Inspection on 23/07/07 for Sowerby Care Home

This inspection was carried out on 23rd July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 10/08/06

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 Anne Prankitt Unannounced Inspection 23rd July 2007 09:15 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.V344102.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.V344102.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 sowerbyhouse@ashbournesl.co.uk www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited 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) vacant post Care Home 51 Category(ies) of Old age, not falling within any other category registration, with number (51) of places Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age Range 60 years upwards Date of last inspection Brief Description of the Service: Sowerby Care Home provides nursing care and personal care only for up to 51 people aged 60 and over. The home has a mixture of single and twin bedded rooms. The premises comprise of a large, Victorian two-storey house with a passenger lift to the first floor. 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 general manager confirmed on 23 July 2007 that the current cost to people living at the home varies from £343.91 - £720 per week (excluding the free nursing care contribution). Items not included within the fee include toiletries, chiropody, hairdressing, papers and magazines. People are provided with a newsletter, copy of the menu, activities sheet and brochure before they are admitted so that they know what the home provides. A copy of the inspection report is also available. Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Before the site visit, the managers returned a self assessment, called an ‘Annual Quality Assurance Assessment’, which provided information about Sowerby Care Home. Surveys were sent to a selection of people who live at the home, their families, and visiting professionals. A record has also been kept about what has happened at the home since the last key inspection in August 2006. During the site visit, discussion took place with some people who live at the home, so that their views about the service could be sought. Time was also spent looking at some documents, making a general tour of the communal areas and viewing a sample of private accommodation. The site visit took eight hours to complete. All of the information gathered was used to form a judgement about the service that Sowerby Care Home offers to the people who live there. The general manager and the prospective registered manager were available throughout the day. They were provided with feedback at the end of the site visit. What the service does well: People who are thinking of living at the home have their needs assessed before they are offered a place. This helps to check that the home will be able to meet them. People’s needs are written down in their care plan. This helps staff to provide care in a consistent way. People’s comments included: ‘I’m happy here – no problems’, ‘I am happy with the home – I have no complaints. Staff respect me’, ‘Staff could be more organised, but I am happy with everything nevertheless’. People are given choices in their daily lives, and flexibility so that they can continue to enjoy their own routine wherever possible. Their comments included: ‘I can go out and have visitors whenever I want – no problems’. Visitors are made welcome into the home. This helps people to maintain contact with their families and friends. People said: ‘Visitors can come whenever’, ‘I can have visitors whenever I want’. Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 6 People know that they can complain, and that they will be listened to. Staff know their responsibilities in passing on any concerns which affect the safety and vulnerability of people. Staff are given training to help them provide people with good care. The managers are interested in the views of people who live at the home and will consider them when deciding how it should be run. One person commented: ‘The general manager has really pulled the place round – marvellous place. No complaints – charming people’. What has improved since the last inspection? What they could do better: To reduce the risk from error, extra care could be taken to make sure that medication is signed for as soon as it is given. The company could check that they comply with the newly introduced laws surrounding smoking, to make sure that they meet legal requirements in the protection of people who live at the home. The malodour to one room could be eradicated so that it is more pleasant for the person who occupies it. Better systems could be introduced to make sure that the fire alarm is checked weekly so that any problems are picked up at the earliest point and dealt with. Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 7 The fire officer could be invited back to the home to comment upon the improvements that have been made to the fire safety systems. Where people have specific mental health or psychological needs, these could be given special attention within the care plan, to include information about specific risks that staff should look for which would suggest a decline in health. This will help to make sure that advice is sought at the earliest point. Staff recruitment records could provide more information. Further advice could be sought about the training that staff need in the control of infection. The views of outside professionals could be sought when measuring the quality of the service that people who live at the home get. Staff who help out in the kitchen at short notice could be provided with a list of tasks that they will need to complete to help make sure that food is being prepared in the safest possible way. The infection control team could be consulted to clarify that the training that staff get to help them maintain good standards at the home meets with their expectations. 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. Sowerby Care Home DS0000065904.V344102.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 Sowerby Care Home DS0000065904.V344102.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. People who use the service experience good quality outcomes in this area. They can be confident that their needs will be assessed before they are admitted. