CARE HOMES FOR OLDER PEOPLE
Stone Gables Street Lane Gildersome Leeds West Yorkshire LS27 7HR Lead Inspector
Sue Dunn Key Unannounced Inspection 20th March 2007 09:30 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 Stone Gables DS0000001510.V332339.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. Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Stone Gables Address Street Lane Gildersome Leeds West Yorkshire LS27 7HR 0113 2529452 0113 2529452 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) Castlegrounds Limited Mrs Karen Lesley Birse Care Home 40 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (40) of places Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 1st March 2006 Brief Description of the Service: Stone Gables is a stone built converted and extended property, situated on the outskirts of the village of Gildersome it has a pleasant outlook. It is convenient for the bus service, which gives access to the surrounding area and Leeds city centre. Stone Gables provides residential care to 40 adults, accommodation is provided on 2 floors in 36 single bedrooms and 1 double bedroom. There are well-maintained safe gardens to the rear of the home. There are sufficient bathing facilities around the home. Toilets are located near to service users accommodation and communal areas; separate toilet facilities are provided for staff. The ground floor has large lounge areas with a separate smaller area for service users who wish to smoke. Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcomes for service users. The inspection report is divided into separate sections with judgements made for each outcome group. The judgements reflect how well the service delivers outcomes to the people using the service. The categories are “excellent”, “good”, “adequate” and “poor”. More detailed information about these changes is available on our website – www.csci.org.uk. The last key inspection was carried out in 29th November 2005. The manager completed a pre-inspection questionnaire and this information with information supplied by the home during the course of the year was used as part of the inspection process. Questionnaire leaflets were sent to the home to be given to relatives and service users. None had been returned at the time of writing. One inspector carried out the inspection visit which started at 9:30 am and finished at 17:00 pm. During the visit there was a tour of the building, documentation was examined, service users, a visitor, the staff and manager were spoken with and routines and practices were observed. The care files of three service users were closely examined and information cross- referenced from the above sources. The current fees for care were between £395.50 and £427 per week. Personal toiletries and clothing, chiropody, hairdressing were not included in the fees. What the service does well:
The home encourages introductory visits and makes sure people are made welcome and have the information required to make a decision. Important factual information can be found as soon as care files are opened therefore is readily available in an emergency. The care files had a clear format for assessing risk. Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 6 An outside organisation visits the home three times a week to organise a range of activities. This gives staff ideas, which they should be able to put into practice at other times. Entertainers and outings take place from time to time. Service users can retain a sense of usefulness by assisting with simple domestic activities such as laying the tables. The home cooked food was of a good standard and included alternatives to the main menu. Menus had been developed in picture form to help people make choices about the food they wished to eat. The manager ensured service users personal allowances were available to them and transactions were well recorded. Attention had been given to making the home easier for people to find their way about independently. Bedrooms doors had on them a photograph of the occupant and a picture, which had some significance to past work or interests. Several people held their own door key. Toilets and bathrooms were easy to identify. There were doors to the secure garden from the communal area so that service users could have unrestricted outdoor access and still be safe. The home has a thorough induction-training programme for new staff. A programme of essential training is backed up by additional training in other areas identified as required to meet service users needs. The percentage of care staff with the NVQ (National Vocational Qualification) award exceeds the minimum of 50 . What has improved since the last inspection?
