital had been diagnosed as being dehydrated. No firm evidence has been made available to date to confirm that this was a result of poor care practice or indeed if the resident was dehydrated before being admitted to hospital. A joint Commission/Social Services visit was carried out at the beginning of March 2006 to look further into this incident. To date neither the home or the Commission have received any feedback verbal or otherwise from the representative from Social Services who are the nominated lead protection agency. The manager however, has taken note of this episode and as a preventative/ good practice measure has introduced daily, fluid intake records for all residents,’ which were seen to be well maintained. Meals were described as being, “ Good” by residents spoken to. This further confirmed by completed resident questionnaires as follows; five of the five residents who completed questionnaires answered “Yes” to the question; ‘ Do you like the meals at the home’. Further comments received included;” A variety of meals are served”. “..Loves the meals, they are lovely”. It was noted that two residents’ had lost weight. Their weights are being taken and recorded monthly. One of these residents’ has a medical condition which records state the doctor has suggested; “ Could cause weight loss”. Residents’ can choose what they want for breakfast from a range of cereals or toast. A full cooked breakfast is provided. Residents’ can choose to have their breakfast served in the dining room or their bedroom. Lunch is a ‘set’ three course meal consisting of soup, main meal and pudding. On the day of the inspection the meal fully reflected what was detailed on that days menu; oxtail soup, liver and onions followed by bread and butter pudding. The meal time was observed. It was relaxed, staff were on hand giving choices where possible. The tables were nicely laid, with tablecloths and artificial flowers. Condiments were available. Residents observed seemed to enjoy their food. It was nicely presented with generous portions served. Food consumption charts are used to record all foods eaten by residents’ on a daily basis. These records showed that residents are offered 4 meals per day; Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 14 breakfast, lunch, tea and supper. Analysis of the records showed that choices are offered. For example; on 3 may 2006 one resident had bacon, egg and sausage for breakfast, others had a range of cereals and/or toast. For tea on the same day one resident had a boiled egg, another had tomato on toast, one had a salmon sandwich another had a cheese sandwich. Choices were confirmed on other days where the records were examined. That meal choices are usually offered was further confirmed by one resident who said;” They usually ask us what we want”. She said of the meals in general; “ We are well looked after regards food . There is always plenty of food”. One shortfall identified was that the supper at the present time is not detailed on the homes’ menu. Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 15 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. Generally, the home has robust policies and procedures in place which staff are aware of concerning complaints and protection. The area therefore, of complaints and protection is assessed as being good. EVIDENCE: The home has a complaints procedure which is on display in the hallway and detailed in the homes’ statement of purpose. Two minor complaints have been received by the home of late. Which have been recorded and action taken. A question in the Commission residents’ questionnaire asks; ‘Do you know how to make a complaint?’ One of the five received answered; ‘ always’ . Four answered; ‘ usually’. Further comments received included;” If I have a complaint I speak to the staff”. “ There are no complaints to make”. One relative commented; “ I would speak to the staff”. Another said; “ If there is anything I speak to the staff and they sort it out”. Two staff were asked what they would do if a relative complained to them. Both responded more-or-less the same; “ I would deal with it and let the manager know. If it was about the manager I would go to the deputy or CSCI”. One incident of abuse-neglectful behaviour by a carer occurred early this year. The manager reported this incident/situation to the appropriate agencies. The staff member no longer works at the home. The home has it’s own abuse procedures. All staff received abuse awareness training in February 2006. One staff member said, “ the training had opened her eyes”. She was able to describe the different types of abuse and what she Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 16 would do if an incident or allegation of abuse was made. Dudley MBC abuse procedures were seen available in the home. There was however, no evidence that these have been read by the staff. Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 17 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): 19,22,24,25,26. The homes’ environment, fixtures, fittings, décor and maintenance are all of a good standard. This section concerning the environment is assessed as being good. EVIDENCE: Micron House is a small home registered for ten residents’. It is a detached property in a favourable position being close to Netherton town and next to a park. The home offers adequate internal living space. The home is well maintained internally regarding décor, furniture, fixtures and fittings. Externally decorative work is needed. The home has a rear garden. One resident said, “ I like to go and sit outside on the bench”. The home has a number of aids and adaptations to enhance independence and safety examples being; a passenger lift, raised toilet seats, a call system and grab rails. Bedrooms viewed, were of a good standard in terms of décor, bedding and furniture. Locks however, are not provided on all doors. The home has two double bedrooms, only one however, is in use at the present time. It was Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 18 noted that the bedroom in use does not have a privacy screen. The manager said; “ Both residents’ use the toilet outside on the corridor, neither get up at the same time”. One of the residents’ occupying the room was asked by