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Specially appointed staff try to meet people before they are admitted to the home, when they collect information about their needs. Information is also collected from other professionals, such as hospital staff and care managers. This helps staff to check that the home will be able to meet these needs properly. People are also offered the opportunity to look round the home and stay for the afternoon if they wish, so that they have some experience of what it is like. This helps them to make more informed decisions about whether they want to live there. Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 10 Sometimes people are admitted in more of an emergency, and for respite care. The staff still insist on getting information about the person before they are admitted, so that they can check that the home can meet their needs. Wherever possible though, a visit to the person will still take place so that a better assessment can be carried out. Staff were satisfied with the information that they get about people before they are admitted, which helps them to provide the right care straight away. The general manager is looking at ways in which the information provided to people before they are admitted can be improved upon. She has produced a selection of pictures of the home for people to look at. The service users’ guide is always offered to people before they are admitted. It would be beneficial to people, if included in this guide, was the fact that they may not always be sharing their home with a permanent group of people. The general manager said that there are no beds at the home which are blocked purchased by the health authority or council. She said that intermediate care is not provided. Although a rapid response service will be considered. Sowerby Care Home DS0000065904.V344102.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. People who use the service experience good quality outcomes in this area. People get appropriate care, which generally meets with their expectations. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Each person has a care plan which explains what their needs are, and whether there are any risks involved in their care. People had signed their own plans where they were able. One recently admitted person does not have a relative who can act on their behalf to protect their interests. The home is trying to find them an advocate, so that they can be supported in the development of their care plan. People’s named nurse keeps their care plans under review. People knew who their named nurse was, because they were given written information and a photograph of them. This helps to keep people involved in their care. The plans contained good up to date information for staff to follow, and identified that the advice of professionals is asked for when needed. Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 12 Discussion took place about how extra information could be included in the care plan where people had specific mental health needs. This would help staff to understand where they need to seek more advice when the person’s needs changed, and where any risks to their welfare could be better recorded. Although trained nurses complete the care plans for people who are admitted for personal care only, they make sure that their nursing needs are tended to by the district nursing team. This makes sure that people have the right care from the right people, and enables continued contact with community services to which they are entitled. The care plan looked at for someone who receives personal care only strongly emphasised the support required for the person to remain as independent as possible, in line with their needs and wishes. This will help them to maintain their individuality. The vast majority of people said that staff treated them with dignity and respect, although a minority commented that day staff were better than night staff. This was discussed with the management at the time of the visit. They have given assurance that they are looking into these comments further with the staff team, to make sure people are being treated respectfully at all times. People have call bells so that they can attract staff attention when needed. One person’s bell which they previously could not manage to use has been specially adapted. She was pleased that she was now able to call staff, and that they came quickly. One person part manages their own medication. A record was made of the medication that they kept, and the manager said that the risk assessment was reviewed with the rest of the person’s care plan on a regular basis. This helps to check that the person is still able to manage safely. The remainder of people’s medication is handled by staff. The majority of staff have completed an update in medication training. It is planned that all trained staff will attend so that they are up to date with safe practice. The manager audits the medication on a regular basis. She raises any areas of poor practice with staff. This helps to protect people from errors caused by poor practice. There were two omissions seen in the administration records. Although the staff member was on this occasion able to confirm that the medication was given, the manager must pay close attention to record keeping during the audit of the medication systems, so that poor practice can be quickly identified, and to make sure that people get the medication at the time that it is prescribed, and at the right intervals. Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 13 The company is considering the installation of air conditioning in the medication room, which can get very warm. However, the staff are keeping track of the temperature of the room so that they can be assured that people’s medication is being stored at a safe temperature. Sowerby Care Home DS0000065904.V344102.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. People who use the service experience good quality outcomes in this area. People can maintain important contacts with their family and friends, and care is taken to help them meet their social needs. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: People were generally satisfied with the activities available at the home, although some prefer their own company other than at mealtimes. The activities organiser is helping compile a memory book for those who wish to make one. One staff member explained how the activities person tries to provide one to one activities for those who stay in their room. His progress is sometimes hampered however when he is needed to provide care because of depleted staffing levels. People from different denominations visit the home. This helps to meet people’s spiritual needs. It was agreed that the activities which are available are not suitable to meet the needs of one of the people who live at the home. Although arrangements have been made for them to attend a variety of community facilities, it was agreed that the care manager should be approached to see whether there are Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 15 any other facilities available that the person may attend so that their social needs are more fulfilled. Visitors are welcomed at the home at any time. They can visit people in the privacy of their own rooms, or in the communal areas. The general manager has created a small quiet area which she stated was used for such visits. People were pleased with the choice that they are afforded, which they said allowed them to rise and retire when they wished, and to eat where they wished. However, one isolated comment was made that the corridor lights were switched off at 10pm. This made the person feel as though they should stay in their room after this time. Following the site visit the general manager has given assurance that this matter is being addressed with the staff team concerned. A new cook has just been employed to work at the home to replace the previous one. They were due to start work the week of the site visit. People had been dissatisfied with the food provided to them over the weekend, when an agency chef had prepared the meals. A senior carer prepared the main meal on the day of the site visit because the new cook had not yet started. People were pleased that a new cook had been found, and looked forward to a return of a more reliable food service. People choose in advance what they want to eat. Special diets are catered for, and clear information is posted in the kitchen so that the cook can tell at a glance people’s dietary needs, likes and dislikes. Since the last site visit, the home has acquired a computer programme into which they input details of the menu. They can then check that it is properly balanced so that people receive a nutritious diet. Fresh fruit and vegetables and home baking is made available. Frozen vegetables are sometimes given as an alternative to fresh, but there were no concerns about this raised by the people who live at the home and who eat the meals provided. Drinks were available in people’s rooms between meals. The mealtime itself was unhurried, and staff had time to sit with people who needed assistance. Help was provided in a dignified way. Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 16 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. People who use the service experience good quality outcomes in this area. People are protected by a management team who will act upon concerns brought to their attention. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: There have been no formal complaints made direct to the home since the last site visit. People spoken with were happy that there would be someone at the home who they could take any complaints to. They were confident that these would be dealt with properly. There were two separate remarks made about the perceived attitude of night staff at the home. The general manager is keen to root out any areas of bad practice, and has already arranged a meeting with them so that the matters raised can be discussed openly, and resolved in the best interests of people who live at the home. It is planned that all staff will have completed training in abuse awareness in the near future. Staff spoken with knew that they must report complaints and concerns to the manager of the home. They also knew that they must report immediately any allegations or suspicions of abuse concerning the people who live at the home. The management in turn were clear of their responsibilities in reporting the matter to the appropriate people for investigation. All understood that they were not able to keep secrets where abuse was suspected. Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 17 The general manager is aware of the Protection of Vulnerable Adults (POVA) List, and there are systems in place to make sure that referrals are made where appropriate. This helps to protect people from receiving care from unsuitable workers. There has been one safeguarding adults investigation since the last key inspection following an allegation about poor care. The allegation was fully investigated, and was not substantiated. Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 18 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. People who use the service experience good quality outcomes in this area. People benefit from pleasant, comfortable surroundings. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The environment was clean and tidy. There was one specific area where an unpleasant odour was detected. The manager agreed to look into this, so that the room could be made more pleasant for the person who occupied it. Previous problems with flies, which were problematic at the last site visit, have not been an issue this year due to the cooler weather. At this site visit, there were no problems noted, and people were able to eat their meal without being bothered by them. However, the general manager said that systems have been put in place to eradicate any problems with infestation that may arise. There is a programme of redecoration in place, which has so far concentrated on the communal areas. People liked the improvements made. Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 19 The dining area is very pleasant. There are insufficient places for everybody to eat at once. This has not created a problem for people, some of who enjoy eating in the privacy of their room. The general manager said that two sittings would be considered should all people wish to eat communally in the future. Since the last site visit, the Environmental Health officer has visited the home and commended the systems in place in the kitchen. The fire officer has also given verbal assurance to the Commission that all previous recommendations made which were outstanding at the last site visit have been addressed, other than a better fire exit from one wing of the first floor of the building. However, as an alternative, a new sprinkler system has just been installed in this area of the home following negotiation with the fire officer. It is recommended that the fire officer be invited back to check that he is happy with the action taken and the updated fire safety risk assessment. It is the current arrangement that except between 2-4pm, the conservatory is used as the designated smoking area. The area is also used by non-smokers, who are removed from the area at times when smoking takes place. The room is also a thoroughfare to the garden. The company must check whether they are acting lawfully, and that they are protecting the rights of those who do not smoke, but who may affected by the current arrangement. Doors were kept locked where signs instructed staff that they should be. This meant that people were kept safe from the risk of hazardous chemicals and equipment stored within. People are pleased with their personal and communal space. Their own rooms contain their personal belongings, and are individualised. The laundry room was suitably equipped. There were systems in place to reduce the risk from cross infection, and staff have information which tells them what to do in the case of contact with chemicals which could harm them and others. Sowerby Care Home DS0000065904.V344102.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 and 30. People who use the service experience good quality outcomes in this area. Staff are provided with training to help them provide good care. Further attention to detail during the recruitment process would provide additional safeguards for the people who live there. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Twelve of the fourteen people who returned their surveys thought that there was either always or usually sufficient staff available when they needed them. One person at the site visit commented that staff could be better organised, and that this sometimes gave the impression that there were not enough of them. Others were satisfied with the number of staff available. One person who is cared for in bed said that staff come quickly whenever she rings. Staff receive training to help them provide good care. They receive induction training when they first begin to work at the home, during which time experienced members of staff assess their abilities before they are able to provide care on their own. This helps to make sure that people are given assistance in a safe and appropriate way. Staff work towards accreditation in National Vocational Qualifications in care. There are staff undergoing the course currently, as well as others who have achieved the award, or who are waiting to enrol. Trained staff are given Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 21 opportunities to attend training which keeps their skills updated. This will help to make sure that people are cared for by a well trained workforce. The recruitment records provided evidence that staff are checked with the Criminal Records Bureau to make sure that they are suitable people to provide care. The general manager now requires an application form to be completed, and keeps notes from the staff member’s subsequent interview. Two staff files were looked at. In the first, the general manager had failed to request a reference from the person’s previous employer. In the second case, the application form could not be found. Therefore it could not be determined what relevance the references had to the previous job history of the staff member concerned. Sowerby Care Home DS0000065904.V344102.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, 33, 35 and 38. People who use the service experience good quality outcomes in this area. The home is run by enthusiastic managers, who are keen to consider the views of the people who live at the home, when deciding how it should be run. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: There are two senior staff who share the management responsibilities for the home. One concentrates mainly on the general management of staff and systems. The second, who has applied to become registered with the Commission for Social Care Inspection, manages the clinical aspects of the service. She realises however, that, as registered manager, she will need to be fit in all aspects of the management of the home. Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 23 People who live at the home and staff were satisfied with the management arrangements, which did not appear to be causing any problems in maintaining clear lines of accountability, and management responsibilities. Staff thought that the management was approachable. One thought that the arrangement was ‘loads better’ than before. They felt that their skills were now recognised and valued. A representative of the company visits on a regular basis to check that the home is running smoothly. Good work has been done since the last inspection to gather the views of people who live at the home and of their families and friends, so that it can be checked that the home is being run to people’s benefit and satisfaction. This includes annual satisfaction questionnaires and regular ‘residents’ meetings’. A number of audits are also carried out in different departments of the home so that the managers can check that the departments are running in the best interests of the people who live there. As well as relatives meetings, the general manager also advertises a weekly ‘surgery’ when she puts the day aside to be available for anyone who may wish to raise concerns with her. Discussion took place about the need to seek the views of professionals who visit the home as part of the quality assurance system. The home has no responsibilities as appointee for any of the people who live there. Their families deal with their finances, and supply the manager with a cheque to