Inspection on 11/10/07 for Strathmore House

This inspection was carried out on 11th October 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Strathmore House 08/09/08

Strathmore House 18/04/07

Strathmore House 10/11/06

Strathmore House 19/04/06

Strathmore House 07/11/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Strathmore House Friday Bridge Road Elm Near Wisbech Cambridgeshire PE14 0AU Lead Inspector Janie Buchanan Unannounced Inspection 11th October 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Strathmore House DS0000066352.V352703.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. Strathmore House DS0000066352.V352703.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Strathmore House Address Friday Bridge Road Elm Near Wisbech Cambridgeshire PE14 0AU 01945 860569 01945 860202 strathmore.house@ashbourne.co.uk www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) vacant post Care Home 46 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (46), of places Terminally ill over 65 years of age (25) Strathmore House DS0000066352.V352703.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Maximum of 25 TI (E) beds Maximum of 20 DE (E) beds Maximum of 46 OP Date of last inspection 18th April 2007 Brief Description of the Service: Strathmore House is situated in secluded mature gardens set back from the road between the villages of Elm and Friday Bridge. It is a large 18th century house that has been extended beyond its original to provide the present facilities. Accommodation in the old house is on two floors with the first floor being accessed by a shaft lift There is a variety of sitting areas and a dining room. The extended area of the house is single story and within this area is a self-contained unit for older people with dementia. A detached bungalow next to the main house has accommodation for six people. Current weekly fees range from £340 for local authority funded residential care to £624 for service users receiving privately funded nursing care. Additional charges are made for newspapers, hairdressing and private chiropody. The inspection report is available on request from the manager. Strathmore House DS0000066352.V352703.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We, the Commission for Social Care Inspection, undertook this visit on the 11 October 2007, it was unannounced and was undertaken by two inspectors. We spoke with five residents, two visiting relatives, three members of staff and the acting manager. A tour of the home and kitchen was undertaken, medication records were checked and a range of documents was viewed. Prior to this visit we undertook a specialist observation of care practices on the dementia care unit. As part of this, we observed three residents for a period of two hours and recorded their experiences at regular intervals. This included their state of well being, how they interacted with staff and other residents, and their environment. The findings of this observation are included in this report. We received completed surveys from 12 residents, 5 relatives and 2 staff. This is a good response and much improved since the last key inspection of 18 April 2007 where CSCI received no returned questionnaires, despite these having been sent to the previous manager for distribution. The home has been subject to additional inspections and enforcement action since its last key inspection because of concerns about the poor quality of the service provided. Details of these reports are available by contacting the Cambridge and Peterborough office of the Commission for Social Care Inspection on 01223 771300. What the service does well: What has improved since the last inspection? There have been many improvements in the dementia care unit at the home. The environment now allows residents to communicate more easily with one another. Increased staffing levels in the afternoons allows staff to better meet residents needs and the introduction of doll and pet therapy is much enjoyed by some residents. Strathmore House DS0000066352.V352703.R01.S.doc Version 5.2 Page 6 The home’s menu has been reviewed and both residents and staff commented on the improved food now being served. Medication administration practices at the home have improved since the last key inspection in April 2007, and the random inspection in July 2007. However, there are areas where further improvements are needed to make sure that residents receive medication in a safe way. Residents’ complaints are now recorded thoroughly, as is the action taken to resolve them. What they could do better: There is much this home could do better: • The Statement of Purpose and Service Users Guide must fully reflect the service that is to be provided to those residents with dementia and detail how their dignity and privacy is to be managed. Residents and their families should be given comprehensive written information about the home before they move in, so that they can use it to decide if it is where they want to live. Residents must be fully involved in planning and reviewing their care, and the plans should be presented in a format that residents can access and understand. Medication practices need to be tighter to ensure residents receive their medication safely. Residents should be encouraged as much as possible to maintain their independent living skills and staff should refrain from helping them to do things that they can clearly manage themselves. The home’s complaints procedure should be in a format the residents can easily access and information in it needs to be updated so that residents know the right