Inspection on 10/05/07 for St Dominics Residential Home

This inspection was carried out on 10th May 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

St Dominics Residential Home 19/12/05

St Dominics Residential Home 07/06/05

St Dominics Residential Home 15/02/05

St Dominics Residential Home 31/08/04

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 St Dominics Residential Home London Road Kelvedon Colchester Essex CO5 9AJ Lead Inspector Marion Angold Key Unannounced Inspection 10th May 2007 11:00 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 St Dominics Residential Home DS0000017937.V340783.R01.S.do c 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. St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 3 SERVICE INFORMATION Name of service St Dominics Residential Home Address London Road Kelvedon Colchester Essex CO5 9AJ 01376 570359 01376 573668 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) St Dominics Residential Home Limited Mrs Frances Stacey Robertson Care Home 29 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (29) of places St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 29 persons) One person, aged 65 years and over, who requires care by reason of dementia, whose name was made known to the Commission in July 2005 The total number of service users accommodated in the home must not exceed 29 persons 19th December 2005 Date of last inspection Brief Description of the Service: St Dominics is registered for 29 people of both sexes, over the age of 65. Accommodation is in single rooms on 2 floors with lift access. Eleven bedrooms have en suite facilities. The home has large well-maintained gardens with a summerhouse, water features and patio areas. A large heated conservatory offers more than adequate communal space for residents, and there are also 2 lounges and a dining room. The home is close to local facilities in Kelvedon and accessible by train and other forms of transport. The current weekly charge for a room is between £500.00 and £574.00 and, for respite occupancy, £580.00. Additional charges are made for chiropody, hairdressing, toiletries, confectionary and a contribution towards the cost of activities. St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection, covering the key National Minimum Standards, took into consideration all recent records and contacts relating to the service, including surveys completed by residents and their relatives. It also included a site visit to the home on 10/05/07, lasting 7.75 hours. This visit involved speaking with residents, a relative, the manager and staff, as well as a partial tour of premises, observation of care practice and the sampling of records. Since the last inspection, Mrs Frances Robertson had taken over the post of manager and was registered with The Commission for Social Care Inspection in January 2007. Of the 27 Standards inspected, 23 were met and, of these, 3 were rated ‘excellent’. The remaining 4 Standards were nearly met. What the service does well: People living at the home and their relatives and representatives, who completed the Commission’s postal survey, used words to describe staff such as ‘caring’, ‘helpful’, ‘kind’, ‘polite’ and ‘approachable’. One person said, ‘We have a lot of consideration and a happy atmosphere’. Another said, ‘We are extremely lucky that the staff consider our needs and accommodate what we wish to do.’ A relative commented, ‘The staff accommodate all of (person’s) requirements in a professional and caring manner.’ People commented favourably about their experience of meals and mealtimes. They said things like, ‘The food is generally pretty good’; ‘Plenty to eat’; ‘They provide good vegetarian dishes,’ and ‘Mealtimes are dignified’. Comments about the suitability of activities were mixed but they suited some people well. One person said the home was ‘very good at encouraging residents to join in activities, which are varied and stimulating’. Another person said that the entertainment and outings had helped their relative settle at the home. People spoke well of their surroundings, the garden and the cleanliness of the premises, in particular. One comment was, ‘The home is always spotlessly clean’. St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 7 be made available in other formats on request. St Dominics Residential Home DS0000017937.V340783.R01.S.do c 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 St Dominics Residential Home DS0000017937.V340783.R01.S.do c 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): 1, 2 and 3. NMS 6 did not apply to this home. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People moving into St Dominic’s did so on the basis of adequate information about the home, an assessment of their needs and a contract of residence. EVIDENCE: Most of the people responding to the Commission’s survey of views felt that they had received enough information to inform their decision to move into St Dominic’s and all said they had received a contract of residence. Records for a person accommodated for respite care included a contract. Two Service Users Guides appeared to be current although neither was dated. One version, in bold print, did not cover all the required information, as set out in the National Minimum Standards. St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 10 Similarly, the new Statement of Purpose did not comply fully with the requirements of the Care Homes Regulations 2001 and this is important because the information is intended to help people decide whether the home is suitable for them. Records showed that a satisfactory pre-admission assessment had been completed for a relative newcomer to the home. This had been reviewed and overwritten after the person’s arrival but these amendments were not dated. The care plan, generated from the assessment, was also not dated. In order to be able to track a person’s progress, it is necessary for all records to be dated and changes recorded as additional entries, without deletions to the original record. St Dominics Residential Home DS0000017937.V340783.R01.S.do c 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 this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People could expect their care to be given according to an individual plan and in a manner that showed respect for them and promoted their privacy