Inspection on 24/08/07 for Silversea Lodge Care Home

This inspection was carried out on 24th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Silversea Lodge Care Home 16/03/09

Silversea Lodge Care Home 06/08/08

Silversea Lodge Care Home 26/02/08

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Silversea Lodge Care Home 46 Silversea Drive Westcliff On Sea Essex SS0 9XE Lead Inspector Sara Naylor-Wild Unannounced Inspection 24th August 2007 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Silversea Lodge Care Home DS0000068495.V349462.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. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Silversea Lodge Care Home Address 46 Silversea Drive Westcliff On Sea Essex SS0 9XE 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) 01702 480502 01702 710482 Mr Pritesh Patel Mrs Shaila Rashid Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection N/A Brief Description of the Service: Silversea Lodge provides care and accommodation for fifteen elderly people and is able to meet the needs of people requiring assistance and support with personal care and mobility. It is not registered to admit people with dementia. The premises and facilities are provided on ground and first floor levels and have been suitably upgraded and adapted for the accommodation of elderly people. There is one main lounge and a separate dining room. There is single bedroom accommodation throughout, some of which have en-suite facilities. A passenger lift is provided for residents to gain access to the first floor. The facilities provided have been maintained to a high standard. There is a medium size garden to the rear of the premises and limited parking available to the front. Silversea Lodge is located in a residential area of Westcliff on Sea. It is in close proximity to local shops and bus routes and other local amenities including Chalkwell Park. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report includes the The evidence contained and residents, a visit to information provided to unannounced inspection site visit on 24th August 2007. in this report was gathered from discussions with staff the home, observation of residents’ interaction and the Commission for Social Care Inspection (CSCI). The Deputy Manager assisted the inspector during the site visit. Feedback on findings was given during the visit with the opportunity for discussion or clarification. The inspector would like to thank the Management and staff team, residents, relatives and visiting professionals for their help throughout the inspection process. This is the first unannounced key inspection of the service since the current registration was agreed. What the service does well: What has improved since the last inspection? This is the first inspection visit to the home under the current registration. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 6 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. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 7 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 Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 8 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&6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents cannot be assured that the service will understand how best to support their strengths, needs and aspirations prior to moving into the home. EVIDENCE: The Statement of Purpose was reviewed at the point of registration of the service and was considered at that time to have sufficient information to meet the expectation of the Care Homes Regulations 2001. This was not considered again at this inspection. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 9 Residents spoken with during the visit stated that where possible either they or their families had visited the home prior to their moving in. They had been provided with information about the service and had made an informed choice about their admission. The service has a care needs assessment format that is used to understand the needs of people who are referred to the service for admission. The format of the form is a very basic yes/no questionnaire. For example under eating and drinking the form asks is the person able to feed themselves, does the person need any special aids, does the person need their food cut up, does the person use a cup/beaker/straw. The files of four residents were read to assess how successful this form is in providing staff with insight into the support required for the person. As an example in the form of one resident their medical history briefly states that they are diabetic. However the section in relation to eating does not ask about the need for a specialist diet and there is no indication in the whole assessment that one will be required. The same plan states the person has a tumour that has affected their balance and cognitive abilities in their medical history, but later states under maintaining a safe environment that they are not prone to falls. Other information such as specialist risk assessments for falls, skin integrity, continence and nutrition are not completed and therefore do not provide the detailed information to give support to the main assessment. All files seen contained the same document formats and level of information. This is insufficient to provide an understanding of how the individual resident should be supported. The purpose of assessments are to ensure that the proposed admission meets the criteria of the home’s category of registration and that the service is prepared to provide the skills and resources necessary to support the residents on admission. Without the correct information neither of these objectives can be fulfilled. The service does not provide intermediate care. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 10 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 & 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users cannot expect their diversity to be supported by the service’s documentation and therefore cannot be assured that the staff will understand how they can best meet their needs. EVIDENCE: The files of the same four residents noted in the previous section of this report were read to consider how care planning is used to support residents living at the home. The inspector was informed that the care plans were in the process of being updated and that this task was not yet complete. None of the files viewed held completed care plans, and where there were entries in care planning documents they did not cover all the issues presented in the initial assessment. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 11 In the care plan of a resident who for example has a medical history of balance issues, diabetes and a brain tumour affecting their cognitive abilities the plan stated “To ensure that X changes their clothes, to change clothing on a regular basis and give them as much choice as possible, to continue with X’s appearance to maintain good grooming. This was the only element of care planning on the file. Additional sheets marked care plan and night plan were not completed for the same resident. No records for health needs were maintained including fluid charts, turning charts although the documentation was present on the files. Health professionals’ visits were recorded on the ‘multi disciplinary review’ sheets. In the file of one resident, a visit from a GP in respect of a swollen leg, had resulted in changes to the residents’ treatment, again there was no care plan to direct staff in how to address these. There was also no record of any other initiatives to assist with the reduction of the swelling such as raising the foot or closer review of skin integrity caused by oedema. In another resident’s care plan it is stated that the resident is prone to falls, and several falls were noted before their discharge from hospital on their hospital discharge notes. Additionally the individuals daily records also indicate they had suffered falls since their admission. However there was not a falls risk assessment in place or care planning in relation to the issue. The accident book maintained has entries for falls suffered by various residents. However there was not any means of auditing these records to determine whether there were links to the events. The Deputy manager was not aware of any contact with the Primary Care Trust to discuss the falls prevention initiatives in the area and seek referrals for those residents at risk. . The Medication administration was not observed at this inspection, as staff member did not notify the inspector of their carrying out this duty as requested. The records relating to the management of medication administration were examined. Although the service does not have a monitored dosage system operating at the home the pharmacist does provide computer generated MAR sheets in for staff to sign when administering prescription drugs. The examination of these records evidenced that staff signatures for dispensing were generally present although there was some confusion about as and when (PRN) painkiller drugs and those with defined administration times. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 12 As a result some PRN medication was always signed out as refused when a resident did not wish to take it and some time prescribed painkillers had gaps in their recording when refused by the resident. Although current medication is kept in a locked metal cabinet the stock drugs and the drugs due for return to the pharmacist are not. The stock is kept in cupboards in the two administration offices with only clip locks to secure them and the returns are kept in baskets loose in the main office. There is not a controlled drugs cabinet in the home and at the time of the inspection there was not a controlled drugs log. The Deputy manager reported that these were on order. Only the manager, deputy manager and four seniors administer drugs. The training records for these staff did not demonstrate updated medication training had taken place. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 13 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 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Not all residents can be confident that the service will provide occupation and stimulation through activities that suit their interests and abilities. EVIDENCE: An activities programme was posted in the home with a pattern of regular sessions throughout the week, and residents spoken with confirmed that there was usually some kind of activity on offer in the home. There were activities provided by staff for residents during this inspection with an armchair exercise session in the morning and puzzles in the afternoon. Not all residents participated in these options and there was not a record of the residents’ individual preferences and past interests on their care plans to help staff understand how to engage individuals’ interests. Some residents go to church activities and pay for taxis to take them. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 14 Residents spoken with said that staff were very kind and welcoming to their relatives visiting the home. The main meal was served during the inspection and the residents spoken with had a mixed view about the quality of meals and mealtimes. None of those spoken with were aware of a planned menu or of any choices they could make if they did not like the meal on offer. Residents were asked what they would do if they did not like the meal, and all said they would either just eat it or leave it, but would not be offered an alternative in either case. There was a menu posted on a notice board in the dining room with details of a four-week rotation of meals. This does not advertise that any alternative choices are available from the main meal. The current dining room arrangements consisted of a large oval table that seated 11 residents at the time of the inspection. There were not any spaces for the other 4 residents living at the home, and when staff were asked about the arrangement they informed the inspector that these residents ate in their rooms. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 15 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 & 18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The residents cannot be confident that they will be listened to and that staff understand how to protect them. EVIDENCE: The service has a complaints policy on file, however this needs reviewing as it contains the name of the previous owner as a respondent to complaints raised and does not contain information about the time scales that complainants can expect responses to be made in. There is a complaint log kept in the home, although there are no complaints recorded at the time of the inspection. Residents spoken with were not aware of the policy. This is an essential element of quality assurance that assists services to understand how they perform against individuals’ expectations. This is an area in need of consideration and development. The records of staff training indicated that their Safeguarding adults or POVA training was not up to date, In addition the services current policy in respect of safeguarding adults was not reflective of the current practice within the local authority. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 16 The policy also states that the registered manager will review all accident, care planning and other records monthly and make a statement about the positive negative responses to these. Clearly this was not the case at the present time. Failure to ensure that staff understood what constitutes abuse of older people and how they should respond to any alleged abuse does not protect residents living at the home and requires an immediate response by the registered persons. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 17 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, 20, 21, 22,23, 24, 25 & 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from an environment that is suitable to meet their needs. However residents cannot be confident that the systems designed to protect them from harm are sufficiently maintained. EVIDENCE: A tour of the premises was undertaken with the Deputy Manager. The communal rooms and residents and bedrooms are in good decorative order although they are all very plain magnolia. There are suitable furnishings in rooms and communal areas to meet residents’ needs and sufficient space for residents. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 18 The downstairs bathroom carpet was very worn in appearance with a frayed and discoloured carpet that was in need of replacement .The deputy manager stated that this is part of the refurbishment plans. However the water tank recently leaked and caused extensive damage to the corridor and dining room so this has taken precedence. There was not a maintenance plan available at the time of inspection although this would assist the service to set out how works were going to be carried out and demonstrate an awareness of the maintenance needs of the home. The upstairs bathroom also requires some updating and at the time of the inspection was used to store items such as laundry equipment, drying racks, ironing board, and walking frames. The dining room has one large oval dining table that seated 11 residents at the time of the inspection. There was not additional space at the table and the deputy reported that this arrangement worked at the present time as four residents only ate in their rooms. The deputy did not know what would be done if they changed this habit or new residents were admitted who wished to be seated at the table. The communal lounge has seating appropriate to the needs of residents, and these are spaced around the room. The room is bright and airy although residents said it can be difficult to communicate with other residents due to the distance between them across the room. The lounge has patio doors that lead to the gardens, with a patio area immediately outside and a grass area at the back of the building. There are garden seats and flowerpots spread around the patio area and residents told the inspector about the barbeque that had taken place recently in the garden. Some areas of the garden are in need of repair and attention and a risk assessment should be carried out in relation to the steps and changing or uneven levels of the outside space. Whilst touring the building the inspector was concerned to note that all the doors, some of which were fire doors were artificially pinned open with a variety of materials acting as wedges. This included doorstops, wooden wedges and coat hangers. A large number of doors, particularly residents bedroom doors were fitted with an approved fire safety door stop, however these were not working and the Deputy manager reported that they had been in this state for some time. The wedges prevented the fire doors from automatically closing in the event of a fire being detected by the fire safety system. In effect this would remove any opportunities to contain the fire allowing it to spread throughout the building and placing residents at risk. Although an engineer was due to visit the following week and the fire officer was also due to carry out an inspection on 4th September 2007, the inspectors Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 19 concerns about the lack of proactive attention to the fire safety system, was such that an Immediate Requirement was made of the proprietor to ensure that remedial works were carried out to the fire system and the deputy manager was also instructed to remove all the wedges during the inspection visit. The fire officer was also notified of the breach in fire safety. The front office used by the inspector was locked at the start of visit, however remained unlocked for the rest of the day, despite the Inspector checking with the deputy manager about this. This office had a small cupboard with a unsecured clip type fastening on doors, and was found to contained loose packets of drugs, syringe needles, and a cup of money with a note indicating it was a residents payment for clothing. In areas of the home there are notice boards and notices posted up, some of which relate to staff and others advising of safety issues that affect residents. For example a large poster relating to the safe use of cot sides was stuck on the wall of a residents bedroom and the notice board in the dining room contained a mixture of menu, health advice notices and instructions to staff in respect of food and cooking. This practice required review to ensure that information shared in public and private spaces is appropriate and does not infringe residents’ rights to dignity and respect. The home’s laundry room is located in an outside room adjacent to a grass area of garden. The laundry has a domestic style machine and tumble dryer, a general sink and hand-washing sink. There are no sluicing facilities. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 20 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 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The residents cannot be confident that the staff working at the home have sufficient skills to support their assessed needs EVIDENCE: The rota on display in the home stated that there are three care staff throughout the waking day with additional staff for catering and cleaning duties. There was also one waking and one sleeping staff member covering the night hours. There was no indication as to whether these arrangements had been reached following an assessment of the numbers of staff required to meet the assessed needs of residents. The Deputy Manager was not aware of the tools used to calculate this ratio. From observation and discussion with residents the numbers of staff working on a daily basis appeared to be sufficient to meet the needs of residents. The rota was dated for the week of the inspection and the week prior, and indicated that the registered manager was on duty the whole of that week including the day of the inspection. However she was actually on holiday that week and not present in the building. The rota therefore did not represent the actual staff working in the home. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 21 The staff files sampled during the inspection contained the individuals’ application forms, two written references, and proof of identity. With the exception of one file that did not have a Protection of Vulnerable Adults (POVA) first or Criminal Records Bureau (CRB) check all other files sampled included these documents. These documents demonstrate a robust system of recruitment and are essential to cross reference the validity of the applicant to work with vulnerable people. The application forms do not ask for full employment history, and this should be considered as a matter of good practice. The staff records contained copies of the individuals’ job description and contract. The staff training profile held in the administration office indicated that a number of staff did not have updated health and safety training with only three staff holding their Moving and Handling certificate, two staff with food hygiene certificates, one staff with infection control, one with fire safety training, one first aid training and none of the staff had taken part in a POVA training session. These are essential aspects of training to assist staff in understanding and protecting the health and safety of residents and themselves. The main office had Flyers advertising upcoming training opportunities with the Local Authority for training on infection control, The Mental Capacity Act 2005, pressure area care and Safeguarding adults (POVA), on offer by Southend Borough Council. There was not evidence of staff application to attend these courses but the Deputy Manager stated that the manager and herself were due to attend at least two of the courses aimed at Managers. According to the same training matrix there is currently only one member of staff who holds the National Vocational Qualification (NVQ) level 2 or equivalent. This is significantly below the 50 of staff recommended by the National Minimum Standards (NMS) for Older People. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 & 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents cannot be assured that the service operates in a way that protects their interests and welfare. EVIDENCE: The current manager was registered by the Commission in February 2007. She has previously worked as a deputy manager in care homes, and had commenced her NVQ Registered managers’ award in February 2007. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 23 New legislation has made it a legal requirement for all registered adult services to fill in an Annual Quality Assurance Assessment (AQAA). The annual quality assurance assessment which is in two parts: A self-assessment that asks providers to tell the Commission how well they think they are meeting the needs of the people who use their service. A data set that asks providers to give us some basic facts and figures about the service. The completed assessment is the main way that providers will let us know how well their service is delivering good outcomes for the people using it. As part of the form providers are asked to detail the evidence they have to support their statements about their performance. The AQAA completed by the registered manager of Silversea Lodge, did not provide evidence of the way in which they supported residents. Along with the findings of this inspection this appears to demonstrate a lack of insight into the way the service needs to operate to provide the best outcomes for residents living there. The deputy manager was not aware of any Quality Assurance systems operating in the service and records relating to this were not located at the visit. The service is responsible for the management of some residents’ monies; this is mainly money provided by relatives for purchasing small items such as toiletries and hairdressing. The monies are kept in individual plastic wallets with the accompanying account book. These were not kept securely but pegged together on the wall in the same office as the home’s safe The monies and accounts were examined The details in the account books did not clearly determine the monies paid in an out of accounts and receipts for transactions were not all attached to the record. The records did show that along with items such as toiletries, chiropody and hairdressing residents had also purchased items such as flannels, baby wipes, prunes and jam. These are items that would normally be expected to be covered by the homes fees. The current residents contract held on their files states that the facilities included in the price of the residents’ fees include all meals, laundry service, and all necessary personal care. It also states the ‘The resident shall provide from their own resources, provide toilet and medical requisites other than prescriptions, newspapers, hairdressers, clothing and other required of luxury or personal nature.’ It is not clear from this statement whether items such as jams and flannels should be proved by the home and as a matter of good practice the provider should gain further advice and guidance. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 24 Monies were also found in a cupboard in the administrators office labelled ‘clothing shop’ and the deputy manager stated that this contained some staff and one resident’s contribution for clothing purchased from a mobile shop. The residents’ contribution of £40 was not entered in any of their finance records nor were there invoices for the purchase. The deputy manager believed the monies might have been given to the home by a relative for payment of the residents’ behalf; however there were no receipts to demonstrate monies had been received in this way. The deputy manager reported that if items were required for residents who did not have monies held by the home they used money kept in a plastic cup marked ‘charity money’ kept in the administration office. There were no records maintained for this money. In general the management of money held for safekeeping was poor and required immediate attention from the registered person to ensure residents best interest were maintained. The staff files contained evidence of some staff supervision, but this was only found on four staff records and had not been consistently carried out. The deputy manager stated that these sessions had only recently started with new formats. The four records completed were all signed off by manager but only two had been signed by the staff member. The format covers a range of subjects such as human relations work relations quality of work, attendance, future plans and other concerns. When completed this would provide a good breadth of discussion for staff to share with their line manager. The service carries out induction using a pre-populated format developed by an independent training organisation. This adheres to the older style induction standards provided by TOPPS that have since been replaced by the Skills for Care Induction standards. The copy seen for the most recent member of staff appointed had been signed off in total but there were not any dates entered to demonstrate the period over which the induction had taken place and the staff member deemed competent. Although the new induction standards allow for staff with greater experience to work at the appropriate pace, the documents should still evidence that the competency was agreed and when. The records relating to the annual maintenance and safety checks of equipment in the home were checked for compliance at this visit. The Deputy manager could not locate any certificates or safety audits for inspection. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 25 The Fire records that were located indicated that the last staff fire evacuation drill had been on the 5th April 2007 and the last date for testing of fire safety equipment such as emergency lighting and fire alarm tests had been the 30th January 2007. This significant short fall in the maintenance of fire safety systems was of such concern that an immediate requirement was made of the provider to address this issue. Essex County Fire and Rescue Service were also informed. Silversea Lodge Care Home DS0000068495.V349462.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 3 2 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 1 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 2 2 2 3 3 3 1 2 STAFFING Standard No Score 27 2 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 1 1 X 1 1 1 1 Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? N/A 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 OP2 Regulation 5(1)(b), Schedule 4(8) 14, Schedule 3(1) Requirement Residents must be provided with a clear definition of what elements of the care provision is included in their fees. The service must be clear that it understands the needs of proposed residents prior to their admission by carrying out a needs assessment. This should identify the levels of support they will require and the resources required to meet this. Timescale for action 31/12/07 2 OP3 30/09/07 3 OP7 15, Schedule 3 (2) Residents needs, strengths and 30/11/07 aspirations must be discussed with them and documented in care plans to support the consistent delivery of person centred support to each resident. Residents health and welfare must be supported by the documentation of health advice the use of monitoring records to assist staff in supporting identified health issues. 30/11/07 4 OP8 12(1), Schedule 3 (3) (m) Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 28 5. 6. OP9 OP12 OP14 OP15 13(2) 12(2)(3) 16(m)(n) Medication must be stored in a safe and secure manner. Residents must be consulted as to their preference in relation to aspects of daily living such as meals and activities. This demonstrates a respect for their individuality and independence. Residents must be able to raise concerns and be assured that these will be responded to appropriately within a timescale. Staff must understand how to recognise and take steps to protect Residents from abuse. Residents must be able to use facilities that are kept in good repair and do not present a hazard. Residents must be protected from the risk of fire by the homes fire safety systems and these must be maintained in good working order. Fire doors must not be obstructed in any way. Residents must be supported by a staff group who are provided with sufficient training to gain skills to meet the assessed needs of those residents they support Duty rosters must contain accurate information in respect of who is actually working. The service must benefit from leadership that has sufficient skills and is able to support staff in meeting the services Statement of Purpose, protect DS0000068495.V349462.R01.S.doc 30/09/07 31/12/07 7. OP16 22(4)(5), Schedule 4(11) 13(6) 31/10/07 8. OP18 30/09/07 9. OP19 OP20 OP21 23(2)(b) (o) 30/09/07 10. OP20 23(4), Schedule 4 (14) 24/08/07 11. OP27 OP28 OP30 18 (c) 31/12/07 12 OP27 18 (a), Schedule 4 10(1) 30/09/07 13. OP31 OP32 31/12/07 Silversea Lodge Care Home Version 5.2 Page 29 residents’ wellbeing and understand how the service will achieve compliance with the Care Homes Regulations 2001. 14 OP33 24 Residents and other stakeholders 31/01/08 must be consulted about how the service delivery matches the Statement of Purpose and individuals’ expectations. Where the service manages residents’ monies they must provide detailed records that provide enquirers with knowledge of the transactions undertaken on their behalf. Staff must receive regular and consistent supervision from their line manager that supports their development and provides them with feedback on their practice. Records relating to the prescribed safe maintenance of equipment used in the home must be kept. 30/09/07 15 OP35 16(l), Schedule 4 (9) 16. OP36 18(2) 31/12/07 17 OP37 OP38 12(1)(a), 17 (2)(3) 23(2) 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP9 OP29 Good Practice Recommendations Medication recording must be reflective of the dispensing directions given by the pharmacist. Applicants for positions at the home should provide details of their full employment history as part of the application process. Silversea Lodge Care Home DS0000068495.V349462.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection 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. 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