people to contact if they have concerns. Staff must receive quality training in caring for people with dementia, so that they fully understand and can respond to their needs Appropriate references must be sought for prospective employees so that residents are protected and only suitable people are employed to look after them. Overall maintenance and upkeep of the home needs to improve. Some residents did not have any hot running water for over a month and the home currently only has one working bath. One member of staff commented: ‘our organisation Southern Cross healthcare should put DS0000066352.V352703.R01.S.doc Version 5.2 Page 7 • • • • • • • • Strathmore House more input into the home e.g. more money to improve it and also money to get the equipment we need’ • More care should be taken with residents’ laundry to ensure that they wear their own clothes at all times and that items of their laundry do not go missing. Supervision for staff is still erratic with some staff not getting as many supervisions as recommended by the minimum standards. The management of health and safety within the home continues to be poor and puts residents at unnecessary risks The home is currently operating without a registered manager. A permanent and experienced manager must be appointed soon, to provide strong leadership and to start tackling the many shortfalls still evident in this home. • • • 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. Strathmore House DS0000066352.V352703.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 Strathmore House DS0000066352.V352703.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): 1, 2, 3, Quality in this outcome area is adequate. Residents’ needs are assessed before moving into the home, and they have information about the terms and conditions of their stay there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s Statement of Purpose and Service Users Guide is readily available within the home. However, both documents need to be amended to reflect that there has been a change of manager; the term ‘EMI’ (elderly mentally infirm) needs to be removed as this registration category is no longer used; and more detailed information is required in relation to the range of needs that the care home is intended to meet (dementia) and how privacy and dignity of residents is to be managed and upheld. The files of two recently admitted residents were viewed and all contained satisfactory pre-admission information about their needs. The files also contained contracts that gave details of the fees to be paid by residents, the accommodation and care to be provided, and the proprietor’s obligations. Strathmore House DS0000066352.V352703.R01.S.doc Version 5.2 Page 10 However, one relative told us that although a helpful member of staff showed him round the home, neither he nor his mother was given any written information about it. He stated that having this information might have allayed some of his mother’s concerns and questions before she moved into the home. The home does not provide intermediate care. Strathmore House DS0000066352.V352703.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. Residents’ health care needs are generally well met at the home and staff treat them respectfully. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of residents’ care plans was viewed. The information they contained was generally detailed and up to date, allowing care staff to offer support consistently. However, more information is required detailing how residents’ dementia specifically affects their every day life. The plans did not reflect residents being fully involved in the planning or reviewing of their care, and were not in a format that residents can easily access. There was evidence that residents’ health care needs were met at the home with their weights, dependency levels, nutrition, falls risk and pressure sore risk monitored monthly. Plans also contained evidence that they saw a range of health care professionals. However, one resident was seen by a speech therapist, who recommended that this resident be referred to a dietician should she lose more weight. This resident continued to lose weight for the next 4 months but was no referral was ever made. Strathmore House DS0000066352.V352703.R01.S.doc Version 5.2 Page 12 Residents who completed the survey reported that staff did listen and acted on what they said. During the observation on the dementia care unit, residents were supported at a level and pace appropriate to their needs, with individual residents not being rushed or made to feel uncomfortable. This was best demonstrated at morning tea and during the lunchtime meal. Care staff were observed to have a good, easy going, relationship with individual residents, providing warmth, understanding and acceptance. However, the home’s laundry management does not promote residents’ dignity. One relative wrote: ‘I dislike it intensely when I find my mother in other people’s clothes. Also mother does like to always have handkerchiefs, and I continually have to provide them as they seem to go missing’. The home uses a ‘Boots’ system for medication administration with blister packs covering a 28-day period. The MAR sheets are mostly printed by the pharmacy and included clear instructions for administration of the medication and its location, e.g. whether it is in the blister pack or another container. The times for medication administration are also printed by the pharmacy. MAR sheets are completed with very few gaps in the records, which would indicate that medication has been dispensed. Most