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Inspection on 19/04/06 for St Judes Residential Home For The Elderly

Also see our care home review for St Judes Residential Home For The Elderly for more information

This inspection was carried out on 19th April 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is a family run business with a very low turn over of staff resulting in continuity of care for the service users. Staff morale is high, resulting in an enthusiastic workforce that works positively with service users to improve their whole lives. A Social worker said that the staff in the home treat all service users as individuals and they work hard at improving their lives. The staff demonstrated a good understanding of the needs of the service users and this was evident from the positive relationships, which have formed and were seen between the staff and service users. A varied activities programme is available for service users should they wish to participate, otherwise they are free make their own arrangements. The home maintains strong links with the local community and many activities involve the service users from the home and residents from the village.

What has improved since the last inspection?

At previous inspections the home had not been undertaking pre admission assessments on prospective service users. Since the last inspection the home has reviewed their pre admission format in line with the National Minimum Standards for Older People. This will enable them to obtain information about prospective service users needs and then assist them in making a decision about whether the home can meet the needs of the prospective service user. Since the last inspection the home has changed a number of floorings both in service users rooms and the lounge and is looking to devise a redecoration programme and carpeting programme to improve the environment for service users. The home has reviewed their medication systems to help ensure service users are able to maintain their independence as well as keeping the medications safe.

What the care home could do better:

At the last inspection the standard of the cleanliness in the home was poor in places. Following a tour of the home at this inspection this continues to be the case, however no service users complained about the cleanliness. Two comments received from service users said they felt the home was untidy. The Registered Provider said that he would look at ways of addressing this immediately. The home has made improvements with their quality assurance systems to ensure the home is run in the best interests of the service users, however the Registered Provider was not recording on the monitoring systems he uses. Consideration should be given to do this. As the home is a family run business the Registered Provider was having difficulty in meeting the requirement of supervising staff, however ways of meeting this was discussed with the Registered Provider.

