Inspection on 05/06/06 for The Doris Watts Home

This inspection was carried out on 5th June 2006.

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

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

Other inspections for this house

The Doris Watts Home 18/12/08

The Doris Watts Home 19/12/07

The Doris Watts Home 29/12/05

The Doris Watts Home 26/05/05

The Doris Watts Home 02/11/04

The Doris Watts Home 10/06/04

The Doris Watts Home 21/02/04

Similar services:

Hillview Farm

St Vincents

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Winton House

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

CARE HOMES FOR OLDER PEOPLE The Doris Watts Home 79 Milestone Road Carterton Oxfordshire OX18 3RL Lead Inspector Delia Styles Unannounced Inspection 5th June 2006 10:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Doris Watts Home DS0000013078.V298448.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. The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Doris Watts Home Address 79 Milestone Road Carterton Oxfordshire OX18 3RL 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) 01993 844103 01933 844432 stephanie@robert-and-doris-watts.co.uk Mr Harry Watts Post vacant. Temporary manager Ms Linda Eastwood. Care Home 21 Category(ies) of Past or present alcohol dependence (1), Past or registration, with number present alcohol dependence over 65 years of of places age (1), Dementia (1), Dementia - over 65 years of age (9), Learning disability (1), Learning disability over 65 years of age (1), Mental Disorder, excluding learning disability or dementia - over 65 years of age (2), Old age, not falling within any other category (21), Physical disability (3) The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The total number of persons that may be accommodated at any one time must not exceed 21 To accommodate a named service under the age of 65. Date of last inspection 29th December 2005 Brief Description of the Service: The home is situated in a quiet residential area of Carterton. This enables service users ready access to the facilities in the centre of the community nearby - shops, dental and medical surgeries, opticians, banks and a library. There is also a weekly street market. The home offers homely accommodation for up to 21 service users over 65 years of age with a range of physical and mental care needs. The care home is not registered to provide nursing care. An adjacent bungalow was adapted and linked to the original Doris Watts Home and registered in August 2002. Residents accommodation is on two floors in the main house, served by a passenger lift and stairs. The additional annexe premises provide three single spacious rooms, a sitting room and kitchen area. In total there are three shared rooms and 13 single rooms. The main kitchen and small laundry room are on the ground floor of the main house. There are enclosed gardens to the rear of the home with ramped path access from the buildings. One garden area has benefited from a landscaping project undertaken in partnership with a local community college in 2003. The garden at the rear of the bungalow annexe accommodation is grassed, with a number of mature fruit trees. The weekly fees for this services range between £510 and £610. The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the Doris Watts Home was an unannounced ‘Key Inspection’. The inspector arrived at 10.15am and was in the home for 5½ hours. The inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that the CSCI has received about the home since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the home was meeting the standards set by the government and has, in this report, made judgements about the standard of the service. The registered manager no longer works at the home and had left 10 days prior to this inspection. She had sent a ‘self-assessment’ survey and a pre-inspection questionnaire about the home to the CSCI at the beginning of May 2006. Comment cards were received from nine residents, five relatives/visitors and one GP. At the time of this inspection Ms Linda Eastwood was the acting manager for the home. Ms Eastwood is an experienced registered manager of two other registered care homes in Carterton run by the same proprietor, Mr Harry Watts. Ms Eastwood has worked closely with the former manager, and knows the residents of the Doris Watts home well, so that there has been little or no change in the day-to-day running of the home from the residents’ point of view. During the day the inspector spoke to several residents, Ms Eastwood and other staff members. A partial tour of the building was done. A sample of residents’ care plans, medicine, finance, staff recruitment and training records, and a residents’ satisfaction survey for 2006 were read. What the service does well: The home provides a clean, homely and welcoming environment. Residents are cared for by staff who understand and respect their individual likes and dislikes and how they like to be looked after. The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 6 Residents and relatives’ written comments show that they are happy with the standard of care and the friendly and welcoming atmosphere in the home – “I feel the care my mother receives is of the best”, “My father is very happy and well cared for in this home, I am always made to feel welcome when visiting him”, “To tell you the truth I enjoy being here”, “I am very happy and well cared for here”. What has improved since the last inspection? What they could do better: Residents’ room doors must not be wedged or propped open- closed room doors slow the spread of smoke and flames should there be a fire in the house and so protect residents and their property for longer. The advice of the fire safety officer should be taken and, if agreed, automatic door closer equipment should be fitted to residents’ room doors, so that the doors automatically shut when the fire alarm sounds. Building materials should be removed from the entrance to the small car parking area at the front of the annexe bungalow part of the home. Blocking one entrance may delay emergency vehicles, such as an ambulance or fire tender, getting access to the home; it also spoils the outlook from residents’ sitting and bedrooms. The hot water supply to the ground floor shower and bath in the annexe should be reconnected with the recommended temperature limiting equipment, so that residents have another bathroom available to use. Frayed and worn towels and linen should be replaced with new items. The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 7 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 Doris Watts Home DS0000013078.V298448.