entries for medication that had not been administered had an explanation in the form of a key code at the bottom of each MAR sheet. However, of the MAR sheets that were looked at for 8 people, there were errors in recording medication administered and medication not administered in 2 on 2 days. Medication was recorded as given, but was still in the blister pack on one day, and medication was not in the blister pack, but there was no record of administration or other reason in the MAR sheet on another day. Although the MAR sheets are printed there were some concerns about more than one prescription for medications. One person receiving twice daily insulin had two prescriptions for the same insulin, although both morning and evening doses were recorded on only one of the prescriptions. Another person had a printed prescription for a nebuliser, with a printed sticker for the same medication underneath. Neither of the second prescriptions for insulin or the nebuliser had any records of administration, but more than one prescription for the same medication, dosage and administration times can lead to incorrect medication administration and should be removed. Medications that are prescribed three or four times a day, such as painkillers or antibiotics, have administration times that do not always allow them to be given with food or to be evenly spaced throughout the 24 hour period. The manager said this is due to the pharmacy printed medication times. However, this means that for one person prescribed anti-inflammatory medication, there was a timeframe of 16 hours when medication was not given, and only 4 hours between each dose of the medication, when the recommended interval should be 6 hours. The printed medication times also meant that one dose was not given with or straight after food, which is recommended for the drug to reduce the risk of side effects. The registered nurse on duty said morning medication Strathmore House DS0000066352.V352703.R01.S.doc Version 5.2 Page 13 rounds started at 6am and 10-10.30am, and breakfast could be at any time between 8.30am and 10am. This means it is quite likely this medication is not administered as it should be. Controlled drugs are stored correctly and the dispensing pharmacy name and address are recorded in the controlled drug register. The drug fridge is kept locked, the temperature is recorded daily and is within the recommended range of 2-8oc. Also on the records for the drug fridge temperature are records for another, higher, temperature. Staff members said this was the temperature of the room where the controlled drugs are stored, although there was no indication of this on the record, and there were no records of the temperature of the room where the medication trolleys are stored. Medication waiting disposal or return to the pharmacy is kept in a large open yellow bucket in the same room that the medication trolleys are kept in. Although this room is locked when not in use, this is not a safe practice and medication should either by destroyed in the home or returned to the pharmacy as soon as possible. Strathmore House DS0000066352.V352703.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. Activities are available for residents to enjoy and daily routines at the home are flexible to meet residents’ needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs a specific member of staff four days a week to undertake activities, and there is a busy schedule of events well advertised around the home. On the day of the visit this staff member spent time with residents on the dementia care unit giving them hand massages and reading to them. One resident told us that he recently enjoyed an outing to a local harvest festival. However, a number of care plans were viewed to check if residents’ preferences regarding activities were clearly recorded. Information relating to activities was inconsistently completed in some cases. This refers specifically to no information recorded within one resident’s care plan as to their interests and everyday activities. The remaining two care plans made brief mention of personal preferences e.g. television, radio, likes going to the hairdresser and “no interest in many things”. Little information was recorded identifying what steps were being taken by staff to provide meaningful stimulation and/or occupation to individual people. Residents were not actively encouraged or involved where possible in day-to-day tasks around the home. For example laying the table, folding napkins etc. Strathmore House DS0000066352.V352703.R01.S.doc Version 5.2 Page 15 Families and visitors are made to feel welcome at the home and one resident reported that staff set up a room downstairs in the home so that he and his family can eat together undisturbed. Another relative told us that he travels a long way to see his mother and is always invited to stay for a meal at the home. Daily routines are flexible at the home and residents can decide how they spend their day. One resident told us that he often likes to have a long lie in when he’s ‘feeling lazy’. Staff respect this and do not disturb him until he we wants. Lunch on the dementia unit was a pleasant and relaxed affair with residents being offered plenty choice of what they ate and drank. Those that needed help to eat were given it sensitively and discretely. However the following shortfalls should be addressed: • • Lunch in the main dining room was somewhat spoilt by members of the maintenance staff walking through carrying black bin bags, and mops and buckets. Some practices did not promote residents’ independence and daily living skills. For example during lunch a member of staff served gravy from a plastic jug for residents, and staff put sugar in residents’ teas for them; rather than letting residents do these things for themselves One resident was served his dessert whilst still taking his time to finish his main course. By the time he came to eat his dessert it was cold • Strathmore House DS0000066352.V352703.