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Inspection on 25/10/06 for Quarry Mount Residential Care Home

Also see our care home review for Quarry Mount Residential Care Home for more information

This inspection was carried out on 25th October 2006.

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

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

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

There are excellent mechanisms in place to ensure communication links between service users, relatives and staff in the form of an informative newsletter and information sheets. The assessments on falls and pressure sores are very good. The recording of staff supervisions provide the reader with information on the discussion that took place, supervisee and supervisor sign to agree the contents. Thought has been given to ensure that bedrooms are age appropriate and furnishings are of a high quality. Having a maintenance man on site allows for the any repairs or redecoration needs to be addressed straight away. The home has a very high standard of cleanliness. This is a very pleasant home with a relaxed, pleasant atmosphere. The owner reports that the home does not receive any complaints and therefore none were recorded. Documents providing information on the service are regularly reviewed and updated. Service users care needs are well met.

What has improved since the last inspection?

There are records to show that service users have agreed or not agreed to have their personal care provided by people of the opposite sex. The storage of controlled drugs is now securely managed. The manager advised the inspector that there has now been hotel locks fitted to all the ground floor bedrooms and that they are planning to do the upstairs rooms. All bathrooms and toilets now ensure that the privacy of service users is upheld. Menus for the week are displayed on the notice board and all alternative meals that are given are recorded. The recording of fire drills has now improved and the fire risk assessment has been reviewed and dated. Red alginate bags are now provided to enable soiled laundry to be transported to the laundry with reduced risk of cross infection. Since the last inspection procedures regarding medication has improved.

What the care home could do better:

Consideration could be given to accessing information on the `End of Life` initiative, which may help staff in their recording of how they can support, reassure and help service users at such times. The statement of purpose could include the homes` policy on evacuation in the event of a fire. The manager must confirm in writing to each service user that the home can meet their needs. All staff should have access to medication training and this should not be dependant on their residential status. When staff have received medication training this should be recorded for reference. Information in a care plan should indicate the date that the medication commenced. Data Protection principles should be considered when recording service users` weights.

