Inspection on 16/05/07 for Quenby Rest Home

This inspection was carried out on 16th May 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Quenby Rest Home 10/01/08

Quenby Rest Home 16/11/06

Quenby Rest Home 03/11/05

Quenby Rest Home 28/06/05

Quenby Rest Home 05/01/05

Quenby Rest Home 12/08/04

Quenby Rest Home 09/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Quenby Rest Home Brightlingsea Road Thorrington Colchester Essex CO7 8JH Lead Inspector Sara Naylor-Wild Unannounced Inspection 16th May 2007 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Quenby Rest Home DS0000017915.V343895.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. Quenby Rest Home DS0000017915.V343895.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Quenby Rest Home Address Brightlingsea Road Thorrington Colchester Essex CO7 8JH 01206 250370 01206 250787 pat.spears@quenbyresthome.com 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) Mr A Sandhu Mr Avtur Singh Sandhu, Mr Sukvir Singh Sandhu, Mr Surinder Sandhu Ms Alison Simmons Care Home 26 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (26) of places Quenby Rest Home DS0000017915.V343895.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 26 persons) Persons of either sex aged 65 years and over, who require care by reason of dementia (not to exceed 11 persons) The total number of service users accommodated in the home must not exceed 26 persons 16th November 2006 Date of last inspection Brief Description of the Service: Quenby is a former domestic dwelling located on the main Colchester Road to Brightlingsea. The property is among established houses of similar age and design. The premises have been extended to the rear to provide the current accommodation comprising of mainly single rooms, most of which have ensuite facilities. There are four lounge/dining areas located to the front, centre and rear of the building providing varied and accessible space. The front garden is mainly laid to hard standing for vehicle parking. The rear garden is mainly laid to lawn with shrubs and trees. The ranges of fees charged by the service are between £367.00 and £495.00 per week. There are additional charges for hairdressing, chiropody and staff and some activities. The provider provided this information to the Commission in August 2006. Quenby Rest Home DS0000017915.V343895.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over two days on the 9th May and 25th May 2007. The inspector looked at records such as residents assessments, care plans, medication records, staff records and quality assurance. During the second days visit to the home the inspector conducted a SOFI (Short Observational Framework for Inspection). This tool was specifically designed to consider how Residents with dementia experience the delivery of the service and includes a two hour observation of residents and staff interaction. In addition the inspector spoke with the Proprietor, the quality manager, deputy manger, staff and the activities coordinator. The registered manager was on sick leave at the time of the inspection, but the deputy manager was present throughout and provided information required by the inspector. The inspector would like to thank the Deputy Manager, the staff team, residents, relatives and visiting professionals for their help throughout the inspection process. What the service does well: The provision of an activities co-ordinator helps the service in supporting residents social and emotional needs. This member of staff is free from other work to concentrate solely on the development of the opportunities to residents both inside and outside the home. The observation of an activities session during the inspection demonstrated a good rapport and understanding of the resident group and activities offered at different levels appropriate to the individual residents abilities. The staff team are keen and interested in developing their skills in delivering care to the residents. The service carries out robust systems when recruiting staff to ensure they protect residents from abuse. Quenby Rest Home DS0000017915.V343895.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Staff they have been unable to transfer their learning from training to the daily routine of the home and their approach to residents. Principally this is a way of working that relates to the individual and how best to respond to their needs. This means that whilst all the residents are provided with care this is general and task orientated. So for example people are provided with drinks, taken to the toilet and assisted to eat en-masse although not at a time or manner that suits their wishes and abilities. Care planning documentation is a way of identifying the individual and how staff should react to their assessed abilities and needs. The service currently has documents whose instructions reinforce the group care approach in that the instructions to staff in meeting the assessed needs of individuals do not differ from each other and contain general instructions. Health monitoring records must be maintained in order to understand how the wellbeing of individuals is affected and where additional health support should be sought. Although the response to complaints has been improved the service needs to consider how it supports and records less acute concerns raised during the course of day-to-day operation of the home. This is an important area of quality assurance that promotes listening to the residents. The service has “stood still” in the areas identified above for some time, and despite commitments made in action plan responses to previous inspection reports they has not been able to transfer these goals into the day to day operation of the service. There is a need for the staff team as a whole to have a stake hold in changing the culture and ethos of the way in which care is provided in the service, achieved through training, supervision and leadership underpinning these developments in the day to day practice of the home. Quenby Rest Home DS0000017915.V343895.