CARE HOMES FOR OLDER PEOPLE St Judes Residential Home For The Elderly Front Street Nympsfield Nr Stonehouse Glos GL10 3TY Lead Inspector Sharon Hayward-Wright Unannounced Inspection 10:00 19 & 25th April 2006 th 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 Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 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 Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Judes Residential Home For The Elderly Address Front Street Nympsfield Nr Stonehouse Glos GL10 3TY 01453 860682 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) Mr Paul Anthony Morgan Mrs Winifred Morgan Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate 1 named service user for category LD(E). Condition to be removed when service user leaves the home. 7th December 2005 Date of last inspection Brief Description of the Service: St. Judes is a small, family run care home providing personal care for older people. The accommodation is on two floors. The home does not have a lift so people living on the upper floor must be mobile. All but one room is single occupancy and the majority have en-suite facilities. There are bathrooms on each floor with the ground floor bathroom offering an electric bath hoist to assist with bathing. The communal areas consist of a lounge and dining room. The outside area is accessible, however, service users who have limited mobility will require assistance from the staff in the home to access the steps to the terrace. The fees range for this home is about £400 per week. St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector carried out this inspection on two days in April 2006. The Registered Manager and Registered Provider were available during the inspection as were other members of the home team. A total of 25 standards were inspected which included the following areas: • The homes process of pre admission assessment and ongoing assessment processes • Care planning, general care documentation and involvement of outside health professionals • How the staff maintain residents privacy and dignity • Residents ability to make choices • Family and friends visiting • Food and dining environment and related records • Complaint processes and related records • How the home protect the residents against harm and abuse • The cleanliness of the home and general infection control practice • Staffing and related records • Staff training and development and related records • The management style and structure • Quality Assurance • Residents personal monies • Staff supervision and related records • General health and safety practice and related records Several residents were spoken with to ascertain their views on the care and services provided. Five service users surveys were returned to the inspector following the inspection. Two Social Workers were contacted to gauge their views on the home. The comments received from service users all indicated they are very happy living at the home and the comments received from the Social Workers were all positive. The Registered Manager and Registered Provider and care staff were spoken with throughout the inspection and were helpful and co-operative. Feed back on the inspection findings were given on completion and were received in a constructive and positive way by the Registered Provider who was going to address the issues mentioned in what they can do better immediately. One requirement had not been complied with since the last inspection. On this occasion the timescale has been extended as indicated in the requirements made. Unmet requirements impact upon the welfare and safety of service users. Failure to comply by the revised timescale may lead the Commission St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 6 for Social Care Inspection considering enforcement action to secure compliance. What the service does well: What has improved since the last inspection? At previous inspections the home had not been undertaking pre admission assessments on prospective service users. Since the last inspection the home has reviewed their pre admission format in line with the National Minimum Standards for Older People. This will enable them to obtain information about prospective service users needs and then assist them in making a decision about whether the home can meet the needs of the prospective service user. Since the last inspection the home has changed a number of floorings both in service users rooms and the lounge and is looking to devise a redecoration programme and carpeting programme to improve the environment for service users. The home has reviewed their medication systems to help ensure service users are able to maintain their independence as well as keeping the medications safe. St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 7 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. St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 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 Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home’s Statement of Purpose and Service User’s Guide provide service users and prospective service users with details of the services the home provides. However minor additions are needed to both guides to ensure all services provided by the home are documented. Since the last inspection the home has reviewed their pre admission assessment format to enable them to obtain information about service users’ needs and to provide assurance that their needs will be met. EVIDENCE: Since the last inspection the home had added a condition to their registration and must now add to their Statement of Purpose how they can meet this condition and how service users’ needs would be met. The home also needs to add their admission procedure for admitting service users as an emergency. St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 10 A copy of the home’s Service Users Guide is located in the main entrance. At the last inspection the home had admitted a service user without completing a full assessment of their needs. Since then the home has revised the format they will use in line with Standard 3.3 of the National Minimum Standards for Older People. The home has not had any new admissions since this service user, however the Registered Provider has completed this new form on this service user. Service users, staff and Social Workers confirmed that service users visit the home prior to moving in and a member of staff visits the service user to complete an assessment unless the service user is admitted as an emergency. The home does not provide intermediate care. St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The care planning system provides staff with the majority of the information they need to satisfactorily meet service users’ health and personal needs; fuller recording in some cases would further improve this. Staff demonstrated a good understanding of service users’ needs but this information was not documented in service users’ care plans. The systems for medication are adequate with arrangements in place to ensure service users medication needs are met. Personal support in this home is offered in such a way as to promote the service users’ privacy and dignity. EVIDENCE: Two-service users’ care was examined in detail. One of the service users was admitted to the home as an emergency admission just before the last inspection and the other service user had been living at the home for two years. St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 12 Both have an assessment of need and from this their care is planned. The first service user had all the correct information in place to assist staff in meeting their needs. The other service user requires further information in one of their care plans in respect of their continence needs. This care plan would be improved with the addition of the number and type of continence aids prescribed and if a toileting plan is in place. This service user is also a diabetic and the Registered Manager said she undertakes random blood glucose monitoring if she notices a change in the service user’s condition. This should also have a written plan. Since the last inspection the home has included a record sheet for health professional visits. From discussions with the staff they demonstrated good knowledge of the all service users’ needs but this information was not always documented in service users care