Inspection on 10/11/08 for Orchard Views

This inspection was carried out on 10th November 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Orchard Views 26/11/07

Orchard Views 17/10/06

Orchard Views 25/10/05

Orchard Views 13/05/05

Orchard Views 17/11/04

Orchard Views 10/08/04

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Snydale Care Home

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Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Orchard Views 39 Gawber Road Barnsley South Yorkshire S75 2AN     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jayne White     Date: 1 0 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Orchard Views 39 Gawber Road Barnsley South Yorkshire S75 2AN 01226284151 01226284151 none Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Mohammed Sharif,Mrs Wendy Sharif Type of registration: Number of places registered: care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Three service users may be accommodated at the home age 60 years and above. Date of last inspection Brief description of the care home Orchard Views is a purpose built care home registered to provide personal care and accommodation to 40 older people. The accommodation and facilities are all ground floor level and there are 38 single and one double bedroom. There is a small car park at the front of the building. The home has a garden area. The home is situated on the outskirts of Barnsley town centre within easy reach of local amenities including a main bus route, post office, shops, pubs, clubs, churches and Barnsley Foundation Trust. Information about the home, including the service user guide is available in the entrance hall. This includes the most current Commission for Social Care Inspection (CSCI) report about the service. The manager said the fees ranged from £351.50. 0 Over 65 40 Care Homes for Older People Page 4 of 31 Brief description of the care home Additional charges were made for hairdressing, private chiropody, dentist and individual toiletries. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a key inspection and comprised information already received from or about the home and a site visit. We visited the home on 10 November 2008 without giving them any notice between 09:15 and 17:15. The manager completed an Annual Quality Assurance Assessment before the site visit. This gives the service the opportunity to tell the CSCI how well they think they are meeting the needs of people using the service and what they are working on to improve. Various aspects of the service were then checked during the site visit. Care pratices were observed, a sample of records were looked at and service provision was discussed with the manager. Care Homes for Older People Page 6 of 31 The majority of people living at the home were seen throughout the visit and several were spoken with about the care they received. The care provided for three people was checked against their records to determine if their individual needs identified in their plan of care were being met. All this information and peoples and staffs opinions and comments were considered for inclusion in this report. The inspector wishes to thank people living at the home, the staff and the manager for their assistance and co-operation during the visit. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: An immediate requirement was issued on the visit for the service to audit the controlled medication the following day to confirm they were being given as prescribed. This was because records were so poor, this could not be established. Subsequent to the inspection confirmation was received that this had been completed with the community pharmacist and it identified the discrepancies were staff counting errors or entering incorrect quantities received. As a result the pharmacist held a training session for staff on 19 November 2008 covering all aspects of dealing with controlled drugs, from receipt to administration or disposal. Care Homes for Older People Page 8 of 31 A warning letter has been sent to the provider to inform them enforcement action may be taken if they continue to fail to comply with taking any action when people lose weight. This was because we highlighted this as a concern at the previous inspection and found again on this inspection a person had lost weight, but no action had been taken. This is poor monitoring of an area that may indicate the health of a person needs closer monitoring. In addition, the warning letter will also include identifying they are contuing to fail to meet the privacy and dignity of people as when we looked round the building, there continued to be locks on toilets and bathroom doors that were broken. Establish a planned programme of activity to improve the quality of life for people, including trips out of the home. Keep the home in a good state of repair to maintain satisfactory standards of hygiene in the home and make the bathroom, shower and toilet areas pleasant places for people to enjoy. This includes replacing tiles, wallpaper, flooring and toilet seats. Demonstrate a through and staff recruitment process, so that people can be confident that staff employed to work with them have appropriate recruitment checks that confirm they are fit to work with vulnerable people. In addition, demonstrate that where an employee commences employment prior to a full and satisfactory Criminal Records Bureau (CRB) check being received, which member of staff has been appointed to supervise the member of staff pending receipt of the CRB and ensure so far as is possible that member of staff is on duty at the same time as the new worker. Formulate a plan from the quality assurance processes that are in place, to put together an action plan of how the service will improve the quality of the service for people. In addition, include as part of the plan, the actions from the monthly report that should be completed by the owners from their monthly unannounced visits to the service to establish the quality of the service provided by speaking with people, their representatives, looking at the environment and inspecting records. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People had their needs assessed before they moved into the home, which meant the home and the person could be sure their needs would be met. Evidence: When we spoke to people they said their family had taken the responsibility for making the decision about the choice of home. One commented, I didnt get chance to come and look around, it was an emergency, my bungalow flooded. Another said, my daughter looked round. We looked at three peoples files to check the admission process. A pre-admission assessment was carried out and an assessment took place. We discussed with the manager that these could contain greater detail. In two of the files a summary assessment and care plan was received from social services. A plan of care had been put together from the information. Care Homes for Older People Page 11 of 31 Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. On the whole, the health and personal care that people received reflected what assistance they needed. Overall, people were treated with respect, dignity and privacy. Evidence: When we spoke with people, they spoke highly of the care and medical support they received. They said, looked after alright, had a lovely bath yesterday, its alright here - well looked after - its warm, clean and meals ok, get well looked after - no grumbles, its not bad here and were looked after well. We looked at three care plans. The plans contained good information that was sufficient to inform staff of the action they needed to take to meet peoples needs. The daily report identified that staff acted on this information. Risk assessments were in place to identify any risks that might be presented by people, for example, mobility and falls. The assessment identified the action required by staff to reduce the potential risks to people, which promoted and maintained their Care Homes for Older People Page 13 of 31 Evidence: independence. Nutritional risk assessments were in place and a record of peoples weights were maintained. However, one of the care plans we looked at identified the person had lost weight, but no action had been taken as a result of this. This identified consistent poor monitoring of an area that may indicate the health of a person needs closer monitoring as it was a requirement at the last inspection. A warning letter has been sent to the provider to inform them enforcement action may be taken if they continue to fail to comply with the requirement. Records of healthcare visits that were undertaken were maintained and demonstrated people did receive visits some visits from healthcare professionals. People confirmed this when we spoke with them. When we spoke to people they said staff treated them with respect. One person said, when my daughter rings they always wheel me to office and leave me to speak to her. When we observed staff working there was clear and respectful communication between people and staff and staff treated people in a kind manner. People were well dressed, with no food spillages on their clothes. Their hair and nails were clean. This indicated respect and dignity by staff when caring for people. However, the privacy and dignity of people was compromised when we looked round the building, as there continued to be locks on toilet and bathroom doors that were broken. This was also a requirement that had not been met since the last inspection. As above, a warning letter will be sent to the provider to inform them enforcement action may be taken if they continue to fail to comply with the requirement. Senior care staff administered medication. Medicines were securely stored. On the same day as the inspection a pharmacy inspection had taken place. They had provided the service with a new storage space for the storage of controlled drugs that would meet the requirements of the Misuse of Drugs (Safe Custody) Regulations 1973. We saw that when people were given their medication it was done in a respectful and dignified way. A drink was available to assist people in taking their medication. People were prompted and encouraged to take their medication where this was necessary. We highlighted to the manager where people needed assistance, this should not be done whilst they were in the middle of their meal. Care Homes for Older People Page 14 of 31 Evidence: We looked at the recording, administration and storage of medication on a sample basis. On the whole, medication received was clearly recorded on the persons medication administration record and medication administered signed for. However, for one controlled medication that was checked the record did not correlate with the balance remaining and it could not be determined from this whether the medication was being given to the person as prescribed. An immediate requirement was issued to the manager to complete an audit of the medication to rectify any errors and take appropriate action as necessary. This was completed with the community pharmacist and it identified the discrepancies were staff counting errors or entering incorrect quantities received. As