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Quenby Rest Home DS0000017915.V343895.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 Quenby Rest Home DS0000017915.V343895.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents are assessed to assist the service in understanding how it can best meet their needs. However residents cannot be assured that the information will be documented in sufficient detail. EVIDENCE: The assessments of prospective residents are always carried out by the service prior to their moving into the home. The sample seen included some very comprehensive information in respect of the individuals needs and abilities, although there was some variation in the quality of their completion with some purely indicating a need identified i.e. needs assistance with dressing, without indicating what this may mean. The service does not provide intermediate care. Quenby Rest Home DS0000017915.V343895.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The diversity of individual Service users needs is not supported by the services documents. This does not help staff understand how they can best meet their needs. EVIDENCE: The files of five residents were examined as part of the case tracking exercise during the inspection. The format of the documents was divided into areas of daily living such as mobility and personal care. However, the completed documents were virtually identical in the way in which the goals or how staff should support the resident was written. As at previous inspections discussions with the staff identified that they did in fact have individual knowledge of the residents that was not reflected in the details of the care plan. So for example staff and relatives described to the inspector the very specific needs of a resident whose nutrition required a high level of additional support and intervention from staff, and for whom weight loss was a concern. However Quenby Rest Home DS0000017915.V343895.R01.S.doc Version 5.2 Page 11 examination of their care plan and the comparison with the other residents did not provide direction that differed in any way. The statements made were general and did not reflect the individual approach required to meet the assessed needs of residents For example, all the care plans stated that the aim in respect of diet was to maintain a health and balanced diet. This was to be achieved in all cases by providing a nutritious menu, monitoring weight and reporting any changes. In order to understand the impact of care planning, the inspector asked the proprietors to carry out an exercise with staff. Staff were asked to identify the person for whom an anonimised care plan was written from the instructions in meeting their care. The proprietors reported that when they had carried this out, staff had been unable to successfully identify the residents concerned and this had clarified the need for well documented care planning and as a result they had begun to develop the documents to provide a better support. Records relating to health care visits were maintained in the documents containing care plans. However issues that required monitoring when identified such as weight, fluid intake, skin integrity were not always maintained to a suitable level to ensure staff understood the impact of the care provision. This was particularly relevant in the case of a resident whose plan of care stated that staff should monitor fluids. A closer examination of the fluid records that were kept in the kitchen showed not only that this individual did not receive any additional drinks from other residents, but also that this recorded is also not accurately maintained with some days recording not commencing until midday. This fails to protect the residents’ health and wellbeing. During this inspection a two hour observation of staff and residents interaction was conducted as part of the SOFI methodology. Part of the observation was carried out during the midday meal and indicated that the staff had mixed skills and insight into the way in which they could best support residents’ dignity and independence. As an example a staff member was distributing plated meals to the residents. There was little if any conversation with the resident when placing the meal in front of them before the staff member moved away. One resident observed sat for some minutes looking with some confusion at the plate in front of them before another member of staff stopped and asked them if they needed help with their meal and assisted them to cut the food and start the meal. In another case staff assisting a resident to eat did not at any time during the meal observation speak with the resident. Having our individuality and humanity recognised is a key part of maintaining dignity within an institutional setting. The lack of understanding of some staff in reacting to the residents as individuals does not support the maintenance of their dignity. The medication system was considered and found that senior staff administering at each shift carry out an audit of all medication left in system to ensure that all the prescribed drugs have been given in the previous shift. Quenby Rest Home DS0000017915.V343895.R01.S.doc Version 5.2 Page 12 This level of quality auditing is above the recommendations of good practice and demonstrates