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 The Doris Watts Home DS0000013078.V298448.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2&3 Standard 6 is not applicable, as the home does not provide intermediate care. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have sufficient information about the home in order to make a decision about whether the home is right for them. Residents’ individual care needs are identified through assessment and planned for before they move into the home. EVIDENCE: A random sample of three residents’ records showed that they had their care needs assessed. All the current residents are publicly funded - copies of the contracts for two residents were on file but a third could not be found at the time of the inspection. Of the nine residents who completed a comment card (‘Have your say about...Doris Watts Care Home), only one said they had received a contract. One person answered ‘yes’, but added that they ‘supposed they had…I need one to live here…I can’t remember’. The inspector is aware that many of the residents have memory problems and may not remember the contract agreed on their behalf with their family member and social services representative. The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 10 By contrast, six of the nine comment cards showed that residents felt they had received enough information about the home before they were admitted. One resident wrote that they had got information from social services and another that a relative had told them about the home. One felt that they had not had enough information from Mr Watts (the proprietor). There is evidence that, if possible, prospective residents are invited to visit the home and spend part of the day, to help them see the home for themselves and to meet residents and staff before moving into the home for a trial period. One resident wrote, ’I was shown around, thought it was all right, and then “Bob’s your uncle”’. The Doris Watts Home DS0000013078.V298448.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of care planning has improved since the last inspection, showing that generally the staff have sufficient written information to provide the level of care needed by the residents. The way in which residents’ health and medication needs are met is good. EVIDENCE: Examination of the care plans for three residents showed that they are well organised and that staff have, since the last inspection, improved the way in which they write comments about whether the residents’ care has matched the expected outcome for them. The pre-admission assessment information contained in their files was not always evident in the care plans. It is recommended that all the relevant information about residents’ needs is available to the staff who draw up their care plans, so that the care plans accurately show that each person’s needs are known to the care staff looking after them. The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 12 There is little evidence that residents or their relatives have been practically involved in the drawing up of the care plans. However, many of the residents are unable to contribute in any meaningful way to a care plan and do not have close relatives that are involved in their day-to-day care. The sample of nine residents’ comment cards showed that the majority felt that, in practice, the staff do give them the care and support they need - six answered ‘always’, one answered ‘usually’ and one ‘sometimes’ to this question. This was supported by the GP’s comment card question ‘Do staff demonstrate a clear understanding of the care needs of service users?’ and the GP’s satisfaction with the overall care provided to residents within the home. The home’s procedures for ordering, storing and administering residents’ medicines are satisfactory; the records were up to date and complete. The home’s ‘homely remedies’ policy, agreed with the visiting GP’s, was clearly set out, with the dosages of commonly-used ‘over the counter’ medicines that may be given without the GP’s immediate permission. Staff were seen to be patient and kind when interacting with residents. One relative’s comment card indicated that a problem that had occurred as a result of a ‘clash of personalities’ between residents sharing a room had been satisfactorily resolved. From observations and evidence seen the inspector considers that the service could adequately meet the needs of service users with equality and diversity needs. The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The range of activities does not match all the residents’ expectations and preferences. Meals and mealtimes provide an enjoyable and sociable experience for residents. Families’ and friends’ experiences when visiting the home are good. EVIDENCE: There were mixed responses about the activities arranged in the home from those residents who completed comment cards. Three residents felt that the home ‘always’ provided activities they could take part in, two said this was the case ‘usually’, one said ‘sometimes’ and two said ‘never’. Their additional comments about this topic included, ‘I don’t take part in activities. I come out. I don’t like them any more’, ‘Not really, but I’m just content to be here’, ‘I would like more people coming in to see us to talk to, preferably in the morning’, ‘I feel I can’t always take part in activities due to my disability’. The home does care for residents with a wide range of abilities and should review people’s recreational interests and the types of activities that could be made available accordingly. A few residents continue to attend an Age Concern day centre in Carterton that they enjoy. The home has a library service and an entertainment company that visits regularly to put on musical events for residents. The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 14 Residents spoken with on the day of this inspection said they had enjoyed their lunchtime meal and that the food was good. Written comments supported this, with four residents writing that they ‘always’ like the meals, four saying ‘usually’ and one saying ‘sometimes’. Additional comments made included ‘very satisfying. Always give you enough to eat, varied and a good choice’, ‘Some foods I can’t eat and the chef offers me an alternative, so I do enjoy the meals’. The cook confirmed that he does check whether the residents like the meals and that residents’ preferences for traditional British dishes guide the menu choices. All five of the Relatives’/Visitors’ Comment Card responses received showed that residents’ family and friends are made to feel welcome, are free to visit the home at any time, that they can visit their relative or friend in private and are kept informed of important matters affecting