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Inspection on 09/07/08 for Perth House Care Home

Also see our care home review for Perth House Care Home for more information

This inspection was carried out on 9th July 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 but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Perth House provides an excellent intermediate care service (see Choice of Home section) with a newly refurbished base. Staff work in a multi-disciplinary way with staff from health, with nurses, physiotherapists and occupational therapists, to offer a complete service. People who currently live at Perth House and their relatives spoke very positively about the staff, and observations of staff members at work during the inspection visit, showed a caring and committed staff team. Perth House is well equipped, and has made a number of improvements in different areas since the last key inspection.

What has improved since the last inspection?

A major refurbishment to the downstairs of the property has just been completed. This means that there are single bedrooms with en-suite facilities for those people who are staying at Perth House for intermediate care. As part of this refurbishment there is also a new kitchenette, where individuals can make hot drinks and snacks, complete with an adjustable height hob, which is easier for use by people who may be in a wheelchair. A new bathroom downstairs has been equipped with a hi-lo bath (one that rises up and down, making it easier for the care staff to assist people using the bath, who might need help). There is a new walk in shower upstairs, the open plan areas downstairs have been redecorated, a number of carpets and curtains have been replaced, fifteen new wardrobes have been purchased, a new hoist has been purchased for upstairs, and staffing levels have increased by one hundred and eleven hours a week to accommodate the new intermediate care wing. In addition the staffing hours in the laundry have been increased, and two new gas tumble dryers have been bought, together with a new widescreen television.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Perth House Care Home Athlone Close Chaddesden Derby DE21 4BP Lead Inspector Rob Cooper Unannounced Inspection 9th July 2008 09:45 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 Perth House Care Home DS0000036250.V368348.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. Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Perth House Care Home Address Athlone Close Chaddesden Derby DE21 4BP 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) 01332 717550 01332 717550 kevinjowett@derby.gov.uk Derby.gov.uk Derby City Council Kevin James Jowett Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th August 2007 Brief Description of the Service: Perth House is situated within a residential area of Derby city. It is registered to provide residential care for 39 Older People, although following the recent refurbishment there are only 36 beds available. All bedrooms are single and are provided across two floors, which are connected by a shaft lift and staircase. A variety of communal areas are provided. A commercial type of kitchen and laundry service the Home. All areas of the care home are accessible to people living at the home and seating is provided in the Homes garden. There is a car park. Fees are calculated by the assessment and collection section in Social Services and are based on capital and any regular income. At the time of inspection the fees were approximately £300 a week. Further information regarding the fees can be obtained by contacting the Registered Manager at Perth House or through your local Social Services office. People who might want to live at this care home can obtain information about the home direct from them, and this would include seeing previous inspection reports prepared by the Commission for Social Care Inspection. Further information about Perth House and residential care can be found on the Derby City Council web site at: www.derby.gov.uk Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was an unannounced visit as part of the key inspection process – so that no one at Perth House knew that the inspection visit was going to take place. The visit took approximately five and a half hours with one inspector present. In preparing for this inspection, the information that the Commission holds about this care home was reviewed, this included looking at the last inspection report, the inspection record, considering any complaints or concerns that have been made about the service, and reviewing any notifications made relating to incidents that affect the well being of the people living there. The methods used during this key inspection were to visit Perth House, where a method called case tracking was used; this involved identifying four people and looking at their individual files and making a judgement about the quality of care they are receiving, and if their needs are being met. This was followed by a partial tour of Perth House, looking at the activities on offer, and talking to three people who live at the home, two relatives and three members of staff about the quality of the service, and their experiences of living and working at Perth House. In addition a visit was made to Derby City Council’s Human Resources Department to review the personnel files of four members of staff held there. During 2007 the Commission for Social care inspection introduced an Annual Quality Assurance Assessment (known as an AQAA) as part of the inspection methodology, this allows care homes like Perth House to self assess their service. Information provided by the care home helped to form the judgements in this report. We also sent out ten surveys asking for views and information to people who live at the home, five to relatives and five to staff. Of these we have so far received back, two from people who live at the home, three from relatives and two from members of staff. The registered manager Kevin Jowett provided much of the information during this key inspection visit. On the day of this inspection there were twentyseven people living at Perth House. Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Three statutory requirements have been as a result of this inspection visit relating to: consultation with individuals about the content of their care plan, staff receiving training in safeguarding adults, and Derby City Council carrying out monthly ‘Regulation 26’ visits (these are monthly visits by a representative of the owners’ management team to ensure that the care home is running properly, and there are no problems or issues.) In addition six good practice recommendations have been made in respect of: Ensuring that copies of the statement of purpose and service user guide in Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 7 alternative formats – particularly large print and audio tape are available in the care home. Care plan should be reviewed on a monthly basis to ensure that people’s changing needs are being met. Care plans relating to people’s wishes at the time of their death should record all relevant information. Upstairs should be refurbished to the same high standard as downstairs. Regular monthly meetings should be arranged for the people who live at Perth House, and all members of staff should receive regular formal supervision and support sessions. 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. Perth House Care Home DS0000036250.V368348.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 Perth House Care Home DS0000036250.V368348.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): 123&6 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. People, who currently live at this care home, and those who would want to, have access to detailed information about the services on offer. People have contracts or a service agreement and they receive a comprehensive assessment of their needs, which allows the people to make an informed decision about whether the home can meet their needs. EVIDENCE: Both the statement of purpose and service user guide for Perth House were seen during the inspection visit, both documents are currently being updated, as some of the information is now out of date, and therefore inaccurate. Both documents contained a great deal of useful information about the care home, and were also available in a large print format, and alternative languages, an audio version is also available, either on tape or compact disc (CD.) These alternative copies would be provided by the city council, and while the Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 10 manager said they would be available, no copies were seen. The information available would allow people living at the care home, and those who might wish to in the future, to make an informed choice about living at Perth House. As part of the case tracking process four people who live at the care home were identified, and their files contained a copy of the terms and conditions of residence. Each of the four files contained a formal assessment of need. There are a number of different health & social care professionals involved with the individuals at Perth House, and examples of their individual assessment tools were seen – nursing, physiotherapy, etc. There was also evidence that individuals had been regularly re-assessed to ensure that their changing needs were identified and being met. In their AQAA Perth House said: “On admission each resident has a care assessment and risk assessment … External professional input is arranged as required e.g. District Nurse, GP and, in the case of intermediate care residents, this can also involve intermediate care nurses, occupational and physiotherapists. For intermediate care residents, a programme is planned and reviewed at intervals to meet identified aims in order to try to reduce the need for hospitalisation.” Intermediate care is a structured short-term care package, usually no more than a few weeks aimed at rehabilitation, with a view to returning home after a short period in Perth House where there is intensive physiotherapy, occupational therapy, nursing and social care support available to make sure that the individual has the skills and confidence needed to move back into their own home, and live independently. Perth House offers ten, newly refurbished intermediate care beds, with a specific team of staff to work with those individuals, which includes nurses, physiotherapists, occupational therapists and carers. Since the refurbishment the home is equipped to meet individual’s different needs, and provide the support necessary to ensure a speedy return to the person’s own home. The home also has a number of respite beds available for people who may require short-term care. The staff team (carers) have been increased by over one hundred hours a week to support the people who are staying for intermediate care, and this is a recognition that this type of work can be quite labour intensive, and therefore need more staff. Perth House Care Home DS0000036250.V368348.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. 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. People have their personal care given in a professional and caring manner by the staff, however the Council’s care planning documentation hinders rather than helps that process. The infrequency of care plan reviews means that people living at the care home are at risk of not having their personal and healthcare needs met. EVIDENCE: Each of the four resident’s files contained a plan of care, which had been produced from the assessments and identified personal goals and needs and how to meet them. The documentation was part of Derby City Council’s care planning system, and the forms in use were the same ones used in all of the Council’s care homes. A review of the documents showed that they are not ‘person centred’ and that means that were about processes rather than the individual they relate too. The page for reviewing the care plans offer little room to record information, and the style of the documents does not encourage staff to record information relating to a person’s changing needs, Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 12 but rather record that the care plan has been reviewed. The National Minimum Standards say care plans should be reviewed monthly in homes for older people, however a number of examples were seen where this had been less frequent. Very few of the care plans had been signed by either the individual to whom