Inspection on 24/08/06 for Newent House

This inspection was carried out on 24th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Newent House 25/09/08

Newent House 26/10/07

Newent House 23/01/06

Newent House 22/06/05

Newent House 23/03/05

Newent House 18/06/04

Newent House 05/02/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Newent House 8 - 10 Browns Road Surbiton Surrey KT5 8SP Lead Inspector Diane Thackrah Key Unannounced Inspection 24th August 2006 10:55a 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 Newent House DS0000034120.V307709.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. Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newent House Address 8 - 10 Browns Road Surbiton Surrey KT5 8SP 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) 020 8547 6311 020 8399 9002 Community Care Services Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2006 Brief Description of the Service: Newent House is part of a large resource centre for older people, owned and managed by the Royal Borough of Kingston Upon Thames. The centre provides residential care and a day service for older people living in the community. The residential service provides accommodation for up to 38 older people. The accommodation is arranged over three floors. There are a number of communal lounges, a conservatory, licensed bar and dining room. Each service user has a single bedroom. There are kitchenettes on the first and second floors. Bathrooms and toilets are available on each floor. There is a well-maintained garden. A copy of the service’s Statement of Purpose and Service User Guide can be obtained on request from the Registered Manager. Fees for the home at the time of writing are £525.64 per week. Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on 24th August 2006 between 10.55 and 17.30. A partial tour of the premises took place and care records were examined. Observations of care practices also occurred. The long term Registered Manager has recently left the home. A locum Manager is currently filling the managers’ post. A permanent manager has been appointed, and it is anticipated that they will commence in post in November 2006. The locum Manager, Deputy Manager and three staff members were spoken with, as were ten service users. The views of twelve relatives and four health care professionals have been received via comment cards. The views of these people will be reflected in this report. What the service does well: This is, in general, a well run home were service users have their needs met. The majority of feedback received about the home was very positive. One visiting health care professional said that there was good communication from staff members in the home. Another said that they were happy with all aspects of their dealings with Newent House. All service users spoken with expressed satisfaction with the care that they received from staff members. One service user said, “I have everything I need here” Another service user said, “the carers are very helpful and do a very good job” There were comments from visitors about the “lovely atmosphere in the home” and the “very friendly and caring staff” One visitor said that their relative was “very well looked after” Another visitor said “the staff should all be praised for their level of commitment” There are good arrangements for ensuring that service user’s needs are assessed prior to them moving into the home. Service users have their health and personal care needs met well and are, in general, protected by good practice in handling medication. There are good arrangements for handling complaints. There are excellent arrangements for ensuring that service users live a fulfilling lifestyle, in accordance with their wishes, and for involving service users in the running of the home. Structured activities are provided daily and there are opportunities for service users to relax and spend time with their family members and friends. The home is comfortable, clean and generally, well maintained and there the grounds of the home offer a pleasant space to relax. Staff members are supplied in sufficient numbers and there is generally, good staff training. All staff members are thoroughly vetted, offering a good level of protection to service users. There are suitable Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 6 arrangements for the management of the home and a good quality assurance system that takes into account the views of those using the service. What has improved since the last inspection? What they could do better: Ten Requirements have been made as a result of this inspection. A further six good practice recommendations have been made. The care planning process in the home is generally good, however, there is a need to ensure that service users or their representatives are given opportunities to sign their care plans. There has been an ongoing failure in the home to complete Medication Administration Records accurately, some improvements have been made, however, this issue remains of concern. Enforcement action may be taken should this Requirement not be met with the given timescale. There is a need to improve practice regarding the provision of liquidised meals. Also, it is of concern that there has been a failure by the home to report incidents of suspected abuse appropriately, and in line with national and local policies and procedures. Urine bottles must not be stored in communal toilets, and bedrooms must not smell of stale urine. There is a need to ensure that cleaning staff members are aware of their responsibilities for storing cleaning products safely. Also, There has been an ongoing failure by the home to produce evidence that all kitchen staff members have been trained in food hygiene. Recommendations have been made regarding the need for improved practice in hygiene at meal times, the provision of adequate disposal facilities for incontinent pads, the provision of a more homely environment and health and safety issues in relation to water. Please contact the provider for advice of actions taken in response to this Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Newent House DS0000034120.V307709.