them. The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be 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 this service. Residents feel safe and listened to. However, as the registered manager’s post is vacant currently, the formal processes need to be reviewed so that the residents and staff are clear about the home’s procedures and how they should be applied. EVIDENCE: Most of the residents who completed a comment card were confident that they knew who to speak to if they weren’t happy or wanted to make a complaint. In additional comments, 50 gave the former manager’s name as the person they would go to to discuss any problems or concerns. As the home is under temporary management, the home-owner and acting manager need to make sure that the residents and their families and friends are aware of how to raise any concerns and who is accountable for making sure that the home’s own complaints procedure is followed. No information from the public had been received by the Commission concerning complaints or allegations since the last inspection. Staff receive training about safeguarding adults as part of their induction to the home and have regular updates. The inspector was told that all the current residents are publicly funded and therefore have regular reviews of their care and any concerns are followed up. There is information in the home about a local independent advocacy service available for residents. The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 16 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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is clean and the décor and furnishings provide a comfortable and ‘homely’ place for residents to live. EVIDENCE: The owner acknowledges that some of the facilities and room sizes do not meet the newer requirements for care homes for older people and is planning to build a new purpose-built facility to replace this home. Outside, the gardens at the rear of the home provide a pleasant outdoor area for residents to use. One part of the garden has a gravelled area and pathway around it, with climbing and container plants and a goldfish pond. At the rear of the adjoining bungalow annexe there is a large lawn area with mature fruit trees. The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 17 At the front of the bungalow annexe of the home one entrance to the crescent front driveway was blocked with building materials. This should be removed, as it is unsightly for residents to overlook from this part of the home and also may prevent emergency vehicles from reaching part of the home in the event of an emergency. The home was clean and there were no unpleasant odours. Residents appreciate the way the home is kept clean. Five of the nine comment card responses stated that the home is ‘always’ fresh and clean, three people stated that it is ‘usually’ kept to this standard and one person’s opinion was that it is ‘sometimes’ the case. The home had just changed the organisation of the domestic team, with one supervisor who will organise the rotas and check the standards of cleanliness in all three of the proprietor’s care homes. A tour of the communal areas of the home and several individual bedrooms showed that they were clean, tidy and homely, with residents’ own chosen small items of furniture and possessions around them. The ground floor bath surround was damaged and should be repaired, as it is difficult to keep clean and may become water-damaged and could be a source of infection to residents. Numerous towels on the shelf in the bathroom were worn and frayed. Some of the sheets in the linen cupboard were also old and damaged. These should be taken out of circulation and replaced with the new items that staff said are in stock. The small ground floor bathroom in the bungalow annexe had a very poor hot water flow. The acting manager said this had been reported and took prompt action to arrange for a plumber to restore the water supply and water temperature limiting valves. This bath and shower room has limited use for more dependent residents because of the narrow doorway, and had a faulty water supply at the last inspection. A first floor step-in shower is also seldom used. The hot water temperature was above the recommended maximum of ‘close to 43ºC’ – it was 45ºC. The temperature should be monitored and adjusted although it is unlikely to be a risk to residents as only very mobile and independent residents could access it. The proprietor is considering converting part of the unused kitchen area to a wheel-in shower facility. This has been recommended at previous inspections and should be implemented, because it will improve the number of useable bathing facilities for residents in the home. The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 18 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staffing levels are generally sufficient to meet the needs of the residents. There are indications that improved levels and skill mix of staff are needed to compensate for changes resulting from the loss of the registered manager and other staff, in order that the residents have continuity of care and confidence that their needs will continue to be met. EVIDENCE: This inspection took place at a time of change for staff, as the registered manager had left and there were other care staff changes that have the potential to cause the existing staff team and residents to feel unsettled. However, the temporary management by the registered manager from Mr Watts’ other two care homes nearby and the recent staff exchanges between homes in readiness for the proposed new care home, have minimised disruption for residents because they know the staff. Residents’ comment cards were completed before the registered manager had left. The responses to questions about whether staff listen and act on what the residents say and whether staff are available when needed, showed that although most residents received prompt attention, they were aware that staff were always busy. They added comments such as ‘’If the staff are near, you (staff) say I have to wait a little while’, ‘Some are too busy at times’, ‘They’re always busy’, ‘Because you’re (staff) busy and don’t always hear me when I The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 19 bang’. This indicates that although residents’ basic needs are met, there are areas that can be improved to make sure that new staff are appropriately supervised and supported, and to allow sufficient time to always meet residents’ physical and recreational care needs. The manager and her deputy were arranging the staff rota for the forthcoming week. Some staff work in both the Robert & Doris Watts Care Home and the Doris Watts Home. Ms