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is adequate. Residents have access to a complaints procedure, and their complaints are investigated. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Of the twelve completed surveys received from residents by CSCI, 10 stated that they did know how to make a complaint and two stated that they didn’t. Information about how to complain is on display on a notice board in the hallway of the home, and on the back of residents’ bedroom doors. However, information on some of the notices is out of date and the print is very small, not allowing those with visual impairments to read it easily. The home has received three formal complaints since the last inspection concerning a resident who waited a very long time for help to the toilet; a lack of staff on a late shift; and the home’s heating being too hot. These complaints had been recorded, investigated and reasonable action taken in their light. Staff at the home have received training in protecting vulnerable adults and showed an adequate knowledge about the different types of abuse and reporting procedures. Strathmore House DS0000066352.V352703.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): 19,20,21,26 Quality in this outcome area is poor. Residents live in a home that is badly maintained and looks shabby and neglected from the outside. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There were a number of improvements in the environment of the dementia care unit. Chairs and tables had bee re-arranged to allow residents to sit together in smaller groups and communicate more easily with each other; large arrows pointing to the lounge area had been put up to help residents find their way about and bedrooms doors had been personalised and decorated with door knockers and letterboxes. A cat now lives on this unit and the residents clearly enjoyed his company. However the following shortfalls need to be addressed: • There is currently only one working bath for residents to use in the main building. Although a new bath has been ordered, the length of time the home was without another bath is unacceptable. DS0000066352.V352703.R01.S.doc Version 5.2 Page 18 Strathmore House • • • • • • • There was a strong smell of urine in the entrance way to the home The grounds at the back of the home, although extensive, continue to be inaccessible to residents as pathways were uneven and overgrown An upstairs bathroom was locked permanently and therefore made inaccessible to residents A number of wheelchairs and a carpet cleaner were stored outside the lift causing an obstruction Paintwork on external windows and doorframes is peeling and unsightly There is torn wallpaper in the stair well. One resident’s bedroom is used as a hairdressing salon. This is unacceptable as it prevents the resident accessing their bedroom during this time. It was not clear if the resident had actively consented to their bedroom being used in such a manner. The home had recently been without hot water on the top floor for over a month. This length of time is unacceptable and the situation was only resolved following an immediate requirement notice serviced by us (now met). Strathmore House DS0000066352.V352703.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): 27,28,29,30 Quality in this outcome area is adequate. Staffing numbers are appropriate to the needs of residents, however the home’s recruitment procedures do not protect residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing levels are adequate. There is one nurse and eight carers on each morning, and one nurse and six carers on each afternoon to meet the needs of 46 residents. One nurse and four carers staff the home during the night. Residents who completed the survey reported that staff were either ‘always’ or ‘usually’ available when they needed them. There has been an increase in staffing levels on the dementia care unit, with three staff on duty in the afternoon. Staff report that this enables them to better meet residents’ needs. Most residents told us that staff were caring and respectful; one resident reported ‘staff are fine, although some are better than others’. One relative commented: ‘In general the staff at Strathmore are very caring. Some staff always go the extra mile, others though well meaning are obviously not tuned into the needs of people with dementia’. Staff questioned on the dementia unit were knowledgeable about individual resident’s care needs, personal preferences and likes and dislikes. However, one member of staff had not received any training in dementia care, despite having worked on the dementia care unit for over three months. This member of staff showed a poor knowledge of the different types of dementia, and common symptoms of the disease and how to deal with them. A copy of the home’s training matrix Strathmore House DS0000066352.V352703.R01.S.doc Version 5.2 Page 20 showed that, out of 32 staff, including the manager only 5 people have undertaken training relating to dementia awareness (12 ). The personnel files of two recently employed members of staff were checked. One file contained all the necessary information and pre-employment checks. However the references for the second member of staff were unsuitable. No reference had been sought from her previous employer at another care home, instead a personal friend had written one of her references. Strathmore House DS0000066352.V352703.