Inspection on 10/08/06 for Sowerby Care Home

This inspection was carried out on 10th August 2006.

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

Sowerby Care Home 23/07/07

Sowerby Care Home 09/03/06

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Sowerby Care Home Front Street Sowerby Thirsk North Yorkshire YO7 1JP Lead Inspector Donna Burnett Key Unannounced Inspection 10th August 2006 09:00 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 Sowerby Care Home DS0000065904.V306814.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. Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sowerby Care Home Address Front Street Sowerby Thirsk North Yorkshire YO7 1JP 01845 525986 01845 526479 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) www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited *** Post Vacant *** Care Home 51 Category(ies) of Old age, not falling within any other category registration, with number (51) of places Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age Range 60 years upwards Date of last inspection 9th March 2006 Brief Description of the Service: Sowerby Care Home is registered to provide nursing care for up to 51 older people aged 60 and over. The home has a mixture of single and twin bedded rooms; all have en-suite facilities. The premises comprise of a large, Victorian two-storey house with a passenger lift to the first floor. The service is owned by Ashbourne ( Eton) Limited. The home is in the village of Sowerby, close to local shops. Sowerby is located within 10 minutes walking distance of the market town of Thirsk, which benefits from larger shops and facilities. The home is in pleasant grounds, which are wheelchair accessible. At the rear of the property is a conservatory and well-maintained garden. There is a seating area which allows residents to greet their visitors in private. The basic, current cost to people live at the home varies from £540 - £670 per week. People eligible for Social Services funding are assessed for their contribution towards the cost of the care. Nursing Care fees are paid to the home in addition. There are a number of other services available that incur extra charges. These include hairdressing, chiropody and some activities and outings outside of the home environment. Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key inspection of the service took place on 10th August 2006. Two inspectors spent nine hours in the home. The visit was brought forward due to an anonymous letter that had been received by the Commission for Social Care Inspection. Concerns had been raised about a number of issues including the quality of care being given to people living at the home and the general environment. Following the site visit, a questionnaire was returned by the general manager, which provided information about the service and its users. Information supplied has been included in the report where relevant. During the visit, the manager, deputy manager and several members of staff were available to talk to. Service users and a visitor were spoken to and the delivery of care was observed in order to get an overview of what life is like for people living at the home. Various records and files were also inspected and a tour of the premises was carried out. Four relatives were sent comment cards in order to gather their views of the service. One relative responded, as did a Social Services Care Manager. What the service does well: What has improved since the last inspection? Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 6 Staff have received more training and are now better able to provide the care that people living at the home need. The shift pattern has recently been changed so that more staff are available at core times of the day. Conversations with residents and staff confirmed that the change had resulted in more time being allowed to assist service users in and out of bed at times to suit them rather than fitting in with the routine of the home. 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. Sowerby Care Home DS0000065904.V306814.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 Sowerby Care Home DS0000065904.V306814.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 Quality in this outcome area is good. Service users have access to some good information about the home and the type of service it offers. Needs are assessed prior to admission to the home and people are admitted in the knowledge that staff are able to provide the care they need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose and Service User Guide is made available to all potential service users and gives detailed, easy to read information about the services on offer at the home. There is no mention however of the fact that the home offers respite care. People living at the home need to be aware of what services are on offer in order to make an informed decision about their choice of care home, including the fact that there may not always be a permanent group of people living at the home. The homes has a clear admission criteria so that all prospective service users are appropriately assessed prior to admission in order to determine their care needs. All service users spoken to said that they were visited and assessed by someone from the home prior to being offered a service. Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 9 The person currently undertaking the assessments is a qualified nurse who is experienced in this field. All files inspected had detailed, written records of assessments, which included the risks associated with moving and handling, falls, nutrition and continence. Care Management Care Plans were on file where placements had been arranged through Social Services. Where risks were high, there was evidence to show that steps had been taken to minimise risks and that service users and families had been consulted with. Care workers have access to good information about the care needs of the people who live at the home, including what each person can or can’t do for him or herself. A Social Services Care Manager who returned a comment card felt that staff displayed an understanding of service users care needs. The home does not provide an intermediate care service so this standard was not looked at. Sowerby Care Home DS0000065904.V306814.