and dignity. Small changes to the way the home handled people’s medicines, would provide better protection from possible mistakes. EVIDENCE: Responses to the Commission’s survey, both from people living at the home and their relatives and representatives, were positive about the care and support people received. A new member of staff commented on the good quality of records at St Dominic’s and, particularly, how easy it was to follow the care plans. The three care plans sampled covered a range of needs and risks, and had been St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 12 reviewed monthly. Staff said that plans were retyped each time they were changed, the new ones put on the file and the old ones retained in the office. They said it helped having only the most recent plan on file. However, the plans inspected were not dated and therefore it was not possible to assess their currency. All records should be signed and dated to give them meaning and provide a clear audit trail. A senior was identified on each shift to complete all the daily records, based on their own observations, as well as verbal reports from key workers and other staff on duty. Key workers were allocated to teams, which met monthly to review the needs and risks of the individuals allocated to them. Staff indicated that it was expedient having a daily checklist for individual personal care, with a separate page for adding any qualifying comments, as this provided an easy reference and meant they did not have to spend time recording in detail the support they had given. Most people responding to the survey said they always received the medical support they needed. Healthcare professionals were also positive about the home’s healthcare practice. The inspector commented on the number of people in wheelchairs during the morning. Staff said people did not spend all the time in wheelchairs and, during the afternoon, more were transferred to armchairs. One respondent to the Commission’s survey wrote that ‘more consideration could be given to patients that are chair-bound’. Another said, ‘Residents could be offered more physical activities to keep their joints supple and perhaps access a qualified physiotherapist. As noted elsewhere, the activities coordinator had introduced an audit tool to determine whether people were getting exercise through the activities programme. Discussions with people experiencing the service and the sample of records provided evidence of the home promoting mobility. For example, one person had progressed from a sling to a standing hoist as a result of a review of their mobility needs, another had benefited from a referral to a physiotherapist, which the home had initiated. It was observed that drinks were available throughout the day, and people who were able could help themselves to water from a machine. One respondent to the survey thought that, ‘More attention could be paid/monitored to the fluid intake of residents’. One care plan sampled included a list of the person’s current medication. The other two, referred the reader to the current Medication Administration Records for this information. The home should keep an up to date and separate record of each person’s medication, as prescribed, so that incoming medication and records from the pharmacy can be checked for accuracy and information about use and side effects is an integral part of individual care plans. St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 13 The home’s medication trolley was secured in a locked cupboard. This cupboard contained baskets of medication for each person living at the home, surplus to the items on the trolley. These baskets contained a number of items. One person’s included 3 small bottles of lactulose, all of which had been opened. Another had 3 bottles of lactulose for February, March and April 07, all unopened. These examples indicated a need for a tighter control of stocks and a more methodical approach to ordering and returns. The administration of medication, observed at teatime, was found to be satisfactory. Responsibility for medication administration was only given to senior staff with the appropriate training. The manager said that people who might need occasionally to administer particular medications, such as ad hoc seniors and night staff, had first to complete an assessment to show they had the necessary knowledge and skills. Medication Administration Records did not include pictures of all people receiving medication to help with their identification and a lack of sample signatures of the people administering medication, meant it was not possible to determine at a glance who had endorsed the records and whether they were authorised to do so. Comments from people experiencing the service were positive about the manner in which they were supported and the respect staff showed for their privacy. One person said, ‘We are extremely lucky that the staff consider our needs and accommodate what we wish to do’. A relative, responding to the survey, commented, ‘The staff accommodate all of (named relative’s) requirements in a professional and caring manner.’ A situation arising on the day of the site visit, illustrated that consideration was given to people’s rights, privacy and independence, without compromising their safety. Staff were observed to be solicitous and respectful in their dealings with people living at the home. St Dominics Residential Home DS0000017937.V340783.R01.S.do c 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 this service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The quality of people’s daily lives was enhanced by attention to their diverse needs and wishes, the provision of activities, opportunities to socialise and enjoyable meals and mealtimes. EVIDENCE: People responding to the Commission’s survey indicated that there were activities that they could take part in. An activity co-ordinator was employed Monday to Friday, full time. During the morning of the inspection, she was working with several people, making shortbread and cheese straws. Other people were reading newspapers or watching the tree felling taking place in the grounds. The activity coordinator had developed a weekly record of activities for each person, covering exercise, mental stimulation, creativity and socialisation. This provided an overview of what people were doing