Inspection on 22/11/07 for Seabank House

This inspection was carried out on 22nd November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Seabank House 31/08/09

Seabank House 24/07/08

Seabank House 21/06/06

Seabank House 17/03/06

Seabank House 13/12/05

Seabank House 10/01/05

Seabank House 21/06/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Seabank House 111 Seabank Road Wallasey Wirral CH45 7PD Lead Inspector Beate Field Key Unannounced Inspection 22 & 28th November 2007 10:30 nd Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 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 Seabank House DS0000018938.V343488.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 Adults 18-65. 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. Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Seabank House Address 111 Seabank Road Wallasey Wirral CH45 7PD 0151 630 2791 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) Ms Helen Gifford Ms Helen Gifford Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st June 2006 Brief Description of the Service: Seabank House is a large detached house in the Wallasey area. The home is registered to provide personal care for nine adults with a learning disability. Bedroom accommodation is provided in one shared room and seven single rooms. Bedrooms are located on the ground and first floor. Toilets and bathrooms are located on both floors of the home. There is a lounge, kitchen, dining room and staff sleeping-in room on the ground floor. Parking is available on the road at the front and side of the home. The home is within easy reach of New Brighton and Liscard town centre. There is a wide range of facilities such as shops, churches, community centres, a library and public transport within walking distance. A copy of the statement of purpose, which describes the services offered at Seabank House, is made available to relatives and social workers. A service user guide is made available for prospective residents. Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection is based on a visit to the home, information received about the service since the last inspection, a pre-inspection questionnaire completed by the manager that gave information about the day-to-day running of the home and questionnaires completed by the residents, relatives, staff and health care professionals. During the visit to the home time was spent looking at a sample of records and policies and procedures and talking to the manager. A tour of the home was undertaken. The inspector spoke with staff and observed the care provided to residents. A second visit was made to the home to view records that could not be located during the first visit, to ensure that improvements had been made to the practices around the management of medication and to spend further time finding out the views of residents and staff and living and working at the home. What the service does well: Residents’ told the inspector they enjoy living at Seabank House and made positive comments about the support they receive from the manager and the staff team. Residents also told the inspector they enjoyed going out and spending time with the staff team socially. Residents are supported to take part in activities in the community including day services, work placements and leisure facilities. Residents’ are supported to make positive choices and decisions in their lives and take responsibility for their actions in their daily lives. Care plans showed that staff are given the information they need to appropriately support the residents. The number of staff available for the residents ensures that the residents get the support they need. The staff are very knowledgeable about the residents needs and how to meet them. The inspector observed members of the staff team supporting residents’ in a sensitive and supportive manner. 6 staff spoken with described the service provided to residents and working at the home in a very positive way, they said the home “is like a big family,” “the staff all get along well” and the residents “have a wonderful life here, the home is run with the residents being the main focus.” Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment process ensures that the service is only offered to individuals whose needs can be met at the home. EVIDENCE: The home’s Statement of Purpose provides detailed information about the type and level of support the home can provide. It also provides information about the staff team and the facilities available for use by prospective residents. There have been no new admissions to the home since the last inspection. Records show the home carries out pre admission assessments prior to prospective residents being admitted. This information is then used to form the basis of care planning and risk management strategies formulated to support the individual. Residents who returned questionnaires said that they were able to visit the home to meet staff and residents before deciding whether to move in. Residents’ contracts could not be located on the first visit to the home. They were made available at the second visit to the service. The contracts provide Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 9 good clear information about what services the home provides and details those that they do not. Contracts also detail the provision of a month trial period which offers both parties time to decide if Seabank House is the right place for them. Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and risk management strategies are clear and provide staff with the information they need to appropriately support the residents. EVIDENCE: A sample of three care plans were seen. The care plans provide the staff team with detailed information and clear guidance as to the type and level of support residents need with their personal care. The plans provide detailed and individualised information about what makes the residents happy, sad, frightened and angry. The plans build a picture of the important things to residents including those things that are non negotiable in their daily lives. The care plans record the religious needs of residents, their sexuality and what residents can do for themselves and where staff help is required. Risk assessment information is detailed and provides the staff team Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 11 with clear guidance and where appropriate instructions as to the support and supervision residents require in a range of environments and situations. Records and a discussion with staff and residents indicated that residents are supported to be central to any decision making about how they live their daily lives. The manager reported that the care plans seen had been recently reviewed and re-written to reflect any changes. Although there was no record of this, there was no evidence to suggest the plans were not up to date. Care needs to be taken to ensure that the date that care plans are reviewed is clearly recorded. There was limited information available on the residents preferred methods of communication. The manager reported that she has made a referral to a speech and language therapist for one resident. Further information on the way residents make their wishes and needs known should be documented for all the residents as this will ensure the staff team are able to communicate effectively with residents living at the home. A review of the communication aids available should be undertaken. Resident spoken with said they are “happy at the home” and “like the staff.” Observations of residents with the staff showed that residents were happy and relaxed in the company of the staff. Residents who returned questionnaires said that they are treated well by the staff. Relatives who returned questionnaires were very positive about the standard of care provided. Some comments made were “the staff care for the residents very well and make them happy and contented.” “ The staff are caring” and “we are very lucky having our relative looked after by kind and caring staff.” Staff on duty were fully aware of the likes and dislikes and of the needs and behaviours of the residents and the ways in which they should respond Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents take part in appropriate activities that provide opportunities for their educational, social and personal development. EVIDENCE: The home works hard to support residents’ to make positive decisions and choices in their lives including being involved in voluntary work, college courses, leisure activities, holiday destinations and relationships. The home has few set routines. However there is an expectation that residents’ will assist with some household chores such as tidying their rooms and helping with meal preparation. Residents’ are encouraged to view Monday to Friday as time to carryout work related tasks and the weekend as leisure time. Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 13 One to one support is provided to a number of residents’ regularly. The manager works hard to promote a sense of community and provides opportunities for the resident group to enjoy time together. For example an annual holiday, visits to local pubs and restaurants. Residents are regularly involved in community life and community activities. Friendships and family contact are promoted. The inspector spent time, over two visits with four of the residents. Residents told the inspector they liked living at the home and enjoy the activities that they do. During the visits residents were observed returning from day services and talking positively about their time there, getting ready to go out Christmas shopping and spending 1:1 time with staff engaging in the activities they enjoy. Relatives who returned questionnaires said that the residents enjoy a good social life, have holidays and are part of the local community. The inspector observed the residents and members of the staff team interacting in a relaxed, supportive and warm manner. The support workers are responsible for all catering duties and encourage residents to eat a balanced diet. Examination of care plans and risk assessments indicate special dietary needs are catered for. Residents told the inspector they liked the meals at the home. Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents’ health care needs are well met but improvements are needed to the records and practices around the administration of medication in order to safeguard the residents. EVIDENCE: The care plans and risk assessments provide the staff team with detailed information about the most appropriate and safe way to support residents with their personal care needs. This guidance involves practical help for the staff team regarding how clients like their hair washed and how to use lifting and moving equipment to cause the least distress and anxiety to residents. Residents have a key worker and a number of staff have worked at the home for several years. This provides both consistency and continuity in support. Staff receive training around supporting the medical needs of the residents at the home. Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 15 Records show that residents have access to medical/health care professionals as needed. However, all contact and input by health care professionals is recorded in the daily diary, which means it can be time consuming to locate this information. A record of health care appointments attended and the outcome should be maintained separately for ease of reference. A questionnaire returned by a health care professional indicated that in general the residents receive a good standard of care, however, improvements are needed to the training staff have received in health care matters and to the communication between staff around the residents health needs. This was brought to the attention of the manager who agreed to address the issues raised. The way in which medication is managed at the home gave cause for concern: On arrival at the home the medication was not stored securely. Blister packed medication was on the kitchen counter and a bottle of