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. Good quality health and personal care is provided with respect to service users privacy and dignity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service user plans inspected were in sufficient detail so that care staff would know what help a person required. There was evidence that the plans were reviewed regularly and amended as new needs were identified. Information on service users files was kept up to date and communication between staff was good resulting in care workers being aware of each persons needs at all times. Service users with specific health care needs were identified and provided with the care they required. Allergies were clearly recorded on files looked at. People at risk of developing pressure sores were identified and care and equipment put in place to prevent sores developing. One service user with memory problems had been referred for screening and further assessment of his mental condition, appropriately and at an early stage. Service user plans incorporate specialist advice that has been given. Staff are aware of people’s changing needs and are responsive in addressing the additional care that may be required. Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 11 Service users and a relative spoken to said that the staff were very good at alerting the GP when required or if asked to do so. There are good links with the tissue viability nurse and dietician; the chiropodist also visits regularly. People living at the home looked well kempt. Medication was stored correctly and safely. Records of medication given were on the whole well kept although on inspection there were two discrepancies where it could not be certain if medication had been given as prescribed. One service user was observed taking tablets which had been dispensed but had not been taken in the presence of the registered nurse. Records need to accurately state what medication was given to whom, and at what time it was taken, in order for the effects of medication to be monitored. Another service user spoken to had chosen to look after her own medication. The medication was stored in a locked cupboard in her room for the safety of other people living in the home. Observation of care in the home found service users being spoken to courteously. Personal care was delivered in private and blankets were available to preserve dignity. Service users spoken to said they always wore their own clothes. People looked well kempt and clothing appeared to be maintained in a good condition. Service users spoken to who were being nursed in bed felt and looked well cared for and did not appear to have their dignity in any way compromised. Carers were described as being ‘up to the job’ and ‘really good’. One service user commented that carers were always careful and respectful when washing intimate areas. Bedroom doors were lockable to allow privacy. Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is adequate. Service users are given choice and whilst the activities and meals on offer are good, the abundance of flies in the dining area is unpleasant and failure to be consistent with certain food hygiene regulations puts service users at risk from food which is potentially unsafe to eat. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users spoken to all indicated that they had choice in many decisions affecting the way they live their lives. People chose where to eat their meals and had the choice between bathing and showering. Social activities going on both within and outside of the home were well ‘advertised’ and promoted. Leaflets for the service users which stated what activities were on offer each day, and what was planned for the next two weeks, were well written and easy to understand. Members of the community are being actively encouraged to attend and visit the home. The dedicated activities organiser is working hard to enable people living at the home to maintain links with the local community. There are no restrictions on visiting times and visitors say they feel welcome. There is adequate room within the home for visitors to be met with in private. Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 13 Service users spoken to had been encouraged to bring personal possessions with them to the home. One person having respite care was maintaining responsibility for her own money whilst in the home, and was provided with lockable facilities to be able to do so safely. One gentleman living at the home had made a list of when he liked to get up, go to bed and have his meals. He confirmed that his wishes were met. There was no evidence to suggest that service users could not eat at times to suit themselves. The kitchen was kept unlocked so that food and drink could be available at all times. A coffee vending machine was also available in the entrance hall. Jugs of water were in each bedroom looked in and service users being cared for in bed could reach their drinks. Service users spoken to did not feel they had to wait long times between meals nor that they were offered food too early or too late in the day. Food is served either in the dining area or in service users bedrooms; whichever they choose. Whilst the dining area was of a comfortable size, the mealtimes observed were marred by the fact that there was an over abundance of flies in the area. No attempts had been made to try and combat this problem, which was unpleasant and not hygienic. The food on offer looked nice, was well presented and clearly hot enough. Menus were nutritionally varied and had been approved by the dietician before being put into use. Aids, such as plate guards, were in use where necessary, helping service users to maintain as much independence as possible. Christmas napkins being used may cause some disorientation to time and were not appropriate. At lunchtime, one