Inspection on 08/12/08 for Rockliffe House

This inspection was carried out on 8th December 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rockliffe House 13/12/07

Rockliffe House 23/01/07

Rockliffe House 05/12/05

Rockliffe House 07/06/05

Rockliffe House 12/10/04

Rockliffe House 06/05/04

Rockliffe House 19/03/04

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Rockliffe House 466 Beverley Road Kingston upon Hull East Yorkshire HU5 1NF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Beverly Hill     Date: 0 8 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Rockliffe House 466 Beverley Road Kingston upon Hull East Yorkshire HU5 1NF 01482342906 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Joanne Marie Bush Type of registration: Number of places registered: Joanne Marie Bush,Jean Susan Goodwin care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 sensory impairment Additional conditions: Date of last inspection Brief description of the care home Rockliffe House is a small family owned business situated on a main road approximately one and a half miles from Hull city centre. It benefits from being sited next door to Hull and East Riding Institute for the Blind headquarters, and residents can attend the day centre provided by them. There are local shops, pubs and churches nearby and the home is on major bus routes into Hull and Beverley. Rockliffe House is registered for up to 21 people and provides personal care and accommodation for both younger adults and older people with a visual impairment. Accommodation is on three floors serviced by a through floor lift and consists of six shared and nine single bedrooms. The home has three separate lounges and a dining room set out with individual tables to seat two, four or six people at each. There are sufficient toilets and bathrooms to meet the needs of people living in the home. There is an enclosed patio/garden area at the side of the home and a small parking area at the front. According to information received from the home their weekly fees are between 298 Care Homes for Older People Page 4 of 31 21 Over 65 21 Brief description of the care home pounds and 393 pounds. The proprietors have decided not to charge a top up fee. Items not included in the fee are toiletries, hairdressing and chiropody. The home had a statement of purpose and service user guide displayed in the home and had the facility to provide documentation in Braille. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this home is 2 star. This means that the people that use this service experience good quality outcomes. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since the last key unannounced inspection on 13th December 2007 including information gathered during a site visit to the home, which took approximately nine hours. Throughout the day we spoke to people that lived in the home to gain a picture of what life was like at Rockliffe House. We also had discussions with the registered manager, who was one of the proprietors, a second proprietor, and care staff members. Care Homes for Older People Page 6 of 31 Information was also obtained from surveys received from residents, staff members and two visiting health professionals. Comments from the surveys and discussions have been used throughout the report. We looked at assessments of need made before people were admitted to the home, and the homes care plans to see how those needs were to be met while they were living there. Also examined were medication practices, activities provided, nutrition, complaints management, staffing levels, staff training, induction and supervision, how the home monitored the quality of the service provided and how the home was managed overall. We also checked with people to make sure that privacy and dignity was maintained, that people could make choices about aspects of their lives and that the home ensured they were protected in a safe and clean environment. We observed the way staff spoke to people and supported them, and checked out with them their understanding of how to maintain privacy, dignity, independence and choice. We would like to thank the people that live in Rockliffe House, the staff team and management for their hospitality during the visit, and also thank the people who spoke with us and completed surveys. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? There has been lots of improvements since the last inspection visit. The management and staff had completed all the things they were asked to do. The care plans have been improved to make sure that all identified needs have a plan to meet them and staff have clear instructions in what to do for people. Staff are also more aware of the need to contact health professionals quickly rather than trying to deal with issues themselves. The way medication is managed has improved with one staff member taking overall responsibility and the drugs trolley is always kept secure. Parts of the environment has improved. A new shower room and disabled toilet has been installed on the first floor, some bedrooms have been recarpeted and have new curtains, and a new call bell system has been installed. The new system comes with high risk pendants for those most in need to wear around their necks. This has decreased anxiety for some people. The numbers of domestic staff on duty has increased, which means that care staff do not have to complete domestic tasks taking them away from caring duties. Also a deputy manager has been recruited, who is also a cook responsible for the main meal of the day. This had freed up the manager so