cough mixture on the dining room table, paracetemols belonging to staff were on the desk in the office, while the office door was open. The manager reported that the two residents at the home at the time would not be unable/unlikely to access this. Not securing medication securely is poor practice and does not safeguard against the risk of residents ingesting medications inadvertently. It is of concern that at the last visit to the home a requirement was made that the medication be stored securely. The medication administration record sheets could not be located immediately at the time of the visit. The manager contacted a member of staff and eventually located these down the side of the settee. A selection of residents’ medications and the accompanying Medication Administration Record (MAR) sheets for the month of November 2007 were examined. There were a significant numbers of gaps where staff had not indicated whether the medication had or had not been administered. One resident administers their medication. The care plan could not be located during the inspection, which contained the risk assessment around this practice. One type of medication was not listed on the Medication Administration Record so there was no record of whether this had been given. The medication administration record did not contain the dosage and frequency of administration for a further type of medication. The home’s medication procedure does not refer to the procedure to follow when checking medication in to the home. This needs to be updated to ensure that staff who have this responsibility identify any discrepancies as soon as possible. Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 16 There were 3 packets of medication that were out of date that were stored in the medication cupboard. All of these medications are not used frequently. One that is used as and when required had expired in November 2005 and a replacement was not found to be available. The manager reported that this had been ordered. A review needs to take place of the training staff have received in the safe handling of medication and appropriate arrangements made for staff to attend training where this is needed. At a follow up visit to the home the above issues had been addressed, however, requirements have been made in this report as medication must be safely managed at all times. Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. In general, residents are protected by the staff training and policies and procedures that are in place to ensure that residents’ views are heard and appropriate action taken. Some improvements are needed to the management of residents’ finances. EVIDENCE: There have been no complaints made to the CSCI about the service provided by the home in the last twelve months. Records showed that the home has received two concerns from a day centre, which had been appropriately responded to. The home has an easy read statement of purpose and service user guide that provides residents with good information about who to talk to if they have a concern or wish to make a complaint, information around how to contact the CSCI is also held in these documents. All but four members of the staff team have carried out training regarding the protection of vulnerable people. This training was provided by an external training organisation. The manager said that the four staff who have not received this training are new staff and that this is to take place next week. Records supported this. Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 18 Staff have access to appropriate adult protection procedures. The staff spoken with were able to demonstrate a clear understanding of how to protect vulnerable adults from abuse. The staff who returned questionnaires also said that they had received good guidance around the adult protection procedures. A sample of residents financial records held by the home were examined. A record is maintained of money received on behalf of the resident, what each resident spends and receipts are maintained. The amount of money held on behalf of each resident did not correspond with the records seen. The records showed that the residents had a minus balance because monies had not been transferred from their savings accounts to cover their expenditure instead the manager had lent the residents money from petty cash but had not transferred a set amount. The manager was advised at the last inspection that accurate maintenance of these records was vital to ensure residents could not be subjected to financial abuse. Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Further improvements are needed to the environment in order to provide residents with a safe and comfortable home. EVIDENCE: The poor standard of decoration and furnishings within the home have been raised as an issue in previous inspection reports and have led to a number of requirements being made. At this site visit there was evidence of continued improvement to the environment of the home as some residents’ bedrooms had been redecorated and replacement windows had been fitted in all but one room. At this visit the decoration to the stairs and landing was incomplete. The decoration to the kitchen incomplete. The office was in the process of being redecorated, upstairs toilet had a panel of the wall missing that needed to be Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 20 re-fitted, the decoration in 3 of the bedrooms needed attention, the decoration to the hall on the first floor needed attention and the carpet in this area was stained with paint and is waiting to be replaced. The manager reported that these works are in the process of being attended to, however some works have remained unfinished for a couple of weeks. The manager is to inform the CSCI of the work taken to address the above on a monthly basis. A television cabinet in one bedroom had a loose door and the drawers were on top of a chest of drawers in one bedroom waiting to be fixed. The yard was being used to store rubbish that is waiting to be removed, such as wood