CARE HOMES FOR OLDER PEOPLE Quarry Mount Residential Care Home 83 Bath Road Swindon Wiltshire SN1 4AX Lead Inspector recordPauline Lintern Unannounced Inspection 25th October 2006 10:00 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 Quarry Mount Residential Care Home DS0000062385.V313170.R02.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. Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Quarry Mount Residential Care Home Address 83 Bath Road Swindon Wiltshire SN1 4AX 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) 01793 527715 01793 616130 Quarry Mount Care Ltd Mrs Karen Meadowcroft Care Home 32 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (32), of places Physical disability over 65 years of age (4) Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users who may be accommodated in the home at any one time is 32 No more than 25 service users aged 65 years and over with dementia may be accommodated at any one time No more than 4 service users aged 65 years and over with a physical disability may be accommodated at any one time 24th November 2005 Date of last inspection Brief Description of the Service: Quarry Mount is a large detached house in the Old Town area of Swindon offering accommodation and care to 32 older persons, some of whom have dementia. The home is a short walk from local shops, post offices, bus stops and churches.The home is arranged on three floors. There is bedroom accommodation on all three floors. The communal space is arranged on the ground floor and consists of a large lounge, a dining room and a further lounge and dining room. There is also some seating accommodation in the hallway. There are two semi-detached bungalows in the rear garden accommodating four residents. A large garden at the rear with seats and tables is provided in the summer so that residents can sit out. A people carrier is provided for outings and for shopping. The accommodation is appointed to a high standard. Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors carried out the unannounced key inspection over seven and a half hours. The inspectors examined individual care plans, risk assessments, health and safety records and recruitment files. The inspectors spoke to service users, relatives and staff to obtain their views on the service. Prior to the inspection surveys were sent out to service users, relatives, healthcare professionals and staff. Response to the surveys was poor. The inspectors toured the premises with the manager Mrs Meadowcroft. The fee charged at Quarry Mount range from £483 per week for self-funding service users and £332 per week for local authority. Items not covered by the fee include hairdressing, toiletries, newspapers, extra occupational therapy and transport by taxis. Entertainment costs are divided between the audiences, typically £3.00 each person. What the service does well: What has improved since the last inspection? There are records to show that service users have agreed or not agreed to have their personal care provided by people of the opposite sex. The storage of controlled drugs is now securely managed. The manager advised the inspector that there has now been hotel locks fitted to all the ground floor bedrooms and that they are planning to do the upstairs rooms. All bathrooms and toilets now ensure that the privacy of service users is upheld. Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 6 Menus for the week are displayed on the notice board and all alternative meals that are given are recorded. The recording of fire drills has now improved and the fire risk assessment has been reviewed and dated. Red alginate bags are now provided to enable soiled laundry to be transported to the laundry with reduced risk of cross infection. Since the last inspection procedures regarding medication has improved. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3 The home ensures that service users’ or their representatives receive detailed and accurate information about the services provided. Each potential new service user has an assessment to ensure that the home can meet their needs prior to being offered a service. Quality in this outcome area is good. This judgement was made from evidence gathered both during and before the visit to the service. EVIDENCE: The manager confirmed that applicants are provided with a statement of terms and conditions of residency, a service user guide and the statement of purpose. There are large print documents in the office for those who need them. The stated terms detail respective rights and responsibilities and offer the option for a trial period of four weeks, permanency of residency subject to any health consideration, termination period and details of fees. Information also confirm that their bedroom is regarded as a residents private space and details the use of shared bedrooms, safe custody of possession, labelling of food, and the possession of pets, arrangements for health and personal care Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 9 and how to complain. The statement of purpose and the service user guide is regularly updated to ensure that the contents are current. The inspector discussed with the manager the use of a template form designed to maintain accurate records regarding residents receiving visitors, resuscitation, early admission to hospital if poorly and preferences in respect to burial or cremation. The inspector raised a concern that it was not for the service to decide with a resident whether CPR should be denied and that they had a duty of care to preserve life. The inspector drew a distinction between such decisions being part of a wider multi disciplinary decision that involves: medical staff, residents and families and the home having decided that this is at the request of only the resident. Details are also provided regarding the safe keeping of valuables. Residents’ or their family members are asked to write down their preferences regarding cross gender care, and details appointee ship. Assessment documentation for people recently admitted covers key areas of risk and their personal care needs but some basic details such as important contact addresses, phone numbers and dates of birth were either not answered or found to be wrong. The inspector felt that the assessment documentation has much improved, but suggests there is scope to improve the assessment process further. These are noted as recommendations later in this report. The home must confirm in writing to the resident that having regard to the assessment the care home is suitable for the purpose of meeting the resident’s needs in respect to their health and welfare. It was noted by the inspector that the use of plastic tabards placed on service users at lunchtime could be seen as institutional practice. This was discussed with the manager for her consideration. Many service users praised the service they are receiving. Comments include ‘Staff are kind and caring to me’, ‘I get help with my care’, I like it here very much and I get on well with my room mate’ and ‘I can have a laugh with the staff’. Quarry Mount Residential Care Home DS0000062385.V313170.