and where they might need St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 15 more input. The activity coordinator said she gave lots of time to people individually, especially those who tended not to get involved in group activities. Examples of other activities included a popular game making words from large letters scattered on the floor. The coordinator also presented topical videos to stimulate group discussion. Residents had access to a mobile library and opportunities for occasional outings. The activity coordinator circulated a weekly programme of activities and prepared a monthly newsletter, reporting on birthdays and activities that had taken place, and introducing forthcoming events. The May newsletter announced a cream tea and an outing to Rowhedge. A volunteer, who came in most days, described how they were able to support the coordinator with group activities and also spend time talking with residents individually. People living at the home and their relatives clearly had high expectations of the activities programme and offered a number of suggestions for improvement. One respondent thought that people could be given more encouragement to keep up previous hobbies. Other proposals to help with future planning of activities, included: ‘There could be more stimulation given to residents and more opportunities to leave the premises, other than the occasional trip out, which does not include all residents.’ ‘More opportunities should be given to residents to spend more time outside in fine weather.’ ‘A change of seating position should be offered to those that are immobile so that they have a different view/perspective.’ People, who spoke with the inspector, indicated that routines were flexible, to accommodate individual needs and preferences. This meant, for example, that they could lie in and go to bed when they liked. Appropriate arrangements had been made for a person who smoked, without infringing the rights of others. The inspector spoke with one visitor, who came every day and was able to come and go as they pleased. The quiet lounge was available for people to go aside with their visitors. It had been used for a strawberry tea the previous day, for the purpose of bringing people together with their families and friends. Relatives / representatives responding to the survey indicated that they were kept up to date with important issues about their family member /friend and that the home was supportive, where appropriate, in helping residents keep in touch with the people who mattered to them. People spoke well of meals and mealtimes. They said things like, ‘The food is generally pretty good’, there was ‘plenty to eat’, ‘good vegetarian dishes’ and St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 16 ‘mealtimes are dignified’. This was confirmed by observation at lunch and teatime. Staff were involved in serving the meals in the dining room, consulting with each person about their choice (made the day before) and monitoring how they were and what they consumed. The atmosphere was relaxed and leisurely. Breakfast trays were prepared for everyone over night. Care staff informed those working in the kitchen when people were up, where they wished to have breakfast and any variation from their usual choice of menu. The home had produced a brochure, advising people of the new 4-week menu, which they had met to discuss and agree. This informed them that they could request a snack at any time and, if they were hungry, ask for both choices on the menu. The menu was varied, balanced and appetising and the cook was enthusiastic and experienced and prepared everything from fresh ingredients. A plate of prepared fresh fruit was handed round during the afternoon because the manager had found that people were not taking the fruit from the fruit bowl to prepare for themselves. A choice of 4 sandwich fillings and white or wholemeal bread was included on the teatime menu. St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Complaints were taken seriously but not always logged in a way that ensured the best outcomes for people living at the home. EVIDENCE: On the whole, people who spoke with the inspector, and respondents to the Commission’s survey, indicated that they had not had complaints or concerns about the home, or that the matters they had raised had been dealt with to their satisfaction. Three out of ten people living at the home who took part in the survey indicated that they were unsure what to do if they had a complaint and one person was concerned about staff being too busy to listen to them. There was a brief record of a complaint received in February 07, showing that the action taken, and the outcome, had been appropriate. The manager said that issues brought to their attention, which were not formal complaints, were recorded in the senior’s communication book so that all staff were made aware of them. Where concerns have been voiced, as surveys indicated had been the case, a record should be logged separately from other communications, so that a clear audit trail is available for quality assurance. St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 18 During the course of the inspection it came to light that two staff were no longer having any involvement with particular residents, due to difficulties in their working relationships. In one case, the manager had sufficient information to determine that the resident’s accusations and complaints were misplaced. Therefore she decided that it was not necessary to consult with the Social Services Safeguarding Adults Team. Although the manager’s account of events showed that the situation had been handled sensitively, comments in the seniors’ communication book did not reflect the same level of impartiality and had potential to influence how staff viewed the particular resident. The issues and ensuing investigations and actions had not been documented, as required by regulation. The other circumstance involved a member of staff feeling undermined by a person living at the home and, again, after meetings had failed to bring about a resolution, it had been agreed that they would have minimal contact. The staff member concerned said that colleagues were supportive in both situations. People living at the home and their relatives and representatives, who completed the Commission’s postal survey were