Inspection on 10/12/07 for St George`s (Banstead)

This inspection was carried out on 10th December 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

St George`s (Banstead) 15/06/06

St George`s (Banstead) 14/11/05

St George`s (Banstead) 15/08/05

St George`s (Banstead) 24/01/05

St George`s (Banstead) 09/08/04

Similar services:

Thorndene

Southfields

Insight - Eastchurch

Magenta

Seabourne House

Dovedale Court

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

CARE HOMES FOR OLDER PEOPLE St George`s (Banstead) 58 Fir Tree Road Banstead Surrey SM7 1NQ Lead Inspector Sandra Holland Unannounced Inspection 10th December 2007 10:15 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 St George`s (Banstead) DS0000013800.V356599.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. St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St George`s (Banstead) Address 58 Fir Tree Road Banstead Surrey SM7 1NQ 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) 01737 370224 firtree@prospectha.org.uk Prospect Housing and Support Services Post Vacant Care Home 8 Category(ies) of Learning disability (1), Learning disability over registration, with number 65 years of age (7) of places St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be: 2 PERSONS 58-65 YEARS AND 6 OVER 65 YEARS OF AGE 15th June 2006 Date of last inspection Brief Description of the Service: The home is registered to provide accommodation and care to eight older people who may have a learning disability. The home is run by Prospect Housing and Support an organisation that runs a number of other homes in the area. Accommodation is provided in a detached property situated on a main road, with limited parking facilities to the front of the property. Bedrooms are situated on the ground and first floors of the home. There is a bathroom on the ground floor with an assisted bath for the use of service users. The home has a large spacious lounge, and a conservatory with air conditioning installed, which is used as a dining room. The back garden is level and well maintained. The fees at this service range from £ 777.23 per week to £ 1130.24 per week. St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection site visit was carried out by the Commission for Social Care Inspection (CSCI), under the Inspecting for Better Lives process. A full analysis of all the information held about the home was carried out before the site visit took place. Mrs Sandra Holland, Regulation Inspector carried out the inspection over six hours. The manager was present representing the service. Most areas of the home were seen and a number of records and document were sampled, including residents’ individual plans, records relating to residents monies, medication administration records and staff recruitment and training files. All seven residents and three staff were met or spoken with. An Annual Quality Assurance Assessment (AQAA) was supplied to the home and this was completed and returned. Information included in the AQAAA will be referred to in this report. Information in the AQAA indicated that staff attend a two-day training course as part of their induction, to raise their awareness of equality, diversity and discrimination issues, and receive an annual update to this. Residents are supported to follow their own faiths and any information relating to residents’ diverse needs, is incorporated into their individual plan. The people living at the home prefer to be known as residents, so that is the term that will be used throughout this report. The inspector would like to thank the residents and staff for their hospitality, time and assistance. What the service does well: The service provides a high level of support and care that is specific to each individual. The majority of residents are able to be independent in some aspects of their lives, although the home can also provide support to very dependent residents. Residents’ healthcare needs are very well met and medication administration in the home is well managed. Staff were observed to treat residents with dignity and respect and to promote residents’ privacy. Residents are encouraged to be as independent as possible and to make their own decisions and choices. Effective support is provided to enable residents to St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 6 maintain contact with their families and friends, to take part in an active social life and to be visible members of their community. The home is very well decorated and furnished and presented as a comfortable place to live. Residents made positive and appreciative comments about living at the home. The majority of staff have undertaken and achieved a National Vocational Qualification in care & the home exceeds the recommended 50 of staff trained to this level. 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 George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. St George`s (Banstead) DS0000013800.V356599.