Inspection on 27/06/07 for Silver Court

This inspection was carried out on 27th June 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 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

Silver Court 23/06/08

Silver Court 24/07/06

Silver Court 12/10/05

Silver Court 01/06/05

Silver Court 29/11/04

Silver Court 28/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Silver Court Halsford Park Halsford Lane East Grinstead West Sussex RH19 1PD Lead Inspector Mr D Bannier Unannounced Inspection 10:00a 27th June 2007 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 Silver Court DS0000014716.V338720.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. Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Silver Court Address Halsford Park Halsford Lane East Grinstead West Sussex RH19 1PD 01342 321717 01342 321202 pantons@anchor.org.uk keri.sherwood@anchor.org.uk Anchor Trust 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) Mrs Soonita Shaw Care Home 42 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (20) of places Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 22 persons in the category DE(E) Dementia to be accommodated. 24th July 2006 Date of last inspection Brief Description of the Service: Silver Court is a care home, which is registered to accommodate up to forty two residents in the category (OP) old age, not falling within any other category. This includes up to twenty two residents who are over 65 years of age who also have dementia. It provides personal care only. Silver Court is a purpose built single storey building providing single flatlet accommodation with ensuite WC and shower facilities to all residents. The accommodation is laid out in four units, three of whom have ten flats whilst the fourth has twelve flats. Each unit also provides a communal lounge and a dining room with a kitchenette. The property is located in a quiet residential area on the outskirts of East Grinstead close to shops and a local post office. Attractive garden and patio areas are also available to residents. The fee levels range from £493 to £550 per week. Additional charges are made for the following services: chiropody, hairdressing, dentist, optician, telephone, newspapers. The registered provider is Anchor Trust, who have appointed Mrs Jane Ashcroft to be the Responsible Individual and to supervise the overall management of the care home. The registered manager is Mrs Soonita Shaw who is responsible for the day to day running of Silver Court. Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report has been written using methods introduced on 1st April 2006. Some evidence used to assess standards has been gathered before this visit took place, during the visit and afterwards. For example, comments made by residents at the time of the visit have been noted; the manager has supplied further information on request that has been considered after the visit took place. The registered provider has also completed an Annual Quality Assurance Assessment (AQAA) providing information about the way the home has been run. This visit was unannounced and started at 10am. It took place over approximately eight and a half hours. The inspector spoke to five of the thirtynine residents who are currently being accommodated at this care home and observed care practices. This enabled to inspector to form an opinion about how it was to live there. The inspector also spoke to four of the staff who were on duty. They told the inspector about their jobs within the care home and the training they had received in order carry out their duties. This gave the inspector a picture of how it is to work at this care home. Some records were also examined. The inspector looked at those standards that are about how new residents are admitted to the care home; how residents are cared for; the daily life and social activities provided for residents; how the care home deals with complaints and how they protect residents from abuse; the environment in which residents live; how staff are recruited and trained; and how the care home is managed. The registered manager is currently on extended leave. The acting manager was present through the inspection and kindly assisted the inspector with his enquiries. What the service does well: This is a care home where older people are well looked after. It has a competent staff team who understand the needs of the elderly people living there, including their nursing needs. Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 6 The accommodation has been well maintained, decorated and furnished in a homely and comfortable manner. Staff have been provided with appropriate training to ensure they have the necessary and knowledge skills to provide good quality care. Where possible residents are encouraged to make decisions and choices about their lifestyle. The registered provider has ensured a range of activities, outings and entertainment is regularly provided for residents to enjoy. What has improved since the last inspection? What they could do better: The registered manager has taken extended leave since May 2007. In this period two managers have been sent to Silver Court to take responsibility for the day to day running of the care home. Several matters have not been dealt with. A recently admitted resident have not been fully assessed before arriving at the care home. As a result the care home is not able to meet the resident’s high level of needs. Care plans have not always been drawn up. Those that are available do not contain clear instructions to staff with regard to what they must do to meet residents’ needs. Some residents have been assessed as needing nursing care but are still being accommodated. Silver Court is not equipped to provide this level of care. Newly appointed staff have not completed the structured induction package. This means they will not have been provided with all the appropriate information and guidance they need to carry out their work. Staff are not receiving supervision as frequently as they need. This means they are receiving advice and guidance from a more senior member of staff to ensure they perform well. Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 7 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. Silver Court DS0000014716.V338720.