Eastwood has altered the shift hours so that they are the same in both homes and staff handover time for the exchange of care information about residents is more effective. The rota showed that several staff work a mixture of night and day shifts and some have split days off. This means that staff are more likely to become over-tired and this may affect the quality of their work with residents. Working mixed day and night duties in the same week should be avoided and rotas should be planned in a way that gives staff sufficient rest periods and time off between shifts. The staff recruitment records showed that the home has taken action to improve their system for obtaining the required police checks and references since the last inspection. The previous home manager had had a key role in the training and development of staff in this and the Robert & Doris Watts Home and there has been some disruption to the training programme after she left. However, the acting manager and other senior staff are reviewing the training programme, and have taken action to maintain the planned sessions as far as possible. Three care assistants have a Level 2 National Vocational Qualification and three more are working towards this award. This means that the home has not yet achieved the recommended proportion of 50 care staff that have an NVQ Level 2 or above qualification by 2005. However, the home is committed to achieving their training targets to make sure that staff have good understanding and skills in order to meet the residents’ needs. The home uses a distance learning pack for health and safety training topics and provides English classes for overseas staff. The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 20 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 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The temporary arrangements for the management of the home are satisfactory and the residents’ views about the quality of the service are taken into account. EVIDENCE: The registered manager who is temporarily overseeing the management of this home is experienced in the role and is supporting the staff and residents well at this time. The results of an annual residents’ survey had just been published. There is evidence that the home’s owner and senior staff follow up on particular themes or comments made by residents about the home and their experience of living there. It is recommended that the home widens the scope of the quality assurance questionnaires to get the views of GPs, visiting nurses, care managers, the chiropodist and other voluntary organisation staff, about how the home is achieving goals for the residents. The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 21 Most of the residents lack the capacity to manage their own money and this is done by their family members or through Social Services money management arrangements. The records of expenditure made on behalf of residents, for example for hairdressing, chiropody or toiletries, were checked and up to date. The company’s administrator had done an internal audit of residents’ ‘pocket money’ accounts on 30 May 2006. The inspector recommends that the facilities for the safekeeping of money and valuables on behalf of residents in the home are improved and made more secure. The cook has no record of formal training in food handling and preparation, although s/he has experience of working in the catering industry. The acting manager said that she would identify suitable local courses and ensure that the cook undertakes formal training for his/her role and is confident that he/she follows safe working practices when catering for residents. One resident had a door wedge in place holding their door open. Room doors must not be wedged or held open as, in the event of a fire, the open door would allow the rapid spread of smoke, fumes and flames, putting residents and staff at additional risk. The fire safety officer should be consulted and, if acceptable, an automatic door closer device that shuts the door when the fire alarm sounds, could be fitted. The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP38 Regulation 23 (4) Requirement Fire doors must not be wedged/propped open. Timescale for action 30/07/06 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 OP2 Good Practice Recommendations The proprietor should consider ways in which residents can be made more aware of information about their contract and terms and conditions of their stay in the home. Staff should have access to residents’ pre-admission assessment information to help them to improve the detail and accuracy of the care plans. The proprietor should review the variety of activities available in the home to meet the individual assessed needs and preferences of residents. The proprietor should ensure that residents and their families know how to raise any concerns or complaints within the home and that staff are familiar with the home’s own complaints procedures. DS0000013078.V298448.R01.S.doc Version 5.2 Page 24 2. OP7 3. 4. OP12 OP16 The Doris Watts Home 5. OP19 The proprietor should: • Complete the work to restore the hot water supply to the ground floor annexe bathroom. • • Remove frayed and old towels and bed linen and replace with new stock. 6. 7. OP21 OP27 Remove the obstructing building materials from the front driveway to the bungalow extension. The proprietor should build a more suitable bath/shower room that will increase the assisted facilities in the home. The proprietor should: • Review the staffing levels and skill mix so that there are sufficient numbers of staff to consistently meet the physical and recreational needs of the residents. Ensure that the shift patterns worked by staff are planned in a way that avoids them having mixed night and day shifts in the same week, and that staff have sufficient rest periods between shifts and day and night shifts. The proprietor should consider extending the quality assurance audit to include the views of GPs, health and social care workers and voluntary visitors about the way in which the home meets the residents’ care needs. The proprietor should provide a more secure facility for safekeeping of money and valuables on behalf of the residents. The proprietor should: • Consult with the fire officers and, if acceptable, fit suitable automatic door closers to room doors where residents wish to have their room doors held open. • Ensure that catering staff receive appropriate formal training in food handling and hygiene. • 8. OP33 9. 10. OP35 OP38 The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 The Doris Watts Home DS0000013078.V298448.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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