Care files have been developed in a way which made for consistency of layout and ease when looking for information and guidance on each person’s care. A fire door had been fitted on the upstairs corridor to meet fire regulations. Floor coverings had been replaced in communal areas and some bedrooms. Several areas had been redecorated, bathrooms had been made more ‘domestic’ looking, and the dining room furniture had been replaced. The chairs were of style which was easier for service users to move. The manager delegated responsibility for key areas of care to senior staff which had encouraged people to develop and put forward ideas for the good of the home. Observation of staff showed them to be putting the principles of good care into practice. Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 7 The manager had put together information as guidance against the standards to be used for the development of the home. Staff had done some dementia training and some work had been done to make the environment easier for people with dementia whose numbers had increased. The agreed that further work needs to be done on training, observation and person centred care planning before the home is ready to provide a specialist service for people with dementia. What they could do better:
The pre admission assessments should include enough information to form a basic care plan at the point of admission. The care file index could make it easier to find information if it referred to numbered sections in the file. This would also ensure information is returned to the right section in the file. Some documentation was undated which could cause confusion as more information is added to files. Care plans were easy to find in the files but information was starting to overlap as they were reviewed. It is recommended that the layout be reviewed to allow more space for the guidance on care. Care plans could be more detailed to reflect the diversity of each service user and give staff clear guidance on how to meet their care needs. There were good systems in place for safe handling and administration of controlled medication but in one instance this had not been followed. It is recommended that staff record peoples’ reaction and participation in activities in the daily records to enable activities to be directed towards particular interests. Care plans should show any particular interests, for example in sport, TV programmes, reading or domestic activities. It is recommended that tables be laid closer to the time when the meal is due to be served and the use of unnecessary objects on the tables, such as decorated mats, which can be a distraction from the food for people with dementia, be avoided. Staff should avoid placing food on the table before they are available to help to avoid food getting cold whilst service users wait for attention. Food should be served on big enough plates to make it easy for people to eat without fear their food will spill. Used continence pads must be properly disposed of to reduce the risk of cross infection, unpleasant odours and a loss of dignity for service users.
Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 8 Consideration should be given to upgrading the laundry area to provide more workable space, which is easy to keep clean. In the interests of equal opportunities notes from staff interviews must be detailed enough to show how interviewers reach the decision that a candidate is suitable for the job. For the protection of service users and staff moving and handling training must be given as soon as possible after employment starts. A report of quality assurance reviews carried out by the home must be made available to the CSCI and service users. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 9 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 Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 10 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): 1,2,3,4,5 (6N/A) Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home provides Prospective service users and their relatives with the information and visiting opportunities to decide if the home will meet their needs. Their needs are assessed and each receives a contract and a copy of the homes terms and conditions to tell them about the service they can expect EVIDENCE: A service user guide, statement of purpose and welcome pack were prominently displayed in a rack in the entrance hall for the benefit of visitors. The manager said additional copies of these could be printed if people wish to take them away. Two service users and a relative said they had visited the home to help them make a choice about its suitability and had been pleased with their decision to move into the home.
Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 11 A contract stating the fees was seen. This was supported by a more detailed document stating the terms and conditions of occupancy. The number of the room to be occupied should be included in the documentation to give people the security of knowing their room cannot be changed without agreement. Pre admission assessments were examined for three people admitted to the home in the last 6 months. The ‘Easy’ care assessment for one, by a care professional outside the home, was of a good standard showing the level of support the person had whilst living in the community and that the service users views about care had been noted. The home had also received nursing assessments to show what physical and psychiatric support had been given. The home had carried out their own assessment, which showed this had been done whilst the person was in hospital. As the assessment by the home is intended to establish if they can meet overall needs, the assessments could have included more of the detail which forms a basic care plan on the point of admission. Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 12 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): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care received by service users is based on individual needs and incorporates the principles of respect privacy and dignity. Care files provided a good sound basis on which to record information to give guidance on care. This could be improved further by including more detail. Service users were protected by the medication systems and with one exception medication recording was thorough. EVIDENCE: Responsibility for care files had been given to one of the principle care workers who described how she was improving the way information was
Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 13 recorded. She had clearly done a lot of work to ensure care files were orderly and consistent in layout. This made it easy to find where information was recorded. A front index had been started which would have been more useful if the file sections were numbered, as some information had not been returned to the right section in the file. Important factual information was found in the front of each file with details of each person’s current medication. Sections in the files included nutritional needs and preferences, areas of risk for holding keys, risk of falls, fire risk, self medication, bathing, use of hoist and wheelchairs. The dates had been overlooked on some of the documentation, which could create difficulty as more information is added to the files. The care plan format was simple and easy to follow but too much information on each page could lead to guidance on one area of care becoming mixed up with another. Moving the monthly evaluations onto the back of the forms would leave more space to record the action to be taken. The inspection was used to discuss ways in which the care plans could be more detailed to reflect the diverse preferences of each service user and give staff guidance on how to meet their care needs. One example was that of a smoker who felt there were ‘too many rules’ to stop him smoking. The manager said there was a smoking area in the home and nothing to restrict his smoking, but there was nothing written in the care plan to show how important this was to him and to support what was said. One person had a separate file for recording behaviour but there was nothing in the care plan to show this was being done. Daily notes did not give a clear picture of the action staff were taking to deal with confrontational situations to show what worked and what didn’t. A couple of detailed care plans from the community mental health teams provided good examples of the level of detail to be recorded. The manager had arranged for a mental health professional to give weekly training for the staff. This is good practice. Accidents were well recorded and included a system for monthly auditing of any trends. An example was given of the action taken when one such pattern had been identified. It is recommended that incident records be completed if staff or other residents have been subjected to extreme behaviour. Staff had received medication training and responsibility for the medication system had been given to a principle care worker. The member of staff observed giving the lunchtime medication was familiar with the medicines she was giving and was doing a refresher medication training course at one of the local colleges. The medication times were highlighted in different colours on the recording sheets to make it easy to see what medication was to be taken when.
Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 14 Sound systems were in place for the receipt and return of medication to the pharmacy with a clear auditing trail. Controlled medicines were securely held and given and signed for by two staff. However, when the controlled medication book was checked there was an error indicating medication had been given but not signed and witnessed as having been given. The manager said she would investigate and inform the CSCI of her findings and the action taken. Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 15 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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offered a varied range of social and recreational activities. The food was well cooked and nutritious with efforts made to assist people to make choices about their meals. EVIDENCE: A whiteboard in the dining area showed the date, menu and events for the day. This proved to be background music, which some people were singing along to. Flowers and cards from mothers’ day were in evidence as were photographs of previous group outings. The manager said an activities company visited the home on three half days a week to offer, crafts games and quizzes. A relative confirmed that he had changed his day to visit to avoid interrupting an activity on Mondays much enjoyed by his mother. Two other people spoke of prizes won at bingo and another had a crossword book ‘to keep my mind active’. Some people said they had their own TV’s which they could watch in their bedrooms.
Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 16 It is recommended that staff record peoples’ reaction and participation in activities in the daily records to enable activities to be directed towards particular interests. Care plans should show any particular interests in sport, TV programmes, reading or domestic activities. It was good to be told by two people that they helped to lay the tables. A payphone in the entrance hall allowed people to keep in touch with their relatives and friends. Tables were neatly laid with cloths, napkins and cruets with packets of vinegar or sauce available. However, the practice of laying tables during the middle of the morning gives people with dementia a signal that food is about to be served. (One person was observed moving objects about on a table and trying to prise apart a coloured tablemat with the cutlery). It is recommended that tables be laid just before the meal is due to be served and the use of unnecessary objects such as decorated mats on the table, which distract from the food, be avoided. Picture menus were being used to help people make choices about the food. The lunchtime meal was sampled. Some people at the table had chosen, soup and cold sliced meat as alternatives to the main menu. In two cases food supplement drinks were given. The ingredients and the quality of cooking were of a good standard. The food was tasty and hot when it reached the table. Staff were observed to assist those people who needed help eating in a discrete and unhurried way but should avoid placing food on the table before they are available to help so that food does not get cold whilst service users wait for attention. The manager said plate guards were available but the practice of using small side plates on which to serve food made it difficult to avoid food falling off the plate. Stone Gables DS0000001510.V332339.R01.S.doc 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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a well-publicised complaints procedure which gave people confidence that any complaints would be listened to and acted upon. Systems were in place and staff trained to recognise and act appropriately to protect service users from abuse. EVIDENCE: A copy of the complaints procedure was on display in the entrance hall. The manager keeps a log of all complaints and how they are handled. There had been no entries since the last inspector visited. The visitor and service users spoken with felt confident that if they had a complaint it would be listened to. One person said ‘I am very happy here’. The adult protection procedure was reviewed in 2006 and 2 staff had adult protection training in March 2006. In house training is given on adult protection which involves staff having to display their understanding through written answers to quiz questions. The manager said she recently had some concerns about the management of a service user’s finances which she quite rightly referred to the adult protection team.
Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 18 The manager holds personal allowances for most of the service users. The records of finances were well kept and the moneys held in separate packets tallied with the records and receipts. Stone Gables DS0000001510.V332339.R01.S.doc 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, 22, 23, 24, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was comfortable and well maintained. The environment offered safe space for people to move around freely and independently and gave them the opportunity for privacy. More attention must be given to avoiding practices which could increase risks of cross infection EVIDENCE: The home employs a maintenance man for general repairs and renewals with equipment upkeep and repair covered by maintenance contracts.
Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 20 Bedrails and special beds are provided by the district nursing service and fitted by specialist equipment fitters. The handyman carries out weekly checks of the bedrails to ensure their safety. A fire door had been fitted on the upstairs corridor as recommended on the fire officer’s last visit. Communal areas of the home were spacious, bright and filled with sunlight on the day of the visit. Service users were able to access the secure neatly tended garden from the lounge areas. Floor coverings had been replaced. One person spoken with said this made it easier to move around with a walking frame. Several areas had been redecorated making them bright and clean, two people said they had been consulted about colours before their bedrooms were redecorated. The manager said she had ordered new lounge chairs as those in use had clearly been around for a long time and one of the corridor carpets was to be replaced. Efforts had been made to make the bathrooms more domestic in style whilst ensuring bathing aids and protective clothing was to hand. It was noted in one bathroom that soiled continence pads had been piled on top of a waste bin, which was full. This could lead to the risk of cross infection, unpleasant odours and a loss of dignity for service users. The manager said she would speak to staff immediately. It was clear that many service users could and did have keys to their own bedrooms for security and privacy. Photographs and pictures relating to each person’s past interests or work were attached to bedroom doors to make it easier for people to recognise their own room. Service users spoke with confirmed they were free to use their rooms during the day. Those bedrooms seen contained personal items and pictures. A slight odour was detected in one enclosed corridor area but otherwise the home was clean and free from any unpleasant odours. Staff were to be commended for maintaining good standards in their care of personal clothing and linen. The laundry was suitably equipped but small and poorly laid out for the volume of washing. An old sluice was badly discoloured and tiling and some of the floor areas needed a thorough clean. Consideration should be given to upgrading the laundry area to provide more workable space which is easy to keep clean. Stone Gables DS0000001510.V332339.R01.S.doc 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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were enough staff in the home to meet the needs of service users in an unhurried way. The staff on duty were putting their training into practice and appeared confident and competent. EVIDENCE: The home has a total of 16 care staff, 11 of whom are shown on the PIQ to have the NVQ award. The files of two staff employed within the last 6 months were examined. Neither was working on the day of the visit. Application forms had been completed, two written references received and CRB checks returned before they commenced employment. A job description was produced but it was not clear if candidates had received this with their application form There was evidence that two people had been involved in the interview which the manager said usually lasts for about an hour. The manager said she had introduced an interview checklist. However, notes from the interviews in the files seen were not detailed enough to show how well past employment and experience had been checked and how the interviewers reached the decision that a candidate was suitable. In order to show evidence of equality of
Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 22 opportunity it is strongly recommended that interviews be based on an employee specification which states the essential and desirable attributes for the job. Interview notes must be detailed enough to show how well each person meets the criteria. New staff receive a thorough induction training which is recorded and signed when they are confident they have understood the information. New staff work with a senior care worker and are supernumery. Night care staff receive their induction on dayshifts and are expected to work occasional days once fully inducted. Neither care worker had received moving and handling training which was not due until August. The manager agreed to bring the training forward to ensure staff and