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 St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of prospective residents have been assessed, to ensure they could be met in the home. EVIDENCE: Staff advised that most of the residents had moved into the home when it opened nearly fifteen years ago, although a small number of residents have moved in since then. Three resident files were sampled at random and it was noted that a detailed assessment of the needs of each resident had been carried out. This is to ensure that the home can adequately meet the assessed needs of a prospective resident and can assure the resident of this. Staff stated that intermediate care is not provided, so this standard does not apply. St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed individual plans have been drawn up to enable staff to meet residents’ needs, although these must be more effectively reviewed and must reflect residents’ changing needs. Residents’ healthcare needs are well met and the administration of medication appears to be appropriately managed. EVIDENCE: As mentioned previously, the files of a number of residents were sampled. A comprehensive individual plan has been drawn up to guide staff to the care and support needs of each resident. These detail the support required in all aspects of residents’ lives, including personal care, mobility, communication, dealing with finances, medication, and religious, social and cultural needs. The manager stated that person centred plans are being developed by key workers and residents, to advise and guide staff in meeting residents needs, but these are based more specifically from a resident’s point of view. The current individual plans include sections titled “What’s important to me”, “things that are not so important” and “things that might upset me”. St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 11 A requirement was made following the last inspection carried out on 15th June 2006, that resident’s plans of care must be kept under review. A timescale of 29th June 2006 was given and this has not been fully met. Each of the individual plans that were seen had been marked to show they had been reviewed although the dates of reviews were not entirely clear. A chart listing the reviews was included in the individual plans, but these recorded reviews taking place in June to December 2006, although from the continuity of the dates, it looked as though these should have been recorded as 2007. The reviews had been signed by a number of staff, but no one had amended the dates, to ensure they were correct or accurate. It was noted that the individual plan for a resident who requires assistance in many aspects of daily living had not been fully updated and did not reflect the resident’s current needs. The plan stated that the resident could get up and sit in a chair, although staff advised that this no longer takes place due to a decrease in the resident’s mobility. Risks to residents have been assessed, recorded and where possible, minimised, to enable residents to live as independently as possible. The risk assessments included actions that could be taken to prevent specific risks arising, or actions to reduce the risks. The assessments included the risks associated with falling, mobility, moving and handling, the use of wheelchairs, eating, drinking and choking and the use of bed rails. From the records seen, it was clear that a number of healthcare professionals are involved the support of residents’ and that their healthcare needs are well met. Residents receive support from general practitioners (GP’s), dentist, optician, community nurse, dietician and hospital specialists. Staff advised that if a change in a resident’s health is noted, a prompt referral is made to the GP, and entries in the daily record notes confirmed this. Staff advised that medication and printed medication administration record (MAR) charts are supplied to the home by a local pharmacy chain. Most medication is supplied in “blister” packs with a single dose of medication in each blister. This is designed to make the administration of medication safer and to enable easier monitoring of medication stocks. The manager stated that only staff that have received appropriate training are involved in medication administration. A list of the initials and signatures of staff that administer medication was included in the medication record folder, along with medication guidelines produced by CSCI. The amounts of medication held were randomly sampled and these all accurately matched the records held. Staff advised that any medication that is returned to the pharmacy is recorded, and the pharmacist or their St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 12 representative signs for receipt of the medication. This is good practice, as it enables an audit trail of all medication to be maintained. It was positive to note that residents were addressed by their preferred name, staff provided support discreetly and ensured any personal care was carried out in private. The previously made requirement regarding Standard 7, that residents’ individual plans must be kept under review, has been made again. St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported to take part in a range of activities, to be active members of their community, and to maintain contact with their families and friends. A well balanced diet is offered to residents, which takes account of their needs and preferences. EVIDENCE: On the day of inspection, residents spoke of looking forward to a pantomime that was to be held in the home that day, and of residents from another Prospect home joining them. This was carried out later in the morning by a visiting company of players and was much enjoyed by the residents. Residents were encouraged to take an active part and to join in with the singing. As it was also the birthday of a resident on the day of inspection, residents and staff had organised a buffet lunch for all to enjoy. A very attractively decorated birthday cake had been provided and a photo of the resident was included in the decoration. Each resident has a social activity plan included in their individual plan and those seen, indicated that residents are supported to take part in a range of St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 14 social and leisure activities. A number of residents attend local day services where they take part in arts and crafts, days out, reminiscence groups and meet up with friends. Other activities are arranged within the