Inspection on 15/12/06 for Rathmore

This inspection was carried out on 15th December 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.

Other inspections for this house

Rathmore 18/12/08

Rathmore 10/02/06

Rathmore 03/10/05

Rathmore 07/01/05

Rathmore 04/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Rathmore 3 St Annes Road East St Annes Lancashire FY8 1TA Lead Inspector Denise Upton Unannounced Inspection 15th December 2006 09:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rathmore DS0000009743.V320456.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. Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rathmore Address 3 St Annes Road East St Annes Lancashire FY8 1TA 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) 01253 729410 01253 729410 rathmore@lineone.net Mrs Mary Jane Jarvis Mrs Mary Jane Jarvis Care Home 8 Category(ies) of Old age, not falling within any other category registration, with number (8) of places Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service is registered to accommodate a maximum of 8 service users in the category OP (Older persons 65 and over) 10th February 2006 Date of last inspection Brief Description of the Service: The Rathmore Care Home is registered to provide personal care for up to 8 older people over the age of 65 who do not require nursing accommodation. The home is a smaller family type establishment with the experienced proprietor providing the majority of care supplemented by a small nucleus of staff that have been employed at the home for a substantial period of time. In consequence, service users individual needs and preferences are well known and therefore more easily addressed with high quality care delivered in an informal setting. The home is conveniently situated close to the main shopping area of the Town and in close proximity to community amenities and resources. The home consists of communal accommodation on the ground floor of the building and single occupancy bedroom accommodation is located on the first and second floors. Stair lifts are provided for ease of access throughout the building. Since the last inspection, a further bedroom has been provided with an en-suite facility. This now provides three individual bedrooms with an ensuite facility. In addition, communal bathrooms and toilets are located close to the lounge and dining room and service user bedroom accommodation. Participation in community activity is encouraged either independently or with the assistance of staff and visitors are made welcome at any time of the service users choice. Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit took place during the course of a mid-week morning and lunchtime period of the same day and spanned an interval of approximately four hours. Twenty-one core standards of the thirty-eight standards identified in the National Minimum Standards-Care Homes For Older People were assessed along with a partial re-assessment of one requirement and two recommendations identified in the last inspection report. The inspector spoke with the homeowner, her husband and the carer on duty. In addition, two service users admitted to the home since the last inspection were spoken with individually. A number of records were also examined and a partial tour of the building took place that included communal areas of the home and some bedroom and bathroom accommodation. Information was also gained from a pre inspection questionnaire completed by the homeowner. In addition, two service users and one relative also completed a Commission for Social Care Inspection service users questionnaire that helped to form an opinion as to whether service users needs and requirements were being met. At the time of inspection, five service users were living at the home. Currently the cost of residential care fees at the Rathmore Care Home range between £324.50 - £366 00 per week. What the service does well: The Rathmore Care Home has a small group of staff that have worked at the home for a long time period of time and know the individual needs and requirements of each service user really well. The home provides a comfortable family like atmosphere and the quality of care is very good. Service users spoken with were comfortable living at the home and got on well with the staff team. Routines are kept flexible to make sure that the people who live there can enjoy the lifestyle they have chosen for themselves that includes social activities and outings. Service users are encouraged to have their say and to be involved in making decisions about how they would like the home to be run. The home has good systems in place to make sure that service users are kept safe. The health needs of service users are well met with evidence of a good working relationship with medical staff such as the district nurses and doctors who visit the home. Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 6 Meals are varied to suit individual taste, well balanced and nicely presented offering choice and variety. The two service users spoken with were very pleased with the variety and choice of the meals served with one saying, “I can have anything I like”. Service users spoken with stated that they were pleased with the standard of decoration and furnishings in the home and felt that the home was “comfortable and homely”. It is clear that there is a good relationship between service users; their family and staff, which helps people who live at the home feel secure and comfortable. What has improved since the last inspection? What they could do better: The homeowner and staff at the Rathmore Care Home work hard to ensure that the needs of people living at the home are well met and that service users feel comfortable living there. However there are a number of things identified at this inspection that could be improved. The written pre admission information obtained could be more detailed to ensure that the home can meet expectations and individual needs and requirements. It is understood that a previously used, more detailed pre admission assessment form is to be reintroduced. Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 7 Although staff are clearly aware of individual requirements, the service users individual care plan that tells staff what the individual can do independently and what help may be required, should be more detailed to ensure a consistently applied response. When a risk has been identified, a detailed written risk assessment should be in place with significant outcomes incorporated in the individual care plan. Although the homeowner and member of staff spoken with were responding well to minimising identified individual risks, a formal risk assessment was not always provided or detailed in the care plan. Measures must be taken to minimise risks when a thermostatic devise is not fitted to a hot water outlet in service user accommodation. 