service users were protected. An ongoing training programme covered all the training required for the work with additional training and advice sought from other professionals if required. The manager had a system of monitoring each persons training to ensure people received periodic updates. Some staff training is done at the home using training DVD’s and question papers which have to be completed before staff receive a certificate of competence. One person said she was doing a three month medication training at a local college, some staff, including ancillary staff, had been on a dementia training course at another college. Observation of staff showed them to be putting the principles of good care into practice. They spoke to service users in a pleasant and respectful manner and ‘can’t be faulted’, ‘they are wonderful’ according to two service users. The manager’s system of delegating responsibility for key areas of care to senior staff had encouraged people to develop and put forward ideas for the good of the home. Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 23 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): 31,32, 33, 35, 36, 37, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed with a commitment to the development of staff and in the best interests and safety of the service users. Records could be improved by including more detailed information EVIDENCE: The manager has the NVQ4 award in management and has had experience at management level in several homes. She was keeping up to date with developments in care and had just created a file to be used as guidance against the standards. Her management approach has helped staff to develop by taking responsibility for areas of care such as staffing, medication and care
Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 24 planning. This leads to staff taking a pride in what they do and using their imagination to find ways of improving systems. Daily handover meetings take place and periodic meetings with different groups of staff are recorded. The manager said she aims to carry out formal staff supervision six times a year but has an ‘open door’ policy if staff wish to discuss any matters in between. A standard pro forma which covers work related topics is used for supervision and care practices are observed. The housekeeper has done supervision with domestic staff. Quality survey questionnaires were periodically given to service users and their families. The result of the first one, which showed where action had been taken had simply had the date and ‘reviewed’ written on it. The manager was advised that she must produce a report of quality review findings and make this available to the CSCI and service users. The following records were examined and found to be in order:Weekly fire alarm checks Last fire drill done on 12/02/07 with names of staff recorded Water temperature checks Monthly health and safety checks of the whole building. Records of service users personal allowances Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 4 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 3 2 Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 26 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. Standard Regulation Requirement Timescale for action 01/04/07 1. OP9 13(2) 17(1)(a) 18 All medication records must be completed fully and systems followed. Staff must be trained to recognise practices which could lead to risks of cross infection. For the protection of service users and staff moving and handling training must be given as soon as possible after employment starts. 2 OP30 OP26 OP38 31/05/07 3 OP29 19 In the interests of equal opportunities notes from staff interviews must be detailed enough to show how interviewers reach the decision that a candidate is suitable for the job. A report of quality assurance reviews carried out by the home must be made available to the CSCI and service users. 30/04/07 4 OP33 24 30/04/07 Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP4 Good Practice Recommendations Pre admission assessments should include enough information to form a basic care plan at the point of admission The layout of the care plans should be reviewed to allow space for more detailed guidance on how care is to be given and the front index relate more clearly to the sections in the care file It is recommended that staff record peoples’ reaction and participation in activities in the daily records to enable activities to be directed towards particular interests. The following recommendations relate to mealtimes: tables should be laid closer to the time food is to be served. Tables should be simply laid to avoid distractions from the food served Food should not be put on the table until staff are available to assist Meals should be served on plates big enough to hold the food Consideration should be given to upgrading the laundry area to provide more workable space, which is easy to keep clean. 2 OP7 3 4 OP12 OP15 5 OP26 Stone Gables DS0000001510.V332339.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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
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