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 There is a well-established system for the planning of care. Residents’ health care needs are met, however they do not give enough attention to the resident’s viewpoint or take into account their psychological needs. Medication is managed appropriately and policies and procedures are in place to safeguard residents where possible. Service users report that they feel respected and their privacy is upheld. Quality in this outcome area is adequate. This judgement was made from evidence gathered both during and before the visit to the service. EVIDENCE: Examination of two case files and other paperwork confirm that there is a wellestablished system for the planning of care. It can be seen that the residents plans broadly reflect the needs highlighted in the person assessments. Like the assessment documentation the service user plans are not good at reporting the viewpoint of the service user (as opposed to health care, social care and relatives viewpoint) and they tend toward a more functional approach to need. Some assessments are undated and not sourced, making it difficult to compare Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 11 progress over time. There are documents to show that care plans are periodically reviewed, though most changes in the care plan reflect alterations to medication or associated health care concerns. The inspector discussed with the manager recordings in the daily notes. There needs to be an improvement in the recording of how reassurance and support is given to service users who may be distressed or unhappy. It was recommended to the manager that she give consideration to the Department of Health ‘End of Life Care’ initiative. The manager reported that the home benefits from having a very good local doctor who visits the home each week. On the inspectors’ arrival at 9.30am, it was noted that the majority of service users in the lounge appeared asleep and dozing. The manager reported that all but one service user is on medication but was unable to say whether there is a connection here or not. Advice was given that the manager raises this with the doctor so it can be considered. The inspector observed the doctor discussing the medical condition of one service user in the corridor; this may have been as the office was in use however this practice is considered unsatisfactory and highlights the need for more office space. The home maintains a weight record for each record for each service user, however these details are not recorded on each file as required by data protection principles Service users report that they are well cared for and a feature of this inspection was that all service users appeared well groomed. The service has a very good and detailed medication policy in place. It requires staff to report all medication errors. Medication was checked and was found to be satisfactory. Staff report that the system for administering drugs works well. Two service users’ records were checked and they appeared in order. Since the last inspection improvements have been made to storing controlled drugs and keeping medications cool when required. Staff confirm that before they can administer drugs they have to be trained. Typically this consists of observing a competent colleague on several drug rounds, shadowing a colleague giving out drugs, giving out drugs under the supervision of a competent person and assessed as to their competency before undertaking the drug round unsupervised. The manager reported that the home does not keep any record to verify when such training is provided and was told that it would be good practice to do. Some staff have attended a local medication training course. The manager said that it was not possible to put forward staff that have not resided in the United Kingdom for three years for this course because they are not entitled to funding. In such circumstances the company should either fund the training themselves or find an alternative training provider. Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Service users have the opportunity to access varied activities to suit their individual needs. Family and friends are welcomed by the home and access to the local community is encouraged. Service users make choices where possible about the way they choose to live their lives. The home ensures that mealtimes are pleasurable, with good healthy food being presented in a relaxed, unhurried manner. Quality in this outcome area is excellent. This judgement was made from evidence gathered both during and before the visit to the service. EVIDENCE: One service user told the inspector that they like to ‘join in with the sing songs’. A couple of service users reported that they prefer to watch television during the day but join in with the activities when they choose. One service user commented that they join in activities such as ball darts, quizzes and the occupational therapy sessions. The activity programme shows that in house activities include gentle exercise, singing, bingo cards, and weekly visits from an organist, ball games and skittles. Staff reported that service users enjoy biscuit decorating and special celebrations such as Christmas. The service users have the opportunity to Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 13 practice their religion, as a minister will come to the home every three weeks. One service user informed the inspector that they are Roman Catholic and they are able to meet with the visiting Sister to take communion if they wish. One visiting relative confirmed that the ‘activities are good and they are excellent staff here’. He continued to say ‘Mum always has her hair done and the chiropodist visits her regularly’. Service users confirm that they are able to meet their visitors in private if they wish. Two relatives reported that they could meet in private if they wished but they usually sit in one of the lounges and they are happy with that arrangement. One relative said that wheelchairs are available for them to take their relative out if they wish. They added ‘I often take my mum for a walk to the Town gardens, which she enjoys when the weather is nice’. The home is very good at maintaining communication with families