the inspector if they wanted a privacy curtain (An explanation of privacy curtain and its use was given). The resident confirmed she did not want this facility. Water temperatures are taken and recorded monthly. Lighting throughout the home is adequate and domestic in style. It was noted that the radiator in one double bedroom is not guarded neither is the one in the lounge. Five of the five completed resident questionnaires confirmed that the home is always ‘ fresh and clean’. Other positive comments were received about the cleanliness of the home which include the following; “ Staff keep the home lovely and clean”. “Very clean and tidy”. “ Never known the home to be dirty or smelly”. It is extremely positive that the majority of staff have received accredited infection control training. Cleaning schedules were seen for the kitchen and other areas. As part of the ‘tour’ of the premises a random audit of the infection control systems was carried out. It is positive that no communal items were seen in bathrooms or toilets. Liquid soap and paper towels are provided in all bathrooms and toilets and that ‘ hand wash’ signs were available throughout the home with the exception of the ground floor bathroom. Concern was raised regarding the kitchen mop that was left wet and stored in the laundry where it could be contaminated with bacteria. Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 19 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. Staffing levels, training and recruitment practices generally are managed, acknowledged and maintained to a good standard. EVIDENCE: At the time of the inspection the home had 3 empty beds. Six of the seven residents’ seen were mobile and able to feed themselves independently. At least three of these residents’ however, as previously highlighted have been assessed as being at risk in terms of tissue viability or nutrition thus, it is vital that adequate staff are provided at all times. At the beginning of the year at least one resident had high care needs, requiring two staff to attend to some aspects of care, yet only one waking night staff was being provided. A requirement was made for two staff to be provided each night. This resident no longer lives at the home. Staffing at the present time is usually provided as follows; All waking hours – 2 staff Night 1 waking and 1 on call. ‘Are the staff available when you need them’ is a question asked in the resident questionnaire and was answered as follows; 4 said ‘ always’ 1 said ‘usually’. Further comments were received which included;” Unless otherwise engaged with other residents-emergency”. “ Yes they are available if I need them”. One relative spoken to said; “ When I visit there are always staff around”. Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 20 It was raised during the inspection for short times only one staff member is available. As was the case on the inspection day-although an additional staff member is living in the premises. A discussion was held with the manager who said; “ It was only a few minutes this morning”. The manager is fully aware of the need to provide adequate staff day and increase at night where needed to provide for example; pressure area care, toileting. It was noted from the rota that the on call staff are not denoted on the rota as they should be to ensure it is clear at all times who is on call. It is extremely positive in that over 50 of the staff team have achieved N.V.Q level 2 or above in care. Generally staffing, staff recruitment processes and record keeping is of a good standard. The only shortfalls identified was the lack of official identity for one staff member. The manager has a contract with a consultancy company who offer guidance and support on employment issues/systems/law. Staff training is also well managed. A training matrix is maintained. Staff have individual training plans. Mandatory training is mostly up-to-date with refresher training booked or being booked where needed. Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 21 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): 31,33,35,36,38. Practices and systems in place concerning management and administration were assessed overall as being of a good standard. EVIDENCE: Whilst it is positive that the owner/manager has achieved an equivalent N.V.Q management qualification she has not to date commenced on the care component required. The registered manager is also the registered owner and has almost daily ‘hands on’ contact within the home. Quality assurance systems within the home have improved and developed over the last months. The manager has been working on a previous system which although robust does not totally meet what is required as it is not based on the Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 22 most up-to-date requirements- the National Minimum Standards for Older People. It is positive that questionnaires have been issued to relatives and residents. One was completed by a district nurse. The outcome of these questionnaires has been determined. The home has a written policy concerning the safe keeping of resident money. This policy does state that if there are any discrepancies in respect of this money then staff members responsible will have to pay it back. This issue was discussed with the manager as the main consideration is that the money must be accurate where there is a discrepancy then a full investigation must be carried out to determine cause and action required. The home has a robust safe where the money is kept. Records of all transactions are maintained and verified by two signatures and where possible confirmed by receipts. Staff files were randomly examined for evidence of staff supervision. It was positive to determine that staff are receiving, regular, formal one-to–one supervision with records maintained concerning these supervisions. Servicing and Health and Safety records were examined. It was identified that servicing of equipment is being carried out for example; the lift was serviced on 7 April 2006. Hoisting equipment was serviced on the day of the inspection. In-house checks are being carried out concerning the emergency lighting and fire alarm system. The manager has a contract with a consultancy company to give guidance and support on health and safety systems and legislation. The home has a fire risk assessment. It has been a number of years since the home has been inspected by West Midlands Fire Service. There have been 6 accidents since the last major inspection. The manager undertakes a monthly audit of accidents. Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 23 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 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 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 3 x x 3 x 3 2 2 STAFFING Standard No Score 27 2 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 3 x 3 Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 24 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 OP7 Regulation 12(1)(a) 13(4) Requirement The registered person/manager must ensure that care plans include all assessed risks, control measures and needs examples being; weight loss special diets, tissue viability and nutritional scorings and preventative/ control measures to reduce risk. Examples being; The encouragement of regular ( hourly-2 hourly) standing / position change for residents’ at risk. ( This to include night times). When the doctor or district nurse should be called. What pressure relieving equipment should be used. When the doctor should be informed of weight loss and what to do. Timescale for action 10/06/06 Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 25 2 OP7 15(1) 3 OP7 15(2) 4 OP8 12(1)(a) 5 OP8 13(4) 6 OP9 13(2) 7 OP9 13(2) 8 9 OP9 OP9 13(2) 13(2) The registered person/manager must ensure that a care plan is produced for any ‘short term’ need/problem an example being cataract correction, chest infection, urine infection. The registered person/manager must ensure that evidence is available to demonstrate that a full care plan review is being carried out every month. The registered person/ manager must ensure that accurate records are made each time each resident receives a health care service examples being; chiropodist, dentist ,optician. And that it is clear from records when a resident has received an over 75 years of age check and medication review. The registered person/manager must carry out a written risk assessment in respect of the one daughter who cuts her mother’s toenails. The registered person/manager must ensure that medicine audit can be completed. The date of opening of all medicine containers recorded and any balances of new medicines carried over onto new medicine chart. The registered person/ manager must ensure that medicines stored in cupboards and in the refrigerator are securely locked. The registered person/ manager must ensure that the medicine policy is reviewed and updated. The registered person/ manager must ensure that the date of receipt of all medication is recorded. 10/06/06 10/06/06 10/06/06 10/06/06 01/06/06 01/06/06 01/06/06 01/06/06 Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 26 10 OP9 13(2) 11 OP10 12(4)(a) 12 OP12 16(2)(m) 13 14 OP15 OP18 17(2) 13(6) The registered manager must ensure that the service users care plans are kept up to date with healthcare needs. The registered person/manager must ensure that the preferred name for each resident is determined and recorded on their personal file. The registered person/manager must explore further the joint and individual activity needs of the residents’ and provide activities to meet these needs. The registered person/manager must ensure that supper is detailed on the homes’ menus. The registered person/manager must ensure that all staff read, sign and date Dudley MBC adult protection procedures ‘Safeguard and Protect’. 01/06/06 10/06/06 10/06/06 10/06/06 10/06/06 15 OP19 23(2)(d) 16 OP24 12(4)(a) The registered person must ensure that exterior décor of the home examples being; the wooden dormer window and windowsills are made good. The registered `person/manager must ensure that suitable locks are provided on all residents’ doors as they become vacant. To be clear about what type of lock to purchase advice must be sought fro West Midlands Fire Service. 01/09/06 01/07/06 Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 27 17 OP25 13(4) The registered person/manager must suitably guard all remaining unguarded radiators’ examples being; the lounge and ground floor unoccupied double bedroom. In the interim period written risk assessments must be produced to ensure risk minimisation by 10 June 2006. 01/09/06 18 OP26 13(3) The registered person/manager must ensure that the; Kitchen mop is stored in the kitchen. That the mop is cleaned daily and left to dry when not in use. That the missing ‘ hand wash’ sign is replaced in the ground floor toilet. 01/06/06 19 OP27 13(4) 18(1)(a) 17(2) 20 OP27 The registered person/manager must ensure that 2 staff are provided during all waking hours. The registered person/manager must ensure that the names of sleep-in and on-call staff per shift are clearly denoted on the rota. 10/05/06 01/06/06 Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 28 21 OP29 19(5)(d) The registered person/manager must ensure that at least two official sources of official identity ( one with present home address) is available on the newest staff members file. The registered person/manager must find and enrol onto a suitable course in order for her to achieve N.V.Q level 4 or equivalent in care. ( Timescale of 01/01/06 not met). 01/06/06 22 OP31 9(2)(i) 01/09/06 23 OP33 24 The registered person/manager must ensure that the present quality assurance monitoring system is updated to measure against National Minimum Standards for Older People. 01/07/06 24 OP35 13(6) 17(2) The registered person/manager must ensure that the homes’ policy on safe keeping of residents money includes instruction that a full investigation must be carried out if ever there was a discrepancy with balances etc. 10/06/06 Micron House DS0000025033.V292884.R01.S.doc Version 5.1 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. Refer to Standard Good Practice Recommendations Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 30 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Micron House DS0000025033.V292884.R01.S.doc Version 5.1 Page 31 - 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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