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 Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care needs of prospective residents are not always fully assessed before admission. Silver Court does not provide intermediate care. EVIDENCE: The names of three residents, who had been admitted on a permanent basis, were identified for case tracking purposes. The inspector spoke to one of them and also looked through the care records of each resident. The inspector also spoke to other residents who were not part of the case tracking exercise. Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 10 Residents said that they were very satisfied with the care and services provided to them. One resident said, “ I think it’s quite nice here, my daughter doesn’t live far away so she can come to visit me. Records seen showed that the provider has designed a form for residents’ care needs to be assessed before admission. Two of the three records seen confirmed that this process had been followed. In the third instance, there is evidence that the resident had been assessed whilst in hospital. As a result of this a recommendation was made that the resident should be invited to spend the day at Silver Court in order to complete the assessment process. Whilst the acting manager confirmed that the resident did spend the day at the care home there was no evidence within the records seen to confirm that an assessment had taken place and its outcome. An assessment carried out by a social worker for the same resident was available. Information provided in this report confirmed that the resident had been referred to the psycho geriatric department of the local hospital. Records of the most recent to this department confirmed that the resident had been diagnosed as having dementia. However, this resident was not being accommodated in that part of the care home registered to provide care for residents with dementia. It was not clear from information available why this was so. Following discussions about the needs of identified residents, staff on duty were able to demonstrate they were fully briefed about the care required by two of the three residents identified and what was expected of them. Staff told the inspector what they do to provide care for the third resident who had recently been as having dementia. As the assessment record is incomplete it was not possible to determine if this is appropriate and meets the resident’s needs. Information supplied by the registered provider confirmed that the registered provider has developed a pre- admission assessment pro-forma. “ Action is taken prior to admission utilising the information gleaned to ensure identified needs are met from time of admission. Although Silver Court is under block contract and an assessment of need is prepared by West Sussex Social Services,we also go out and assess for ourselves to ensure we can meet the needs trial visits to Silver Court take place. Should we feel that West Sussex have wrongly assessed for Silver Court we will say no. All Assessors have knowledge and skills of the assessing process. Assessors limited to Manager, Deputy and Team Leaders with experience and training.” This information also confirmed, “No intermediate care is provided at Silver Court.” Silver Court DS0000014716.V338720.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 adequate. This judgement has been made using available evidence including a visit to this service. Staff do not always have appropriate information to ensure they are able to meet residents’ needs. The registered provider has not always ensured residents’ health care needs have been fully met. Unused medication has not been regularly been returned to the dispensing pharmacy for safe disposal. Current care practices have ensured residents feel they are treated with respect and their right to privacy has been upheld. EVIDENCE: Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 12 In two instances care plans have been drawn up from the information gathered when residents’ needs were assessed. The inspector was informed that two residents have been assessed by a Nursing Needs Assessor, employed by social services, who has determined that they require nursing care. However, care plans have not been amended to reflect changing needs and the level of care they now require. It is also of concern to note that assessments were carried out a month before this inspection took place and residents still remain in a care home that cannot provide that level of care. In addition, care plans seen did not include appropriate information and instructions which staff are expected to follow to ensure identified needs are met. In the third instance, there was no care plan at all. It was, therefore not possible to determine if residents’ care is provided in a consistent and continuous manner. Nor was it possible to determine if care plans take into account the individual wishes and preferences of residents about how they wish to have care provided. Staff are expected to complete daily notes about the individual care provided to each resident. Staff also record instances when they observe a change in their condition. For example one entry recorded that a resident had a bruise, with an additional note that the senior had also been informed. However, there was no record to confirm what further decision or action had been taken in the light of this information, to ensure the safety and wellbeing of the resident concerned. From direct observations, residents appeared to be relaxed when talking with staff and very well cared for. A resident was talking a member of staff about the trees in the garden and was trying to work out the name of a particularly attractive variety. The manner in which this conversation was carried out confirmed that staff do treat residents with dignity and with respect. One resident told the inspector, “The staff are very nice.” Care records included a record of visits made by District Nurses, GP’s to provide residents with medical treatment. Whilst this record included details of the treatment prescribed, this information had not been transferred into the resident’s individual care plan, detailing the action members of staff should take to ensure the treatment is carried out. It was not clear for observation of care practices, and discussion with staff, if appropriate care had been provided. Information supplied by the registered provider