a result the pharmacist held a training session for staff on 19 November 2008 covering all aspects of dealing with controlled drugs, from receipt to administration or disposal. Care Homes for Older People Page 15 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were assisted to make choices and decisions about their daily life, but there was little provision for people to take part in social activities. Evidence: When we entered the home there was a pleasant ambience in the communal areas. When we spoke to people about social activities they took part in they said, day to day a bit boring - just left watching TV all the time. Now and again have someone in singing, but it is now and again. I enjoy that. Tends to be when theres an event, went to Cleethorpes a long time since, have a little sing, song. They come from church and play piano and not a lot going off. We have a singer occasionally and church visit occasionally. This does not provide a fulfilling quality of life for people. The AQAA has identified this is something they could do better, by employing an activities co-ordinator and they need to act on it. Our observations during the visit and discussions with people identified people could spend their day as they wished following their preferred routines. For people who were not as independent we saw it was only when staff were undertaking caring tasks with Care Homes for Older People Page 16 of 31 Evidence: them, that they had any interaction with another person. They spent their time asleep, watching events and staring at the television. People told us their family and friends could visit at any time and that they were made to feel welcome by being offered a drink and staff being friendly. This means they were able to maintain important personal and family relationships. When we spoke to people they said, meals, good. You get enough to eat - too much for me, food very good, couldnt go anywhere else and get any better and foods good. Them that go hungry, its their own fault, theres always a bit more. The dining room was welcoming, being bright and clean. The menu for the day was written on a board in the dining room so people knew what their meals would be. Meals were served at two sittings. This was so that there was enough staff available to serve people without them having to wait for long periods and provide one to one support for people who needed assistance to eat. We saw the lunchtime meal being served. There was no rush to the mealtime and people were given sufficient time to eat. Staff were patient and helpful and allowed people time to finish their meal. Care staff were sensitive to the those people who found it difficult to eat their meal themselves and needed assistance. They helped the person at their pace, making them feel comfortable and unhurried. Care Homes for Older People Page 17 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were able to express their concerns and had access to a complaints procedure. There were adult safeguarding policies and procedures in place that promoted the protection of people from harm. Evidence: On the whole, people were satisfied with the care they received and felt safe. They said they would speak up if there was something they werent happy about. This indicated there was an open culture that allowed people to express their views and concerns in a safe and understanding environment. On the whole, people knew who they would talk to if they were unhappy about any aspect of their care and when I spoke with them the majority said they had no complaints. They said, if I wasnt happy Id tell them, but I dont have to, if I wasnt happy Id say something to the bosses (whoever was in charge at the time), but everythings alright. People could access the complaints procedure because it was displayed in the foyer and clearly described the procedure for people should they have any concerns. It was clearly written, easy to understand and explained what the procedure was and how long the process would take. It was brought to the managers attention to update information about the contact details of the Commision for Social Care Inspection. A record was maintained of complaints that had been made. The record identified four Care Homes for Older People Page 18 of 31 Evidence: complaints had been made and upheld. We discussed with the manager how the record could be improved by including more detail. The knowledge of the manager in respect of safeguarding adults had significantly improved since the last inspection. She had obtained the local adult safeguarding policy and procedure for South Yorkshire. She had made two adult safeguarding referrals. After the first referral she improved the timescale in which she reported the concern. All recommendations that had been made as a result of the safeguarding referrals had been acted on. This included, care planning and adult safeguarding training for all staff. During the visit a further allegation was made and this was reported immediately to the persons care manager, for them to refer to the adult safeguarding protocols to determine the next course of action. Care Homes for Older People Page 19 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. On the whole, the living environment was clean but improvements were still required to make all living areas a well maintained and comfortable environment for people to live and enjoy. Evidence: When we spoke to people they said they were satisfied with their living environment. They said their bedrooms were comfortable and some people had personalised these with pieces of their own furniture and