Inspection on 17/11/09 for Scaleford Retirement Home

This inspection was carried out on 17th November 2009.

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

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

Scaleford Retirement Home 03/03/09

Scaleford Retirement Home 10/09/08

Scaleford Retirement Home 14/08/07

Scaleford Retirement Home 02/08/06

Scaleford Retirement Home 02/02/06

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report CARE HOMES FOR OLDER PEOPLE Scaleford Retirement Home Lune Road Lancaster Lancashire LA1 5QU Lead Inspector Christopher Bond Key Unannounced Inspection 17th November 2009 09:30 DS0000064565.V377647.R01.S.do c Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Scaleford Retirement Home Address Lune Road Lancaster Lancashire LA1 5QU 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) 01524 841232 Scaleford Care Home Limited Mrs Lynette Anne Owen Care Home 32 Category(ies) of Dementia - over 65 years of age (32) registration, with number of places Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only. Care home only - code PC, to service users of the following gender:Either. Whose primary care needs on admission to the home are within the following categories: Dementia over 65 years of age - Code DE (E) Up to 3 named service users can be accommodated in the category of OP. The maximum number of service users who can be accommodated is: 32 Date of last inspection 3rd March 2009 Brief Description of the Service: Scaleford Residential Home Ltd is owned and managed by Mrs Lynette Owen who has over 15 years experience of managing a care home. This service is situated in a residential area of the Marsh in Lancaster and overlooks the River Lune. It is close to local amenities. There are three lounges and a dining room, these are used for a variety of purposes and provide residents with a choice of where to sit and who to sit with. Bedrooms are situated on both the ground and first floor and the upper floor can be accessed either by stairs or by a stair lift. All people living at Scaleford have their own General Practitioners who are responsible for their medical needs. Those residents requiring nursing support have the services of the District Nurses made available to them and other healthcare professionals as required. The current weekly fees range from £426.00 to £460.00. There are additional charges for hairdressing, dry cleaning, private chiropody, public transport, incontinence aids and toiletries. This information and information about the service is available in the service user guide and statement of purpose. A copy of the latest inspection report is also available for people to read. Scaleford Retirement Home DS0000064565.V377647.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 1 star. This means the people who use this service experience adequate quality outcomes. As part of the inspection process an unannounced visit took place over a total of 6 hours on the 17th November 2009. A tour of the home was carried out, which included bedrooms, lounge, dining areas, and bathrooms. The residents’ personal files and care plans were examined. Care staff records and recruitment records were also looked at. Safety certificates and medication records for the home were also examined. The manager, residents and care staff were spoken to during the inspection to find out their views of the service. We also spoke to visitors to the service about their views regarding how their relatives were cared for. Every year the Commission for Social Care Inspection sends out an Annual Quality Assurance Assessment for the owner or manager of the home to complete. This tells us about important aspects of the home and how it runs. From this we can also find out the things that have been happening within the service and what plans there may be for the future. The contents of this assessment have been used in the finalisation of this report. What the service does well: This service provides a specialist service for the care of those who have dementia. The care staff have received training and instruction in this area and specialist activities have been introduced to ensure that those with this condition are stimulated and included. Activities within the home are regular and well planned and people have the choice as to whether they should participate or not. We spoke to several residents and visitors to the service who told us that the care within this service was good and that personal care issues were dealt with properly. One resident told us that the care was “excellent”. Care planning was good and written recordings within the care plans that we saw were detailed and informative. The care of each resident was reviewed monthly to help ensure that individual care addressed current need and was consistent. We observed the care staff working within the home; the residents were cared for properly and politely whilst we were there. Overall, we found that the standard Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.2 Page 6 of personal care was good, and people were pleased with the level of care they received. We saw that training records were in good order and that the care staff received regular training and support within their roles. The staff that we spoke to were able to confirm this. Good records were kept regarding individual support from the manager. It is clear that the manager has worked to improve the handling of medication and is keen to implement further improvements as necessary. Residents’ files contain detailed information on visits by healthcare professionals and changes to medication so that these are easily tracked. There were many comments expressed about the quality of the catering at this home. All of the people that we spoke to said that the food was very good. The menus that we looked at showed that there was a good choice of food and that meals were nutritious and balanced. Regular deliveries of fresh produce were made. One of the residents was able to tell us “the food is lovely”. What has improved since the last inspection? What they could do better: Records for administration of medication require improvement so that they accurately show the medication received by residents and reasons why it is omitted. Whilst there is not a recurring problem of medicines running out we did note an inhaler that was not available for at least three weeks until the inspection date. The service must ensure that all medications are available so that residents can receive the treatment they need to keep them well. Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.2 Page 7 The manager should discuss ‘as directed’ medication with residents’ doctors and the pharmacist so that staff have clear dosage instructions to follow. Care plans for the administration of ‘when required’ medication should be more person-centred so that residents receive safe and effective medication. Storage of some medication, including controlled drugs, should be reviewed. Overall, we found that the service had improved in some areas since our last visit. The administration of medication was still in need of improvement and this affected the quality rating of the service. Although the home was being renovated and redecorated in certain areas, our records show that this has been ongoing for some considerable time. Our report of September 2008 showed that the main lounge was closed due to renovation. We found that this was still the case during this visit. Renovations need to be managed properly and completed promptly so as not to affect the people who use the service for long periods of time. Although decoration had taken place in some areas of the service there were still areas that needed to be looked at. Some of the furniture in some of the bedrooms was old and mismatched. Some of the carpets within the home were soiled and in need of replacement. There were 16 people living at this home at the time of our visit; the home should have communal space for the registered number of 32. The residents of the service were using a smaller lounge at the opposite end of the building, and there were easy chairs in the reception area for people to use. The manager of the service needs to ensure that all of the care staff receive mandatory training in food hygiene to help ensure that risks are minimised in the kitchen area when food is being prepared and served. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 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 Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good information is available for prospective residents and their family to read before they make a decision as to whether the home is right for them. People’s needs are assessed properly to help ensure that the home can meet their health and social requirements. EVIDENCE: The manager had recently updated the information available about this home. She showed us the ‘Service User Guide’ for the home and this document explained the services that were available and what people could expect if they Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 10 chose to use this service. Prospective residents received a copy of this information which was clear and easily understood. The manager also explained the process of admittance and how she visited people to assess their needs before the decision was made that the home was right for them. We looked at some of the pre-admission assessments that had been completed by the manager. Things such as mobility, healthcare needs and social needs were looked at and peoples’ health and social needs were written down clearly and precisely. This information helped the manager to decide if the home had the facilities to care for the person properly. The residents’ care could be planned properly using this information. The manager also told us that the people who were thinking about using the service were invited to view the service before they made a decision as to whether or not the home was right for them. . We spoke to a relative, who was visiting the home at the time of our visit, and this information was confirmed. This service did not supply intermediate care and this standard has not been assessed. Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9, and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People’s care is planned properly, and their needs are being met because of this. The residents are treated with respect and are looked after properly. Care was not always taken with the administration of medication, which could put people at risk. EVIDENCE: We spoke to four people who were living at the home. They told us that the service met their needs and they felt that they were being cared for properly. One resident told us that the care that she received was “spot on”. We also spoke to a relative who was visiting the service during our inspection. They told us that they were very pleased with the care and attention that their Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 12 family member received. They told us “I visit this home nearly every day and I am very happy with the quality of care and the attention that the staff give.” It was good to see the care staff speaking politely to the residents and treating them with respect. We observed the care staff whilst they worked and spoke to them about their roles and responsibilities. All of the carers were polite to the residents and very considerate. Everyone who lived within this service had a plan of care that was regularly updated and reviewed. We looked at six of the care plans and looked at the information that was available about each person. This included information on mobility, personal hygiene, health needs, social needs and nutrition. There was also some good information regarding the residents’ skin condition, and a nationally recognised tool was being used to assess this. The plans also explained clearly the individual attention that people needed and what care the people who used this service should receive. The residents’ individual weight was regularly recorded and a careful eye was kept on this information regarding rapid weight loss or gain. We noticed that this was being done in line with instructions written within the care plans. Special equipment was available within this home for those who had a physical disability, and those who needed pressure area care. We saw evidence that showed that each care plan was reviewed on a regular basis to help ensure that all the information that was held was current, and that health and social needs were regularly assessed. Changes were made within the plans to reflect the findings of the review. There was also information in the care plans about visits by health care professionals, such as the district nurse, or the doctor. We also found information about people’s nutritional needs and any special diets that people needed, such as those with diabetes. The pharmacist inspector examined the handling of medication by looking at relevant documents, storage and meeting with the manager and other staff. The inspection took 4 hours and 20 minutes. Feedback was given to the manager at the end of the inspection. Overall, and despite much work by the manager to improve medicines handling, we found that there were still a number of areas that needed improvement in order to fully protect the health and well-being of residents. We looked at records for receipt, administration and disposal of medication. We found that some records for administration contained errors. For example, some were incomplete especially for creams and inhalers suggesting that residents had not received their medication. Also, the reasons for medication not being