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 Newent House DS0000034120.V307709.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. There are appropriate arrangements for obtaining information about the needs of service users before they move into the home, which allow these needs to be met. The home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Assessment information was examined for the one service user who has been admitted to the home since the last inspection. Assessment documentation included a social history, risk assessments, and detailed information about the service user’s personal and health care needs. This information had been obtained through Care Management arrangements. There were also medical reports that had been obtained from the service user’s General Practitioner. There was documentation detailing that service user and some family members had been involved in this process. Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 10 Newent House DS0000034120.V307709.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. There have been improved arrangements for care planning which allow service users to have their health, social and personal care needs well met. There are generally good arrangements for ensuring that medication is handled safely, however, there remains a need for improved practice in medication record keeping in order to protect service users. An emphasis is placed on protecting the dignity, and respecting the privacy of service users. This ensures that the well being of service users is protected. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: There was positive feedback from both service users, and visitors to the home. All service users spoken with expressed satisfaction with the care that they received from staff members. One service user said, “I have everything I need here” Another service user said, “the carers are very helpful and do a very good job” There were comments from visitors about the “lovely atmosphere in Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 12 the home” and the “very friendly and caring staff” One visitor said that their relative was “very well looked after” Another visitor said “the staff should all be praised for their level of commitment” The arrangements for reviewing care have been improved since the last inspection of the home and a Requirement made regarding this issue has been met. Care plans seen for two service users contained records detailing that they had been reviewed on a monthly basis. Care plans seen were appropriate and in line with National Minimum Standards. They described the needs of the service users, and how staff members should address these. They detailed how staff members should support service users to retain a degree of independence. However, the service users, or their representative had signed none of the care plans seen. It is necessary that service users and their representatives are involved in the care planning process. A Requirement is made regarding this issue. Care records seen detailed that service users have access to a range of health care professionals and that the home is proactive in arranging health care appointments. There were records detailing that service users are registered with a general practitioner, have their weight monitored regularly and see opticians and dentists as necessary. One service user spoken with said that they received good support from the staff members with their health needs. There was positive feedback about the home from a visiting general practitioner and two district nurses. One visiting health care professional said that there was good communication from staff members in the home. Another said that they were happy with all aspects of their dealings with Newent House. The locum Manager said that there is no service user in the home that currently has a pressure sore and there were records detailing that district nurses visit one service user regularly to check pressure areas. The locum Manager said that work has been undertaken to improve practice in the handling of medication since the last inspection of the home. There were minutes of a meeting that detailed that senior management in the home have met with the home’s pharmacist to discuss improved practices. There is a fridge for storing some medication. The fridge lock was broken on the day of this inspection and it was positive to note that there was a maintenance worker on site who rectified this problem before the end of the inspection. There were records detailing that regular medication audits in the home occur. Three Medication Administration Records examined were, generally, in good order. There was, however, one Medication Administration Record that detailed that the service user had been administered ‘as required’ medication. Staff members had recorded the dosage of medication administered on some occasions, but not on others. Medication Administration Records must clearly detail the dosage of all medication administered. A repeat Requirement is made regarding the need to ensure that Medication Administration Records are maintained in good order. It is acknowledged that improvements in the Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 13 handling of medication have occurred. However, it is of concern that this is the third inspection of the home that has identified unsatisfactory recording on Medication Administration Records. Enforcement action may be taken should this Requirement not be met with the given timescale. Staff members were observed to treat service users with respect and to uphold their dignity. Positive interactions were noted throughout this inspection. Staff members were noted to knock, and wait for a response before entering service user’s bedroom. One service user confirmed that this practice was usual. Newent House DS0000034120.V307709.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. There continues to be a varied activities programme that ensures that differing expectations and lifestyles are well catered for and there are excellent arrangements for involving service users in the day to day running of the home. Food is generally good and enjoyed, however, improvements must be made in order to ensure that all service users have positive experiences of dining in the home. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: There is a full time activities coordinator who organises a wide range of social and recreational activities. A number of service users spoken with said that they had participated in the social activities and enjoyed these. There are a range of areas throughout the home were service users can spend time, including five lounges, a large conservatory, a pleasant garden and a licensed bar, which doubles as the home’s smoking area. A number of service users were noted to be socializing in the bar at the time of this inspection. Service users can arrange to see religious groups in the home, or attend a regular Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 15 church service. The locum Manager said that the activities coordinator was in the process of arranging a special ‘dining day’ were the bar area will be used to provide a special meal in a restaurant like setting. This is seen as good practice. A number of service users were noted to have a newspaper. One service user said that the staff members ensured that they had a daily newspaper. There was a hairdresser working in the home at the time of this inspection. Records of service user’s meetings were not available for inspection. However, the locum Manager said that service users do have opportunities for being involved in decision making in the home. One service user said that they had recently been part of the interviewing panel involved in appointing a new manager to the home. It is extremely positive to note that service users are given opportunities for being involved in such processes. There was a weekly menu available that detailed that meals provided are varied. There was a notice board in the dining room detailing what meals would be served. This was well presented and had been thoughtfully written. There was a notice detailing that choices of meals are always available. Some service users spoken with said that they enjoyed that food in the home. One service user said, “The food is usually very good” Another service user said, “They always ask you what you want to eat” One service user said that they had chosen to have salad for lunch on the day of this inspection, as they didn’t like what was on the menu. Fresh salads were being prepared in the kitchen during this inspection and these were well presented and appeared appetising. Two service users spoken to said that they had had sausages for lunch that were “hard” and “over cooked” It is acknowledged that it is difficult to ensure that all meals meet the expectations of all service users, however, these service user’s comments must be addressed. One service user is provided with a liquidised diet. It was noted that this service user was provided with a liquidised meal that was not well presented, nor did it appear appetising. It is strongly recommended that this service user is consulted with about their meals, and that they are given the opportunity of having each element of their meal purred separately in order that they are able to appreciate the individual tastes of the foods that they enjoy. There is a pleasant dining room. It was noted during this inspection that tables had been set after breakfast, and after lunch without tablecloths being cleared of crumbs. The locum Manager said that this was because some service users set the tables. It is positive to note that service users are given opportunities for being involved in domestic tasks in the home if this is there wish. However, a recommendation is made regarding the need to ensure that sensitive action be taken for ensuring that service users are able to eat at dining tables that are clean, whilst continuing to support service users to set the tables. Newent House DS0000034120.V307709.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. There is a system in place for the effective handling of complaints and service users and their relatives are encouraged to raise any concerns they have. Service users therefore know that their concerns will be acted upon. Arrangements are in place for handling allegations and instances of abuse however these must be improved to ensure that users will be protected from harm. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: There are policies and procedures in place for dealing with complaints. Information is made available in the Service User Guide about how a compliant, concern or suggestion should be made, and how this will be handled. This information also includes details about how a concern may be raised with the Commission for Social Care Inspection. Feedback from nine relatives indicated that they had been made aware of the home’s complaints policies and procedures. The locum Manager said that no complaints have been made about the home since the last inspection The home has a copy of the Royal Borough of Kingston Council’s vulnerable adult protection procedures and there were records detailing that staff members are trained in adult protection. There were records detailing that a recent incident had occurred in the home involving suspected neglect of care Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 17 by a staff member. Records available detailed that this incident had been investigated ‘in-house’ however; it is necessary to ensure that incidents such as this are reported to the local Adult Protection Coordinator, and local Commission for Social Care Inspection office, in line with local and national policies and procedures for responding to suspicion or evidence of abuse. Staff members must be clear about their responsibilities for reporting such incidents. A Requirement is made regarding this issue. Newent House DS0000034120.V307709.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24, 25 and 26. The home is maintained, decorated and furnished generally, to a good standard and facilities are clean and safe. This ensures that service users live in a pleasant, homely and comfortable environment. However, some improvements regarding maintenance are required in order to protect the wellbeing of service users. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The home is generally well maintained and provides a pleasant and homely environment to those who live there. There was, however, peeling wallpaper in a number of areas throughout the home. The locum Manager said that there is a planned programme of redecoration, and that it is scheduled that these areas be improved. She also said that there are plans to carryout major improvements in the kitchen. There is a well-maintained garden to the rear of the property containing a number of seating areas, and there are ramps providing access to wheelchair users. Some service users were noted to be Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 19 enjoying time in the garden at the time of this inspection. There is parking available at the front of the building. The locum Manager said that the London Fire and Emergency Planning authority visited the home in March 2006. Records were not available detailing the outcome of this inspection; however, the locum Manager said that the home complied with fire safety Regulations. There has not been a visit by the Environmental Health Officer since the last inspection of the home. Lavatories and washing facilities seen were, in general, appropriate and accessible to service users. There was a urine bottle stored in one toilet. Urine bottles must not be stored in communal toilets, as this creates an institutional feel to the home. There are appropriate facilities for the disposal of clinical waste; however, the Registered Provider should ensure that suitable facilities are provided in communal toilets, for service users to dispose of incontinence pads. Since the last inspection, a number of bedrooms in the home have been redecorated and provided with new carpets and curtains. Service users had personalised their bedrooms with their own ornaments, pictures, photographs and some furniture. A service user said that they were “Very happy” with their bedroom and that they had been able to choose the colour scheme. However, one bedroom seen was not homely in appearance and contained only a small amount of the service user’s personal possessions. There were holes in the wall were a shelf had been removed and there was a broken handle on a set of draws. It is strongly recommended that, were a service user does not bring items to personalise their bedroom, the Registered Provider ensures that the bedroom has some homely touches such as plants, a clock or pictures. The locum Manager said that this bedroom is to be redecorated soon. The writer is confident that this will occur, in line with the home’s programme of redecoration. Compliance with this will be examined at the next inspection of the home. Water temperatures from sinks in four bedrooms were tested. Water from two sinks was distributed at an appropriate temperature. However, water from the second two sinks was not hot enough. A Requirement is made regarding this issue. The maintenance worker said that the home has a contract in place, for monitoring water temperatures on a monthly basis, and there were records to back this up. It view of the fact that at least two bedrooms did not have a adequate hot water supply at the time of this inspection, and for improved risk management. It is strongly recommended that hot water temperatures be monitored, in-house, on a weekly basis, with records kept. All areas of the home viewed were noted to be clean. Two bedrooms viewed had offensive odours. It is acknowledged that the home caters for service users who are incontinent, however, it is necessary that every effort is made to remove unpleasant odours from bedrooms in order to ensure that service users are able to enjoy the environment in which they live. Laundry facilities are suitable and there are policies and procedures for the control of infection. Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 20 Newent House DS0000034120.V307709.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 and 30. Staff members are provided in sufficient numbers and the procedures for the recruitment of staff are robust and provide the safeguards to offer protection to people living in the home. There is, in general, a good staff training and development programme, however, some staff members are not provided with the training necessary for fully meeting the needs of service users. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Staffing levels appeared to be appropriate, and in line with the needs of current service users at the time of this inspection. As well as care staff, there was the locum Manager, a cook, kitchen assistants, cleaners and a maintenance worker on shift. There was feedback from staff members, service users, and visitors that staffing levels are sufficient. Two new staff members have been employed to work in the home since the last inspection. Personnel files for these staff members were examined. Files contained all the information and documentation required and there was documented evidence that all required checks had been carried out prior to the staff members commencing work in the home. Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 22 Records available detailed that one new staff member had undergone a detailed induction programme and that a senior staff member had been satisfied that the staff member had understood the information provided to them during induction. There were no records detailing that the second staff member had undergone induction training and the locum Manager was unclear whether such training had occurred. Further more, there were no records detailing that this staff member, who is the home’s new cook, had undertaken Food Hygiene training. Concerns were raised at the last inspection of the home regarding Food Hygiene certificates not being available for some kitchen staff members. It is necessary that all staff members who handled food in the home, have received Food Hygiene training and that there are records available detailing that this has occurred. Food Hygiene certificates were however, available for the majority of staff members who work in the home’s kitchen. There were records detailing that staff training has been ongoing since the last inspection of the home. There are good arrangements for providing staff members with NVQ in Care training. One senior staff member said that they had completed the NVQ Level 4 in Care qualification. Newent House DS0000034120.V307709.