and friends by way of a regular informative newsletter, which includes photographs of events and new staff. The manager has recently attended a course on Dementia and on her return she sent out a information leaflet to families to enable them to get a better understanding of this condition. The family of one service user told the inspector that they had found this extremely helpful and that they had learnt a lot from it and appreciated that the time had been taken to send out such information. One service user reported to the inspector that the local authority are in the process of reviewing their care package, to see if they are able to move to a more independent setting. They commented ‘ I do not want to move, I like it here.. A recommendation was made at the last inspection for service users to have the opportunity for group discussion and sharing of information. The manager confirmed that this did take place a few times but unfortunately there are now less service users who are able to participate fully to the forum. At the time of the inspection the cook was on annual leave so the deputy manager was covering for her. The menu for the week is displayed in the hall for residents to refer to. Observation of the menu indicates that the food is nutritionally well balanced and varied. There is an alternative option for people who are diabetic. One service user told the inspector ‘The food here is very good, it makes my son’s mouth water’. All comments made to the inspector regarding meals were positive. Service users confirm that they are offered drinks throughout the day and have the opportunity to have a snack if they wish. The dining room provides a pleasant environment, where staff supports some service users. Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Service users and their families feel that their concerns and complaints are listened to. Where possible service users are protected from any form of abuse. Quality in this outcome area is good. This judgement was made from evidence gathered both during and before the visit to the service. EVIDENCE: The manager reports that there have been no complaints or concerns raised since the last inspection. There is a complaints policy and procedure in place, which all service users and their families have access to. Although there have been no complaints the home should have a record available to document any concerns that may arise and which will provide the reader with timescales and outcomes of any investigations. Relatives who spoke to the inspector confirmed that they knew the procedure for making a complaint. Comments from service users confirmed that they felt able to make a complaint if they wished. One service user commented that ‘ I like Karen and if I was unhappy I would tell her’, another person said ‘I know whom to complain to if I need to’. Staff report that they have attended ‘safeguarding adults’ training and have a copy of the Wiltshire and Swindon ‘No Secrets’. Staff explained to the inspector what action they would take if they suspected any form of abuse was taking place. The home has a ‘whistle blowing’ policy in place. Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 15 The home’s policies and procedures regarding service users money safeguards the service users where possible. Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The home provides a safe and well-maintained environment for service users to live in. The home has a very high standard of cleanliness and appropriate to the needs of the service users. Quality in this outcome area is good. This judgement was made from evidence gathered both during and before the visit to the service. EVIDENCE: A tour of the premises took place at 9.30am. The home was very clean and tidy but with a slight odour in a couple of rooms. The manager explained that they are considering having to remove the existing carpet in some rooms and replacing it with a more appropriate flooring to prevent this reoccurring. All radiators are covered to prevent scalds. Bedrooms are all pleasantly decorated and are age appropriate in their furnishings. Service users are able to bring in their own personal belongings such as small pieces of furniture, photographs and pictures. Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 17 The manager explained that although some service users share a bedroom, if a ‘share’ dos not work put for any reason then the service user will have the opportunity to move into another room. She added that some service users prefer to have the company of another rather than be in a room alone. The home has a maintenance person on site, which ensures that all areas are maintained to a high standard. The manager explained that he is now in the process of decorating some bedrooms. Service users comments relating to their rooms were all positive. One service user reported that she would like to have a mobile phone and that she had discussed this with the manager. The manager confirmed that she was in the process of finding the most suitable tariff for the service user. Another service user commented that ‘I am happy here and the way that I am treated and I have a nice single room’ Training records and the training programme show that staff receives training in infection control. During the tour of the premises the inspector met with the laundress who was in the process of using the two large commercial washing machines and tumble drier. She explained that soiled laundry is transported to the laundry in red alginate bags that are then placed directly into the washing machine to avoid infection. Both the laundry and the sluice were found to be clean and hygienic. Following the last inspection all locks have now been removed from the downstairs rooms. All service users are risk assessed to their capability to manage their own bedroom doors. There is a call system in place. All bathrooms and toilet doors now have a suitable locking system to promote privacy. Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 29 and 30 Staffing levels are appropriate to the needs of the service users. Staff are provided with a good training programme. The homes’ recruitment practices protect service users where possible. Staff induction takes place however this is not clearly documented. Quality in this outcome area is good. This judgement was made form evidence gathered both before and during the visit to the service. EVIDENCE: The staff rota indicates that there is sufficient staff on duty at all times. Staff reported that the mornings are the busiest time however they feel that there is sufficient staff on duty to meet the service users needs. Service users commented that staff take the time to sit and chat to them even though they are busy. The home provides a 24-hour on call to provide the staff with support and guidance if needed. One staff member reported that ‘there is always someone available to talk to, we can always phone on the home mobile if we need to’. Another member of staff commented ‘We are valued as carers’. The inspector met with three staff members who all confirmed that they had completed their National Vocational Qualification (NVQ). At the time of the inspection 76 of staff have achieved their NVQ level 2 or above. The inspection involved examination of three staff files, which showed that checks have made with the Criminal Record Bureau (CRB) and the Protection of Vulnerable Adults (POVA) list to safeguard service users where possible. Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 19 The recruitment and selection process involves obtaining two written references. Files sampled show that staff are provided with a contract of employment and a job description. All staff has a health assessment completed to ensure that they are fit to carry out their duties. Staff informed the inspector of the training they have received to date. This included dementia, manual handling, first aid, and basic food hygiene, abuse awareness. One staff member commented that ‘Karen even arranged for someone to come in to talk to staff about MRSA, which was very informative’. There is a training programme for staff members and the forthcoming courses cover many topics such as palliative care, challenging aggression and health and safety. Refresher courses are also available. The manager reported that she has the opportunity to attend training in subjects such as recruitment strategies, train the trainers and time management. Staff confirmed that they attended an induction period however there are no certificates available to confirm this. The manager has reported that she will develop a document that evidences when an induction has been completed. Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 The home is well run by a competent and qualified manager. The home is run in the best interests of the service users who live there. Mechanisms are in place to safeguard service users’ finances where possible. The home has clear policies and procedures in place to ensure the health, safety and wellbeing of the service users. Quality in this outcome area is good. This judgement was made from evidence gathered both before and during the visit to the service. EVIDENCE: The manager of Quarry Mount is well qualified and has many years experience within the care sector. Staff, service users and their relatives speak highly of the manager stating that she is approachable and supportive. There is a deputy in place to support the manager. One relative told the inspector ‘the deputy is very good’. Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 21 The home goes to great lengths to ensure that there is good communication between service users, the home and relatives. There is a relatives committee and they frequently ask for people to participate in these. The home completed a Peer Group Quality survey in March 2006, which was issued to eight health and social care professionals to obtain their views on the service. There was a quality management system issued on 1st June 2006, when questionnaires were sent out. The manager reports that they are going to pick three questions from the quality assurance tool and attach them to the newsletter to obtain family feedback. Quarry Mount has achieved ‘Investor in People’ status. In line with the care home regulations the provider carries out a monthly audit of the home. Policies and procedures are updated and reviewed. Service users’ money appears to be managed well and records are kept of any transactions. The inspection involved the examination of various health and safety records. The generic risk assessment has been reviewed and updated following the last inspection. Fire records show that the alarms are tested weekly, smoke detectors are tested quarterly and fire-fighting equipment is checked annually. Records show that all staff has received fire instruction. The statement of purpose provides safety procedures in the event of a fire however it could also include the homes policy on evacuation. Small electrical appliances were tested on 27/07/06 and a certificate was provided. The home has a health and safety policy. Staff receive mandatory training in manual handling, fire safety, basic first aid and infection control. The home is well maintained to safeguard the service users where possible. Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 22 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 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 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 3 X 3 X X 3 Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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 OP3 Regulation 14(1)(d) Requirement Following an assessment of needs the registered person must confirm in writing to the service user that they able to meet their needs in respect of his health and welfare. Timescale for action 25/01/07 Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 6 7 8 9 10 Refer to Standard OP1 OP7 OP7 OP3 OP9 OP9 OP9 OP16 Good Practice Recommendations It is recommended that the statement of purpose includes information on the homes’ evacuation policy and procedure in the event of a fire. It is recommended that staff members record how they reassure and support service users when they are distressed. It is recommended that the manager gives consideration to the Department of Health ‘End of Life’ initiative. It is recommended that assessments are dated and sourced to enable comparison of progress over a period of time. It is recommended that staff that has not resided in the UK for more than 3 years still have access to medication training. It is recommended that all staff medication training is recorded. It is recommended that the manager explore with the prescribing doctors if there is any connection relating to medication and service users sleeping patterns. It is recommended that the registered manager keep a record available to document any complaints or concerns and the action taken with timescales. It is recommended that the registered person ensure that all records are stored in accordance to data protection principles. It is recommended that any discussion relating to service users medical conditions does not take place in any communal areas. OP7 OP10 Quarry Mount Residential Care Home DS0000062385.V313170.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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