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. Rathmore DS0000009743.V320456.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 Rathmore DS0000009743.V320456.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 Quality in this outcome area is adequate. The actual assessment undertaken by the homeowner prior to a person being admitted to the Rathmore Care Home is thorough to ensure that individual needs and requirements can be met. However, the information gained is not always comprehensively recorded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In order to ensure that service users are only admitted to the Rathmore Care Home if their health, personal and social care needs can be met, the homeowner undertakes a pre admission assessment of current strengths and needs to determine if the level of care and support required can be provided at the home Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 10 Since the last inspection, two new service users have been admitted to the home on a permanent basis. As part of the inspection, these two service users were ‘case tracked’. This involves looking at their individual care files to make sure that the correct information is recorded and that the individual care plan, that tells staff what the service user can do for themselves and what help may be required, is reviewed on a regular basis and kept up to date. In respect of one of these recently admitted service user’s, although an assessment of individual needs and requirements had been undertaken by the homeowner prior to admission, the written account of the assessment was not comprehensively recorded. Whilst it was clear from discussion with this service user that her needs had always been fully met, the written outcome of the pre admission assessment should have been more detailed. From observation of the written pre admission record, it was evident that an alternative pre admission assessment form had been used that was not as detailed as the previously used document. In order to address this issue, it is understood that the former pre admission assessment form is to be reintroduced in respect of future prospective admissions to the home. With regard to the second recently admitted service user, his strengths and needs were well known through various periods of respite care at the home. However it is recommended that in order to confirm that requirements remained the same, the previous assessment of strengths and needs should be revisited to ensure the information remains current. The date this reassessment takes place should be recorded. In some instances, the ‘in-house’ pre admission assessment is further supplemented by information provided by family/friends, previous care providers or by a health and/or social services multi disciplinary assessment. This collated information is then used to make an informed decision as to whether the home could satisfactorily address the prospective service user’s current strengths, needs, wants and wishes. This collated information forms the basis of the initial plan of care. The member of staff spoken with was clearly aware of the needs, wants and wishes of the two recently admitted service users who stated they were very satisfied with the level of support and care they had received. Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is adequate. There is a consistent approach to the care planning and review system however care plans and review records could be more detailed. The health care needs of service user’s are well met with evidence of good multi disciplinary working taking place on a regular basis. The home also has good systems in place for the administration of medication to ensure service user’s medication needs are well met. Personal support is provided in such a way as to promote and protect service users’ privacy, dignity and independence. This judgement has been made using available evidence including a visit to this service. Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 12 EVIDENCE: There is a consistent approach to the care planning and review system however the two care plans observed were incomplete and did not provide sufficient written detail. Likewise the monthly review of one of the service users ‘case tracked’ could have been more detailed. Whilst there is no suggestion that the current strengths, needs and requirements of both service users were not being fully met, a detailed written care plan should provide staff with sufficient written information and guidance. This would help to ensure service users needs and requirements are always addressed in a consistent way. Likewise although some risk assessments were available, in other instances although a risk had been identified and staff were taking appropriate action to minimise the risk, a formal risk assessment to explain why the action was necessary had not been completed. It is recommended that whenever a risk is identified, a formal risk assessment be undertake with significant outcomes incorporated in the care plan. This would guide staff and provide a constant approach in addressing the identified risk. Both service users spoken with were very pleased with the level of care and support received. One service user said that “I get loving care here, the staff and other residents are ‘friends and family’, I cannot fault it in any way” A relative spoken with also commented that “ the staff are ever so caring, they are great, everything is superb”. Through discussion with service users and the homeowner and observation of documentation, it was confirmed that service user’s health care needs are fully met. There is a good relationship with health and social care professionals in order to maintain health and social well-being. Comments on the Commission for Social Care Inspection, comment cards confirmed that service users felt that they always receive the medical support that they needed. The administration and recording of medication is well managed at the Rathmore Care Home. All service users who wish to and have capacity to do so are enabled to self-administer their own prescribed medication. Medication administered by staff is stored in a locked cupboard secured to a wall. All staff with responsibility for medication administration have received medication training and are expected to adhere to the procedures for the receipt, recording, storage, handling, administration and disposal of medication. Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 13 However it is understood that staff with responsibility for the administration of medication are to receive updated medication training in the near future. There are good links with the local pharmacist used by the home for the supply of prescribed medication, who visits on a regular basis to conduct a pharmacy inspection and also provides advice to the home on medication matters. The medication administration records of the service user’s that were ‘case tracked’ were examined and found to be well recorded and accurate. Service users also confirmed that they felt that their privacy and dignity was well respected. One service user spoken with said that “I feel very comfortable here all the time” All staff receive training in respect of maintaining privacy and dignity during induction training, National Vocational Qualification (NVQ) training and through regular supervision. Rathmore DS0000009743.V320456.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. Service users are encouraged to keep in regular contact with family and friends in order to maintain family and friendship links. The routines of daily living are kept flexible to enable service users to live the lifestyle of their choice. This takes into account individual social, cultural, religious and recreational interests and needs. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Routines of daily living and social activities are kept flexible and varied in order to address individually assessed strengths and needs. A number of service users access community resources and facilities independently while other service users enjoy the one to one support of staff for outings and activities. Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 15 The majority of people living at the home enjoy listening to music or watching television and determine their own social activity. One service user is provided with transport to attend a church service on a weekly basis and another service user explained how much she enjoyed trips in the car and ‘coffee out’ with the husband of the homeowner. Another service user had expressed a wish to visit a Christmas production at a local venue and this was being arranged. A Christmas party has also been arranged. As observed at the time of inspection, it was clearly evident that service users can entertain visitors of their choice at a time to suit them either in a communal area of the home or individual bedroom accommodation. A relative spoken with during the course of the inspection, who visits on a regular basis, stated that he is always made welcome and confirmed his satisfaction with the level of care provided. The same gentleman said, “I feel totally secure that mum is being well looked after when I am back home”. All service users at the Rathmore are encouraged to maintain control of their own financial affairs for as long as they wish to and have capacity to do so. However in some cases, a member of their family will assist a service user in this task. Where purchases are required and the service user needs assistance, if a family member cannot assist, the homeowner purchases the items required and then sends an account to the service user’s advocate. Details of independent advocacy services are also made available for service users to access if and when they choose. From observation and discussion, it was evident that service users are encouraged to bring some of their own possessions with them into the home to make their individual bedroom feel homely and more familiar. Meals and mealtimes at the Rathmore Care Home are given high priority with a varied and balanced menu provided that is designed around the known likes and dislikes of service users living at the home. Service users spoken with were positive about the variety and quality of the meals served with one service user describing the food as “very good”. Another service user stated that ‘we get family type meals here, good home cooking. Mary (homeowner) will do anything for you, what ever you feel like eating”. There is a rotating menu, but this is flexible to take into account what service users feel like eating on any particular day. Snacks and drinks are also available at all times. There are systems in place to ensure that the needs and requirements of service users with specific dietary demands can be adequately addressed. This can include medical, religious or cultural dietary needs in addition to specific preferences. Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. The home has a satisfactory complaints system with evidence that service users feel that their views are listened to and acted upon. Staff have received training in respect of adult protection issues, which protects service users from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection, no complaint has been made regarding the Rathmore Care Home either ‘in-house’ or to the Commission For Social Care Inspection. The home has a comprehensive complaint policy and procedures, which outlines the home’s commitment to resolving complaints within 28 days. The complaints procedure is incorporated in the Statement of Purpose and Service Users Guide to inform service users and their relatives how to make a complaint should the need arise. The two service users and the relative spoken with confirmed that they were aware of how to make a complaint. All confirmed that they would have no hesitation about speaking with the homeowner if they had a concern and felt confident that any concern would be taken seriously and acted upon. One Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 17 service user stated that she felt very safe living at the home and had “no complaints at all. If I had, I would talk to Mary (homeowner) or staff” The home also has a policy in place, which contains robust procedures for responding to an allegation of abuse. Since the last inspection, the homeowner was partially involved in the investigation of an allegation of abuse regarding a newly admitted service user. The alleged incident took place while the service user was living in alternative accommodation and the allegation did not involve the Rathmore Care Home. However the homeowner supported the newly admitted service user at this time and fully cooperated as required during the course of the investigation. All staff have undertaken ‘in-house’ adult abuse training that has incorporated the home’s policy and procedures with regard to any allegation of abuse, which is based on the ‘No Secrets in Lancashire’ multi agency response to alleged abuse. This helps to protect service users. The staff member spoken with was clearly aware of her role if an allegation of abuse was made. Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. The standard of the environment within this home is good providing service users with a comfortable and homely place to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users at the Rathmore Care Home continue to live in well-maintained accommodation that is domestic in character and has been designed to meet the individual and collective needs of the people living there. The home is situated in close proximity to the main shopping area of the town and local community facilities. There is a lawned garden and patio area to the front of the home with tables and seating that service users can enjoy in the summer months. The layout of the home gives people opportunity to move freely round the building and access all areas with ease. The home is well maintained and Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 19 decorated and offers stair lifts for ease of access to first and second floor bedroom accommodation. Service users spoken with were pleased with their individual bedroom accommodation and the communal accommodation. One lady spoken with in her bedroom stated she was ‘very satisfied” with her bedroom accommodation that was comfortably furnished and well decorated. It was clearly evident that service users are encouraged to access all areas of the building including their personal bedroom accommodation whenever they so wish. All radiators in bedroom and communal accommodation are fitted with guards to prevent the risk of accidental injury and thermostatic devises have been fitted to all but one hot water outlets in service user accommodation to prevent the risk of accidental scalding. One hand washbasin in a communal bathroom located on an upper floor has had the thermostatic devise removed because the two service users accommodated on this floor complained that the water from this outlet was not sufficiently hot. Whilst this satisfies service user choice, formal risk assessments with regard to this matter should be undertaken in respect of the individual service users and the bathroom environment. It is essential that both service users be formally assessed, as having the ability to self determine if the water delivered is too hot and the ability to take immediate appropriate action should this be the case. It is also essential to take appropriate measures to ensure the safety of other service users who may occasionally use this bathroom independently. It is strongly recommended that appropriate risk assessments be undertaken that are reviewed on a regular basis with any significant outcomes identified on the individual care plan. This also applies to any new service user that may be admitted to the home. Since the last inspection, another further bedroom has been provided with an en-suite facility. As recommended in the last inspection report, the last remaining bedroom has now been fitted with an appropriate lock to ensure privacy for the occupant. The Rathmore Care Home remains clean, pleasant and hygienic. There are a variety of policies and procedures in place for the control of infection and safe handling of waste products including clinical waste and dealing with spillages. Laundry facilities are sited in the basement area of the home and do not intrude on service users. All laundry is washed at an appropriate temperature Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 20 and it is understood that facilities comply with the Water Supply (Water Fittings) Regulations. The home complies with the requirements and recommendations of the Environmental Health Department and health and safety requirements to meet the needs of service users accommodated. Rathmore DS0000009743.V320456.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. Staffing levels are determined to ensure that there is sufficient staff on duty to adequately address the individual needs and requirements of service users accommodated The arrangements for the induction and more advanced National Vocational Qualification (NVQ) training in care are good with staff demonstrating a clear understanding of their roles. There is a structured and robust recruitment process applied in order to protect service users This judgement has been made using available evidence including a visit to this service. EVIDENCE: Observation of the staffing roster confirmed that sufficient staff are on duty during the waking day and night time period. Service users and the member of staff spoken with all felt that there were enough staff on duty at any one time to ensure that the needs and requirements of service users could be adequately met. Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 22 As recommended in previous inspection reports, the hours worked by the homeowner and her husband is now identified on the staffing roster. Since the last inspection, a further member of staff has successfully achieved a National Vocational Qualification (NVQ) in care. This is a nationally recognised qualification for care staff to ensure they have the skills and abilities to provide a high quality service. All care staff at the Rathmore Care Home have now achieved this qualification. There have been no new staff appointments since the last inspection. However the Rathmore Care Home operate a structured recruitment and selection process that includes obtaining all required references and clearances before the applicant actually takes up post at the home. Newly appointed staff undertake the ‘Skills for Care’ induction training programme to ensure they have basic skills to provide an appropriate level of care. A staff-training matrix was evidenced that highlighted the additional range of courses that staff had undertaken in order to provide a high quality service. This included training in respect of optical awareness, food hygiene, continence, first aid and moving and handling training. Without exception, all service users and the relative spoken with praised the staff team. One service user described the staff as “very caring. I am quite sure that anything I wanted to do would be made possible. I get on very well with all the staff, they are like family, I cannot find a fault in any way” Rathmore DS0000009743.V320456.