home, including hand massages and manicures, sensory sessions and musical events. Daily notes recorded that residents were supported to go shopping for Christmas items, to go out to a local restaurant for lunch and to go out to deal with everyday tasks such as to the post office, or to buy household shopping. Residents were seen assisting with laundry tasks, but it was clear from speaking to residents that they can choose which activities they prefer to take part in. Information supplied in the AQAA advised that a resident had asked to reduce the number of times they attended a day service, as they found it too tiring, and this request was accommodated. Information also supplied, stated that two residents regularly attend local places of worship, and a service is held each week in the home for those residents who wish to attend. Staff advised that most residents are supported by their families and friends and residents spoke of their families coming to visit them. Residents who were able, spoke of going shopping to buy gifts for their families and friends, supported by staff. The manager stated that a four-week menu plan has been drawn up, with the involvement of residents, and to reflect their likes and dislikes. The plan currently in use was the summer plan, but the manager advised that this was soon to be reviewed to include dishes and meals that are more suited to winter. It was positive to note that diet advice sheets and lists of residents likes and dislikes, were included in the menu folder to provide guidance to staff about residents’ specific dietary needs. Meals are served in the spacious conservatory that is attractively furnished with two large tables. Residents and staff all eat together in a family style, and residents are encouraged to be independent wherever possible. Staff advised that residents usually have their main meal of the day in the evening as that fits better with residents’ various activities. St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know who to speak to if they are unhappy or dissatisfied, but no complaints have been received for the last year. All staff have received training in safeguarding adults, but the home’s policy and procedure regarding abuse needs to be reviewed, to ensure staff know what action to take if abuse is ever suspected or alleged. EVIDENCE: Information supplied in the AQAA stated that no complaints had been received in the last year and this was confirmed by the home’s complaints record. No information has been provided to CSCI about any complaint made to the home. It was positive to note that three letters or cards of compliment had been received by the home, and all made appreciative comments about the care and support provided. The home’s complaints policy and procedure is displayed in the entrance hall and includes photographs of the manager and Prospect deputy director, who should be contacted in the event of a complaint or dissatisfaction. This has also been supplied to residents and was displayed in their bedrooms. It was clear that the majority of residents would be able to tell of any concern or unhappiness. Staff also advised that they are aware of residents’ moods and behaviours, and would recognise changes in these which may indicate that St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 16 a resident unhappy or dissatisfied and would look for the reasons for this. Most residents knew who their key-worker was and said they would tell their key-worker or the manager, if they were unhappy or wanted to make a complaint. From the staff training records, it was clear that all staff have received training in safeguarding adults (formerly Protection Of Vulnerable Adults). This is to ensure that they are aware of the types of abuse that may occur, the actions to be taken to prevent it, or the actions to be taken in the event of a suspicion or allegation of abuse. The manager stated that in the event of a suspicion or allegation of abuse, the home would follow the Surrey Multi-Agency Procedure for Safeguarding Adults. An up to date copy of the procedure is kept in the home for staff to refer to if needed. The homes own procedure regarding abuse was reviewed, and it was noted that this did not make a clear reference to the Surrey Multi-Agency procedure. It is recommended that this is reviewed and revised to include a clear reference to the Surrey procedure, to ensure that staff are fully aware of it and work in accordance with it, if required. St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is attractively decorated and furnished to meet the needs of residents, and all the areas seen were very clean and freshly aired. Paper towels must be provided and used to maintain hygiene. EVIDENCE: From the information provided in the AQAA and viewing the home, it was clear that improvements are regularly made. During the last year, a new garden shed, new conservatory blinds and a new specialist bath have been provided. Any maintenance issues are reported immediately, and any risks or potential risks are identified, to ensure that a safe and homely environment can be maintained for residents. The AQAA also stated that residents are encouraged and supported to personalise their rooms. St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 18 Three residents were proud and happy to show their bedrooms. It was positive to note that these had been very individually decorated and made personal with photos, certificates, soft toys, televisions and music facilities. Residents were pleased to show photographs of themselves on outings, on holiday and with their family members. The communal lounge is large and well decorated in a homely style. It has been furnished to a high standard to meet residents’ needs and opens