and an empty gas cylinder. This is not satisfactory. At the time of the visit the home was in need of cleaning and tidying. The dining room floor was sticky, kitchen disorganised with work surfaces in need of cleaning, cat faeces was in the litter tray in the hall, the residents bedrooms seen were untidy. The manager reported that she carries out the cleaning of the communal areas in the morning but had been delayed as one of the residents was unwell today. The manager further advised that the staff who come on duty in the afternoon clean and tidy residents bedrooms before the residents return home. On a further visit to the home all areas of the home were seen to be clean and tidy. However, arrangements must be in place to ensure that the communal areas are kept clean and tidy even when there are emergency circumstances. Regular checks are carried out of the fire alarm and emergency lighting and regular drills are undertaken. Portable appliances had been recently tested. There was no up to date gas safety certificate or electrical wiring certificate. The manager was unable to produce the last electrical wiring certificate for the home as this had been mislaid. A copy of the service checks of the fire alarm and emergency lighting were not available. A sample of the first floor windows seen had restrictors in place. The manager reported that all first floor windows have restrictors. The manager reported that the water is temperature controlled. Although the manager reported that regular checks are taken of the water temperature these are not recorded. The manager was advised to do this. Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff team are well motivated with staff moral high. This has a positive impact on the quality of care offered to residents. However, in order to safeguard residents a robust recruitment procedure must at all times be in operation. EVIDENCE: Discussion with members of the staff team, examination of residents’ daily diary sheets and the staffing roster indicates there are sufficient staff on duty to support the needs of the residents. One to one time is allocated to support residents with particular activities or when individuals need support through crisis situations. The manager employs twelve support workers to care and support residents with all aspects of their daily lives. A number of the staff have worked at the home for some time which provides continuity in the care residents receive. Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 22 Records showed that staff receive a brief induction. This covers the home’s policies and procedures, day-to-day routines; resident’s care plans and health and safety issues. Staff need to have access to a more thorough induction, which meets the standards of Skills for Care. A more detailed evidence based recording system should be put in place to identify that the Skills for Care workforce training targets have been met and any learning needs identified for staff. At the time of the site visits five members of the staff team had successfully completed NVQ 2 with a further two undertaking this training. A senior member of staff is working towards an NVQ 3. Since November 2006 members of the staff team have taken part in the following training sessions: fire awareness training, basic food hygiene, adult protection awareness training, communication methods for adults with a learning disability, manual handling, COSHH awareness training and managing bereavement, dementia awareness and managing challenging behaviour. First aid training has been planned to take place in the next three months. At previous inspections the manager has been advised of the need to provide further specialist training in the area of learning disabilities. To ensure the staff team are aware of best practice within this field. Since the last inspection staff have attended some training linked to the disabilities and specific conditions of some residents. The manager is looking into additional training courses in this area. Members of the staff team spoken with told the inspector that they enjoy working at the home and are well supported by the manager. The staff spoken with were very enthusiastic about their work. They knew the needs of the residents well and presented as caring and responsible. Staff were very positive about the service provided to the residents. Some comments made were the home “provides a good service and residents are well looked after”. “It’s really homely.” “Staff get on well with each other and the residents. The home is run like a family”. The questionnaires returned by staff provided similar information. During the two site visits the inspector observed the staff team supporting residents in a caring supportive manner. Residents told the inspector they liked being with the staff and liked going out with them. Two staff files were examined during the inspection. These contained contracts and job descriptions, however, both files had only one written reference and a record made that a verbal reference had been obtained. There was no indication as to whether the verbal reference was satisfactory. The Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 23 criminal records bureau check on one file had been returned after the member of staff had started work at the home. The manager reported that a POVA first check had been obtained and that the member of staff was supervised until their criminal records bureau check was returned. There was no evidence of this. Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is inadequate management overview with regards to some record keeping. Improvements need to be made in this area in order to ensure that the home is fully managed in the best interests of the residents. EVIDENCE: The manager is a qualified nurse. The manager is currently working towards an NVQ Level 4 in management. The management style within the home supports and guides the staff team to be focused on the care and support of the residents and to be aware of the impact of their actions and behaviour on residents’ in their own home. The Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 25 staff are very aware of the needs of the residents. The manager and staff gain the views of residents on an informal basis through group and individual discussion. Discussion with residents and examination of a selection of care plan and daily diary entries indicate residents opinions are sought and valued in all areas of the homes life. During this visit several records (including care plans, medication administration record sheets and contracts) could not be located immediately and some were not satisfactorily maintained. The office was in the process of being redecorated, however appropriate arrangements must be in place to ensure that all records that staff need to refer to, to carry out their duties within the home are accessible. The medication administration records were found down the side of the settee and it was identified that the staff had taken two of the residents care plans home to work on. It is recommended that a computer be obtained for use within the home as records that staff need to refer to and are required for the protection of residents must not be removed from the home. The shortfalls in the record keeping around the administration of medication, staff recruitment records and residents finances have been issues that have been identified at previous visits to this service. There is inadequate management overview with regards to some record keeping and improvements need to be made in this area in order to fully safeguard the residents. It is recommended that the manager assess the time she has available for maintaining records and her other responsibilities, such as domestic tasks and makes adjustments as needed. The accident/ incident records were examined and indicated appropriate information and actions had been taken. As already indicated, some records relating to the safety of the environment were not up to date at this visit and action needs to be taken to address this. Staff are provided with training around health and safety matters with training updates being arranged when needed. Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 1 25 2 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 X 2 X 3 X 1 2 X Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 27 Yes Are there any outstanding requirements from the last inspection? 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 YA20 Regulation 13 Requirement Timescale for action The registered person must 22/11/07 ensure the medication practices within the home safeguard residents at all times (this requirement remains outstanding from a previous inspection.) The registered person must ensure the medication procedure provides guidance to staff around the process to follow when ordering and receiving medication at the home. The registered person must ensure that all records required for the protection of residents, namely care plans, medication records and contracts are readily accessible for staff to refer to. The registered person must ensure residents financial records are appropriately maintained. The registered person must continue to improve the home environment for residents and provide the Commission with a DS0000018938.V343488.R01.S.doc 2. YA20 13 22/12/07 3. YA20 YA41 17 22/11/07 4. YA23 16 22/11/07 5. YA24 23 22/12/07 Seabank House Version 5.2 Page 28 YA25 monthly update as to the work to be carried out and work completed. 16 The registered person must ensure that all residents have access to suitable furnishings. Any broken furnishings are to be fixed or replaced. The registered person must ensure that any rubbish stored at the back of the home is removed. The registered person must provide evidence that the gas appliances and electrical wiring at the home are safe and that the fire alarm and emergency lighting have been recently serviced. The registered person must ensure that all parts of the home are kept clean. 22/12/07 6. YA24 7. YA24 16 22/12/07 8. YA24 23 22/12/07 YA42 9. YA30 23 22/11/07 10. YA34 19 The registered person must 22/11/07 ensure staff records are well maintained and are available for inspection when required (this requirement remains outstanding from a previous inspection.) The registered person must 22/02/08 ensure that a variety of specialist training is provided to the staff team. Enabling them to support adults with learning disabilities in a proactive and enabling manner. 11. YA35 10 Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 29 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 YA6 YA7 Good Practice Recommendations A record needs to be clearly made of the date that care plans are reviewed. Further information on the residents preferred methods of communication should be documented for all the residents as this will ensure the staff team are able to communicate effectively with residents living at the home. A review of the communication aids available should be undertaken with a view to providing more pictorial aids. A record of health care appointments attended and the outcome should be maintained separately to the daily diary for ease of reference. A record of water temperature checks should be made. Staff should have access to a more thorough induction, which meets the standards of Skills for Care. The manager is to obtain an NVQ Level 4 (or equivalent) in management. It is recommended that a computer be obtained to assist staff in their record keeping. It is recommended that the manager assess the time she has available for maintaining records and her other responsibilities such as domestic tasks and makes adjustments as needed. 3. 4. YA7 YA19 5. 6. 7. 8. 9. YA24 YA35 YA37 YA41 YA41 Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Merseyside Area Office 2nd Floor, South Wing Burlington House Crosby Road North Waterloo L22 0LG 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 Seabank House DS0000018938.V343488.R01.S.doc Version 5.2 Page 31 - 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. 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