Inspection on 15/07/08 for Salford House

This inspection was carried out on 15th July 2008.

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

Salford House 16/06/09

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

CARE HOMES FOR OLDER PEOPLE Salford House Station Road Salford Priors Evesham Worcesterhire WR11 8UX Lead Inspector Patricia Flanaghan Unannounced Inspection 15th July 2008 08:50 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 Salford House DS0000070679.V368300.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. Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Salford House Address Station Road Salford Priors Evesham Worcesterhire WR11 8UX 01789 772 461 01789 778 115 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) Salford House Ltd Mrs Pamela Hancox Care Home 25 Category(ies) of Dementia (25), Old age, not falling within any registration, with number other category (25) of places Salford House DS0000070679.V368300.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 To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age (OP) 25 Dementia (DE) 25 The maximum number of service users to be accommodated is 25 2. Date of last inspection 9th January 2007 Brief Description of the Service: Salford House is a care home providing personal care and accommodation to frail elderly persons. The home is situated in the small Warwickshire village of Salford Priors, which is close to the Worcestershire border. The home itself is a large Georgian house that has been extended and adapted to meet the needs of elderly people. On the ground floor there is a large lounge and dining room. Many of the ground floor rooms open out to a pleasant and secure garden. Access to the first floor is via a chair or shaft lift. Service users are encouraged to bring items in with them and can furnish and redecorate their private room to their own taste if they wish. The majority of bedrooms are en-suite and single. Limited car parking space is available at the front of the home. Service users who require nursing attention receive this from the community nursing team, as they would in their own homes. The information on fees was not available in the Service User Guide. People will need to contact the home for these details. Salford House DS0000070679.V368300.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 2 star. This means that people who use this service experience good quality outcomes The focus of our inspections is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. We, the commission, visited the home on Tuesday 15th July between 9:00am and 5:40pm. Two inspectors conducted the inspection, one of which was a specialist pharmacist inspector. The manager was present for the duration of the inspection. There were 22 people living at the home at the time of this visit. We used a range of methods to gather evidence about how well the service meets the needs of people who use it. This included talking to people who use the service and observing their interaction with staff where appropriate. We also looked at the environment and facilities provided and checked records such as care plans, risk assessments, staffing rotas and staff files. Prior to this inspection an Annual Quality Assurance Assessment (AQAA) document was sent to the home for completion. The AQAA is a selfassessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for providers to share with us areas where they believe they are doing well. Earlier this year questionnaires were sent out to ten of the people living in the home as well as being distributed to relatives and staff during the inspection visit. We received four completed surveys from residents, two from staff and three from relatives. Their comments about the service provided are included within this report. We also spoke with two visiting professionals to assess their opinion of the home. Three people using the service were identified for case tracking. This is a way of inspecting that helps us to look at services from the point of view some of the people who use them. We track peoples care to see whether the service meets their individual needs. Our assessment of the quality of the service is based on all this information, plus our own observations during our visit. Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 6 At the end of the visit we discussed our preliminary findings with the home manager. We would like to thank the residents, relatives and staff for their hospitality throughout this inspection. What the service does well: What has improved since the last inspection? The medicine management is good. Following two errors new systems had been put in place to prevent similar errors occurring again. The range of activities has increased enabling the home to provide more group and one-to-one outings for residents. Many parts of the home have been redecorated and this work is continuing. Residents have a choice of menu and they are reminded what the mealtime option is for the day, in order that they can ask for a change of meal before it is cooked, if they wish to do so. Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Salford House DS0000070679.V368300.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 Salford House DS0000070679.V368300.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): 1 and 3 Quality in this outcome area is good. People who may use this service have good sources of information to make decisions about living there and benefit from having their care needs assessed so that they can be sure the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a Statement of Purpose and a Service User Guide. Both of these documents give people the information they need to make choices about the service the home provides. We have recommended the home include the range of fees it charges people to live there. Once this is completed people thinking about using this service will have up to date information upon which to base their decision. The manager told us that the fees are discussed with people when the visit the home to look around. Everyone is given a service user guide and a summary of our latest inspection report. Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 10 Before people are admitted to the home the manager and a senior carer, or two senior carers, usually visit the person to complete a pre admission assessment. This gives people to opportunity to ask about the home and also for both parties to be sure that the home can meet their needs. We looked at the assessment for a person who had been recently admitted to the home and saw that most of their needs were detailed and gave good sources of information about the person. This means that staff are able to plan good care with people because they have all the information they need to do it. We spoke with a recently admitted resident who told us they had been given information about the home and their family decided to visit to see if it was suitable. The person told us “I then came myself to make my own mind up.” They told us they were still settling in, but had found all the staff very helpful. They said; “when I came in, the manager and staff did all they could to make me welcome.” A visitor told us that they had visited the home on a few occasions to assess if was suitable for their relative. They told us that the manager also met with them to answer any questions they might have. This home does not provide any intermediate care service. Salford House DS0000070679.V368300.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 and 10 Quality in this outcome area is good. People living in this home are treated respectfully and can feel confident that their health and personal care needs will be met. The medicine management was good. Staff had worked hard to ensure that the medication was administered correctly and recorded accurately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As part of our case tracking process we looked at the care records of three residents. Care plans are based on the assessment that is completed before the person moves into the home. Care plans had some good detail in some areas but did not cover all aspects of the individuals’ lives and how staff were to meet identified needs was not always included. For example, personal hygiene care plan for a person who had been at the home for a moderate length of time gave very little detail of individual specific needs. Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 12 Care plans must be available for each of the identified needs of people to make sure that their needs are met. We discussed this with the manager who undertook to review the care plans for people living in the home. Nutritional screening is carried out when the resident moves into the home and the outcome of regular weight checks recorded. Risk assessments for the prevention of pressure sores and moving and handling were in place and a risk assessment for the prevention of falls was held for a resident assessed as being ‘at risk of falls’. Visits by health care professionals were recorded on separate sheets so they were easy to track and they did cross reference to the daily records. The records indicated that when staff identified any health care issues these were then followed up and monitored. For example, a person insisted that “they didn’t want to eat.” The manager had contacted the GP who had arranged for a Speech and Language Therapist to come and assess the person, in case they had a problem swallowing food. There was evidence of visits from GPs, district nurses, people being admitted to hospital when necessary and check ups by dentists and opticians. We spoke with a community nurse who was visiting the home to dress a wound for a resident. She told us that the community nursing service have a good relationship with staff in the home. She explained that staff seek advice when necessary and gave an example of being asked to examine another resident on her visit today. She said she also gave training where necessary, for example, she had recently given staff training on the safe use of sliding sheets. These are special sheets that allow carers to safely move a person’s position in bed. We spoke with the chiropodist who was visiting the home to provide treatment to the people living there. He said he visits every six weeks and provides treatment to people in the privacy of their rooms. He gives the manager feed back on the treatment he has provided for each resident, so that any problems he has identified can be recorded appropriately on their care records. Residents requiring specialist equipment such as a pressure relieving mattress, cushion or hospital type bed have their needs assessed by the district nurse who also arranges for any equipment necessary to promote the health and well-being of the resident. The manager said none of the people living in the home were being treated for pressure sores. The pharmacist inspection took place at the same time as the key inspection. Five residents medicines were assessed together with their medicine charts and care plans. Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 13 Medicine charts had been printed by the community pharmacist but medicines that were no longer prescribed were still printed on the charts and care staff had not crossed them off. This may lead to potential errors if the medicine was still available to administer to the resident. Hand written entries were recorded well and complicated dose regimes were easy to understand due to the high standard of these extra entries. The quantities of medicines received or balances carried over from previous cycles had been recorded enabling audits to take place. These demonstrated that the majority of medicines had been administered as prescribed. Two errors had occurred in the last six months and new systems had been put in place to prevent any further errors occurring. Currently the home has no quality assurance system to assess individual staff or general practice. Such a system would highlight any problems in the administration and recording of medicines. The home sees the prescriptions before they are dispensed but have no system to use these to check the dispensed medicines and charts into the home. The manager was keen to improve this. Staff were cautious in enabling residents to look after and take their own medicines but offered support to those who wished to. The staff checked all new residents medicines before they came into the home to ensure that they have their current medication as prescribed by the doctor. All medicines are stored in a medicine trolley that is transported through the home. This was well organised and clean. Surplus medication was stored in a separate metal medicine cabinet that was kept locked at all times. The home currently had no controlled drugs on the premise but there was adequate storage and a register to record all transactions. All senior care assistants have received medication training and take responsibility for the administration of medicines in the home. One senior care spoken with had a good understanding of what the medicines she administered were for which would help support the residents clinical needs. The care plans contained information detailing their clinical condition and any healthcare professional visits including the outcome. It was possible to track why new medicines had been prescribed enabling staff to look after the residents better. Before this inspection we had received information that medication records were often forged. We didn’t find any evidence to substantiate this allegation. Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 14 Time was spent in the communal areas with residents and staff. People were cared for in a respectful manner and this ensured that their dignity and selfesteem were maintained. Conversations between staff and residents were respectful and observations of staff practices found that staff responded promptly and sensitively to the needs of residents. Terms of preferred address were on the person’s care plan and heard to be used by staff. All people spoken with were positive about the care they receive in the home. Comments received on the day include: • • • “I am very happy here.” “All the people are very caring. “I think they can’t do enough for everyone, always very cheerful.” Two visitors spoken with on the day of the inspection told us that they were very happy with the care provided to their relatives. They told us: • • • “They’re wonderful here” “I am so blessed X is in this home” “I am always kept informed of my relatives health, my relative has improved physically since they have been here.” Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. People living at the home are occupied and stimulated and are able to make choices in their daily lives. Visitors are welcomed and residents enjoy the meals provided which are nutritious and varied. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents in the main lounge area were sociable and all appeared to get on well with each other. There were no rigid rules in the home and residents were free to come and go as they wish. Observations made and discussion with people showed that they have the opportunity to make choices in their daily lives, such as when to get up and go to bed, what to eat, whether to join in activities or not and where to spend their time. Small pieces of furniture, pictures, ornaments and photos belonging to the occupants were seen in bedrooms showing that residents were able to bring personal possessions with them when they came to live in the home. Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 16 Each of the residents’ files examined contained a biography recording the person’s life history, their enduring interests and relationships. This should assist staff to deliver ‘person centred’ care. Staff spoken to were familiar with the preferences of residents and the type of activities that might engage and stimulate each individual. A record of group and individual activities is maintained in the home. The home offers a good choice of activities. Trips are organised outside the home on a monthly basis. Recent trips were to a teashop in the Cotswolds, picnics at local beauty spots, walks in a park, a shopping centre, and the theatre. We were told that 8 residents and two carers have planned a trip to a brass rubbing centre in Stratford upon Avon in July. A care assistant has been identified to be the activities leader. Recent in-house activities include cooking, reminiscence therapy, musical therapy and mobility. External entertainers also visit the home monthly. One resident told us, “I’m really happy here. There’s plenty to keep us occupied.” The home has an open visiting policy. People are encouraged to maintain links with their family and friends. Residents told us that visitors are made welcome and this was confirmed by two visitors we spoke with. They told us “I am always made welcome, my relative has improved no end since they have been here.” Ministers from the local Church of England and United Reform Churches visit people in the home which supports their spiritual well being. Lunch was evidently a social occasion with residents coming together and chatting over their meal. Dining tables in the spacious dining room were attractively set with tablecloths, condiments and floral arrangements. The food was well presented, wholesome and nutritious. Residents can choose whether to eat their meals in the dining room or their own room. Drinks were freely offered and staff were on hand to give discreet assistance if necessary. We had received information that the home often ran out of food. We spoke with the cook who showed us that the store cupboards were full. She said if they ever ran out of something between the weekly shopping delivery, she or the manager would purchase what was necessary from a local supermarket. We saw receipts to support this. Four residents spoken with said there has never been any shortage of food. People commented: • • “The meals are really nice here. Every meal is lovely” “there’s plenty to eat and plenty of choice.” DS0000070679.V368300.R01.S.doc Version 5.2 Page 17 Salford House Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. People living in the home can be confident that their concerns will be listened to and acted upon. There are systems in place to respond to suspicion or allegations of abuse to make sure people living in the home are protected from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a formal complaints policy which is accessible to people living in the home and their families. We saw the policy displayed in the entrance lobby to the home. People are encouraged to raise their concerns with the manager or senior staff on duty. People told us that they would initially raise concerns with their relatives or representatives who would speak to the manager on their behalf, but they said they felt they could go to the manager or deputy and they would be listened to. Residents were observed to be familiar with the senior staff on duty and felt confident to make requests. This suggests residents would be confident in raising concerns with staff. Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 18 Comments received include: • • “I can’t think of anything to complain about, they’re always there when I need them (the staff)” “I haven’t needed to make a complaint, but I would talk to one of the staff” We have received two complaints about services offered by the home since the last inspection. One of the complaints had been received from family members. Concerns were raised about the poor standard of care resulting in deterioration in their health and wellbeing. We referred the concerns raised to the provider for investigation. The second complaint, which was anonymous, alleged that the home was often short of food, windows in peoples bedrooms remained locked, poor attitude of staff, medication errors and forgery of medication records and morning staff not starting work on time. We were unable to find any evidence to substantiate these allegations. A record of complaints and concerns received by the home is maintained along with the action taken by the home regarding each issue raised. Evidence was available that the manager makes a timely and objective response to concerns raised. The home has an adult protection policy to give staff direction in how to respond to suspicion, allegations or incidences of abuse. Staff have had training in recognising signs and symptoms of abuse. Discussions with two members of staff demonstrated that they are aware of their role and responsibility in reporting any suspicion of, or actual harm to residents. It was evident through discussions with the manager that she is aware of local Social Services and Police procedures and her responsibilities for responding to allegations of abuse. Salford House DS0000070679.V368300.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 24 and 26 Quality in this outcome area is good. People live in a pleasant and comfortable environment which is clean and generally well maintained to ensure residents can be cared for safely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the home was undertaken with the manager. The home was clean, bright and tidy. We were able to go into all areas of the home, including some personal rooms and all communal areas and the gardens. There is a large communal and a dining room available. The gardens are well maintained and garden furniture is available for the residents to sit out if they wish. Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 20 Parts of the home had been decorated since the last inspection, however there is a general need for decoration in a number of areas around the home. The walls and doors in some of the corridors on the first floor would benefit from being painted or wallpapered, as some walls were grubby. Carpets were also shabby and stained. The bedrooms of some of the people living in the home were viewed. Rooms were comfortable, cosy and generally attractively decorated with ensuite facilities. All the rooms were personalised with people’s own belongings and looked as though it belonged to the person. One person who was reading in their room told us they were very happy and liked to read quietly in their large bedroom. Some of the bedrooms on the first floor were also in need of redecoration. The manager told us it is the owner’s intention to apply for planning permission to extend the home and replace worn and grubby furnishing and carpets in communal areas and bedrooms at this time. The home provides equipment necessary to assist residents to maintain their mobility and independent access around the home. Grab rails are positioned throughout the home. Zimmer frames, tripod walkers and walking sticks were seen in use and residents moved around the home safely. The home has good systems in place to manage infection control. The laundry in the home is adequate to meet the needs of the residents and the size of the home. It was clean and tidy with a number of health and safety procedures displayed. Staff have access to gloves and aprons, all communal toilets and bathrooms have liquid soap and paper towels. These measures will help reduce the spread of infection to residents. The kitchen was clean and tidy on the day of the inspection. Salford House DS0000070679.V368300.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 and 30 Quality in this outcome area is adequate. There are sufficient staff on duty to meet the needs of people living in the home. Recruitment procedures are not consistently robust to safeguard vulnerable people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We saw from duty rotas and the numbers of staff on duty at the time of inspection that there were sufficient staff to meet the needs of residents accommodated in the home. The manager confirmed that the usual staffing complement for the home one senior carer and three or four carers from 8am to 8pm. There are two carers on duty at night. The carers are supported by a cook and two housekeepers. The home employs 17 care staff, 14 of them have achieved their National Vocational Qualification (NVQ) level 2 in Health and Social Care, while the other 3 are working towards this qualification. This means that staff will have gained the knowledge they need to build on their skills and provide care to the people living in the home. Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 22 The homes recruitment policy was poor. Not all staff had two references and none inspected had a reference from their previous employer. Gaps in employment had not been explored. Many application forms had not been completed fully and a lot of information had not been recorded. This had not been addressed prior to interview. All staff however, had a satisfactory police check in place before they started. The CSCI publication “Safe and Sound” was left with the manager to encourage her to improve practices seen. Robust recruitment checks, including satisfactory Criminal Record Bureau (CRB), Protection of Vulnerable Adult (PoVA) and references must be obtained before staff start working in the home to safeguard the vulnerable people living there. Staff training was patchy. Formal induction training was not always given and other training was not comprehensive. The manager said she had sought further training to meet the needs of both staff and residents. Following discussion with the care staff they believed that they had been satisfactorily trained. From the files examined and discussion with staff, induction training appeared to be a shadowing exercise for two days only, with another member of staff. The manager said the home followed the Skills for Care Common Induction Standards. She told us that this was organised through an external training organisation and she had enrolled the most recently recruited members of staff on the course. The manager told us that only two people working at the home hold first aid training certificates. It could not be evidenced exactly what the training needs were for all the staff in the home as the staff member who monitored training was not available and an up to date training matrix was not evident. Salford House DS0000070679.V368300.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, 32, 33, 35, 36 and 38 Quality in this outcome area is good. The home is managed by an experienced and competent person to ensure the service is run in the best interests of people living in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager had worked at the home for a considerable amount of time and was appropriately qualified. Throughout the course of the inspection she demonstrated a very good knowledge of the needs of the people living in the home. She told us she had a very good relationship with the proprietor and stated he was very supportive and a regular visitor to the home. Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 24 The people living in the home were very comfortable in the presence of the manager and could speak to her at any time. One of the visitors spoken with said the manager was very approachable and kept them up to date on their relative’s life in the home. The staff spoken with during the inspection spoke highly of the manager and felt that they could approach her for help in any area. There have been a number of quality assurance initiatives at the home that have included the views of the people living at the home and their families. The manager explained that the views of the people living at the home were sought during daily discussions and targeted quality questionnaires, for example the food provision in July 2007. We saw some quality assurance questionnaires that had been completed by relatives, however these had not been dated so we were unable to ascertain when these people were surveyed. Monitoring visits are being carried out at the home and the reports are held on file at the home. The reports reflect discussions with service users, staff and sampling of important documents, such as medication sheets and care plans so that any shortfalls can be identified and addressed. An annual meeting is held each year for people living at the home and their families so that they make comment on the home and contribute ideas for improvement. We saw three complimentary letters that had been received in the past three months. Comments included: • • “…thank staff for the wonderful care, friendship and patience.” “…grateful for all the loving care you gave to X, we are aware this was often above the call of duty.” Where the home is responsible for resident’s money it works to a safe system and maintains clear records. The manager gives staff supervision to the senior staff and they then each give supervision to a designated group of staff. Staff supervision is necessary as it allows the management to meet with staff on a one to one basis to discuss practice, personal development and philosophy of the home issues. It is also an opportunity for staff to contribute to the way that the service is delivered. Information sent to us in the AQAA tells us that equipment is serviced or tested as recommended by the manufacturer or other regulatory body. A sample of service and maintenance records were examined and found to be up to date. For example, • Hoists, stair lift and stand aid were serviced in March 2008. • Fire alarm systems are checked weekly. • Fire safety equipment and systems were serviced February 2008. • Passenger life was serviced in June 2008. • Call bell system was upgraded in January 2008. Salford House DS0000070679.V368300.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 12, 13 Requirement Care plans must be available for each of the identified needs of residents. This is to make sure that people’s identified needs are met. Two written references must be obtained before appointing a member of staff and any gaps in employment records must be explored. All staff must receive training appropriate to the work they perform. New staff must receive induction training in line with the specifications laid down by Skills for Care within 6 weeks of appointment to their posts This will ensure the safety of the people living at the home. Timescale for action 31/08/08 2 OP29 19(4)(c) sch 2 31/08/08 3 OP30 12(1) 18(1)(c) 31/08/08 Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 27 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 OP1 OP9 Good Practice Recommendations The details of the range of fees charged should be included in the service users guide, for people’s information. It is recommended that a quality assurance system to assess individual staff practice and overall practice is installed to ensure that staff administer all medicines as prescribed and records reflect practice. It is recommended that an enhanced checking system is installed to ensure that all medicine charts and medication are checked against the prescription before administration to the service users. Arrangements should be made for all staff to have first aid training. This will ensure that residents have the correct treatment in the event of an accident or health emergency. The home should develop an “at a glance” training record which shows dates of training for all staff and training due to ensure all staff are kept up-to-date with necessary training to support people who live in the home. 3 OP9 4 OP30 5 OP30 Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection West Midlands Office West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Salford House DS0000070679.V368300.R01.S.doc Version 5.2 Page 29 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!