through an archway to the spacious conservatory. A lift or stairs enable residents to access both floors of the home. Each resident has a wash-hand basin in their room, but some rooms also have en-suite toilet and shower facilities. Two en-suite shower rooms have been refurbished the manager advised, and two more are still to be completed. Information in the AQAA also indicated that the kitchen is to be refurbished. A tour of the communal areas of the home was carried out and residents’ rooms were seen with their agreement. It was positive to note the high standard of cleanliness in all areas and that the home was so freshly aired. As mentioned earlier a specialist bath has been obtained to enable residents to have a bath in their bed if required. An easy access bath is also provided in the ground floor bathroom. Although all areas of the home appeared clean and hygienic, it was noted that no towel was provided in the ground floor toilet. The manager stated that fabric towels are used in most places in the home except the kitchen, as residents prefer these. These are washed each day, but had not been replaced that morning. There has also been a problem of blockages, as paper towels have been disposed of in toilets rather than bins, the manager stated. A laundry room is available on the ground floor, away from food preparation and serving areas, and was equipped with washing and drying machines with the required settings. A requirement has been made regarding Standard 26, that paper towels must be provided and used in the home to maintain hygiene and prevent infection or the spread of infection. St George`s (Banstead) DS0000013800.V356599.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are effectively supported by a small team of staff who have been appropriately recruited and are well trained. EVIDENCE: From speaking to staff and reviewing the rota, it was clear that a small team of care staff have been employed to meet the needs of residents. Care staff advised that they carry out all roles in the home, supporting residents with personal care and undertaking shopping, cooking, laundry and housekeeping tasks. Staff also support residents with their social and leisure activities and transport residents to these. The manager advised that a number of the staff have worked at the home for many years, providing stability and continuity of support for residents. The recruitment files of two members of staff who have joined the home in the last year were sampled. It was positive to note that the appropriate checks had been carried out before the staff were employed, including a Criminal Records Bureau (CRB) disclosure and two written references. All the required information and documents had been obtained and held on file. Information supplied in the AQAA stated that six members of staff have achieved a National Vocational Qualification (NVQ) to level 2 or above and St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 20 another three members of staff are working towards this, so the home exceeds the recommended ratio of 50 of staff qualified to this level. The AQAA also indicated that two staff in the home are NVQ assessors and are able to provide support to staff who are undertaking NVQ’s. Staff training records were seen and these included induction training records for the staff who had recently joined the team. The records showed that staff have received training required by law (mandatory training), such as first aid, fire safety and food hygiene, and other training to develop their knowledge and skills, such as infection control and equality and diversity. St George`s (Banstead) DS0000013800.V356599.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Most of the outcomes for residents indicate that the home is being effectively managed and is being run in the best interests of the residents, although the management of residents’ monies must be more robust, to ensure residents are safeguarded from abuse or exploitation. As the home has not had a registered manager for over a year, the manager needs to submit her application for registration by CSCI without delay. EVIDENCE: The manager stated that she has been employed at the home for a year, and has started the process for registration, but has not yet applied to be registered by CSCI as the registered manager. The manager is waiting for her CRB disclosure to be completed and will then submit her application for St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 22 registration, she advised. The manager has many years experience in care and was previously a registered manager at another Prospect service. A very experienced deputy manager, who has worked at the home for some years, provides management support. The majority of outcomes for residents have been assessed at this inspection as good and excellent, but the outcome for management and administration has been assessed as adequate. This is due to the lack of a registered manager for more than a year and the shortfalls in regard to the management of residents’ monies. No formal system of quality assurance has been carried out this year, the manager stated, although staff listen to what residents say at residents’ meetings, care reviews, through key-worker meetings and by listening to each individual on a day-to-day basis. Information supplied in the AQAA indicated that the home receives good feedback from visitors to the home and had a good audit report earlier this year. The audit was carried out by Prospect and the summary stated the “home meets core objectives” and the auditor was “made very welcome in the home by the manager and staff”. The auditor went on to state that the home has a “calm and relaxed atmosphere which was reflected in the countenance of the