service user being assisted to eat her meal was not given one to one help. The assistance was sporadic in that the carer did not spend much time with the lady, but would offer her a spoonful of food as she passed. This neither helped promote independence nor seemed a very dignified way of eating lunch. The assistance given at teatime was done in a far more thoughtful manner. Some service users said they had previously chosen what they wanted to eat whilst others said they just waited for whatever they were given. The board in the dining area stated what was on offer and one service user produced a menu sheet from which she had selected her choice of meals. Inspection of the kitchen and discussions with the cook showed a good awareness of individual service users special dietary needs. The cook on duty was well organised, experienced and appropriately trained. There were effective systems in place to ensure the safety of people in the home through good food hygiene. However, these systems were not followed at all times so it was not evident that food was always served at the correct temperatures to avoid food poisoning or that strict control measures had been adhered to. Noncompliance with such systems had apparently been brought to the attention of the general manager previously, but there was no evidence to suggest that this matter had been addressed or dealt with. Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 14 The home was subject to a Food Hygiene Inspection on 23rd May 2006. The manager was unable to clarify what steps had been taken to comply with the Food Hygiene Regulations 2006, as detailed in the Environmental Health Officer’s report. Records suggest that service users are not always presented with food that has been stored or cooked in accordance with relevant guidelines intended to ensure food is safe to eat. Sowerby Care Home DS0000065904.V306814.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is adequate. Complaints and concerns are dealt with appropriately but service users are not sufficiently protected from harm due to inconsistencies within the senior staff about how suspected incidents/allegations of abuse should be dealt with. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In discussions with a service user, a verbal complaint made to a member of staff was responded to appropriately and he was satisfied with the outcome. A visiting relative said she would know who to complain to and felt that staff were approachable and responsive to any concerns raised. A relative who returned a survey also knew about the home’s complaints procedure. An anonymous letter sent to the Commission for Social Care Inspection prior to the inspection implied that the person writing the letter felt unable to approach the manager and that the concerns raised would not be taken seriously. An incident of alleged abuse prior to the inspection taking place was dealt with appropriately and following Policy and Procedure thus ensuring the ongoing safety and protection of service users. Discussion with senior staff members during the inspection however showed a poor understanding of how and when to contact Social Services in the event of an allegation of abuse. Carers found to have been abusive should be referred for inclusion on the Protection of Vulnerable Adults list, but the staff members spoken to did not know how to make such a referral. This is a potential failure to protect vulnerable adults from people who could cause them harm. Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 16 Records indicated that care staff had been trained in adult protection issues and had been taught how to recognise and report suspicions of abuse. Whilst care staff may be able to identify poor and harmful practice, it was not clear that senior staff would always know what steps to take to then ensure the ongoing protection of service users. Sowerby Care Home DS0000065904.V306814.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22 & 26. Quality in this outcome area is adequate. The service provides a homely environment but service users are at some risks from harm due to access to potentially hazardous areas of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Redecoration is currently taking place at the home and the general environment is fairly comfortable and looks well maintained. Doors into the kitchen, wheelchair and equipment stores were unlocked. Hazardous chemicals were in some cases not locked away, again in rooms accessible to service users. Service users are at potential risk from injury or harm from equipment and chemicals, which can be easily accessed. The safety of service users is not protected due to some requirements of the fire service and environmental health department, which have not been met. The means of escape in the event of fire on the first floor has to be improved as there is currently no mean of escape from one part of the building other than towards the main staircase. Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 18 The environmental health officer has detailed a number of compliances with law which need to be addressed as they currently pose a risk to service users. The kitchen needs to undergo substantial ventilation and improvement work in order to provide a safe environment for food, which is given to service users, to be prepared in. It was observed that there was no satisfactory means of escape from the basement in which the maintenance person works. The manager was advised in writing to seek further advice from the fire officer with regards to this matter. (See Management and Administration). Communal space is naturally well lit and comfortably furnished with a variety of different chairs available to choose from to sit on. A service user who was feeling too warm had been supplied with an electric fan for her comfort. The conservatory is the designated smoking area apart from between the hours of 2-4pm when it is smoke free. It is well ventilated and does not impact on service users who choose not to smoke. Service users spoken to seem happy with this arrangement. There