the heightened awareness of staff in ensuring the systems are safe and robust. There were no omissions to the drugs records and changes or alterations to the medication dispensed were recorded at the back of mar sheets. i.e. when tablets were refused or dropped. The senior care on duty stated that the home did not have a controlled drugs cabinet but that there was a controlled drugs records book. They said that medication in this category had previously been kept in the homes safe. The staff member was not aware that temazepam was controlled drug, and this was not kept in accordance with the guidance. All staff that handles medication took part in competency tested training from Boots and Hunter solutions who carried out a days training in classification of medicines, understanding labels and prescriptions, dosage routes of administration how medicines work responsibilities of care staff and emergency situations. Certificates demonstrating staff attendance on the courses were held on personnel files. Quenby Rest Home DS0000017915.V343895.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 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents can expect to be stimulated by the range of activities offered by the co-ordinator but this could be further enhanced by the involvement of all members of the care team. EVIDENCE: The service employs an activities co-ordinator to provide a specific opportunity for residents to take part in organised and one to one activities. During the visit to the home the inspector observed a group of residents participating in a morning activities session with this staff member. The coordinator was skilled in supporting the different needs and abilities in the group to participate in the event, and demonstrated a good knowledge of them as individuals. The residents demonstrated a high level of positive response to the interaction and generally appeared to enjoy the opportunity. The activities coordinator felt that they were well supported by the proprietors, which included funding and training. Quenby Rest Home DS0000017915.V343895.R01.S.doc Version 5.2 Page 14 Although other staff were coming and going throughout the morning to assist people to the toilet, the hairdressers or dining room, they did not take part in any of the activity taking place in the lounge with the residents. From discussions with the staff and proprietor it was clear that staff in general did not participate in the organised activity and observation of their working with residents indicated that they did not use the tasks of daily living as an activity. So for example when assisting someone to eat their meal, they did not speak about the meal or use the opportunity to talk to other residents at the table about food and cooking. This had also been identified as an issue at the last inspection and as a result training had been provided to support staff in developing an understanding and skills in engaging residents. Although the staff had understood the training it was apparent that they did not utilise the skills they had learnt, and the organisation of the daily routine did not support them The staff and visitors have been fundraising for some time to purchase a minibus for residents to go out on trips. The proprietor had promised to match the fundraisers total in order to speed up the process. The notice of the running total is now kept in the office and discussions with staff indicated that they believed they had reached the target to buy a second hand bus, but as this had now gone on some time they were not clear what was happening with the proprietor to secure the vehicle. This would be a useful resource to the service and allow residents who are otherwise isolated in the home to enjoy the outings. The visitors’ policy remains unchanged and provides arrangements to support and welcome relatives and visitors. Part of the time spent the inspector spent observing residents and staff interaction took place during the mealtime. The atmosphere in the dining room was relaxed and unhurried with staff serving plated meals of their choice to residents. As previously stated in this report, the way in which some staff supported residents to eat their meals was more successful than others, although in all cases residents who needed staff to help them eat the meal were supported individually by staff. Quenby Rest Home DS0000017915.V343895.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 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents can expect their complaints and concerns to be listened to and actioned. Residents can expect staff to respond to allegations of abuse, although the service has not understood all its responsibilities in Safeguarding Adults. EVIDENCE: There have not been any serious complaints made about the service since the last inspection. The complaints policy itself meets the expectation of the Care Homes Regulations 2001 and is available to residents and relatives. At the last inspection the way in which complaints were responded to, was raised as a concern, however since this there have not been any further formal complaints made to test the services approach. The need to recognise all levels of complaints and create a log of the response made was discussed with the services quality manager as a point of development. This ensures that the issues that matter to the individual are listened to and that small concerns do not escalate because they are not attended to. The service has a policy and procedure in respect of Safeguarding Adults and staff have a programme of training in recognising the signs of abuse and whistle blowing. Staff spoken with were clear about their responsibilities