confirmed that, “Holistic assessment tools are available as part of the Service User Plans to enable effective identification of individual needs. A referral system in place to ensure access to other health and sovial care proffessionals; e.g nursing needs assessments or referral to CPN (Community Psychatric Nurse). Staff training on specific areas of health care takes place according to service user need.” The inspector was informed that the registered provider is aware of the shortcomings of the paperwork currently in use. It is in the process of introducing a new system to ensure care plans capture information regarding Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 13 individual residents’ needs and present it in a format that is readily accessible to care staff. However, during the change over period it is essential that appropriate steps are taken to guard against information being lost or not being acted upon. Failure to do so may result in the consistency and quality of care and support afforded to residents being compromised. The inspector examined medication records, including the controlled drugs register. Records had been well maintained and were up to date. The inspector was advised that the current practice is for medication to be given to residents directly from packs and containers marked by the dispensing chemist, with the name of the resident, a photograph, the dosage and strength and time the medication is to be given. The inspector expressed concern that, in some instances, unused medication has not been returned to the dispensing pharmacist. The inspector was advised that this has arisen as the resident no longer needs to taken the prescribed medication. It was also noted that the dispensing pharmacist raised this during a visit to monitor practices in September 2006. Information supplied by the registered provider confirmed that, “Robust medication policies and procedures are in place. An assessment process is in place for residents who wish to self medicate to enable independence. Individual drug storage for all residents. Training programme is in place for all levels of administration” Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social and recreational interests and needs. Residents maintain contact with family and friends Residents receive a wholesome appealing balanced diet in pleasing surroundings. EVIDENCE: Residents’ social, and recreational interests have been recorded in individual care plans. Residents spoken to have confirmed they enjoyed the programme of activities provided at Silver Court. Activities were displayed on the residents’ notice board and include art and craft classes. The inspector saw a selection of residents’ artwork on display in the activities lounge. Photographs of residents Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 15 taking part in various outings and activities were on display. One resident said, I like to go out, we sometimes go into town.” Televisions and music centres have been provided in lounges in each unit. There is also equipment available for residents to play board games such as scrabble and dominoes. A bookshelf in a small library area was well stocked with paperbacks and large print books for residents’ use. Information supplied by the registered provider confirmed that, “Social interaction/activities are service user specific and outlined in the Service User Plans as well as the homes programme. The pace of the day is set by the residents but is an area that we can improve upon. A variety of facilities are available within the home for flexible use, such as the library, shop and magazines. Residents’ care plans include a record of residents’ families and friends, and the contact they have with them. One resident said, “My daughter doesn’t live far away. She comes to visit me.” Residents are not expected to get up if they do not wish to, nor are they required to go down to the dining room for their meals. Residents are also encouraged to bring in their own possessions to make their rooms personalised. Information supplied by the registered provider confirmed that, “Residents right to choose is paramount to service delivery, enhanced in different routines for different residents. Decision making is integral to the day to day life of the home. Independence is encouraged,with the following personal facilities,e.g kitchenettes,gardens,hairdressing room,etc.” Residents are afforded a choice of cooked meal for lunch and supper. Residents are provided with a cooked breakfast every Saturday, if they wish. On the day of his visit the inspector noted that the lunch time meal was a choice between kidney turbigo or poached marlin in parsley sauce, mashed potatoes, cauliflower and mixed vegetables, followed by bread and butter pudding with custard. The chef explained to the inspector that kidney turbigo is a casserole with kidneys and sausages. The inspector sampled each of these dishes; they proved to be very tasty! There were sufficient staff on duty during the mealtime to ensure residents who need help with eating get the assistance they require. From menus seen the inspector concluded that residents have been provided with a varied, wholesome and balanced diet. Residents told the inspector that they enjoyed the food provided. One resident told the inspector they liked bread and butter pudding and was very pleased when they were told it was no the menu for lunch. Another resident said, “The food is quite good!” Information supplied by the registered provider confirmed that, “Individual Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 16 nutritional screening has been carried out for each residents needs. Menu planning by the Chef is done in consultation with residents. Culteral and dietry needs are assessed and provided for as required,such as vegetarians. There are various choices of snacks on offer in different locations such as fruit platters, finger foods and supper trays.” Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives know that their complaints will be listened to, taken seriously and acted upon. The registered provider has ensured that residents are protected from abuse. EVIDENCE: A written complaint procedure was on display. This clearly identified who residents, or their relatives should speak to if they wished to make a complaint. The procedure also set out the steps any investigation would go through and the timescales by which the complainant would be notified of the outcome. The inspector noted that the address of the Commission’s local office needs to be changed. The acting manager confirmed this would be done. Whilst the inspector did not examine the complaint record, information supplied by the registered provider confirmed that twelve complaints had been received in the last 12 months, all of which had been resolved within 28 days of receipt. Information supplied by the registered provider confirmed that, “Complaints and feedback is actively welcomed as a mechanism to improve service Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 18 provision. A complaint process is in place and documented in statement of purpose, notice boards, service user guide and leaflets. There is also a documentation process for all complaints and fixed response times with action taken. Procedures identify clear guidelines of responsibility and escalation.” According to records seen training provided to all staff includes training in Adult Protection procedures. It was also noted that the registered provider has a copy of the Adult Protection procedures published by West Sussex Local Authority. Staff on duty were able to tell the inspector about different types of abuse and to whom they should report any instance they may find. From observation of care practices residents were comfortable and relaxed when speaking with staff. From this the inspector concluded that staff knew how to respond to residents needs appropriately and in accordance with the principles of good care practices. Information supplied by the registered provider confirmed that, “ Safeguarding Adults process is in place and has been outlined in a policy. Alert Training( POVA ) for all staff has taken place. Rights and responsibilities booklets are given out at induction and training has been given to all staff. A restraint policy is in place.” Silver Court DS0000014716.V338720.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 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, well-maintained environment. The home is clean, pleasant and hygienic EVIDENCE: The inspector went round the premises accompanied by the acting manager. It was noted the premises were very clean, tidy and well maintained in a homely manner. The inspector viewed several bedrooms. It was noted that the door to each room had been fitted with a door bell and a number, presenting the accommodation as individual flatlets. Residents have been able Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 20 to personalise their own rooms by bringing small items of furniture, pictures, ornaments and family photographs. The inspector was informed that each flatlet had been equipped with an ensuite shower/WC. The inspector also viewed the lounge and the dining room in Ash and in Bluebell, the two units which make up the accommodation which are used by residents who have dementia. These were very clean and tidy, well maintained, furnished and decorated to a high standard. Residents told the inspector that they were very comfortable and thought the accommodation was very good. The registered provider has designed its own scheme for auditing the care homes it owns in terms of health and safety issues. In the entrance foyer of Silver Court an “Anchor Safe Home Award” certificate is displayed. The acting manager informed the inspector that this means that the premises has passed the audit. The inspector was also advised that the care home has the services of maintenance staff for three days each week, who can deal with smaller jobs. A communication book is in operation in which staff are expected to report any repairs required. The registered provider calls in outside contractors if major works are required. From this and from direct observation the inspector concluded the premises has been well maintained and is a safe environment in which residents can live and in which staff can work. Areas of the home, which were seen were also very clean and hygienic. Information supplied by the registered provider confirmed that, “Silver Court is welcoming and provides a homely environment. Tasteful furnishings,pictures and palnts both in and out. We have good quality facilities which have been designed specifically for purpose. We review dining and communial areas to make them more homely. Residents personalise their environment, which may include specific aids and adaptions. Small group quiet areas are available throughout the home. All rooms have en-suite and all bathrooms are fitted with equipment to assist independence. Home maintainence is in place supported by the Surveyor Team. Infection control procedures and policy is in place. Silver Court DS0000014716.V338720.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 good. This judgement has been made using available evidence including a visit to this service. Residents’ needs have been met by the numbers of staff provided. The home’s recruitment policy and practices ensure vulnerable residents are supported and protected. Newly appointed staff have not received a full induction training to ensure they are competent to do their jobs. EVIDENCE: The inspector noted that there were two care staff on Ash and on Bluebell. A more senior member of staff, known as a team leader was also available and was overseeing the care being provided. The acting manager confirmed that two care staff are provided on each unit, including two further units which were not seen by the inspector. In addition there were house keeping and catering staff to ensure the premises are kept clean and residents are provided with cooked meals throughout the day. Staff rotas were also examined and confirmed the staffing levels provided. Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 22 During the last inspection it was noted that staff had been commencing employment before a criminal records check (CRB) had been obtained. The inspector examined the records of two staff recruited since the last inspection. Records seen on this occasion were well maintained and were up to date. The information seen included references, criminal records checks and evidence which confirmed the identity of the member of staff. The inspector concluded that the manner in which staff are recruited ensures appropriate checks are carried out to confirm the applicant is appropriate to work with vulnerable residents. An appropriate structured induction package is also in place that newly appointed staff are expected to undertake. In one record only the first day of the pack has been completed, despite the member of staff working in the home for approximately three weeks. A second record was also seen and this also contained gaps and had not been completed. This person had been working in the home for approximately seven weeks. It was therefore, not clear if induction training had been completed. This was brought to the attention of the acting manager who informed the inspector that the senior member of staff responsible for supervising new staff had not been present at Silver Court for the past two weeks. Records of training provided were also examined and demonstrated that training for all staff has included mandatory training such as fire safety, food hygiene, adult protection and health and safety. It also demonstrated that staff who work on units accommodating residents with dementia have received additional training with regard to understanding dementia. Information supplied by the registered provider confirmed that there are, “Clear job profiles and adverts, with formal interview process; Appropiate staffing levels and no use of agency staff; A variety of training programmes are available including Anchor generic courses and specific courses, as well as externally purchased individual training to meet residents needs; BTEC Induction training; Probationary periods are in place for all staff ; NVQ Training programme is in place and staff at Silver Court have 84 per cent of staff qualified to NVQ 2 standard.” During the last inspection it was noted that staff supervision had lapsed. As a result the inspector idetified this as a requirement. According to records seen, since the inspection the registered manager had set up a system to ensure all staff are supervised with a target of six sessions during the year. However, since the registered manager has been absent, supervisions have lapsed again. Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered provider has not taken appropriate action to ensure Silver Court is being well managed. Staff are not being appropriately supervised. The registered provider has taken appropriate action to ensure the health, safety and welfare of residents and of staff. EVIDENCE: Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 24 The registered manager for Silver Court is Mrs Soonita Shaw. Mrs Shaw has demonstrated her fitness to manage Silver Court through the process of registering with the Commission. The inspector was informed that Mrs Shaw is currently on extended leave. However, the manner in which this post is being covered is cause for concern. Since this period began, in May 2007, two different managers take over responsibility for the day to day running of the care home for short periods. There was no evidence to confirm the Commission had been notified of the changes to the management of the care home. however, there is evidence that, as a result of the changes, the management of the care home and the leadership and direction afforded to staff has suffered. For example, issues related to assessments of residents’ care have not been followed through to ensure their safety and wellbeing, stock piling of medication has not been addressed despite it being raised by the dispensing chemist in their last visit, newly appointed staff have not received a full induction, staff supervision has lapsed. Whilst records were not examined on this occasion, information supplied by the registered provider before this visit took place indicated that an annual development plan for quality assurance is in place. This confirms that, “ A Home business plan outlines the development of the service and the plans for the future. Resident and relative questionniares are given out quarterly. All findings are then looked at and an acton plan put together to allow us to identify and implement changes.” Visits made by a representative of the registered provider were also available for inspection. They indicate that residents and their families are consulted regularly with regard their views about the day to day running of Silver Court. During the last inspection the system for handling residents’ money was discussed. The inspector was informed that all monies have been pooled, either in the care home or in an Anchor bank account rather than in individual accounts. The registered manager stated that this has been discussed with the registered provider and one of the Commission’s Provider Relationship Managers and was to be reviewed in August 2006. At this inspection the inspector was informed there has been no change to the system. Residents’ money continues to be pooled in one account held by Silver Court or by the registered provider. Information supplied by the registered provider confirms that, “Financial and home occupancy information is produced monthly to homes, as well as acess to computer systems to support appropiate processes.” The premises have been well maintained, ensuring a safe environment in which residents can live and staff can work. The registered provider has supplied information that indicates equipment such as boilers, other gas installations and electrical equipment have been regularly serviced and maintained. According to training records staff have been provided training in such subjects as moving and handling, food hygiene, infection control, health Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 25 and safety. Staff on duty, who were spoken to confirmed the training they had received. Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 2 x 3 Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP31 Regulation 38(1)(b) Requirement The registered provider must inform the Commission who will be responsible for the day to day running of the care home whilst the registered manager is taking extended leave. This person must be appropriately experienced and qualified and be able to ensure the care home is run in the best interests of residents. Timescale for action 24/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Silver Court DS0000014716.V338720.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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