they related or that person’s relatives. In their AQAA Perth House stated: “Each resident has a care plan which is reviewed and updated to address changing needs.” All of the files contained care plans related to resident’s health care needs, and these in several cases had entries by health care professionals. Two people were asked about seeing the doctor, and they all said that there was not a problem, as staff would contact the doctor if they were unwell, and the doctor would come to see them at Perth House. Several files contained risk assessments relating to falls and or continence issues, and examples were seen that specific health care problems were being recorded and monitored by the staff. An inspection of Perth House’s medication systems showed that medication is handled safely. Administration records were seen and found to be complete, and any medication that needs to be double signed, was seen to be so. No one living at the home currently self-medicates. Evidence was seen that staff working at the care home are being trained in medication procedures. All aspects of the medication procedures that were seen showed a clear audit trail for medication, and indicated that people living at the care home were safe. Observations during the inspection visit showed that people who live there are treated with respect by the staff. Discussions with three people who live at Perth House, and observation of the staff working with people showed that the staff treated them with respect and dignity. This included observing staff knocking on people’s doors before entering, and speaking in a respectful manner. In their AQAA Perth House said: “Residents are treated as autonomous adults with their dignity, choice and individuality respected. Privacy is also respected and staff knock on bedroom doors before entering. Conversation with residents is respectful and takes into account the communication needs of residents.” Three of the four people’s files had details about their wishes at the time of their death. Some people living at the care home have pre-paid funeral plans, which identify in some depth their wishes when they die, which is very good practice. However some people’s files had no information relating to their wishes, or funeral arrangements, and no evidence that the issues had been discussed either with the individual concerned or their relatives. Perth House Care Home DS0000036250.V368348.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. People have a lifestyle that reflects their cultural, social and religious interests, and needs, which means that their social care needs are being met. EVIDENCE: Discussions with three people who live at the home identified that they thought there were plenty of good activities arranged. Comments received included: “There’s enough to keep me interested.” “I like the bingo, and the quizzes” and “There are activities, but I’m not one to join in.” The activities on offer ranged from bingo and table topped activities (games and puzzles) sometimes outside entertainers come in – singers and musicians usually. There is a small day centre, which operates three days a week within Perth House, this is mainly for community based clients, although there are some joint activities with people living at the care home. In one of the staff surveys the following comment was made: “The Day Centre needs to be five days a week, not three. It needs more entertainment eg singers, speakers, bus trips. The home needs a mini bus of it’s own.” Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 14 Two relatives were spoken with during this inspection visit. Both relatives were very positive about Perth House, and said they were quite happy with the care that their relative was receiving. They also said they were always made to feel welcome, and that there were tea and coffee making facilities, so they could share a cuppa with their relatives. Both relatives said the building was very comfortable, and they always found it clean, with one making particular reference to the recent refurbishment. Two people were spoken with about family contact, and they both said that their relatives were able to visit when they wished, and that staff always made them welcome, with the following comments: “No problem, no problem at all, they come, and the staff make them very welcome.” “My family come most weekends, it’s fine.” One comment of note received from a relative in a survey was: “Please be aware that it is frustrating to be kept waiting to enter the home before someone lets you in, this can be quite a while” During the inspection visit staff were observed to see how they were with the people living at the care home, and how they interacted with people on an individual basis. Staff were found to be very friendly, and lots of examples of them speaking in a respectful and pleasant manner to people in the care home were seen and noted. Informal discussions with a number of different people who live at the home, showed that they all thought the staff were very good, and looked after them very well. One individual who has dementia was observed in a slightly distressed state, as they were ‘lost.’ A member of staff was observed speaking in a very tender and reassuring manner to this individual, and helping them to get back to more familiar surroundings. There was a good choice of meal on offer including a vegetarian option if required. Information related to individual’s likes and dislikes was also seen in the kitchen. The food was well presented, and the dining areas were attractively laid out. Everyone spoke positively about the food with comments such as: “The food is excellent, really nice” “they always find something for me, if I don’t like what they’ve cooked” and “I’m quite content, the food is lovely.” Discussions with the catering staff, and observations in the kitchen showed that dishes are cooked with fresh ingredients, and there is plenty of choice. Individual’s likes and dislikes are recorded, and a homemade birthday cake is produced whenever it is someone’s birthday. Perth House Care Home DS0000036250.V368348.