she can complete management tasks. The way the home is managed has improved. Staff and residents meetings have restarted and staff are receiving formal supervision as required. The manager is documenting what is said at meetings and any action points. Care Homes for Older People Page 8 of 31 Staff induction meets requirements and the training plan includes dementia care awareness to enable staff to increase their knowledge and improve their practice when supporting people with dementia and memory impairment. More care staff had completed national vocational qualification training in care at level 2 and 3, which meant the home had exceeded the target of 50 percent of care staff trained to this level. The training plan still needs to include conditions affecting older people. All the health and safety issued mentioned in the last report have been addressed. All wheelchairs have footplates on and staff use them when supporting people in them, cleaning products are locked away, fire doors are not wedged open and the staff pay more attention to the security of the building. What they could do better: 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Older People Page 9 of 31 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensured that people were only admitted after an assessment of their needs has been completed. Evidence: Three care files were examined, two of which were for people recently admitted to the home. Of these, one was for a person funded for respite care by the local authority and the second was for someone privately funding their care. The home had obtained an assessment and care plan, prior to admission, completed by care management for the person funded by the local authority. The manager had also completed the homes in-house assessment for both residents. The homes assessment covered all aspects of health, personal and social care needs and the assessment process enabled the home to be sure they could meet peoples needs prior to admission. Staff spoken with were clear about peoples needs and Care Homes for Older People Page 12 of 31 Evidence: residents told us their needs were met. We checked the terms and conditions for the newly admitted resident self-funding their care. The document requires information about the room number to be occupied and needs updating with new contact details for the Commission if this information is to be included in it. The home does not provide intermediate care services. Care Homes for Older People Page 13 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs were planned for and met in the home. Improvements in the management of medication has ensured that practice is safe and people receive their medication as prescribed. Evidence: The home had twenty people resident during the site visit and we examined three of their care files in detail. The files had assessments and risk assessments in place in order for staff to formulate plans of care. There had been improvements noted in care planning since the last key unannounced inspection. Those examined were clear and detailed the assessed needs and what staff had to do to meet them. The care plans reminded staff to respect privacy and dignity and were clear about preferences and wishes, for example how the person liked to have two pillows at night, where they preferred to sit during the day and preferred times of rising and retiring to bed. Care plans had not been signed and dated by the person formulating them or by the Care Homes for Older People Page 14 of 31 Evidence: resident or their representative as agreeing to them. Goal and action plans were produced although these tended to be generic rather than tailored for individual goals. There was evidence that care plan evaluations took place and the persons key worker maintained a basic summary every two months. Daily recording generally evidenced the care provided, although some staff were more comprehensive than others when explaining how the person had been over a twentyfour hour period. Risk assessments were completed for issues that staff felt posed a risk for individual people. These included skin integrity, nutrition, alcohol use, moving and handling, falls, a tendency to wander and isolation. There was also a generic risk assessment document that staff completed for all residents covering issues such as, hoist use, water temperature when bathing, cross infection and slippery floors. There was evidence that residents had access to health professionals and visits were documented in the care file. One health professional did comment in a survey, there have been incidents when staff should have called the emergency night service. This was mentioned to the manager to take note and pass on to care staff. Weight was recorded monthly and the home had sit-on scales for people unable to weight bare. People spoken with stated that their needs were met in the home, the staff are very good, they look after us well, we get ourselves dressed in the mornings, they help the ones that cant, I have just changed my dentist and we see the doctor and the optician here. Five surveys received from residents all indicated they received the care and support they needed. People told us that staff respected their privacy and dignity and there were examples of people being supported to maintain their levels of independence. A health professional stated, provides good care for visually impaired people who are unable to manage on their own. A comment made in a survey indicated that staff did not always offer the resident the opportunity to see health professionals in private. This was