Inspection on 23/08/07 for Newland Care Home (Nursing)

This inspection was carried out on 23rd August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Newland Care Home (Nursing) 04/08/09

Newland Care Home (Nursing) 18/05/09

Newland Care Home (Nursing) 29/04/09

Newland Care Home (Nursing) 08/12/08

Newland Care Home (Nursing) 12/05/08

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Newland Care Home (Residential) 18 Tetlow Lane Salford Manchester M7 4BU Lead Inspector Adele Berriman Unannounced Inspection 23rd August 2007 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Newland Care Home (Residential) DS0000069741.V345341.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. Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newland Care Home (Residential) Address 18 Tetlow Lane Salford Manchester M7 4BU 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) 0161 792 0993 Angel Care Plc Mrs Patricia Wallace Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only: Code PC, to service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP The maximum number of service users who can be accommodated is: 30 Date of last inspection Brief Description of the Service: Newlands is a residential home that provides personal care only for up to thirty people over the age of 65 and offers services to meet the needs of Jewish people. The home is owned and operated by Angel Care Plc who purchased the home in March 2007. The home is situated on a main road in a residential area of Salford. The home has no car park but there are generally parking spaces available on the roadside. The home has strong links with the local and extended Jewish community. The cost of the service is between £327.92 and £500.00 per week. Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Angel Care Plc purchased Newlands in April 2007. This is the first inspection of the service under the ownership of Angel Care Ltd. The current manager of Newlands had been in post for approximately three weeks at the time of the visit. This inspection was unannounced and took place on 23 August 2007 between the hours of 11am and 8pm. During the visit time was spent talking to several residents, two staff members and the manager of the service. Three visitors to the home also gave their views on the service. A selection of records, care plans, medication records, policies and procedures were assessed during the visit along with a tour of some areas of the building. Prior to the visit, written information, about the service had been submitted to the Commission by the previous manager. At the time of the visit twenty two people were in residence. No complaints had been received by the home, or the Commission about the service since Angel Care Plc purchased the home. During the visit the inspector observed a relaxed pleasant atmosphere around the building with conversations taking place. Residents spoke positively about the care they received at Newlands, for example, one resident said “very happy. Enjoy the food. Staff are very good” and another resident said “very happy, I like it here because its small and homely”, “ the food is very good and you get a choice” and “I feel like I’m at a hotel when going into the dining room.” What the service does well: Residents stated that they were happy with the care and support they received whilst living at Newlands. The home offers specific cultural services and support to meet the needs of the residents with links to the local Jewish community. Residents said they were happy to approach staff with any concerns or complaints they may have about the service. Copies of the complaints Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 6 procedure was available in resident’s bedrooms so they, and their relatives had access to the procedure at all times. Residents have access to local healthcare professionals. Regular entertainment is provided five afternoons a week to entertain the residents. The home is furnished to meet the needs of the residents. What has improved since the last inspection? What they could do better: Improvements need to be made to the information written in residents care plans to make sure that all the details are up to date and correct. The policy and procedures relating to medication need to be updated to include all the information needed for staff to administer medication in a safe way. The policy on abuse needs to be updated to contain information about what actions staff need to take if they have a concern. All equipment available around the building needs to be in working order at all times to protect residents, staff and visitors from harm. A procedure for the recruitment of staff needs to needs to be developed and implemented to ensure that only staff suitable for the role are employed at Newlands. All staff need to receive regular updated training and supervision for their role to ensure that they are able to meet all the residents needs. Policies and procedures relating the health, safety and wellbeing of all need to be developed and implemented to ensure that any risk to peoples welfare are minimised at all times. Failure to have up to date policies and procedures in place may result in people being put at unnecessary risk of harm. Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Newland Care Home (Residential) DS0000069741.V345341.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 Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People coming to the home can be confident their needs will be assessed prior to moving into the home. EVIDENCE: When a person considers moving into Newlands an experienced member of staff visit the proposed resident to carry out a full assessment of their needs, this is to ensure that the home is equipped with the resources to meet the individuals’ needs and wishes. Since the previous inspection the format for recording these assessments has changed with the new format giving the person carrying out the assessment the opportunity to document the needs and wishes of the person in all aspects of their day to day life. Information about the home is also supplied in a brochure. Copies of this brochure were readily available in the foyer of the home. Newlands does not provide intermediate care facilities. Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 & 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Inconsistent information contained in care plans may result in residents needs not being met. Development of a detailed policy and procedures relating to medication may result in residents medication not being managed appropriately. EVIDENCE: Individual care plans were available for all residents. A new care planning and recording system for recording peoples needs and wishes relating to their care, their long term needs, personal information details and personal history of the resident has been introduced. A selection of these records were assessed during the visit. Most care plans contained informative information about the resident and their needs. There were several good written examples seen of what staff had to do to meet the needs of the residents, for example, ‘X has an upper set of dentures, help to Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 11 clean them with toothbrush and toothpaste and soak overnight in strident’ and ‘encourage X to have a strip wash in the morning and evening. Encourage X to do as much for himself as possible.’ However, some records were written in a manner that was not person centred and on occasions, information was contradictory. For example one care plan clearly stated that a resident had a mental health issue and was on occasions “anxious, sometimes distressed”, however, in the section of the care plan to recorded personality and mental health issues it stated “no issues.” The care plans contained pre-printed record sheets for staff to record what care and support had been offered and/or delivered to the resident that day. The information in these recording sections of the care plans did not always fully demonstrate what care and support had been offered or delivered to the individual. For example, one resident’s record of personal hygiene stated that they had had a bath and bed linen change on the 08.08.07, had their face washed on the 16.08.07 and had a body wash on the 19.08.07. it is essential that all care delivered to an individual is recorded to demonstrate that a consistent service is being delivered to residents. The care planning format gave staff the opportunity to records information about each individual on a daily basis. Several of these records were read and the majority were informative. However, some records gave limited information and one record was written in a manner that was not understandable. It is essential that all call and support offered and delivered throughout the day is recorded. Individual risk assessments for pressure care, moving and handling, nutrition and falls were available on residents care plans. These assessments were reviewed on a monthly basis along with other care plan information. During the visit a district nurse and a GP were seen entering the home to visit residents. One resident was observed requesting to see their GP and a staff member dealt with this request. The outcomes of healthcare professionals’ visits were recorded on resident’s care plans. A policy for the administration of medication was available. However, guidance and information contained in the policy did not reflect the practice of the home. For example, the policy stated that the administration of medication “must always be carried out by a trained nurse”, however, the care home does not employ trained nurses. The document only briefly referred to the administration of ‘as required medication’ (PRN), medication that is not given on a regular basis, only when required by the resident. The policy must give clear guidance to staff on how to record and administer PRN medication. Failure to have an up to date policy on the receipt, administration, storage and disposal of medication may result in people not receiving their medication as prescribed. Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 12 Medication was stored in a locked trolley in a locked environment. Medication requiring refrigeration was stored in a locked medication fridge. The temperature of this fridge was being monitored on a weekly basis. It is strongly recommended that the medication fridge temperatures are monitored on a daily basis to ensure that medication is being stored appropriately. Medication Administration Records (MARs) were in use to record what and when resident had received their medication. However, not all the MAR’s were completed in full, for example, some did not have the amount of medication, the date of delivery of the medication or who had received the medication recorded. A further example, relating to a resident who partly administered their own daily injection, was that there was no written information to demonstrate what role the staff had in checking the amount of medication to be injected or how to change a needle, nor was there any evidence of training being given to carry out these procedures. It is essential that staff receive appropriate training to support residents in administering medication to ensure that the procedures are carried out appropriately. It is essential that all medication received at the home is recorded appropriately to ensure a clear record of medication received. An audit of controlled drugs in use at the home was carried out. There were two residents on the same medication. However, the content of the two bottles of tablets did not correspond with the records in the Controlled Drugs Register. When assessed, the number of tablets were correct, however, it appeared that the tablets had been taken out of another bottle for another person. A senior member of staff addressed this situation during the visit. It is essential that all medication is managed and dispensed appropriately to ensure that all records are maintained to demonstrate that all medication has been administered appropriately and that residents are receiving medication prescribed for them. A selection of ulcer dressings were seen stored in a residents bedroom, these dressing were past their use by date and were being stored in direct sunlight. Staff stated that these dressing were no longer in use and were removed from the room. It is essential that all dressing are stored appropriately. Throughout the visit staff were seen supporting residents in a positive and respectful manner. A policy was available to support inform staff about the care and support of a resident who is at the end of their life and at the time of death. The policy did not give reference to specific cultural requirements for this time. It was strongly recommended that a copy of Manchester Beth Din’s guidance was obtained and be made available to all staff. Staff stated that a copy of this guidance would be made available. Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Regular planned cultural and social activities provide residents with entertainment and stimulation. EVIDENCE: A part time activities co-ordinator is employed at Newlands to plan entertainment for five afternoons a week. A monthly programme is produced that list what activities and entertainers are planned for that month and this programme was readily available around the home. Two residents spoken to during the visit stated said that the entertainment varied from “singers to majician. The manager stated that preparations were underway for the festival of Rosh Hashanah in September with the support of the Shomer. Many family members and friends of residents were seen entering and leaving the building on the day of the visit. Residents confirmed that they were able to receive visits at any time of the day and visitors commented that they were always made welcome. Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 14 Residents stated that they were able to choose from the menu what they wanted to eat and whether they wanted to participate in the arranged activities. Two residents confirmed that they were given their post to open independently. During the visit a resident was seen requesting a visit from her doctor. A four weekly menu plan was in place. It is the general practice of the home to display the menu for the day on a board outside the dining room however, at the time of the visit these menus were not displayed as they were in the process of being revised. During the visit a choice of meatballs or breaded fish and vegetables were available with a selection of fruits. All food served is suitable for the Kosher diet and is prepared and cooked in a facility with both dairy and non-dairy kitchen. The home has a Shomer who visits on a regular basis to oversee food preparations in the kitchen. All meals were served in pleasantly decorated dining room situated on the ground floor of the accommodation. Prior to a meal being served tables are set with appropriate condiments for the meal, jugs of water and fruit juice. All residents spoken to at the time of the visit were very complimentary about the food served at mealtimes. Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident in the homes complaints procedure. However, the lack of appropriate procedures and awareness of adult protection does not fully minimise the risk of harm to residents. EVIDENCE: The home had a complaints procedure that was readily available at the home. Copies of the procedure were available in resident’s bedrooms along with other information relating to the home. A complaint information form was available to record any complaints made about the service. There was no record of any complaints being made about the service since the previous inspection. There was no register available to record any complaints about the service. It is strongly recommended that a register is developed and implemented to record any concerns or complaints received about the service. During the visit a relative raised a concern on behalf of a resident. Although, they did not wish to make a formal complaint, the manager of the service encouraged the relative to take a complaints form away with them. A copy of Salford Social Services policy on safeguarding adults was available and smaller information booklets relating to adult protection that were published by Salford Social Services were available in residents bedrooms. Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 16 The home had a policy titled “abuse”, however, this policy was in need of review and updating as the information did not refer staff to or relate to Salford Social Services joint agency safeguarding adult’s policy. It is essential that the home develops a policy and guidance for staff to direct them to follow the reporting and referral process under Salford Social Services safeguarding adults procedures to ensure that all concerns are reported, managed and investigated appropriately. The homes current policy states “when a resident claims to have been abused by another resident, they should be encouraged to refer their concerns to the manager of the home. The manager may feel it necessary in certain cases to refer the matter to the police.” It is essential that the revised policy clearly states that any act of abuse by a member of staff or a resident against a resident is reported under Salford Social Services safe guarding adult’s procedure to ensure that individuals’ rights to be protected are promoted at all times. Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home offers a comfortable environment for resident to live. However, all safety measures in place to protect people must be operational at all times to ensure to minimise the risk of harm to people. EVIDENCE: The home is fully accessible to all via a ramped entrance at the front of the building. A passenger lift is available between both floors of the building. A handy person is employed at the home to carry out general maintenance and monitoring of equipment. Communal areas were furnished in a manner to meet the needs of the residents. Since the previous inspection new carpets had been fitted to some areas of the home and some decoration had taken place. Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 18 Several bedrooms were visited and all were found to be comfortably furnished and personalised with resident personal effects. A selection of bathrooms were visited and the temperature of the hot water provision assessed around the building. The hot water tap in the toilet opposite room 24 was not working. The hot water tap in the upstairs kitchen was constantly running very hot water. Once highlighted, the manager of the service turned of the water supply to this sink. It is essential that all hot water provisions are maintained so that they are operational at all times. A window restrictor on the 1st floor of the accommodation was broken and the window could be opened in full. It is essential that all restrictors in place are operational at all times to minimise the risk of harm to people. Equipment was in place to enable fire doors to remain open safely. However, the dining room door was ‘wedged’ open. This door was clearly marked as a sign stating ‘fire door keep shut’. When the ‘wedge’ was removed the door closed however, it did not close fully into its recess. It is essential that all fire doors are maintained and operational at all times for the protection of all. The home was clean and tidy. Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents spoke positively about the staff team. However, to ensure staff competence, a robust recruitment policy, regular training and support must be provided to the staff team. EVIDENCE: At the time of the visit three carers and a senior carer were on duty along with the manager of the service to meet the needs of the twenty two people in residence. The manager stated that it was the current practice of the home to have three carers and a senior carer on duty in the mornings. From 2pm onwards two carers and one senior carer are on duty until 8pm. Waking night staff are on duty throughout the night. The manager stated that the current staffing levels were under review. During the visit the inspector observed that many residents were watching TV and talking at the time when the night staff came on duty. One person stated that they had difficulty locating and speaking to a member of staff one evening as they were extremely busy. It is essential that sufficient staff are available at all times to meet the needs of the residents. Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 20 Residents commented positively about the staff team, these comments included “very happy, the staff are very good” and “the staff can’t do enough for you.” There was no recruitment procedure available at the home during the visit. The newly recruited manager stated that she was in the process or organising the staff files and collating information. Six staff files were assessed and the majority of these files did not contain all the documentation required. For example, one staff file contained no references and another contained no evidence that a Criminal Records Bureau check or POVA 1st check had been carried out. It is essential that each staff file contains evidence that appropriate checks and references have been sought for staff prior to commencing employment at the home. This is to ensure that only people suitable for the role are employed. Some, but not all staff files contained evidence that some staff had received recent training in Fire safety, health and safety (first aid) and basic safety and handling training. There was evidence that senior staff had recently received medication training and one senior told the inspector that they had found this training very good and informative. Written information supplied to the Commission by the previous manager of the home prior to this inspection taking place demonstrated that ten staff had achieved their NVQ level 2 or above award. However, there was little documentary evidence available at the home to demonstrate this. There were no records available to demonstrate that staff had received awareness training in safe guarding adults. However, the manager had recently obtained a training video titled “No Secrets” that she intended to deliver to the staff team. It is essential that all staff receive regular up to date training relevant to their role to enable them to support resident with their needs and wishes safely. Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Failure to implement robust policies and procedures relating to health and safety may result in people being put a unnecessary risk. EVIDENCE: Since the last inspection the previous manager had resigned and new manager had been in post for three weeks at the time of this visit. The newly recruited manager explained that she had several years experience working in social care and held the NVQ level 4 in care. The demonstrated that she was in the process of completing a written induction pack devised by Angel Care Plc and was being supported and supervised on a regular basis by a manager from a nearby care home with the same proprietor. Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 22 A residents meeting was held on the 5th June 2007. The minutes of this meeting were displayed at the home and demonstrated that the menus and activities on offer at the home were discussed. There was no evidence that a staff meeting had taken place and the manager stated that it was her intention to arrange meetings for residents and their families and for the staff team in the near future along with a formal quality assurance procedure. No policy or procedure was available relating to management of residents finances. Balance sheets and records relating to residents fiancés prior to Angel Care Plc purchasing the home were not available. A selection of the record sheets introduced by Angel Care Plc were assessed and the balances were found to be correct. However, some residents had two balance sheets which made the records difficult to understand. Also, some resident had a minus balance indicating that monies for personal items or services purchased, for example, hairdressing etc were being loaned to the resident from the homes petty cash. It is essential that arrangements are made for all residents to have sufficient monies to purchase what they require and that clear records are maintained of all transactions. There was no evidence that staff were in receipt of regular supervision for their role. However, the manager stated that she had devised a programme for staff supervision that will be implemented