in Quenby Rest Home DS0000017915.V343895.R01.S.doc Version 5.2 Page 16 reporting alleged abuse and their expectations of the proprietors action as a result. The proprietors had reported an allegation in respect of a staff members conduct to Social Services under their Safe guarding adults protocol and dismissed the staff member. They had not however referred the individual to the POVA list as required by the Care Homes Regulations 2001. This list is referred to as part of the employment checks made before staff can be appointed to a care position and is intended to prevent individuals who have been accused of abuse working with vulnerable people. In not referring the staff member to the list they were not protecting the interests of vulnerable adults in other care settings. This was discussed with the proprietors at the inspection. Quenby Rest Home DS0000017915.V343895.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, 20, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents can expect the location and overall layout of the home to support their needs but they cannot be assured that appropriate signage and use of colour to identify key rooms is in place. EVIDENCE: Since the previous inspection the premises had undergone an improved level of redecoration. Walls had been refreshed with paint and in some areas carpeting that had been noted by the inspector as worn had been replaced. The building works to an additional office in the centre of the building had progressed although was not completed, were less intrusive to the home. The communal areas arrangements had remained the same with the dining room at the front of the building and the two communal lounges situated in the Quenby Rest Home DS0000017915.V343895.R01.S.doc Version 5.2 Page 18 middle and back of the building. There had been consideration of how the layout of the larger of the two rooms supported residents; with chairs brought together in small groups and at the time of the inspection was being used by the activities coordinator for activities with a group of residents. Overall the building has a straightforward layout with one corridor through the centre of the building leading to all communal rooms and the majority of the residents’ bedrooms. The rooms are well lit with plenty of natural daylight and have sufficient space to accommodate seating and other furnishing comfortably. The gardens area accessible from the ground floor rooms and seating is provided. There were some use of signage on the residents’ bedroom doors and communal lounges, which will assist residents to navigate the home. These are a mixture of photocopied pictures to indicate the use of a room i.e. toilet on the toilet door, and in the case of residents their photo had been placed on bedrooms doors. The quality of this could be further developed in the use of wall and door colours as well as clearer signage at appropriate levels, as recommended by dementia care good practice. The home was free from odour and appeared clean and tidy on the day of inspection. The home employs both domestic and laundry staff and staff had undertaken training in infection control. Quenby Rest Home DS0000017915.V343895.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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents are supported by staff in sufficient numbers to meet their needs. EVIDENCE: The staffing numbers maintained by the service are arrived at following a calculation against the assessed residents needs. Rotas indicated that this translated into a person in charge, 4 care staff, plus housekeeping and catering staff. There appeared to be sufficient opportunity for staff to spend time with residents in communal areas of the home, especially with the added support of an activities coordinator although as stated elsewhere staff require support in understanding how to utilise this time. There continues to be a robust system for the recruitment of staff, and staff files examined evidenced that the service gains two references and carries out CRB checks. A number of staff are foreign nationals and their recruitment checks are carried out by specialist companies in their own country. The service states in its Annual Quality Assurance Assessment (AQAA) that 6 of the 12 care staff hold NVQ level 2 or above, or equivalent and that a further 2 are undertaking the course. This represents that 50 of staff recommended by the NMS. Quenby Rest Home DS0000017915.V343895.R01.S.doc Version 5.2 Page 20 Since the last inspection a series of training sessions conducted by a specialist consultant had been provided to staff. Principally these session set out to support staff in understanding communication, activity and the needs of older people and those with dementia. The staff reported this had been a useful experience and the trainer felt staff had demonstrated a good understanding of the topic. Despite this effort the discussions and observations of staff interaction with residents did not indicate that in general their understanding of older people and particularly those with dementia had improved significantly. Although none of the staff were uncaring in their approach to residents, apart from the activities coordinator staff did not exhibit a sense of the individuals diversity in how they approached residents care and there was an overriding concentration on the tasks rather than the quality of interaction with residents. Examples of this include staff not interacting with residents whilst they were supporting them to eat and a descriptions of their care that centred on their physical needs. From this evidence the Commission concludes that whilst training is being provided, the way in which this is translated and supported in the daily routine and leadership of the home does not support staff in developing these skills into their daily practice. Other training in the staff record included items such as first aid and food hygiene, infection control, the Alzheimer’s Society yesterday, today and tomorrow programme and planning included items such as Safeguarding Adults. Quenby Rest Home DS0000017915.V343895.