positive about their experience of staff; they used words to describe them such as ‘caring’, ‘helpful’, ‘kind’, ‘polite’ and ‘approachable’. One person said, ‘We have a lot of consideration and a happy atmosphere’. The protection of vulnerable adults was covered in the home’s core training programme and a sample of staff records showed that safeguarding adults was addressed in one-to-one staff supervision. The manager said that, when she observed potential for improvement in the way staff approached people living at the home, she would take them aside to offer advice and guidance. St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 26 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People, living at St Dominic’s, benefited from clean and well-maintained and presented surroundings, suitable for their needs. EVIDENCE: St Dominic’s offered very pleasant, bright and comfortable surroundings, with particularly good communal areas, including a large conservatory. One comment was received about the leaking conservatory roof but the manager indicated that repairs were in hand. A maintenance person was on hand three days a week and kept the home in a good state of repair and decorative order. St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 20 The house is set in attractive gardens, although, for some time to come residents will experience the impact of the work being done to extend the home. They were being kept informed of proposals and developments in this respect. Bedrooms sampled during this inspection were individually appointed and reflected the personality and interests of the occupants. People commented positively about their rooms. People who spoke with the inspector, or responded to the Commission’s survey, said the home was clean; one person described it as ‘spotlessly clean’. This was confirmed during the site visit. Liquid soap and paper towels were available in communal areas and plentiful supplies of protective clothing for people providing assistance with personal care. The laundry was fit for purpose. As people using the laundry do not have a separate facility for washing their hands, they should have written procedures for avoiding cross infection. The ground floor bathroom was well adapted and equipped to suit the needs of people with poor mobility as were the lavatories sampled. Handrails fitted in the corridors also provided support with mobility. St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People at the home were generally well served by the home’s staffing, recruitment and training procedures, although sometimes staff were not around when they needed them. EVIDENCE: Respondents to the Commission’s survey said that staff were always (5 respondents), usually (4) or sometimes (1) available when they needed them. Responses were similar to the question as to whether they received the care and support they needed. Relatives offered similar views. Although staff indicated that they felt they could care for people properly with the number of care workers on duty, a number of comments from people using the service, or their representatives, suggested that they felt there were times when staff were not available to meet people’s needs: People said things like, ‘ More carers should be available for toileting’. ‘Handover time leaves the residents without sufficient supervision.’ St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 22 ‘After lunch, I could do with a little more help and attention – it seems quieter and the carers are not usually in the lounge unless I am able to call.’ ‘I think (staff) should not all take a break together. I think someone should be in the lounge at all times.’ ‘Staffing levels do not allow access to the community…’ Whilst there were three housekeepers and a laundry assistant working from Monday to Friday, there was only one person for domestic duties on Saturdays and none on Sundays. This meant that weekend care staff had some additional duties, making them less available for residents. People also did not have support and input from the activity coordinator at weekends. It was noted from information sent in by the manager that the home had experienced a significant turnover of staff between inspections. However, the situation appeared to have stabilised as staff said they seldom needed to call on agency staff, who would be less familiar with the needs of individuals and the routines of the home. They also had bank staff, who they could call on. A sample of records for staff, who had started working at the home this year, showed a robust recruitment process that safeguarded the people using the service. References from one file had been mislaid but there was verbal evidence that these had been obtained. Full and satisfactory Criminal Record Bureau disclosures were obtained for each person, before they started working at the home. A person, who had been coming to the home as a visitor for many years, was also helping out with activities several times a week. The manager said that the person’s role continued to be primarily that of a visitor and, therefore, they had not felt it necessary to carry out the usual recruitment checks. The fact that Criminal Record Bureau checks had been obtained for others, who provided a service in the home but were not part of the establishment (such as a volunteer and hairdresser), showed that management was taking seriously its responsibility for ensuring that people living at the home were in safe hands. They should ensure they carry out all necessary checks, should the role of the visitor change to warrant such safeguards. The manager said they were using the Skills for Care induction programme for all new staff, with assessments of individual competence in the key areas of learning, and additional moving and handling training. Induction records were not to hand for 2 out of 3 of the sample. The manager acknowledged that they had fallen a little behind with records, as she was also new to the home. She showed the inspector records for a person, who had started in the autumn 2006, which evidenced the full process, adopted by the home. One relatively new member of staff, with lots of experience of care in a senior role, said that a week of shadowing staff at St Dominic’s had prepared them sufficiently for St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 23 working with people