Inspection on 15/04/09 for Rastrick Hall

This inspection was carried out on 15th April 2009.

CQC found this care home to be providing an Poor service.

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

Rastrick Hall 17/04/08

Rastrick Hall 10/10/07

Similar services:

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report CARE HOMES FOR OLDER PEOPLE Rastrick Hall Close Lea Avenue Rastrick Brighouse HD6 3XB Lead Inspector Gillian Walsh Key Unannounced Inspection 15th April 2009 10:00 DS0000070125.V374910.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rastrick Hall Address Close Lea Avenue Rastrick Brighouse HD6 3XB 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) 0845 6037752 rastrickhall@orchardcarehomes.com www.orchardcarehomes.com Orchard Care Homes.Com Limited Manager post vacant Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC; to service users of the following gender: Either; whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is: 40 17th April 2008 2. Date of last inspection Brief Description of the Service: Rastrick Hall is a new purpose built home. It offers residential care for 40 older people. The accommodation is arranged over three floors. All of the bedrooms are single and have en-suite toilets and showers. There are lounges and dining rooms on each floor. All of the rooms are comfortable and nicely decorated. There is a garden area at the side of the building that can be used in fine weather. There is a car park to the front of the building. The current weekly charges range from £417 - £570 per week. Additional charges are made for hairdressing, chiropody, dry cleaning, newspapers, personal toiletries and private phone installation and calls. Rastrick Hall DS0000070125.V374910.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 zero star – poor service. This means the people who use this service experience poor quality outcomes. As part of this inspection we asked the home to complete and return to us a self-assessment of the quality of the services provided at the home. This was returned to us when we asked for it. This document is known as an AQAA (Annual Quality Assurance Assessment) and is for the home to tell us how they think they are doing and how they think they can improve services for the people who live at the home. It also gives us some information about staffing and staff training. Comment cards were sent to 10 people living in the home, 10 staff and 5 health care professionals; these cards provide an opportunity for people to share their views of the service with us. Information received in this way is shared with the home without identifying who has provided it. Seven people using the service or their relatives on their behalf and five members of staff wrote to us with their comments. Their comments have been used in this report. During this inspection, one inspector made a visit to the home and spoke with some of the people living at the home, some of the staff and the home’s management. The inspector also read care records, looked at some staff records, checked systems for medications, walked around all areas of the home and observed meals being served. What the service does well: People who live at the home appear to be well supported in making sure that they are clean and smart. People can make decisions about the routines they follow in their daily lives. The home arranges for people to receive health care as they need it. The home is clean and tidy. Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Care plans need to give staff all the information they need to make sure people receive the correct care. Staff need to make sure they follow correct procedures to deal with complaints and to safeguard people. People told us that that they were not at all happy with the food they receive at the home. People said: ‘The meals are served onto cold plates. Cheap margarine and cheap bread are used. Sometimes they run out of milk and marmalade. Cheap brands are an area that could be improved upon.’ ‘I do not get what I order and I am constantly told that they have ‘run out’ of items. I think that many times this is because I am on the top floor and they either do not have the time or do not wish to go down to the kitchen. I am allergic to strawberries and eggs but keep being offered them.’ ‘I was present when potato wedges were served for tea. I would not have fed them to a dog! They were overcooked/black and soggy.’ (Relatives comment) Meals need to be improved upon so that people enjoy nutritious, wellpresented food. Problems with lack of stability in management and staffing must be addressed. One person said, ‘It would be better if we didn’t use so many agency staff. If we had more permanent staff it would be better for the residents to know who is caring for them.’ Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 7 Staff need to receive training in the work they are doing so that people are cared for safely. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Rastrick Hall DS0000070125.V374910.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 Rastrick Hall DS0000070125.V374910.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 does not apply) People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People do not move into the home without being given confirmation that the staff will be able to meet their assessed needs. EVIDENCE: A selection of care files were looked at and all contained a copy of the assessment completed by staff from the home prior to the individual concerned being offered accommodation. The content of the assessments varied, some gave quite good detail of the persons lifestyle and care needs whilst others did not contain the information staff would need to decide whether or not the home was an appropriate placement for the person or to develop an initial care plan. It is important that Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 10 good pre admission assessments take place so that the manager can make sure that the staff working at the home have the skills to meet the persons needs and that the environment is right for the person. The home does not provide intermediate care. Rastrick Hall DS0000070125.V374910.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People generally feel well cared for but some care needs are not being met. EVIDENCE: During the visit to the home care files for five people were looked at. Each file contained a number of assessments covering areas such as skin condition, nutrition and moving and handling. In some of the files, where an assessment had indicated that the person had specific needs in that area, a care plan had been developed. However this was not the case in all of the files. For example, one person who had been identified as having lost over nine pounds in weight in the six weeks since their admission to the home had not had a care plan developed to address this. Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 12 Other people who had lost weight had care plans for this in their file but staff had not followed the care plan or taken the actions identified to address the problem. For example the care plan said to weigh the person monthly and to inform the GP of the weight loss but neither of these actions had been taken and the care plans had not been evaluated. Care staff were seen to be completing food intake charts for some people but when asked why they were doing this they were unsure. Discussion took place with managers about the effectiveness of staff completing food charts if they are unsure why they are doing it and if nobody is monitoring the information recorded on the charts. It was also of concern that one person who was losing weight had been identified on their pre admission assessment as being vegetarian. This information had not been included in the care plan or the nutritional assessment and the food charts showed that this person was being served meat on a regular basis. Some care plans gave good information about individuals preferences within their lifestyles and what actions staff should take to give the person the support they need to meet their needs. Others lacked specific detail and staff could struggle to know exactly what to do to meet the persons needs. It is particularly important that care plans are clear and detailed as the home has high usage of agency staff at the moment who will not all be familiar with the needs of the people living at the home. One person said ‘when agency staff are on duty I have to constantly keep explaining what help I need.’ One person who was receiving respite care had not had care plans or risk assessments developed in relation to the specific areas identified in the pre admission assessment. Other files did contain risk assessments which told staff how to minimise the risk of harm or injury to the individual concerned. Daily records are maintained but in some cases were difficult to follow due to entries being made on the wrong page within the file. Staff should be careful to make sure that significant events are recorded on a daily basis so that oncoming staff know what has happened in the individuals day and can follow up as needed. An example of this is where an accident record showed that a person had fallen but this information had not been recorded in the daily notes. Documentation in the care plan file showed that receive the attention of healthcare professionals such as the district nurse or doctor as and when they need it. A district nurse who was in the home during the visit said that staff are helpful and follow any care advice she may give. Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 13 Systems for dealing with medications were checked and found to be generally safe. Some issues relating to recording of stock balances and handwritten MAR (Medication Administration Record) sheets were discussed with the acting manager who confirmed that she would take action to address the issues. The Commission were informed recently of a medication error when someone was given their medication twice. One person also told us that the key to the medication cupboard had been lost on one occasion and it was very late before the night medication was given. People said that most staff were kind and respectful in their approach although some people said that this was not always the case with some of the night staff. Two people said that night staff did not always respond to call bells and one person said some night staff could be “very short” with them. One person said ‘buzzers sometimes seem to be ignored especially when there is a staff shortage.’ One person told us that she had found night staff sleeping on duty on two separate occasions. This was discussed with the acting manager who said that there had been some problems with agency staff which she had dealt with but she would continue to monitor the situation. All of the people seen during the visit looked clean, well groomed and well cared for. Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are enabled to make choices but do not get enough recreational opportunities. The food is poor and this issue has particularly affected this judgement. EVIDENCE: Some of the care plans seen contained details of how people like to spend their days, the routines they like to follow and their preferences in social and leisure activities. On the day of the visit some people were observed to be spending their time as they chose, some reading the newspaper, some staying in their rooms and some people were accompanied by staff on an individual basis on a walk out. Music was playing in one of the lounges, which some people seemed to be enjoying but others said they were “fed up” with it. When the music stopped one person shouted out for it not to be put back on again. Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 15 One person asked for the television to be put on to watch a specific programme. This was done but then staff failed to make sure that the person could hear the television. Action was only taken when the inspector prompted staff. In two of the lounges children’s television was playing during the afternoon. One person was seen arriving in the lounge where according to notices in the home, an art session was to take place. Unfortunately this was cancelled due to the person delivering the activity being ill but people had not been informed of this and no alternative had been organised. The acting manager said that the company do not employ activities personnel but organise for people to come into the home to deliver activities on three or four days each week. At other times care staff should deliver activities. No evidence of this was seen during the visit other than people being taken out for walks. People on two of the floors said that they were bored and had nothing to do other than “just sit here” A visiting relative said that they were always made to feel welcome and sometimes stayed for a meal. All of the people spoken with complained about the meals at the home. The acting manager said that agency catering staff were being used due to problems with recruitment. People said that the home often runs out of basic supplies such as bread, eggs, bacon and cheese. They said that the meals were of such poor quality that they leave most of it, the teas are repetitive, usually sandwiches and they do not get supper other than a cup of tea and a biscuit. People said