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, 32, 33, 35, 36 and 37 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents can expect to the service to be able to support their needs but they cannot be assured that this is holistic. The service lacks leadership in developing and improving the quality of the support residents’ experience. EVIDENCE: The service has not developed a significant improvement in the compliance with the Care Homes Regulations 2001 and the many of the requirements made in previous reports are repeated here such as responses to complaints, development of care planning and daily routine. These have been raised previously with the Registered Manager and the proprietors and whilst there Quenby Rest Home DS0000017915.V343895.R01.S.doc Version 5.2 Page 22 have been responses to inspection reports and improvement plans provided to the Commission these have not been in reality developed. The accounting measures in place to safeguard residents monies held by the service are unchanged with an external accounting system used to monitor individuals expenditure and income into a central float. The records for these are available for examination by residents, relatives and the Commission. Staff supervision had been affected by the absence of the Registered Manager over the previous 12 months, and was less consistently applied. The staff felt they had opportunity to discuss issues with the Deputy Manager on a day-today basis, but this is not a qualitative means of monitoring staff performance and development. This is especially important when addressing issues of practice and developing a change of ethos in the working methodology identified in this report. The services Quality assurance questionnaires had been sent to stakeholders earlier in the year and the results were due to be collated and reported on in June 2007. The plans to develop the skills of staff to carry out dementia mapping continue to form part of the services development plan. The service has provided the Commission with an improvement plan in response to the last inspection, however the successful implementation of this plan was not evidenced at this inspection and this was discussed with the Proprietor and Quality Manager. The documents relating to the maintenance and safety checks for equipment and systems operated in the home were seen and evidenced that items such as the fire alarm systems and emergency lighting had been annually maintained and checked. Quenby Rest Home DS0000017915.V343895.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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 X 3 2 X 3 Quenby Rest Home DS0000017915.V343895.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 OP8 Regulation 55 Requirement Residents’ plans of care require further development to ensure that the instructions to staff in meeting individual needs reflect all the information known about them. Opportunities for residents to exercise choice in relation to social, recreational and leisure interests must be supported by the staff team in their delivery of support to residents. This includes supporting residents to participate in the daily routine of the home. Staff must develop skills in supporting residents in a way that upholds their rights to respect and dignity. Specifically this refers to engaging with residents whilst supporting them with intimate care. The policy and procedure for protection of vulnerable adults must be fully understood and followed. Specifically this refers DS0000017915.V343895.R01.S.doc Timescale for action 31/08/07 2. OP12 OP14 16 31/08/07 3. OP10 OP14 OP15 12 30/09/07 4. OP18 13 31/07/07 Quenby Rest Home Version 5.2 Page 25 to the requirement to refer alleged abusers to the DOH POVA list to protect all vulnerable adults. 5. OP30 OP28 OP36 19 Staff skills must be supported and monitored by the service to ensure that the residents benefit from improvements in the delivery of their care. Specifically this refers to the way in which teaching is upheld in the daily routine and leadership of the service. 31/08/07 6. OP31 OP32 10, 12 The manager must work to 30/09/09 continuously improve services and provide an increased quality of life for residents. This is represented by a resident focus and development of staff skills to support these. 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. Refer to Standard OP3 OP19 OP16 OP33 OP36 Good Practice Recommendations Pre admission assessments should gather full information about the individual resident as possible to support the home in deciding whether it can meet their needs. Residents’ independence should be supported by the design and adaptations to the environment using tools such as signage and colour. The service should develop tools to gather the views of resident with dementia and include this in consultation such as the complaints and quality assurance system. The registered person should develop the staff supervision to ensure the elements set out in good practice are incorporated. Quenby Rest Home DS0000017915.V343895.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Quenby Rest Home DS0000017915.V343895.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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