and knowing the needs and preferences of individuals they would be supporting. Respondents to the Commission’s survey expressed the view that staff usually had the right skills and experience to look after people properly. Information sent in by the manager, showed that 50 of staff had achieved the National Vocational Qualification (NVQ) Level 2 in care and that others were working towards it. The manager said that because she had previously worked as a trainer in the field of social care, and as an assessor in respect of the NVQ in care, she had taken on all staff training at St Dominic’s. On the day of inspection, she was preparing to deliver a day of training on dementia, based on a programme devised by the Alzheimers Society. She felt that, having a familiar person to lead the training put staff at ease and improved their performance. Staff confirmed that they felt more relaxed and comfortable attending in house training than courses delivered by an independent provider. They also indicated that the manager had a professional approach to training and gave constructive help when she assessed their competence. The training plan, which provides a good overview of staff training needs and development, would be more useful and relevant, if it were dated. St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Management ethos and style fostered positive working relationships and good outcomes for people living at the home. EVIDENCE: The manager and staff indicated that the providers considered the best interests of people living at the home. They provided money towards activities, paid extra to staff for unsociable working hours to ensure that staffing levels were consistent, and had been willing to offer a good member of staff full time hours, rather than lose them. St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 25 Staff said that the new manager and administrator had started within a month of each other. They felt the transition period had gone smoothly, with changes being small and manageable. Staff indicated that working relationships at the home were good and that they could point things out to each other without being rebuffed. They spoke positively about the manager leading their training and being open to new ideas. Developments in quality assurance and monitoring included the circulation of surveys to residents and their relatives. The manager and administrator said they had written to everyone, making known and responding to issues that had arisen. The manager was completing a review the policies and procedures and making appropriate amendments. Application for a Local Authority grant had met with success. The manager reported that residents had been consulted about how they would like the money to be spent, and detailed some of the requests they were meeting, including new carpet. People living at the home and their representatives had also been kept informed about proposals to extend the building and increase the number of residents. Two people who spoke with the inspector expressed concern that the home might get too large. It was evident from the number of people managing their own personal money that the home encouraged independence in this area. The manager agreed to check that everyone had lockable storage in his or her rooms. Records, receipts and balances in respect of small amounts of personal money, deposited by relatives and held by the home for safekeeping, were found to be accurate and to present a clear audit trail, in respect of two of the case-tracked residents. The incoming manager had changed arrangements for supervision. The new system involved some delegation of responsibilities, with the manager and deputy manager still supervising seniors but senior carers supervising their junior colleagues. Records sampled for two staff showed that supervision had lapsed between May 2006 and January or March 2007, but the manager indicated that, with seniors now trained for their supervisory role, the supervision of all staff would continue at a minimum of two monthly intervals. Senior staff, who spoke with the inspector, confirmed that the manager had adequately prepared them for this task. Records showed that the content of supervision was relevant to the work and development of the individuals concerned. The home had a comprehensive training policy and plan, which included health and safety topics. Records showed that staff had received training in the key areas, including fire awareness, manual handling, medication, basic first aid and basic food hygiene. Policies relating to the health and safety of people living and working at the home had been updated in February and March 07. Records showed that installations and appliances were routinely inspected and serviced. No hazards were identified during the tour of premises. St Dominics Residential Home DS0000017937.V340783.R01.S.do c 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 2 3 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 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 4 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 (2) Requirement The home must review procedures for the administration of medication to provide people with better protection from possible mistakes. All complaints must be logged to show how people’s views have been listened to and acted on, and to inform the process of monitoring and improving standards. Timescale for action 31/07/07 2. OP16 13 (6) 04/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP9 OP3 OP7 OP30 OP37 Good Practice Recommendations The home should keep a tighter control of medicine stocks and not allow them to build up. Records should be signed and dated to provide a clear audit trail and so that people referring to them know whether they are current. DS0000017937.V340783.R01.S.do c Version 5.2 Page 28 St Dominics Residential Home 3. 4. OP27 OP36 Staff should be available at all times so that people living at the home are assured of the assistance they need. Staff supervision should be maintained at a minimum of two monthly intervals. St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 29 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Dominics Residential Home DS0000017937.V340783.R01.S.do c Version 5.2 Page 30 - 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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