possessions. They said, I like my room and they keep it clean, rooms OK and they keep it nice and clean and rooms very good. Beddings changed once a week. I look after it. When we looked round the home, the main lounges and dining area presented a pleasant and homely environment for people to live and they were well lit. There were a number of sitting areas and there were sufficient toilets for people that were appropriately located and easily accessible. Nearly all of the toilets, however, compromised peoples privacy and dignity by not having working locks (see health and personal care). The bathroom areas, despite recommendations to improve them at the last inspection had not improved and were still stark and bare. There were gaps in tiling in some toilets, bathrooms and shower areas, there were some toilets and bathrooms where paper was peeling from the walls, the flooring in the bathroom and Care Homes for Older People Page 20 of 31 Evidence: shower areas was pitted and toilet seats in some toilet areas did not look clean as the enamel was wearing. We also saw when people were having their mid morning drinks they had to hold their drink all the time because there was nowhere to put it. Having more occasional tables was highlighted by someone living there as something that could improve. Care Homes for Older People Page 21 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. On the whole, there was an experienced, trained and stable staff team in sufficient numbers to support people and the smooth running of the service. However, the recruitment of staff was insufficient to ensure people using the service were protected. Evidence: Generally, when we spoke to people they had confidence in the staff that cared for them and that on the whole staff were available when they needed them and they listened and acted on what they said. Their comments included, staff are good, kind, I feel safe with them. I feel sorry for them theyre busy, staff are pretty good - some days better than others, staff are good and pleasant, theyre all friendly, theyre ever so kind to me, staff are good and kind and staff are wonderful - like family. We observed how staff worked during the visit. This told us there were good relationships between staff and people and they responded in a timely way when people needed assistance. Staff were clear of their roles and what was expected of them. The AQAA told us training opportunities were provided that tried to deliver a programme that meets statutory requirements and National Minimum standards. It stated staff had received training in infection control, 33 of care staff had received Care Homes for Older People Page 22 of 31 Evidence: training in food handling, all staff had received induction training to Skills for Care standards and 92 held NVQ Level 2 in Care or above. All staff had received emergency aid training, but the manager had not completed a risk assessment as required at the last inspection to determine this was sufficient in assessing, providing and obtaining assistance in the event of an emergency/incident. It has remained as a recommendation at this inspection. The AQAA stated there was a recruitment policy in place and that everyone who had commenced employment in the last twelve months had satisfactory pre employment checks. However, this was not what we found when we looked at three staff files. They contained an application form, declaration of health and identification, but as at the last inspection did not contain the employees full employment history with written verification in gaps of employment. All of the files only had verification of one written reference, although the employment checklist on one of the files said a second reference had been received. A protection of vulnerable adults first check had been received before staff commenced work, but the file did not identify the arrangements for supervision that were/had been in place until a full Criminal Records Bureau check was received. Care Homes for Older People Page 23 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home was based on openess and respect. However, the manager still needed to improve her knowledge of her responsibilities and the owner needed to act on their responsibilities in meeting the legislative requirements and National Minimum Standards of a registered care home to ensure the health, safety and welfare of people and staff. Evidence: On the whole, people were pleased with the service they received and spoke highly of the manager and staff. The manager had many years experience within the caring profession and a year acting as a manager at the service. However, she has not applied to be registered by the Commission for Social Care Inspection (CSCI). The registration team at CSCI have been told about this, so they can achieve compliance in having a registered manager. She has obtained her Registered Managers Award and had a good knowledge of the needs of people and was committed to learning, so that the service would improve and meet the regulations and National Minimum Standards. Care Homes for Older People Page 24 of 31 Evidence: Her direction and leadership promoted a relaxed and friendly atmosphere. When we spoke to both people and staff they spoke highly of her and commented, Tina - out of this world. Shes on your level. She deals with things and is getting more experience and shes a better manager. All sections of the AQAA were completed and the information gave a reasonable picture of the current situation within the service, but action is needed to put in place what they have identified as