that as a result of these issues, they often feel hungry. The lunchtime meal on the day of the visit was roast beef or poached fish in parsley sauce with cabbage, swede, mashed potatoes and Yorkshire puddings. The cabbage and potatoes being served on the ground floor were visibly burned and people said the meat was very tough. The inspector tasted the vegetables, which had little taste other than burned. On the middle floor care staff were heating the food up in the microwave as it was cold (despite being taken immediately from the kitchen to the dining room in the hot trolley) again people were complaining about the quality of the food. A jacket potato, which had been requested by one person, was very burned but again staff were warming it up in the microwave ready for serving it. On the top floor the food was being served cold. People were complaining about the toughness of the Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 16 meat and were struggling to cut the Yorkshire puddings. They were also complaining that the food was cold and tasteless. Large amounts of food were left on people’s plates. People made the following statements in comment cards: ‘The meals are served onto cold plates. Cheap margarine and cheap bread are used. Sometimes they run out of milk and marmalade. Cheap brands are an area that could be improved upon.’ ‘I do not get what I order and I am constantly told that they have ‘run out’ of items. I think that many times this is because I am on the top floor and they either do not have the time or do not wish to go down to the kitchen. I am allergic to strawberries and eggs but keep being offered them.’ ‘I was present when potato wedges were served for tea. I would not have fed them to a dog! They were overcooked/black and soggy.’ (Relatives comment) ‘I was got up at 8:15 am and breakfast arrived at 10:20am. I only had a slice of buttered bread and had to ask for a cup of tea.’ People have to choose their meals a day in advance. This causes some confusion. Menu boards are not available to remind people what the meal options are on a daily basis. Of the four permanent residents care plans looked at; three of the people had lost significant amounts of weight. A requirement made during the random inspection of 29 August 2008 relating to meals and mealtimes has not been complied with. Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures to keep people safe have not been followed. EVIDENCE: The complaints procedure is included in the service user guide and a copy is on display in the hallway. People who live at the home said that they knew to speak to staff if they had any concerns but were unsure who the person in charge of the home was. One person said that they had raised a complaint with the previous manager but did not know if anything had been done about it. Nothing had been recorded in the complaints book about this and despite the issue being one of potential abuse; this had not been reported either under local safeguarding procedures or to the Commission. The complaints book held details of two complaints, one from a relative and one from a person who lives at the home. Neither of these complaints had been fully managed in line with the company’s own procedure and no outcomes had been recorded. This was discussed with the acting manager and the area manager, both of whom agreed that there had been a failure to Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 18 manage the complaints correctly. One person said in a comment card ‘We have made verbal and written complaints and although promises are made nothing improves.’ On the day of the visit a possible safeguarding issue had arisen early in the morning. The acting manager was dealing with the situation appropriately. Some staff spoken with knew what do to report suspicion of abuse, others were unsure. A requirement made during the random inspection of 29 August 2008 relating to following adult protection procedures has not been complied with. The area manager said that she had booked some training for staff in this area. Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean and well maintained home. EVIDENCE: Rastrick Hall is a new home that opened in July 2007. The accommodation is arranged over three floors. Each floor has its own lounge and dining area. There is a kitchen area in each dining room. All of the bedrooms are singles with en-suite toilets and showers. The bedrooms are well decorated and comfortably furnished. There is a TV in each bedroom and lockable space, so people can keep their possessions safe. Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 20 There is an assisted bathroom on each floor and an additional shower room. Generally the home appeared clean, tidy and well maintained. Some areas are in need of some minor redecoration and this should be done as part of the home’s maintenance programme. In the surveys everyone told us that the home is kept fresh and clean. One person said ‘my room is kept spotless and my relatives are always happy to visit knowing that cleanliness is a priority.’ Paper towels were not available in the staff toilet and some staff were observed not to be changing their aprons between care tasks. Both of these issues could present a risk to infection control within the home. Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People using the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Adequate numbers of appropriately trained staff are not available to care for people at all times. EVIDENCE: Duty rotas seen for several weeks prior to the inspection did not evidence that safe staffing levels had been maintained. The acting manager and the area manager explained that there is very high agency use and that agency staff may not have been included in the rotas. The rotas were very unclear and difficult to understand. A requirement made during the random inspection of 29 August 2008 relating to safe staffing levels has not been complied with. Currently there are no regular senior care assistants on either days or nights employed at the home. Senior care shifts are all covered by agency staff. In the surveys people made the following comments: ‘Too many agency staff.’ Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 22 ‘It would be better if we didn’t use so many agency staff. If we had more permanent staff it would be better for the residents to know who is caring for them.’ Rotas organised for the coming weeks by the acting manager are much clearer and agency staff are clearly identified. Examination of personnel files revealed that criminal record bureau clearances had not been obtained for one member of staff working at the home. The acting manager said she was starting to sort out the staff files as they were rather disorganised and some required documentation such as evidence of clearances and photographs were not contained in the files. The acting manager and the area manager said that they were aware of problems in relation to staff training. A number of staff have not had any training in important areas such as moving and handling and fire safety. Two of the staff due to work the night duty on the day of the inspection had not had moving and handling training. The area manager made changes to the rota to prevent this situation. Several people working at the home have not had any induction training. The previous manager had informed the Commission within their annual quality assurance assessment that six of the current staff team hold the national vocational qualification level two or above. This is less than the minimum standard of at least half of the staff. Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People using the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Poor management processes mean that the health, safety and welfare of people living at the home have not been properly protected. EVIDENCE: Although the home has been open for less than two years, four managers have been in position and have left. The latest left a week prior to the inspection visit. This manager had not applied for registration with the Commission despite being in post for almost a year. Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 24 The current arrangements are for the manager of Rastrick Grange, the care home attached to Rastrick Hall and run by the same company, to manage both homes. This was explained to us as being for a trial period of six months and had only been in operation for a few days at the time of the inspection visit. It was explained by the acting manager that it was anticipated that she would be supported by two deputy managers within Rastrick Hall. Both of these positions are yet to be filled. The company that owns the home are aware of the current difficulties and on the day of the inspection visit, a manager from another of their homes was supporting the acting manager. The area manager is also giving support. Such rapid changes have resulted in disorganisation and difficulties within the management and administration of the home. We recognise that many of the issues highlighted in this report are as a direct result of these changes. People who live at the home were unsure of who the current manager is and staff have found difficulty in the lack of continuity and uncertainty. The manager holds money within a safe for some people living at the home. On the day of the visit the safe was found to be unlocked. Records relating to this money were not checked during this visit but a relative who had come to query the whereabouts of their relative’s money found the correct amount to be in the safe. Issues relating to staffing, staff training, complaint handling and poor processes for managing the safety of people living at the home mean that the health, safety and welfare of people living at the home have not been properly protected. Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 25 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 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 3 X X X X X X 3 STAFFING Standard No Score 27 1 28 1 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 2 X X 1 Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 26 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 15 Requirement Care plans must be developed and reviewed to make sure that all staff know what actions to take to support people and to make sure that their needs are met. • Timescale for action 31/07/09 2. OP15 12 31/07/09 People living in the home must be consulted about the meals and mealtimes and changes made accordingly. • Food must be served hot and properly cooked. • Adequate stores of food must be available in the home at all times. • People must be served sufficient amounts of food when they want it. This will mean that people will get meals they will enjoy and will not feel hungry. This requirement has been amended. The previous timescale of 31/08/09 for compliance with this requirement was not met. Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 27 3. OP16 22 All complaints must be dealt with in line with the companies own complaints procedure and outcomes must be recorded. This will give people confidence that their complaints are being taken seriously. The adult protection procedures must be followed and staff must know what incidents must be reported. This will make sure that people are kept safe. The previous timescale of 31/08/09 for compliance with this requirement was not met. 30/04/09 4. OP18 13 30/04/09 5. OP27 18 6. OP27 17(2) All staff working at the home must receive training in all areas relevant to their work. This must include moving and handling and fire training. This will make sure that people are cared for safely. The duty rotas must show every member of staff that is on duty, what they are working as, the time they start work and the time they finish. This will make sure it is easy to find out if there are enough staff and exactly which staff have worked on any given day. The previous timescale of 31/08/09 for compliance with this requirement was not met. The rotas must be arranged to make sure that at all times there are suitably qualified, competent and experience staff on duty. This will make sure that the needs of people living in the home are met consistently. The previous timescale of 31/08/09 for compliance with 30/07/09 30/04/09 7. OP27 18 30/04/09 Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 28 this requirement was not met. 8. OP29 19 Schedule 2 People must not work at the home unsupervised unless a criminal records bureau clearance had been obtained. This is to protect people living at the home. The registered person must make sure that the home is managed in a manner, which protects the people who live there. 30/04/09 9. OP31 OP38 24 30/04/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP9 OP15 Good Practice Recommendations Medication administration record (MAR) sheets should be clear and easy to follow. Handwritten MAR sheets should be signed by two staff. The daily menu should be displayed in the dining rooms. This will remind people of the choices on offer. Rastrick Hall DS0000070125.V374910.R01.S.doc Version 5.2 Page 29 Care Quality Commission Yorkshire and Humberside Region Citygate Gallowgate Tyne & Wear NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.yorkshirehumberside@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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