is sufficient outdoor space for people living at the home to enjoy. Service users requiring specialist equipment are identified and provided with the equipment they need. Equipment looked at appeared to be in a good, clean condition. Service user plans state the frequency at which aids and equipment are to be checked in order to maintain their safe use. There were no records available to show that these checks were being carried out as required although the maintenance person said that they were. Call bells, which could be used remotely, were evident in communal areas and bedrooms so that the majority of service users are able to ask for help at all times. One service user confirmed that staff responded quickly to call bells; none were heard ringing excessively during the site visit. One service user who was being cared for in bed was unable to use the call bell due to her physical condition. Whilst this had been recognised and documented, the measures being taken to address this issue were not sufficient in that she was not always able to attract the attention of staff when she needed it. Whilst the home was free form offensive odours, the presence of lots of flies made the environment somewhat unpleasant and unhygienic. No problems were reported with the laundry and people spoken to felt the general cleanliness of the home was satisfactory. Ant traps were evident where there had been a problem and other than the issue with flies there was no further evidence of infestation of any kind. Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is adequate. Service users are cared for by staff who are suitable to work with vulnerable people and who are on the whole, competent in the delivery of care. The well being of service users is compromised due to some staff not following food hygiene regulations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home appeared to have sufficient numbers of care, kitchen and domestic staff on duty during the inspection in order to meet the needs of the service users. A member of staff is designated to specifically look at activities within the home. Duty rotas were looked at and showed an appropriate ratio of staff to service users. Service users, staff and a relative spoken to, felt that there had been a lot of changes recently which they found unsettling but not necessarily for the worse. Two qualified nurses are usually on duty at any one time and are supported by care workers, many of whom have gained a recognisable qualification in care. A Care Manager confirmed that that there was always a senior member of staff available to confer with. Induction training takes place for new staff, and staff files looked at showed that there had been training on fire safety, moving and handling and protection of vulnerable adults. Service users are cared for by staff who have a good skill mix and are suitably trained and supervised. The file of a member of the kitchen staff was looked at and showed that there had been plenty of recent in-house training. Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 20 Despite this training, good practices in the kitchen were not consistently being followed, accurate records not always kept and there was no evidence to suggest that these failings were being addressed in supervision. Service users are potentially at risk due to some ongoing poor practice and record keeping in relation to food hygiene. Three staff files were inspected and confirmed that staff had satisfactory clearance from the Criminal Records Bureau before starting work at the home. Two references were obtained for two of the staff. The home employs male, female and overseas staff and promotes equal opportunities. Interview forms completed by the general manager, however, did not detail how the candidates had been considered as suitable for the post. Service users are cared for by staff who have been checked for their suitability to work with vulnerable adults but for whom it could not be evidenced that they necessarily have the requisite skills. Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome area is adequate. The home is in need of a period of stability, guidance and leadership in order for it to be run safely and in the best interests of service users. This judgement was made using available evidence including a visit to this service. EVIDENCE: The manager of the home is new in post and has not yet applied to be registered with the Commission for Social Care Inspection. She has still to be interviewed by the Commission for Social Care Inspection as a fit person to run the home. The General Manager who oversees the general day to day running of the home was unavailable during the site visit but was spoken to afterwards. It was not clear during the inspection where the lines of accountability lie although it was evident that both the deputy manager and the general manager will support the new manager in her role. The organisational structure of Sowerby House, as outlined in the Statement of Purpose, fails to clearly identify the position and of the general manage. Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 22 This could lead to confusion from service users and visitors as to who has what responsibility in the home. Service users have recently been sent an internal ‘Client Opinion Survey’, which allows them to express their views about life at the home. Residents meetings take place regularly and are minuted so that comments and observations can be considered. Relatives have also recently been sent surveys and meetings are being arranged which will allow the opportunity for family members to have their say. Kitchen staff do their own four weekly audit and the General Manager conducts one every eight weeks. There are a number of internal audits carried out in order to monitor the quality of the service for the service users. The home also has an annual development plan, which is part of the quality assurance system as is detailed in the homes Statement of Purpose. The home is presently without a permanent administrator who usually deals with the records and