plans. Service users records and service users confirmed they have access to health professionals. This includes Community Psychiatric Nurses (CPN), Chiropodists and Community Nurses when needed. One service user has care plans from the CPN to assist the home in meeting their needs. Records were seen for medication received, administered and returned to the local pharmacy. The home uses computer generated MAR sheets devised by them. The home needs to ensure the spelling of medication is correct as one spelling mistake was noticed. Staff who administer medication have undertaken training in the safe handling of medication. All medication is stored in a locked cupboard. Records were seen of medication that is stored as controlled medication. One service user requested to have their own cough mixture in their room at the last inspection and they find it difficult for this to be stored in a locked draw due to there failing eyesight. The home has completed a risk assessment for this, as they do not wish to take away their independence. The procedure for administration of medication was discussed and the home is aware they must ensure the safety of medication at all times. It is recommended that the home obtain an up to date drug reference book. One service user had a medication review recently. Staff were observed as being very attentive to service users during the inspection. Service users, without exception, said that the staff were kind and caring. Some said that they were happy with the care they receive, and the way in which it was given. Another person said that staff were very kind and respectful. On the tour of the home it was noticed in one service user’s room their incontinence pads were visible to anyone that entered the room. However from discussions with the Registered Provider this service user has requested to have them positioned there due to their poor eyesight. The home has one shared room and screening is provided. St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the home. Links with the community are good and support and enrich service users’ lives and social opportunities. A varied activities programme is offered by the home allowing service users the choice to participate or undertake their own activities. The dietary needs of service users are catered for with a selection of food available that meets service users’ tastes and choices. Further improvement would be to offer service users the opportunity of a more healthy diet. EVIDENCE: The home have a list of outings planned for the year as part of the ‘Golden Age’ club that includes the residents from the village. Two keep fit classes take place monthly one is ‘Chi Gong’ and the other is a ‘balance’ class. Nearly all the service users join in these classes and residents from the village can also take part. Several service users said how much they enjoyed these and staff can also participate. A diary is also maintained of the activities provided by the home. One of the service users was going out with a member of staff at the end of the inspection. The home has recently obtained an allotment and is planning to plant vegetables. One service user is planning to work with the St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 14 staff on this as they used to do all the gardening when they were living at their own home. Staff and service users confirmed that visiting is not restricted and visitors to the home had brought in young children that the service users were enjoying. The home is actively involved in the community life and the home is well known to local residents. Some service users were living in the village prior to moving in to St Judes. Service users confirmed they are able to choose how they spend their time each day and information about advocacy services is displayed on the notice board in the dining room. Two service users need to have liquidised meals and the home had liquidised all the main meal together, which made the meal look unappetising. However both service users said they enjoyed their meal. It is recommended that for presentation the home liquidise the meat and vegetables etc separately unless the service users say they are happy to have it liquidised together. One of these service users is happy to have their food liquidised together and this should be written in their care plan. They also require additional calories due to their medical condition and the home ensures they receive the appropriate supplements and drinks throughout the day. The Registered Provider said the home does not have a set menu but they plan the meals a few days in advance. This is usually dependent on the vegetables that are in season. The home ensures the Sunday roasts are rotated for variety. The home has one set dish for lunch but service users can request alternatives as one service user had salad instead of the cooked dish. This service user said the home would always make them a salad if they request it. Two service users are diabetic but they are able to eat the same meals as the other service users and if they are not the home will provide an alternative. Records were seen of food provided. The inspector discussed with the Registered Provider about how to offer service users the choice of a more nutritious diet. For example by offering brown bread and leaving a fruit bowl out for service users to help themselves. It is recommended that the home read the Commission for Social Care Inspection report on ‘Highlight of the day’ improving meals for older people in care homes for advice. Lunchtime was observed on one day and found to be a very sociable event and one service user assists the staff by laying the table. Service users said they enjoyed the food provided by the home, however one comment in the service users survey said there was not enough food at the evening meal and they have to buy their own. Fridge, freezer and food temperatures were seen. The Registered Provider said he and another member of staff are booked on a course in June to learn about the changes to the legislation. St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. The home has a complaints system in place but to date this has not been tested. The staff have an understanding of Adult Protection issues to assist in providing service users with a safe environment. EVIDENCE: The home has not received any complaints since the last inspection. The home has a complaint policy but it is not visible in the home, it is recommended the home display a copy of their complaint policy in the main entrance. Service users spoken with and service users survey said that if they were unhappy they would talk to the staff. It is recommended the home make an addition to their complaint procedure to add that if a service user is funded by Social Services they can contact them if they have a complaint. Social Services telephone number and address should also be added. The home has adult protection policy and a copy of the ‘Alterers Guide’ (this is displayed in one of the communal rooms). As this is a family run business the Registered Manager and Registered Provider are always closely involved and contactable if staff had any concerns. The Registered Provider said training is planned for staff in abuse. A Social Worker said the home had contacted them St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 16 when an issue arose with a service user and they worked with the family at resolving it. St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Since the last inspection the home has changed a number of floorings and is looking to devise a redecoration programme and carpeting programme to improve the environment for service users. Service users are able to personalise their rooms with their own belonging, the extent of which is decided prior to admission. The standard of cleanliness of the home is poor in places and could pose a risk to service users. EVIDENCE: A tour of the premises took place with all service users rooms seen. The home has changed the carpet in the lounge and in one service user’s room and changed the flooring in another service user’s room to non-slip. The St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 18 Registered Manager said they have plans in place to renew other carpets in the home and is looking at redecoration programme. Service users’ rooms contained their personal possessions and one service user said he was able to choose