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 Quality in this outcome area is good. The homeowner/manager is experienced, competent and qualified and well supported by the staff team in providing a high quality service. The systems for service user consultation are good with a variety of evidence that indicates service users’ views are sought and acted upon. Although the home does not currently assist service users with their financial affairs, systems are in place to ensure that service users financial interests would be safeguarded. Systems are in place to ensure as far as possible the health and safety of service users, staff and visitors This judgement has been made using available evidence including a visit to this service. Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 24 EVIDENCE: The registered homeowner/manager is competent and experienced to run the home and meet its stated purpose, aims and objectives. The homeowner/ manager has successfully achieved the Registered Managers Award and has undertaken periodic additional training in order to supplement her existing skills and knowledge. This has recently included optical awareness, food hygiene and continence training. The Rathmore Care Home has available service user satisfaction questionnaires the outcomes of which are incorporated in the Service User Guide. In addition, anonymous service users/relative questionnaires are also available. However these have not been utilised recently as current service users prefer a more verbal approach to express their views and opinions on how the home is meeting their needs. The relationship between the homeowner, staff, service users and their family/friends is very cordial and the current system of obtaining views and opinions on how the home is achieving aims for service users is adequate and meets service user/relative wants and wishes. Rathmore Care Home has also achieved the ‘Investor In People’ award. This independent quality award is only provided when a care home has achieved a certain standard. This award also assists the internal audit on how the home is achieving aims and outcomes for service users accommodated. At this present time, all service users remain financially independent or are assisted in this task by a family member or independent advocate. In consequence the home do not hold any monies or valuables in safekeeping for service users or support service users to manage their personal allowance. If items are purchased on behalf of a service user, the homeowner pays for the purchase and then issues a monthly account. However systems are in place to protect the financial interests of service users should this situation change and secure facilities are provided. The Rathmore Care Home has policies and procedures available in order to ensure the health, welfare and safety of service users, relatives and staff. Through observation of the staff training matrix and discussion with the homeowner, it was confirmed that all staff have now undertaken ‘in-house’ moving and handling training via a book and videos concluding with a questionnaire that the homeowner considers sufficient. All staff have also undertaken basic first aid training with one member of the staff team achieving the more advanced ‘First Aid At Work Course’ However it Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 25 is recommended that a qualified first aider who has undertaken the more advanced course of study be on duty at all times. In addition, the majority of staff have undertaken food hygiene training and the remaining member of staff that has not received this training will do so in the near future. An infection control policy is available that all staff are expected to read and implement and all staff receive fire safety training as part of the induction process that is regularly updated. A written statement in respect of the policy, organisation and arrangements for maintaining safe working practices was also available. Risk assessments are routinely conducted in respect of electrical appliances taken into the home with the proprietors reserving the right to refuse equipment the service user takes in if it does not meet current safety requirements. This is clearly identified in the Service User Guide. Systems are in place for checking the fire alarm system and emergency lighting system on a monthly basis. The gas installation was to be re-inspected on the day of the inspection and arrangements had been made for a reinspection of the electrical installation system. It is also understood that the temperature of hot water delivered from hot water outlets is regularly undertaken however this is not routinely recorded. It is recommended that the temperature of the hot water tested from each outlet be recorded to maintain a permanent record of the date the temperature was recorded and of any action required. Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 26 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 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 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 Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 27 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP3 Good Practice Recommendations The written pre admission assessment should be holistic in content and more detailed. With regard to any service user already known to the service, the previous assessment should be formally reviewed to ensure the information remains current. The date of the review should be recorded. The individual care plans should be detailed and holistic in content incorporating the outcome of any risk assessments undertaken. When a risk has been identified, a formal written risk assessment should be completed. It is recommended that formal written risk assessments be undertaken with regard to the hand washbasin in the bathroom that has had the thermostatic devise removed. It is recommended that when the temperature of water delivered from hot water outlets in service user accommodation is tested, outcomes are recorded and the DS0000009743.V320456.R01.S.doc Version 5.2 Page 28 2. OP7 3 3 OP25 OP38 Rathmore record signed and dated. There should be a qualified first aider on duty at all times. Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Rathmore DS0000009743.V320456.R01.S.doc Version 5.2 Page 30 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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