safekeeping of some service users finances. One service user spoken to was able to safely and securely look after her own money. Money held for five service users was checked against the records and found to be in order. Service users have a personal allowance contract with the home. Any cheques are ‘pooled’ and paid into a joint bank account until they clear, at which point cash is withdrawn and held in individually named wallets. Interest earned is not paid to the individual service users but transferred to a ‘residents fund account’. Pooling of monies is not acceptable practice and alternative ways of dealing with the cheques must be looked at and implemented. No explanation could be given with regards to an anonymous concern that funds raised for service users was donated elsewhere. Finances are presently looked after in a way that is not always in the best interest of the service users. Staff are trained to work safely and good practice was observed during the inspection. Some poor food hygiene practices, however, could adversely affect the health and safety of the service users. The home currently has shortfalls in meeting certain fire and environmental health legislation intended for the protection of people living and working in the home. During the site visit the manager was unable to clarify what steps, if any, were being taken to comply with the legislation. (See Environment.) A telephone call received from the General Manager after the site visit indicated that the issues were being addressed. A letter has since been sent to the Commission for Social Care Inspection, confirming what work is being planned in order to meet the requirements and recommendations made by both the fire and environmental health officers. Discussions with the fire and environmental health officers confirmed there have been some delays, which have resulted in the timescales set not being met. Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 23 Throughout the home there were plenty of fire notices and instructions as to what to do in the event of fire. The fire alarm system and equipment is checked regularly. Bed rails are checked and remedial action taken when necessary. Portable electrical appliances have been recently checked and approved for safe use. Water temperatures checked at random were within safe limits and signs warned people that the water was hot. Cold water not suitable for drinking was clearly identified and jugs of fresh water available as an alternative. Service user are protected by such measures being put into place. The door leading from the ground floor corridor into the basement was unlocked and posed a danger to service users. In discussion with the general manager, steps are being taken to secure the safety of people at the home whilst allowing exit from the basement in the event of a fire. One comment received was that under the new ownership, some new policies had been introduced without consulting with service users, family members and Social Services. Whilst this does not appear to have had a negative effect on the service users, in order for the home to be run in the best interest of the people living there, they should be consulted with. Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 24 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 1 3 X 2 X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 1 x x 2 Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13(2) 17(1)(a) Schedule 3(i) 12(1)(a) 16(2)(i)(j) Requirement Accurate records must be kept of all medication given. Food must be stored, cooked and presented to service users in accordance with relevant food hygiene regulations. Accurate records must be kept which show that food has been received, stored and prepared appropriately. The kitchen area must be improved to comply with food safety contraventions as detailed in the food hygiene inspection report (23/05/06). Access to the kitchen and store rooms must be restricted for the use of staff only, in order to minimise the risk of potential harm to service users. All service users must have the facility to request assistance in a dignified manner ie. without having to rely on shouting out for help. Improvements to the ventilation and repair of the kitchen must DS0000065904.V306814.R01.S.doc Timescale for action 10/09/06 2. OP15 10/10/06 3. OP15 23(2)(b) 23(5) 03/12/06 4. OP19 13(4) 10/10/06 6. OP22 16(2)(c) 23(2)(n) 10/11/06 7. OP26 12(1)(a) 13(3) 31/12/06 Sowerby Care Home Version 5.2 Page 26 16(2)(j) be implemented in order for food, which is to be consumed by service users, to be prepared in a hygienic environment. The abundance of flies, particularly in the dining area, must be addressed to avoid the risk of spread of infection and to provide a more pleasant environment in which to eat. The manager of the home must apply to be registered with the Commission for Social Care Inspection so that she can be interviewed for her fitness to manage the care home. Service users money must not be paid into a ‘pooled’ bank account. Cheques payable to named service users must be paid into an account in their own name. The home must provide to the Commission for Social Care Inspection an improvement plan, which states clearly how the service provided in the home, will be improved and by what time. 10/09/06 8. OP26 12(1)(a) 13(3) 16(2)(j) 9. OP31 9(1)(2) 10/11/06 10. OP35 20(1)(a) 10/11/06 11. OP9 OP15 OP19 OP22 OP26 OP31 OP35 24(a) 22/11/06 Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP22 OP29 Good Practice Recommendations Records to be kept of all checks made on equipment so that there is evidence that they have been checked for defects and faults. The recruitment procedure should be thorough and records of interviews should show that the interviewee has the required skills and attributes to be able to care for people living in the home. Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 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 Sowerby Care Home DS0000065904.V306814.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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