improvements, so that the quality of life for people is improved and they meet Care Home Regulations 2001 and National Minimum Standards. On the whole, people expressed satisfaction with the service. Quality audits were conducted for health and safety, medication and care plans to identify areas for improvement. In addition, she has sent surveys to stakeholders of the service to identify areas for improvement. However, these had not been collated into an annual development plan to identify any areas that needed to improve. In addition, the registered owner had not completed a report of his visits to the service since 16 June 2007 despite a requirement at the last inspection to do so. This does not demonstrate commitment and working together with the manager to identify and put together a plan for improvement. It has remained in this report as a recommendation. People were encouraged to maintain control over their finances unless they did not want to or lacked capacity. We checked the record of financial transactions for two people. For one person the actual monies remaining did not correlate with the balnce on the record. The manager was asked to keep a closer check on this, as the entries had been verified by a second entry and clearly somewhere there was an error. The AQAA stated maintenance of equipment was in place for portable electrical equipment, hoists, fire detection and alarms, fire fighting equipment, emergency lighting, emergency call equipment, the heating system and gas appliances. It also stated a contract for soiled waste disposal was in place. The servicing for the premises electrical circuits had expired and this was identified to the manager for her to action. When we looked round the building fire exits had been kept clear, which should make it easy for people and staff to leave the building in the event of a fire. A fire risk assessment had been carried out, which meant an assessment of the service had taken place to identify action that needed to take place to safeguard people in the event of a fire. Care Homes for Older People Page 25 of 31 Care Homes for Older People Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action 1 8 13 (1) (b) This also links to the outcome for standard 7, service user plan. Advice must be sought from appropriate health care professionals when people gain or lose weight. To demonstrate the health needs of people are being monitored and appropriate action taken. Previous timescale of 30/11/2007 not met. 10/01/2009 2 10 23 (2) (b) Locks on toilet and bathroom 10/01/2009 doors must be in working order. To maintain the privacy of people. Previous timescale of 03/12/2007 not met. Care Homes for Older People Page 27 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 23 Regulation 23, section (2) 10/05/2009 (b). It also links to standard 26, regulation 16 (j) Bathroom, shower and toilet areas must be refurbished including replacing tiles, wallpaper, flooring and toilet seats. To keep the home in a good state of repair, maintain satisfactory standards of hygiene in the home and make the areas pleasant places for people to enjoy using. 2 29 19 Regulation 19, section 11 10/12/2008 (a) & (b) Where an employee commences employment prior to a full and satisfactory Criminal Records Bureau (CRB) check being received it must be demonstrated which member of staff has been appointed to supervise the Care Homes for Older People Page 28 of 31 member of staff pending receipt of the CRB and ensure so far as is possible that member of staff is on duty at the same time as the new worker. So that people are protected from harm. 3 29 19 Regulation 19, section (1) (b) Staff must not commence employment until two written references have been received and a full employment history has been obtained, including satisfactory written explanations of any gaps in employment. So that people are protected from harm. 10/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 12 19 27 Establish a planned programme of activity to improve the quality of life for people, including trips out of the home. So that people have someone to put their drinks provide sufficient occasional tables. This also links to standard 12. Consider the employment of an activity co-ordinator, so that time can be provided to people for social activites to improve their quality of life. This also links to standard 30, Staff Training and standard 38, Safe Working Practices. A risk assessment should be in place to identify whether emergency aid training for staff is sufficient in assessing, providing and obtaining assistance in the event of an emergency/incident. 4 28 Care Homes for Older People Page 29 of 31 5 31 The manager should submit an application to register to the CSCI, so that an assessment can be made of her fitness to be able to complete her full responsibilites. A plan should be formulated from the quality assurance processes that are in place, to put together an action plan of how the service will improve the quality of the service for people. A monthly report should be completed of the owners monthly unannounced visits to the service to establish the quality of the service provided by speaking with people, their representatives, looking at the environment and inspecting records. In addition, the report should identify areas of improvement that they will make as a result of those visits. The premises electrical circuits should be serviced to make sure they continue to be safe. 6 33 7 33 8 38 Care Homes for Older People Page 30 of 31 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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