mentioned to the manager to address with staff. There had been improvements in the way medication was managed. One staff member took overall responsibility for ordering, signing in medication and any returns to the pharmacy as required. Medication was stored appropriately and there was good stock control. The home did not have any controlled drugs but had acquired a controlled drugs cabinet for when such occasion occurred. Staff followed policies and procedures when administering medication. Care Homes for Older People Page 15 of 31 Care Homes for Older People Page 16 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home continues to provide a good quality of life of people and nutritional needs are met via well prepared and presented meals. Evidence: The home continued to provide a good quality of life for people living in the home. Visitors were welcomed at any time and residents confirmed they were offered refreshments. Routines were flexible and there was a range of activities provided, which included access to the day centre managed by the Hull and East Riding Institute for the Blind situated next door to the home. One resident continued to work at their sheltered workshop. Some residents were very independent and were able to visit local facilities without assistance and some still took part in clubs and groups, such as assisted tandem bike rides and bus trips to local venues. Residents told us they participated in chats, quizzes, had their nails done, visited public houses and enjoyed weekly saturday entertainment evenings in the home. Entertainers visited the home and and some residents accessed the talking book service and magazines in braille. Some residents were due to visit City Hall next week to see The Searchers. One person took pleasure Care Homes for Older People Page 17 of 31 Evidence: in knitting and some people just preferred to sit quietly and listen to music. Church services were held and two residents told us they went out to their local church to participate in Sunday service. Some people in the home told us that they wished there was more to do to keep them occupied. One person wanted to play more dominoes and another expressed a wish to do some baking and have some exercises to music. This was discussed with the manager and they confirmed they will look at introducing a broader range of activities for people that are unable to access outside facilities. People spoken with stated that they were able to make choices about aspects of their lives and were quite emphatic when asked if staff treated them with respect. Comments were, at times I will join in if I want to, I look after myself, I get myself washed and dressed, the staff are great, theyll bring things in from the shops for us, its a good atmosphere here, Ive seen a lot of changes here for the better and the home is first class. One resident told us how they can please themelves with what they do and another person stated in a survey that they could make their own decisions each day. People continued to be happy with the meals provided. The new deputy manager was also a qualified cook and prepared the main meal of the day. People told us that choices were available and comments about the meals were, very good, I dont like certain things so they give me different meals, great food, we get plenty to eat and drink, there isnt a lot I dont like and hearty meals. One person told us that the dietician was very pleased with them because they had put two stones in weight on since coming to the home. Care Homes for Older People Page 18 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provided an environment where people felt able to complain and express their views. Residents were protected from abuse by staffs awareness of policies and procedures and completion of appropriate training. Evidence: The home has a complaints policy and procedure displayed in the home. It is also available in braille. Residents spoken with felt able to complain if they needed to and most mentioned the manager by name or their key workers as the person would talk to if they were unhappy about something. Staff were also aware of what to do should a resident or visitor raise any concerns with them. Generally complaints received were minor and were recorded in a complaints book despite the availability of a complaints form in the entrance. The two complaints recorded in the book were minor in nature but they did not have any signatures and the manager advised they were niggles rather than formal complaints. To avoid confusion all complaints should be recorded on the form designed for that purpose. The form prompts staff to sign the form and has space to record complainant satisfaction with the outcome of any investigation however minor this may be. The home follows the local authority multi-agency policy and procedure for safeguarding adults from abuse and all staff apart from two new ancillary staff have Care Homes for Older People Page 19 of 31 Evidence: completed safeguarding training. Staff spoken with confirmed training had taken place and knew what to do if they witnessed anything that concerned them. There had been two safeguarding referrals received by the local authority since the last inspection. One referred to the length of time a resident was kept waiting after they summoned assistance. The second referred to the proprietors response to two residents wishing to return to Rockliffe House from another home but without them following correct procedures. Both were investigated by the local authority and no further action was taken. Care Homes for Older People Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Redecoration and refurbishment has progressed according to plan, which has improved sections of the home for people. Evidence: The proprietors continue to progress with their redecoration and refurbishment plan. Since the last inspection visit a new walk in shower room and disabled toilet has been installed on the first floor and paper towel dispensers have been installed in communal bathrooms and toilets. The flooring in the three downstairs toliets was in the process of being replaced with non-slip material and the tiles are to be replaced in January. The left side front lounge has had equipment removed, making it more homely and the right side has been fitted with a new large shelving unit. The dining room floor is still awaiting replacement and the manager confirmed plans to replace existing cupboards in the dining room in the new year. A new call bell system has been installed and five residents have been issued with high risk pendants to wear so they can summon staff quickly. Some bedrooms have been recarpeted and redecorated and some have had new curtains fitted. Those bedrooms seen were personalised to varying degrees and people spoken with were happy with them. Shared bedrooms had privacy screens and those Care Homes for Older People Page 21 of 31 Evidence: people that required a lockable facility had one in place. The home was warm, clean and fresh throughout, and was furnished and decorated in a homely way. Some of the bathrooms upstairs were looking a little jaded and the manager confirmed they were on the refurbishment plan for the next year. Care Homes for Older People Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff members had access to training opportunities which helped to ensure residents wellbeing and provided staff with the knowledge and skills required for their roles. A gap in the recruitment process means that residents are supported by people that have not been fully checked. Evidence: There have been improvements noted in staffing since the last inspection visit. A deputy manager, who also acts as a cook for the main meal of the day, and a domestic worker have been recruited. This means that care staff can focus more on care tasks and has freed up the managers time to complete management tasks. In surveys staff reported there was enough staff on duty either, always or usually and residents stated staff were available when required. The increase in staff means that, in addition to the manager, there are always three staff members on duty during the day and two in the evenings and at night. People spoken with were complimentary about the staff, the staff are very good, they look after us well, the staff are great, its a good atmosphere here, we get well looked after in here and Im very satisfied with the staff and the food. Care Homes for Older People Page 23 of 31 Evidence: Staff spoken with stated that since the employment of more staff the home had a better atmosphere and they were not as stressed. The home was clean, tidy and fresh, which told us that arrangements for the domestic service was good. New staff members completed skills for care induction standards as well as a general orientation to the home. This prepared them for more in depth training in care practices. The home accessed training from the local authority, external facilitators and distance learning. All staff have completed basic food hygiene, moving and handling, infection control, health and safety and first aid. In addition, four staff have completed the more advanced four-day first aid course. Five staff have been booked on a sensory impairment training course in the new year, facilitated by Hull and East Riding Institute for the Blind and five staff have progressed through dementia awareness booklets. All staff have completed a medication course with Selby College and all but two staff have completed safeguarding adults from abuse training. The new domestic worker has completed health and safety and national vocational qualification training (NVQ) level 2 in cleaning. Nine out of thirteen care staff had completed NVQ in care at either level 2 or 3, which equated to 69 percent and was an excellent achievement. Although service specific training regarding sight impairment and basic dementia awareness has taken place there is still a need for staff to have knowledge and skills in other conditions that affect older people. For example one resident has epilepsy and other relevant courses would be diabetes, strokes and Parkinsons disease. The local authority training, on offer for all staff in residential care, could address this shortfall. Three recruitment files were examined during the day. Some discrepancies were noted with one of the files which related to the non return of a criminal record bureau check. It appeared there had been a delay with the signatory body sending off an application form. As the person did not have a valid CRB or check against the protection of vulnerable adults register in place, the manager decided the staff member would not return on shift until the povafirst had been received. The manager must ensure that all checks are in place prior to the start of employment. Staff photographs are required for the three new files. Care Homes for Older People Page 24 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements have been made in management systems, which has meant the home is a safer place for people to live in. Evidence: There have been improvements noted in management practices in the home. Recruitment of additional staff