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 adequate; this judgement has been made using available evidence including a visit to this service. A robust complaints procedure is in place to support people, however shortfalls in safeguarding procedures may potentially put people at risk. EVIDENCE: Perth House has not received any complaints since the last key inspection in August 2007, the last recorded complaint having been received in October 2005, which was reflected in the AQAA. The home’s complaints procedure, is on display in the foyer, and also forms part of the service user guide. Discussions with two people who live at the home indicated that they knew who to complain to, and how to complain, although none of them had ever needed to. Discussions with two relatives about complaints identified that no one had made a complaint, as they had not needed to. Both relatives said they would speak to the manager, and felt confident that he would deal with the complaint. A review of the staff training records in relation to safeguarding adults, showed that ten staff out of thirty-three had undertaken this training during the last two years. The subject is covered in induction for all new staff, but ‘refresher’ training, and more in depth training to ensure staff understand the correct procedures is lacking. The training is aimed at raising staff awareness of abuse, and issues around abuse and through raising those issues, offering people greater protection against abusive practice, while also making sure that Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 16 the staff understand the correct policy and procedure to follow if abusive practice is found. Three members of staff were asked about safeguarding adults training and one said they were aware of the issues, and had undertaken this training, while the other two were waiting for a date for the training. Perth House have not had made any safeguarding adults referrals since the last key inspection. Perth House Care Home DS0000036250.V368348.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 good; this judgement has been made using available evidence including a visit to this service. People live in a safe, clean, well maintained and comfortable home, with their personal possessions around them, which means that they are living in ‘homely’ surroundings that meet their needs. EVIDENCE: A partial tour of Perth House showed that it was comfortable and well maintained, with good quality fixtures and fittings. Downstairs has recently been refurbished, with bedrooms now having en-suite facilities, and comfortable lounges and communal areas. Upstairs has seen some redecoration, but has not been refurbished to the same extent, and is therefore in sharp contrast. With downstairs accommodating the intermediate and short-term care people, this means that the people who live at Perth House long-term and living upstairs, are by comparison living in Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 18 accommodation of a lesser standard. There is a good range of different bathing options available, from walk in showers, to fully assisted bathing for those who require more help. In their AQAA Perth House said: “We provide a safe, well-maintained environment which suits their needs and promotes independence and privacy. Hygiene standards are good with Health and Safety, COSHH and infection control guidelines in place and followed. Bedrooms and communal areas can be personalised and residents can bring their own possessions within the constraints of space. Bathrooms have been decorated to make them more homely. Downstairs bedrooms are en-suite and newly decorated and furnished to high standard. A new larger TV with a flat screen has been provided in the upstairs lounge. Where possible notices are displayed in a manner trying to keep the environment as homely as possible.” Domestic staff were seen cleaning in different parts of Perth House during this inspection visit, and discussions with staff showed that there were systems in place for cleaning, and that the home had a good supply of cleaning materials. The building was found to be clean, and smelt fresh. Perth House Care Home DS0000036250.V368348.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 good; this judgement has been made using available evidence including a visit to this service. Staff have been recruited professionally, and are competent and trained to do their jobs, which means that the people who live at the care home are having their needs met. EVIDENCE: Perth House’s staffing rota was reviewed and this showed that there was enough staff currently employed to meet people’s needs. Discussions with the manager and related documentation showed that since the last key inspection staffing levels have been increased, and this has seen an extra one hundred and eleven hours for the intermediate care team, and an extra ten hours in the laundry. One person living at the care home was asked about staffing levels, and they said that they thought there was enough staff on duty. Three members of staff were also asked about staffing levels, everyone said they thought they were alright, and there had been a recent increase, including some community based health care assistants coming in to work at the home. One staff survey suggested that staffing levels had been an issue, although they had improved recently, and one relative commented in their survey: “We have been aware there are not enough staff on duty. This can be a worry.” The care industry considers National Vocational Qualifications (NVQ) to level II in care to be the basic qualification for staff working in residential care. A Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 20 review of the staff training records showed that currently there are thirty-four care staff at Perth House. There are currently nine staff with NVQ level II qualifications, and another four studying for their NVQ level II. One member of staff has an NVQ level III in care, and another an NVQ level IV. Two staff working in the kitchen have an appropriate NVQ level II, and two domestics have NVQ level I in cleaning. The files of four members of staff were seen, to check that they contained all of the information that would show that staff at Perth House had been recruited in a safe manner – namely that applicants had filled out an application form, provided two written references and had had a Criminal Records Bureau check. The documentation showed that Perth House’s recruitment policy and procedure had worked to protect the people living there. Some staff records are held locally, while others are held within the Human Resources Department of Derby City Council, so files were seen at both places. Discussions with three members of staff about their recruitment showed that they had gone through all of the pre-employment checks, and had not started working until those checks had been completed. The staff training records showed that Perth House does have a training plan for its staff, this was reviewed together with staff training files and records and these showed that staff were receiving the training to help them to do their jobs. Discussions with three staff members provided evidence of the training courses staff had attended, including training in fire safety, first aid, health & safety and moving & handling etc. Perth House Care Home DS0000036250.V368348.