ladies in residence, who were all willing and eager to talk to me during my visits”. The audit report concluded “No recorded complaints and a contented service user group reflect the commitment the staff team shows towards providing a safe, secure and homely environment for those in their care”. The manager stated that it is planned to issue quality surveys to residents and those involved in their support early in the new year. Staff advised that small amounts of monies are securely held for safekeeping, on behalf residents, although some residents are more able than others to manage their own financial affairs. The manager stated that two staff sign to show their involvement in all transactions of residents’ monies, and receipts are kept for all expenses, in order to safeguard residents. It was stated that a Prospect procedure is in place to safeguard residents from potential financial abuse. This requires authorisation from an assistant director for withdrawals of residents’ monies that are over a specified amount. This procedure had not been followed on at least three occasions however. It was noted that withdrawals had been made of three different residents’ monies, which exceeded the authorised amount. For one of these, the amount recorded as withdrawn on the cheque stub, exceeded that which was recorded as withdrawn on the resident monies record sheet. For another resident, a withdrawal was made which again exceeded the authorised amount, but no record of this had been made on the resident monies record sheet. A petty cash voucher had been signed and dated by two St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 23 members of staff to show that they had received this money. The manager stated that this was to support the resident when buying clothes and gifts for Christmas. Staff stated that this would be entered on the record sheet when the purchases were made, and would be accounted for when the receipts were presented, but this practice does not ensure that an accurate record of resident monies is maintained. As no assessments of residents’ vulnerability to financial abuse or exploitation have been carried out, it is recommended that the risks associated with this are assessed, recorded and minimised wherever possible. It was clear from this random sampling of residents’ monies, that the procedures for managing and recording residents’ monies that are held for safekeeping must be more robust, and the amounts of monies held must accurately match the record held. Information supplied in the AQAA indicated that equipment and systems in the home are serviced and maintained as required, to protect and promote the health and safety of all who live and work there. These include checks on the electrical circuits and appliances, gas appliances and heating system, lift and fire safety equipment. An engineer was visiting the home on the day of inspection, to maintain fire safety and call equipment in the home. The home’s insurance policy and Health and Safety At Work poster were both displayed as required. It was noted from information supplied in the AQAA, that a number of the home’s policies and procedures have not been updated since 2004 and other policies and procedures were not dated. It is recommended that these are kept up to date, to ensure that staff are fully aware of current practice and are working in accordance with current legislation. The manager advised that a quality assurance manager has been employed by Prospect and one of their roles will be reviewing and revising the organisations policies and procedures. A requirement has been made regarding Standard 35, that an accurate record must be maintained of all monies deposited by a resident, or received on the resident’s behalf, and the amounts of monies held must accurately match the record held. St George`s (Banstead) DS0000013800.V356599.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 3 17 X 18 2 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 1 X 2 3 St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? 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 OP7 Regulation 15(2)(b) Requirement The resident’s plans of care must be kept under review. Timescale of 29/06/06 not complied with. Arrangements must be made to maintain hygiene and prevent infection or the spread of infection. Specifically, paper towels should be provided and used in the home. Timescale for action 11/01/08 2 OP26 13 (3) 11/01/08 3 OP35 17 (2) An accurate record must be 11/01/08 maintained of all monies deposited by a resident, or received on the resident’s behalf. The monies held must accurately match the record held. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000013800.V356599.R01.S.doc Version 5.2 Page 26 St George`s (Banstead) 1 Standard OP18 The home’s policy and procedure regarding abuse should be reviewed and revised, to clearly refer to the local authority safeguarding adults procedure, to ensure staff are fully aware of this. The manager should submit her application for registration by CSCI without delay. Assessments should be carried out of the risks to residents, of financial abuse and exploitation. Staff in the home should follow the Prospect organisation’s policies and procedures when handling residents’ monies. It is recommended that the home’s policies and procedures are kept up to date, to ensure that staff are fully aware of current practice and are working in accordance with current legislation. 2 3 4 5 OP31 OP35 OP35 OP37 St George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Office The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 George`s (Banstead) DS0000013800.V356599.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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