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): 31,36,38 Quality in this outcome area is adequate. The home is without stable management and health and safety needs to be better managed so that residents are not put at unnecessary risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has recently resigned and an interim manager was appointed on 13 September 2007 to oversee the day-to-day running of the home. It is not clear what her plans are, and whether or not she will become registered as the permanent manager with the CSCI. Staff report that the interim manager has introduced some positive changes in the dementia unit and also to the variety and quality of the food at the home. One commented: ‘we have just had a new manager come into the home who is very supportive’ Staff also stated that lines of accountability were much clearer in the home since she has taken over. Strathmore House DS0000066352.V352703.R01.S.doc Version 5.2 Page 22 Supervision at the home has improved a little but still remains erratic for some staff. Records viewed showed that one member of staff had not received any supervision since March 2007; another had not received any between October 2006 and March 2007. One member of staff reported that she had received her first supervision that very morning (without notice) despite having worked at the home for over three months. The following items seriously compromised the health and safety of residents living at the home: • • • • A bedroom fire door did not fully shut, causing danger in the event of a fire A member of night staff has still not received in any training in fire safety, food hygiene, and health and safety Foodstuffs stored in the kitchen were not labelled correctly and did not display an accurate date of when they were made A call bell point had been attached externally to the entrance the cottage, in order to keep it from the rain; half a biscuit tin lid had been used to partially cover it. Strathmore House DS0000066352.V352703.R01.S.doc Version 5.2 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 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 2 2 2 x x x x 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x x x x 2 x 2 Strathmore House DS0000066352.V352703.R01.S.doc Version 5.2 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 OP7 Regulation 15 Requirement Care plans must reflect how residents’ dementia impacts on their everyday life and how staff, are to deliver person centred care. Residents must be fully involved in planning and reviewing their care so that they can contribute, and agree, to how they are assisted Medication must be given at recommended intervals and at times that reduces the risk of side effects, to provide optimum health benefits from its administration. Appropriate references must be obtained for all prospective employees so that residents are protected All staff who work on the dementia care unit must receive training in dementia care so that they can provide skilled and knowledgeable support to those residents. An application to register a permanent manager must be received by CSCI to ensure DS0000066352.V352703.R01.S.doc Timescale for action 01/12/07 2 OP7 15 01/12/07 3 OP9 13(2) 01/12/07 4 OP29 7,9,19 01/12/07 5 OP30 18(1)(c) 01/12/07 6 OP31 8 01/01/08 Strathmore House Version 5.2 Page 25 7 OP36 18(2) effective running and leadership of the home. All staff must receive regular supervision so that their working practices can be monitored and their training needs identified. Previous timescale of 01/10/07 not meet Staff member ME must receive training in fire safety, food hygiene and health and safety so that residents are protected Previous timescale of 01/10/07 not met. CSCI is seeking further legal advice in relation to this continued breach. 01/12/07 8 OP38 18(c)(1) a 03/12/07 9 OP38 13 (4) All hazards to residents’ health and safety mentioned in standards 31-38 of this report must be addressed 01/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP1 Good Practice Recommendations The Statement of Purpose and Service Users Guide should fully reflect the service that is to be provided to those residents with dementia and detail how dignity and privacy is to be managed for individuals. Residents should receive good written information about the home before they move in so that it can help them decide if it is where they want to live Residents care plans should be available in a format they can easily access such as large print. Residents should be encouraged as much as possible to maintain their independent living skills and staff should refrain from helping them to do things that they can DS0000066352.V352703.R01.S.doc Version 5.2 Page 26 1 2 3 OP1 OP7 OP10 Strathmore House clearly manage themselves. 4 OP10 More care should be taken with residents’ laundry to ensure that they wear their own clothes at all times and that items of their laundry do not go missing. The home’s complaints procedure should be in a format the residents can easily access and information in it needs to be updated so that residents know the right people to contact if they have concerns. 5 OP16 Strathmore House DS0000066352.V352703.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Strathmore House DS0000066352.V352703.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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