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. Perth House’s management strategies indicate that the quality assurance system is not working effectively, and staff are not receiving the supervision and support to ensure they are working effectively, both of which potentially leave people living at the home vulnerable and at risk. EVIDENCE: Kevin Jowett is the Registered Manager, having been in post for sixteen years. He is suitably qualified and experienced and she has been judged by the Commission for Social Care Inspection to be a fit person to run a care home. Perth House’s quality assurance system relies on questionnaires being filled in by people who live at the home, relatives and visitors. Copies of these Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 22 questionnaires were seen together with evaluation of the results, with the latest evaluation dated April 2008. Perth House does hold meetings for the people who live there, although the records showed that these are not held regularly, with the last minutes that were seen were dated 01/07/07. Regulation 26 visits (these are monthly visits by a representative of the City Council’s management team to ensure that the care home is running properly, and there are no problems or issues) are not taking place on a regular basis, with the most recent report dated 12/11/07; both of these (meetings for the people who live at Perth House and Regulation 26 visits) are part of the home’s quality assurance system. Perth House has a system for holding people’s personal monies. This is operated on their behalf by the staff (dependent on individual choice and their ability to manage the money, or relative’s involvement). Four people’s finances were checked at random. All of the cash tallied with the records, and receipts were seen, which enabled a clear audit trail of the individual’s financial expenditure to be followed. Perth House has a formal staff supervision system in place, in which staff receive supervision, either with the manager or with one of the other senior members of staff. Formal supervision offers staff support and guidance in carrying out their work, and is seen as an essential management tool in residential care. The records of four members of staff, together with talking to three members of staff during the inspection visit, showed that formal supervision is not currently happening on a regular basis. Many different health & safety records were seen, including the fire safety records – weekly tests, emergency lighting tests and extinguisher maintenance records, and the Control of Substances Hazardous to Health (COSHH) records, all were found to be correct and up-to-date, which showed that people living and working at Perth House, are doing so in a safe environment. Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 2 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 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation Requirement Timescale for action 31/10/08 2. OP18 3. OP33 Regulation People living at Perth House 15 must be consulted with in respect of their care plans. This should be achieved by getting individuals or their relatives to sign care plans to show their agreement. Regulation All members of staff working at 31/12/08 18 (1) c Perth House must receive training in safeguarding adult’s procedures, so that people living at the care home are protected from abuse. Regulation A representative of Derby City 31/08/08 26 Council must visit Perth House every month and carry out a ‘Regulation 26 visit’ and a record of the visit, and the representatives’ findings must be kept, and be available for inspection to show that Senior managers are aware of any issues at Perth House. Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 25 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. Refer to Standard OP1 Good Practice Recommendations Copies of the statement of purpose and the service user guide in alternative formats – large print, audio tape, a selection of foreign languages, should be available in the home, so that they are readily available should they be needed. Care Plans should be reviewed on a monthly basis, with a record of the review kept, showing any changes in an individual’s needs. All people living at Perth House should all have their wishes identified and recorded in respect of when they die. Relatives should also be involved, so that when the time comes, staff are clear about what individuals want to happen. Efforts should be made to ensure that the accommodation upstairs for the people who live at Perth House long-term is brought up to a comparable standard to that downstairs, so that the building offers choice, and meets people’s individual and collective needs. Regular meetings should be held for the people who live at Perth House, to give them the opportunity to comment on the service they are receiving, and to have their voice heard in a formal meeting. Ideally these meetings should take place on a monthly basis. All members of staff working at Perth House should receive formal supervision a minimum of six times a year. 2. 3. OP7 OP11 4. OP19 5. OP33 6. OP36 Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Perth House Care Home DS0000036250.V368348.R01.S.doc Version 5.2 Page 27 - 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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