very soon. A selection of polices and procedures were available to promote the health and safety of residents and staff. These polices and procedures were in need of reviewing and updating to ensure that they reflected the services offered and the procedures of the home. The polices referred to “patients” and two smoking policies were in operation giving very different information. Staff stated that the temperatures of the hot water provisions available to residents were tested on a monthly basis. It is strongly recommended in this report that these tests take place on a weekly basis to ensure that any variation in temperature is addressed quickly. Staff stated that fire detection equipment and call bells was tested on a weekly basis. However, no records of these checks or any other maintenance information was available as it appeared that the records had been locked away by the hand person who was on holiday. It is essential that all records relating to health, safety and welfare of residents and staff are available at all times. During the visit the inspector noted that the fire panel was showing that an inspection was required in one zone of the system and the print out from the system stated that the fault had been recorded at 3.02am on the 23.08.07. Arrangements were made for an engineer to call and inspect the panel that day. Information supplied by the manager following the visit stated the Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 23 engineer had visited and the system was fully operation. It is essential that all fire detection systems are operational at all times. Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 2 2 X 2 Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? N/a 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 Requirement Residents care plans must contain consistent, up to date information and all care offered and delivered needs to be recorded appropriately to ensure that that residents receive the care and support they need at all times. All Medication Administration Records needs to be completed in full to ensure that a full record of prescribed medication is maintained at all times. Al windows restrictors in place must be operational at all times to ensure the safety of residents and minimise any risk to them. All fire doors must be operational at all times to ensure that they would protect people in the event of a fire. Appropriate references and Criminal Record Bureau checks must be undertaken and be recorded to ensure that residents are being cared for by staff suitable for the role. To ensure that residents receive the care they require all care DS0000069741.V345341.R01.S.doc Timescale for action 20/09/07 2. OP9 13 20/09/07 3. OP19 13(4)(a) 13/09/07 4. OP19 23(4)(c)(i) 23/08/07 5. OP29 17 20/09/07 6. OP30 18(1)(c)(i) 27/09/07 Newland Care Home (Residential) Version 5.2 Page 26 7. OP31 8 8. OP36 18 staff must receive regular up to date training in all aspects of their role. The person managing the home must be registered with the Commission for Social Care Inspection. Staff must receive regular supervision for their role to ensure that residents receive the care and support they require. 27/09/07 20/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP9 OP11 Good Practice Recommendations The temperature of the medication fridge should be monitored on a daily basis, to ensure that residents medication is being stored at the appropriate temperature. A copy of the Manchester Beth Din’s guidance on death should be made readily available for all staff to ensure that at the time of the residents death staff are aware of what action to take. It is strongly recommended that a register to document all complaints is developed. A regular review should take place of the number of staff on duty to ensure that there are always sufficient staff available to meet the needs of the residents. The home should develop and implements a quality assurance programme to continually monitor the satisfaction of the service that residents are receiving. A medication policy and procedure needs to be developed and implemented that reflects the needs of all the residents and implemented to ensure that all residents receive their medication as prescribed at all times. Full written guidance must be available at all times to support residents who administer or part administer their own medication. Clear guidance must be available for staff on what their role in the process is and staff with the appropriate skills and experience must deliver this support DS0000069741.V345341.R01.S.doc Version 5.2 Page 27 3. 4. 5. 6. OP16 OP27 OP33 OP9 7. OP9 Newland Care Home (Residential) to ensure that the resident receives the support they need when administering their medication. 8. OP9 Resident’s wound and ulcer dressings need to be stored appropriately and returned to the pharmacist when no longer in use or if they are past their expiry date to ensure that residents have access to dressings that are fit for purpose. In order to protect residents from abuse a policy, procedure and awareness training needs to be developed to advise staff on what actions to take in the event of a concern being raised. A recruitment policy and procedure must be developed. A policy, procedure and recording system for the management of finances needs to be developed to ensure that resident’s monies are safe guarded. Residents and staff must be protected by clear, up to date policies and procedures relating to their health, safety and wellbeing. Up to date records that demonstrate regular monitoring and maintenance of utilities and equipment must be available at all times. All faults recorded on the fire system must be addressed immediately to ensure that the system would operate effectively if there was a fire. 9. OP18 10. 11. 12. 13. OP29 OP35 OP38 OP38 14. OP38 Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Central Registration 9th Floor Oakland House Talbot Road, Old Trafford Manchester M16 0PQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Newland Care Home (Residential) DS0000069741.V345341.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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