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, 36 and 38. There are suitable arrangements for the management of the home and there is a quality assurance system based on running the home in the best interests of service users. There are, in general, good arrangements for health and safety, which promote the well being of service users, some improvements, however, must occur in order to fully protect both service users and staff members. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The long term Registered Manager has recently left the home. There was feedback from service users and staff members that this manager would be missed, but that they were happy with the new locum Manager. A permanent Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 24 Manager has been appointed and it is anticipated that this person will commence in post in November 2006. Quality monitoring in the home occurs in a number of ways. A senior staff member said that service users and their family members are surveyed on a regular basis about their views on the home. Published results of these surveys were not available for inspection. These will be examined at the next inspection of the home. There was an annual development plan for the home. There are regular service user meetings and a relatives meeting is scheduled to occur. Family members, in general, retain control over service user’s finances. Small amounts of money are kept in the home’s safe for some service users. Records were not examined during this inspection regarding the money held by the home on behalf of service users. However, previous inspections of the home have found records to be in good order. There were records detailing that it is common practice for staff members to be trained in safe working practices such as moving and handling, food hygiene, infection control and first aid. However, a Requirement has been made regarding one staff member, who has worked in the home’s kitchen for a number of months, without having a food hygiene qualification, or induction training. Records indicated that there are regular safety checks on fridge and freezer temperatures, emergency lighting, fire fighting equipment, and the fire alarm. Regular fire drills occur. There were records detailing that the home’s hoists, bath seats and lift have recently been serviced. Testing for legionella has also recently occurred. There was a Landlords Gas Safety Certificate available for inspection. There is a hairdressing room in the home. During this inspection there was a vacuum cleaner that was stored near the doorway to this room. The cord on the vacuum cleaner had not been wound in and a service user was noted to struggle to pass this as the wheels of their zimmer frame became caught in the cord. This is potentially dangerous. Cleaning equipment in the home must be stored safely at all times. A Requirement is made regarding this issue. Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X 3 X X 3 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (1) Requirement The Registered Provider must ensure that service users and/or their representatives are given an opportunity to agree and sign the care plan. Should the service user and/or their representative decline this offer, there must be a written record reflecting this. The Registered Provider must ensure that Medication Administration Records are completed accurately. Timescale for action 01/11/06 2. OP9 13 (1)(a) 01/09/06 3. OP15 12 (1)(a) 4. OP18 12 (1)(a) 13 (6) Repeat Requirement. Timescales of 01/10/05 and 23/01/06 not met. 01/10/06 The Registered Provider should consult with the service user who receives liquidized meals, and offer them the opportunity of having each element of their meal purred separately in order that they are able to appreciate the individual tastes of the foods that they enjoy. The Registered Provider must 01/09/06 ensure that any suspicion or evidence of abuse is reported to DS0000034120.V307709.R01.S.doc Version 5.2 Page 27 Newent House 5. 6. OP21 OP25 12 (1)(a) 13 (4)(a)(c) 7. 8. OP26 OP30 23 (2)(d) 18 (1)(C)(i) the local Adult Protection Coordinator without delay. The Registered Provider must ensure that urine bottles are not stored in communal toilets. The Registered Provider must ensure that water that is close to 43 degrees can be obtained from hot water taps in all bedrooms and bathrooms. The Registered Provider must ensure that there is not a smell of urine in bedrooms. The Registered Provider must ensure that all staff members who are responsible for handling food are trained to at least foundation level in food hygiene and that there are records in the home detailing when this training occurred. Repeat Requirement. Timescale of 01/04/06 unmet. The Registered Provider must ensure that cleaning equipment is stored safely in the home and is not trip hazard. 01/10/06 01/10/06 01/10/06 01/10/06 9. OP38 13 (4)(a) 01/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP15 OP21 OP24 Good Practice Recommendations The Registered Provider should ensure that sensitive action be taken for ensuring that service users are able to eat at dining tables that are clean. The Registered Provider should ensure that suitable facilities are provided in communal toilets, for service users to dispose of incontinence pads. It is strongly recommended that, were a service user does DS0000034120.V307709.R01.S.doc Version 5.2 Page 28 Newent House 4. 5. OP25 OP38 not bring items to personalise their bedroom, the Registered Provider ensures that the bedrooms has some homely touches such as plants, a clock or pictures. The Registered Provider should ensure that there is documentation available detailing that the home complies with the Water Supply (Water Fittings) Regulations 1999. The Registered Provider should undertake safety checks on hot water temperatures on a weekly basis. Newent House DS0000034120.V307709.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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. 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