given were not always documented so we did not know why it was omitted. We saw an inhaler that was out-of-stock and administration records showed that the resident had not received this treatment for at least three weeks. This puts the resident at risk from breathing problems and more prone Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 13 to chest infections. We also saw a number of medications where the pharmacy label did not state a dose but said ‘as directed’. There were no records to indicate exactly how these were to be administered and we could not tell if they were being given in the correct dosage. It is recommended that the manager discuss this with the residents’ doctors and the pharmacist so that dosage instructions are clear to ensure residents receive their medication correctly. It is also suggested that the manager request medication reviews for residents highlighted during the inspection so that they get the best from their medication. We counted a sample of medications and compared them with records to check that they tally and are given in the correct dosage. Overall this showed that medication could be accounted for, however, two samples showed antibiotics that had been signed for administration but not given. We looked at a sample of residents files and checked for changes to medication. We found that there were detailed records of visits by healthcare professionals and subsequent changes to medication so that it was easy to check when and why treatment had changed. We also looked at a sample of care plans for managing ‘when required’ medication. Care plans are needed to that staff have clear guidance on when and why medication is needed, and how it must be given and monitored so that residents receive safe and effective treatment. Whilst these contained general information about the medication they were not tailored to the individual needs of the residents. It is recommended that the manager review these care plans to make them more person-centred. We checked medicines liable to misuse, called controlled drugs. At the last pharmacy inspection on 3rd March 2009 we found that these were stored in a safe and we recommended that the manager check that this complied with regulations for safe storage. Although the manager had done this the information that was received did not take account of the amended Misuse of Drugs (Safe Custody) Regulations 1973. It is therefore recommended that the manager check this further. We also checked storage of other medicines and whilst this was mostly in order a few medications were stored inappropriately. For example, medicines requiring cold storage were stored at room temperature and this may affect their safety and effectiveness, and others were stored on the floor which is unhygienic. The manager should review this. The manager did regular checks, or audits, of medication and these should continue and be more thorough. This will allow any concerns regarding medication to be identified and managed without delay to keep residents safe and to protect their health and well-being. Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 14 Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People’s social needs are being addressed and activities are available to help enhance people’s lives. Catering arrangements are good, meaning that people look forward to mealtimes. EVIDENCE: Several people told us that the food that was served was very good. Information about the residents’ likes and dislikes were recorded and the owners of the service had built up a good knowledge of people’s preferences. There were regular deliveries of fresh produce and the menu’s told us that there was a good choice of nutritious food served. One resident told us that the food was “excellent”. A visitor to the service told us that she was frequently around when meals were being served and that the food always looked well Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 16 presented and ‘delicious’. She also told us that she was always made welcome and was offered privacy, and refreshments when needed. The manager said that visitors were always encouraged. This helped to enhance the residents’ well being and enhance positive relationships. The manager also acknowledged that people had the right to refuse visitors if they wished to do so. People were given the choice regarding attending a church service and religious representatives visited the home on a regular basis. The manager also acknowledged that people had the right to refuse visitors if they wished to do so. We noticed that a residents meeting was being held during our visit. People were being encouraged and enabled to express their views regarding the service and make suggestions about how the service could improve. There meetings were a regular occurrence and notes of them were kept for the staff to read and for reference purposes. There was a regular programme of daily activities for the people who lived within this service. There were specialist activities for those who had dementia. Activities included the use of memory cards to stimulate recollections of people’s lives. A representative from the local museum had visited the home to talk about fashions in wartime Britain, and had brought along interesting objects for discussion purposes. The manager told us that this was a success and important memories had been recalled. Training had also taken place for the care staff regarding Dementia awareness. This is important because this is a home that is registered to care for those who have this condition: the care staff that we spoke to told us that this was useful and gave them a greater knowledge of dementia and what to expect from those who had the condition. There were also notices around the home regarding a keep- fit group that met on a weekly basis. This helped to keep people active and help ensure that joints were kept supple. A professional singer also visited quite regularly and encouraged the residents to join in. Records of social interests and hobbies were seen within the care plans, along with their religious preferences. This information assisted the care staff to provide a more personal service with individual preferences in mind. Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Concerns and complaints are taken seriously, meaning that people feel that they are listened to. Good training and staff knowledge means that people live in a safer home. EVIDENCE: The manager of this home had ensured that training was available to help ensure that people are safeguarded from harm. Most of the care staff that were working in the home during our visit had undergone this training. Other care staff had covered this whilst undertaking a nationally recognised qualification in care (National Vocational Qualification level 2 or 3). There were robust policies and procedures available to instruct the care staff in safeguarding issues. The manager was fully aware of her responsibilities regarding reporting incidents of a safeguarding nature, should they occur, and aware of the role of the local authority in helping to ensure people are protected from harm. There was a copy of the latest safeguarding policies and Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 18 procedures from the local authority and the manager had a good knowledge of these and her responsibilities should a safeguarding issue arise. The home had a clear and understandable complaints procedure. The manager told us that people were encouraged to voice their views on the service they received. Two of the residents that we spoke to were aware of whom to speak to should they be unhappy about anything at the home. The instructions about making a complaint were clearly displayed on the wall of the home. They were also written down in the information they gave out to prospective residents and their families/ carers. The procedure had recently been updated and simplified to assist the residents and their representatives. Regular house meetings took place where the people who used this service were encouraged and enabled to voice their opinions about daily life within the home. One of these was in progress whilst we were there and there were clear records and minutes of previous minutes. There was information within the home regarding the Mental Capacity Act and the manager demonstrated that she had a good knowledge of this. Some training had taken place regarding this and related Deprivation of Liberty safeguards. We spoke to a visitor to the service who told us that she was aware of how to voice her opinions of the service and how to use the complaints procedure. She was confident that the manager would take her concerns seriously, should she have any. Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People live in a service that is homely, comfortable, clean and warm. The décor and furniture in parts of the home were ‘tired’ and in need of renewal. EVIDENCE: There had been a major refurbishment of one of the communal lounge areas, this had not yet been completed and the residents were to begin using this area on completion. This work had been longstanding and the manager of the home should ensure that this room is available as soon as possible. We made Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 20 reference to this in our inspection report of September 2008, and the lack of space available for the residents of the service. Reference was also made to the decoration of the lounge in our report of March 2003. There were 16 people living at this home at the time of our visit; the home should have communal space for the registered number of 32. The residents of the service were using a smaller lounge at the opposite end of the building, and there were easy chairs in the reception area for people to use. Work was also in progress regarding the refurbishment of two of the bedrooms on the first floor. One of the main staircases was also in the process of being redecorated. We looked at most of the bedrooms and all of the communal areas within this service. It was noticeable that some of the décor and furnishings within the home were looking ‘tired’. Some of the bedroom furniture was looking old and mismatched. There were a number of soiled carpets that were in need of renewal, most noticeably in the reception area and one of the first floor bathrooms. The owners of the service should be mindful of this, and have a programme of refurbishment and renewal where older items are systematically replaced for the benefit of the people who use the service. In the bedrooms that we viewed there were personal possessions, such as pictures, photographs and ornaments that helped to make people’s space more individual and homely. Some of the bedrooms had pleasant views of the garden area at the front, or the river at the side of the house. There was a nice garden area to the front of the property and there was space for people to sit out in good weather. Overall the communal areas were quite homely. Generally, people that we spoke to thought that the facilities within this home were good; this included the residents and visitors to the service. We spoke to three of the residents and one person told us that they thought that their bedroom was ‘smashing’. The home was clean and warm and there were no unpleasant odours in any of the areas that we looked at. Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were protected by good staffing numbers and well trained care staff. Good recruitment practices helped to make sure that only suitable people are employed to work at the home. EVIDENCE: There were enough care staff on duty during the inspection to ensure that the assessed needs of the residents were adequately dealt with. The staff rotas showed that staffing was good and that there were plenty of staff on each shift to ensure that people were being properly looked after. The rota also showed that the residents were being properly supported at night. Most of the care staff had achieved a nationally recognised qualification in care (National Vocational Qualification level 2 or 3). Those that had not yet achieved this qualification had been enrolled. There was also a good training programme to ensure that the care staff were able to improve their skill and learn new ways to care for people. There had been a number of training events Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 22 at the home since we last visited. The manager had a training matrix to show which staff had been trained in certain areas. Certificates were also available on file regarding completed training events. One of the senior care staff was spoken to during the inspection and it was clear that she had the knowledge, skills and ability to provide a good standard of care for the residents of the home. She told us that she was pleased with the amount of training that was available and both felt that this had improved their caring skills. There was a good induction process for new care staff ensuring that staff were taught how the care home operated before starting to care for people and being included on the rota. The staff are taught how to help move people who may have mobility issues. There had been regular moving and handling training to ensure that people were assisted to move the residents safely and professionally. Staff records showed that new carers had been properly checked before starting their jobs, including obtaining Criminal Records Bureau disclosures. This helped to make sure that the residents were safer by ensuring that only suitable staff are employed. There was evidence within the care staff files to show that the correct information had been gathered prior to employment. Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home is managed well and is run in the best interests of the people who live there. The residents live in a safe home where the care staff are aware of health and safety matters. EVIDENCE: Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 24 The owners/ manager of the service should ensure that refurbishment and decoration within the home is undertaken promptly, without detracting from the available facilities for any period of time. It is understood that major refurbishment work could take some time; the work to main lounge was, however, begun over 12 months ago and the work had still not been completed at the time of our visit. The refurbished lounge will add to the overall facilities that are available, and provide a quiet area for the people who use this service. Other areas of work within the home must be completed within a reasonable time so as not to encroach on peoples’ ability to move around the home freely and use all the available communal space. Alterations and refurbishment need to be managed properly, with the well-being of the people who use the service in mind so that work does not affect their every day life. Good records were being kept of safety checks within the home. These showed that professional trades’ people were checking the lift, electric and gas equipment and the fire alarm system regularly. This helped to ensure that the residents lived in a safe home. Trained maintenance people were also checking the lifting equipment in the home on a regular basis. Staff were being instructed in safety aspects within the service. They were being shown how to move those residents, who had difficulty in supporting their own weight, safely and respectfully. Other safety training included fire safety awareness, and health and safety. All of the care staff that were spoken to were able to confirm that they had received safety training. The manager of the service needs to ensure that all of the care staff receive mandatory training in food hygiene to help ensure that risks are minimised in the kitchen area. There was evidence on the carers’ personal files to show that everyone was being supervised properly. Time was set aside for regular one to one meetings with the staff to ensure that they were happy and doing there jobs successfully and professionally. Staff were able to discuss their performance and training needs. There were several quality checks undertaken by the manager on all aspects of the running of the home. These checks helped to ensure that the people who used the service lived in a safe and clean environment. The information that was currently available about the functions and services that the home provided (the Service User Guide and Statement of Purpose) had recently been reviewed and updated. This meant that only current information was available about the home, which ensured everyone had good information. The service has staff meetings and informal residents meetings and these are recorded. The home gave out an annual “customer satisfaction survey” to relatives and advocates to find out their opinions and comments on the service being provided .The manager should look at ways to make sure the results of their satisfaction surveys are made available to current and prospective users of Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 25 their service and any other interested parties. This way, people taking part can also see what effect their views have had on the service. The policies and procedures of the service had also recently been reviewed and updated, which meant that the manager and care staff had good, current information available to help them provide a good service. Small amounts of money were kept by the service for the residents. The manager checked this monthly to ensure that this was being handled properly and safeguarded. The home has a manager who is registered with CSCI, has several years relevant experience working with older people is and has achieved the Registered Manager’s Award. Several changes and improvements have been made at this home since the last key inspection of the service. The manager must, however, improve the administration of medication within this service to help ensure that the people who live within this home are not put at risk by poor practice. Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 N/A 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 N/A 18 3 2 3 3 X 3 2 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 2 Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 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. 1. Standard OP9 Regulation 13 (2) Requirement Records for administration of medicines must be complete and accurate to protect people from errors that could affect health. This is an element of a requirement that was to have been met by 18/10/08 and again at 01/04/09 Timescale for action 31/12/09 2 OP9 13(2) Medicines must not be allowed to 31/12/09 run out as the lack of medication could affect residents’ health. The home must have a 31/12/09 programme of renewal and replacement to ensure that old and worn fixtures and fittings are replaced periodically. This is to help ensure that people live in a pleasant and well maintained home with nice things around them. The owner of the home must 31/12/09 ensure that renovations to the existing property are carried out within an appropriate timescale. 3 OP19 39 (h) 4 OP20 23 (1) Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 28 This is to help ensure that minimum space requirements for the people who use the service are not affected for long periods of time. 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 OP9 Good Practice Recommendations The manager should check that the safe used for the storage of Controlled Drugs complies with regulations and if not a suitable cabinet should be obtained. It is recommended that the manager discuss with residents’ doctors and the pharmacist those medicines prescribed ‘as directed’ so that dosage instructions are clear to ensure residents receive their medication correctly. It is recommended that the manager reviews care plans for ‘when required’ medication to make them more person-centred. Storage of medicines should be reviewed to ensure they are stored at the correct temperature so that they remain effective, and are stored hygienically. Training in food hygiene should be available for all of the care staff within the service and refreshed on a regular basis. This is to help ensure that the people who use the service are not put at risk by poor hygiene practice. 2. OP9 3. OP9 4. OP9 5 OP30 Scaleford Retirement Home DS0000064565.V377647.R01.S.doc Version 5.3 Page 29 Care Quality Commission Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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