his personal possessions to bring in from his home. At the last inspection a requirement was issued for the home to improve their cleanliness. At this inspection areas of the home were found to be unclean with cobwebs around lights, in corners of rooms and around window frames. This was shown to the Registered Provider; as was the downstairs bathroom where cobwebs were seen around the drainage pipes, the toilet bowel was stained and the window frame has a visible build up of dirt. The build up of dirt was seen on the fire door next to this bathroom and along skirting boards. The Registered Provider said he would speak with the staff following the inspection and look at ways of addressing this immediately. Service users spoken with said they were happy with the cleanliness of the home, however two service users said they think the home is untidy. This was fed back to the Registered Provider who was also going to look at this. Staff were seen wearing protective clothing in the kitchen and when serving food. St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of lives. The home has invested in a training programme to ensure the staff are meeting the needs of the service users. To ensure this continues the home needs to provide training and updates for staff on a frequent basis. The management of the home is aware of the recruitment checks needed if a new member of staff is appointed to the home. EVIDENCE: The home is a family run business with a core group of staff that has not had many changes in the last few years. The staff are motivated and work well with service users. All service users praised the staff in the home and a Social Worker spoken with said the staff treat all service users as individuals and work hard to improve their lives. Another Social Worker said the staff are friendly and helpful. The Registered Provider has changed the duty rotas in the last week. The home has three care staff on an early shift and two at the weekend. Two staff on a late shift and one member of staff awake at night. When questioned the staff demonstrated good knowledge of service users’ needs. One service user St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 20 made a comment in their service users’ survey that it is difficult to make the staff hear them at night. The home will need to address this concern. One staff member is undertaking NVQ 3 and another staff has just started NVQ 2. A qualified nurse is also working at the home but not in the capacity of nurse. The home has not had any new members of staff start at the home since the introduction of the POVA list. The Registered Provider is aware of the requirements of the Care Homes Regulations in relation to the recruitment checks. The Registered Provider said staff are in the process of completing the rolling programme of training, this includes basic food and hygiene and moving and handling. Other training the staff have received includes safe handling of medication and fire. The Registered Provider said the next training for staff is on abuse. The home is aware of the importance of keeping staff up dated with training. As the home has not had any new staff the induction training was not inspected. St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. The management of this home is adequate overall, however the home needs to continue in developing further their quality assurance systems to ensure they continue to run the home in the best interests of the service users. The home has procedures in place to safeguard service users’ monies. The home needs to ensure staff are appropriately supervised. The home ensures so far as is reasonably practicable the health, safety and welfare of service users and staff. EVIDENCE: St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 22 The management of the home remains unchanged. The Registered Manager is considering retiring from this position and the Registered Provider is planning to become the Registered Manager as well. The Registered Provider has completed the NVQ 4 Registered Managers award and he is an NVQ Assessor. Both the Registered Manager and Registered Provider undertake the same training as the other staff. The home has a development plan in place for the environment to include new furniture and redecoration. Plans are in place for three service users to go on holiday and possibly for another service user. The home is to send out questionnaires to service users and it is recommended this includes relatives. The home has a suggestion book in the main entrance. Monitoring systems were discussed with the Registered Provider as some of these are taking place but records are not being maintained. The home does not store service users monies as each service user now has a Post Office account and the home take service users to the Post Office to draw out their money. The Registered Provider said they receive 3-monthly statements and can request one at any time. The Registered Provider has gone through the checking procedure to act as an agent for several service users. It is recommended that if the Registered Provider takes money out of these accounts records are maintained by the home. The Registered Provider said he is not up to date with staff supervision, however he did say that as the home is small they have frequent staff meetings. If it is appropriate the home can use some of these meetings as group supervision and maintain records of these. Records were seen of evidence of servicing of equipment and health and safety checks. It is recommended that the home undertake their fire risk assessment of the premises. St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 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 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 2 X 2 St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 4&6 Requirement The Registered Persons must add to their Statement of Purpose how they will meet the new condition of registration and their procedure for admitting service users as an emergency. The Registered Persons must ensure that service users’ have written care plans, that will demonstrate how service users needs in respect of their health and welfare are to be met. (This is with particular reference to, continence and dietary needs on this occasion). The Registered Persons must improve the cleanliness of the home as it potentially puts service users at risk. This requirement has been repeated from the last inspection. The Registered Persons must ensure that the staff are appropriately supervised. Records of these sessions must be maintained. Timescale for action 30/06/06 2. OP7 15(1) 30/05/06 3. OP26 23(2)(d.) 30/05/06 4. OP36 18(2) 30/06/06 St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 25 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 OP15 Good Practice Recommendations The home should obtain an up to date medication reference book. The home should liquidise for example the meat and vegetables separately to enhance presentation of the meal, unless it is the service users choice to have it liquidised together. This should be documented in their care plan. The home should offer service users the choice of a more nutritious diet for example by offering brown bread and leaving a bowl of fruit out for service users to help themselves. The home should read the report complied by the Commission for Social Care Inspection called ‘Highlight of the day’ improving meals for older people in care homes. The home should make an addition to their complaint procedure to add that if a service user is funded by Social Services they can contact them if they have a complaint. Social Services telephone number and address should also be added. The Registered Provider should maintain records of the monitoring systems he uses as part of their quality assurance systems. The home should send out quality assurance questionnaires to service users relatives. If the Registered Provider withdraws any money on behalf of service users from their Post Office account records should be maintained. The home should undertake a fire risk assessment of their premises. 3 OP15 4. 5 OP15 OP16 6 7 8 9 OP33 OP33 OP35 OP38 St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Judes Residential Home For The Elderly DS0000016586.V289768.R01.S.doc Version 5.1 Page 27 - 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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