cover personal allowances for their relative. This is paid into a collective bank account which is set up for the people who live at the home only, and which accrues no interest. It is then cashed, and the cash kept at the home for the person to who belongs. Ideally, people should have their own bank account, and this is something which the general manager is currently looking at as a best practice matter. People however have access to their personal allowances at all times, and can lock them up in their own room if they wish. The information provided before the site visit confirmed that equipment at the home is kept maintained. The electrician was testing the Portable appliances on the day of the site visit. The general manager said that works detailed on the last service as being required to a gas appliance are being organised by the company’s estate department. The maintenance man carries out a number of in house checks to make sure that the environment is kept safe for people. This includes bed rail checks, hot water checks and weekly checks of the fire system. There were periods when the fire alarm checks had not been kept up to date because of holidays. It is important that someone else is appointed to carry out these checks in his absence to make sure that the weekly checks do not fall behind. Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 24 Two bath temperatures were checked and were too high. The records seen showed that this was unusual, and the maintenance man adjusted them at the time of the site visit. However, as an additional safety measure, each bath has a thermometer so that staff can check that the water is of a safe temperature before they assist people into the bath. One bedroom carpet was ripped. The general manager said that a replacement was on order. She asked the maintenance man to tape down the carpet until such time that the carpet was replaced. This should reduce the risk from trips in the meantime. There were no checks taken of the serving temperature of food on the day of the site visit. It would be good practice to provide staff who help at short notice, as was the case on the day of the site visit, with a list of tasks that they need to carry out to make sure that food prepared and served in the safest way. Staff agreed that they receive regular statutory training to help them work in a safe way. The general manager said that infection control is not classed by the company as statutory training, but that this is currently under negotiation. Staff currently get information about how to control infection during induction, and when they receive training in the safe handling of chemicals. Advice should be sought from the infection control team to check that the training that has been given meets with their expectations, when considering how a safe environment can be provided for people. The general manager was satisfied that there were sufficient staff trained in first aid to make sure that there was a suitably qualified person available at all times to deal with emergency situations that may arise. Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 25 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 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 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 3 X 3 X 3 X X 2 Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 26 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 Requirement During future medication audits, further attention must be paid to shortfalls in accurate record keeping. This will help to keep records accurate, will quickly identify poor practice and will help to make sure that people get their medication at the time that it is prescribed, and at the right intervals. Enquiries must be made, and corrective action taken where necessary, to make sure that the current smoking arrangements comply with the law, and are in the best interests of the collective needs of the people who live at the home. Timescale for action 23/07/07 2 OP19 23 31/08/07 3 OP26 16 Steps must be taken to eradicate 23/07/07 the malodour from the room identified at the site visit so that it is more pleasant for the person who occupies it. To ensure that the system remains in safe working order, arrangements must be made to DS0000065904.V344102.R01.S.doc 4 OP38 13 23/07/07 Sowerby Care Home Version 5.2 Page 27 make sure that the weekly fire alarm check is always carried out. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations Where people have specific mental health or psychological needs, these should be given special attention within the care plan, to include information about specific risks that staff should look for which would suggest a decline in health. This will help to make sure that advice is sought at the earliest point. Further enquiries should be made regarding the activities on offer for the person discussed at the inspection, to see if there are any other activities available to make their life more interesting. It is recommended that the fire officer be invited back to check that he is happy with the newly commissioned sprinkler system, and the subsequent updated fire safety risk assessment. All records pertaining to staff employment should be kept safe and readily available. A reference should always be sought from the previous employer so that any problems relating to that employment can be fully explored so that all possible measures are taken to protect people who live at the home. 5 OP33 The views of outside professionals should be sought when measuring the quality of the service provided to people who live at the home. Staff who help at short notice in the preparation of food should be provided with a list of tasks that they need to DS0000065904.V344102.R01.S.doc Version 5.2 Page 28 2 OP12 3 OP19 4 OP29 6 OP38 Sowerby Care Home carry out to make sure that food is prepared and served in the safest way. Advice should be sought from the infection control team to check that the training that has been given meets with their expectations, when considering how a safe environment can be provided for people. Sowerby Care Home DS0000065904.V344102.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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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