has freed up management time and enabled the manager to focus on specific management tasks such as staff supervision, quality monitoring and consultation with residents. Both the proprietors, one of whom is the registered manager, have completed the Registered Managers Award and NVQ at level 4 in care. They have updated their mandatory training, and safeguarding of adults training with the local authority was completed in a previous year. Residents spoken with all knew the managers names, which told us they managed to get out and about the home rather than remaining in the office. Staff described management as, approachable and stated they would get things sorted out for them. Care Homes for Older People Page 25 of 31 Evidence: The atmosphere in the home was calmer and the manager stated they definitely had more time to supervise staff and oversee management systems. Care staff were on track to receive the required number of supervision sessions and the supervision meetings with staff had more structure and planning. Staff spoken with confirmed supervision took place and monthly staff meetings had re-started. They also stated training was more organised and kept them up to date. The home had a quality monitoring system in place that consisted of audits and questionnaires. It was a little disorganised and some audits had not been completed, for example, recruitment files. However some audits had taken place, for example, medication practices, a physical environment check, finances and care plans. There were plans to send questionnaires to residents, families, staff and visiting professionals and to produce an action plan to address any shortfalls. There was evidence of a change in menu following a request by a resident in one of the meetings. The manager needs to make sure that questionnaires are dated and give people the opportunity to sign the form if they wish in order for a discussion to take place with them as required. The home had gained parts A and B in the Quality Development Scheme with the local authority. This means that the local authority considers the home to have good systems in place for planning and monitoring the quality of care provided. General residents or their families manage finances. However, the home manages the personal allowance for two residents. Both have individual records and two signatures and receipts were required for all withdrawals. For one person, when checked, this was for deposits to their own bank account. The proprietors purchased any sweets and toiletries for the person and kindly funded their chiropody. The residents fund had a healthy balance, which was accrued whilst the home was managed by the Hull and East Riding Institute for the Blind. The money had not been accessed by the residents since the new proprietors took over, as it was still held by HERIB. This should be addressed with HERIB quickly to enable residents access to money donated to them, or collected for them, on their behalf. Management had addressed health and safety issues mentioned in the last report, which had made the home a safer place for people. Wheelchairs are checked to ensure foot plates are in place, the keys to the medication cupboard are kept secure, fire doors are not wedged open and staff make sure the front door is securely locked when required. The temperature of the hot water outlets have been adjusted to ensure a more ambient temperature but the nature of the old building means this can fluctuate. Staff are aware of this. Care Homes for Older People Page 26 of 31 Care Homes for Older People Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 19 New staff must have full 31/12/2008 checks in place prior to the start of employment. In exceptional circumstances only, it is possible to employ people after a povafirst and prior to the return of the full CRB but this must not be routine practice. This will ensure people are supported by appropriately vetted care staff. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 The terms and conditions document should have the room number the new resident is to occupy. It could also be updated with new contact details about the Commission if these are to be included in the document. Care plans should be signed and dated by the person formulating them and by the resident to evidence they have seen them and agree with them. Staff should always give residents the opportunity to see health professionals in private. Page 29 of 31 2 7 3 10 Care Homes for Older People 4 12 The range of activities provided should be expanded to include the preferences expressed by a few individual residents. All complaints however minor should be recorded on the designated form and signed by the person writing the complaint and by the complainant when happy that the complaint has been investigated and resolved. The home should continue to progress with its redecoration and refurbishment plan to improve the environment further for people living in the home. The home should enhance staff members knowledge of conditions affecting older people by accessing appropriate training courses. The home should organise the quality assurance system more effectively to ensure a consistent record of questionnaires and audits, and action plans to address any shortfalls. This will evidence a robust system of selfmonitoring and the actions taken to resolve issues. 5 16 6 19 7 30 8 33 Care Homes for Older People Page 30 of 31 Helpline: 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 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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