CARE HOMES FOR OLDER PEOPLE
The Haven - Colchester 84 Harwich Road Colchester Essex CO4 3BS Lead Inspector
Marion Angold Unannounced Inspection 26th July 2006 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 The Haven - Colchester DS0000017966.V305934.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 Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service The Haven - Colchester Address 84 Harwich Road Colchester Essex CO4 3BS 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) 01206 867143 01206 793166 Comfort Care Services (Colchester) Limited Mrs Mary Louise Innes Care Home 29 Category(ies) of Dementia - over 65 years of age (29) registration, with number of places The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 29 persons) 22nd November 2005 Date of last inspection Brief Description of the Service: The Haven is a detached property in a residential area of Colchester. The accommodation is mainly on the ground floor, with two lounges serving different parts of the building and a common dining room. With one exception, bedrooms offer en-suite facilities. Three bedrooms are located on the first floor and are accessed by a stair lift. There is a small garden and a parking area to the front of the property and an enclosed garden at the back. The Haven is registered to care for 29 older people with dementia. The current weekly charge for a room is between £367.13 and £580.00. Additional charges are made for chiropody, manicures, hairdressing and toiletries. The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection, covering the key National Minimum Standards, took into consideration all recent records and contacts relating to the service, including information sent to the Commission by the Providers. It also included a site visit to the home on 26/7/06, lasting 8 hours, and a very brief follow-up visit on 24/8/06. The initial visit involved speaking with residents, the provider, manager and staff, as well as a partial tour of premises, observation of care practice and the sampling of records. Where possible, the main site visit focussed on the experience of a sample of 3 residents, a process known as case tracking. The second visit involved only a brief discussion with the person in charge of the home in the manager’s absence. Of the 24 Standards inspected, 16 were met and 8 presented minor shortfalls. What the service does well:
Residents benefited from having their needs fully assessed before coming to the home, and their relatives and representatives being welcomed as visitors and consulted about the care provided. The Haven offered residents a clean and comfortable environment and flexible routines. Residents also enjoyed nutritious and varied meals, prepared on the premises from fresh ingredients. Having their meals served from a trolley, meant that residents could make informed choices from the available options. Comments from medical sources showed that the home worked effectively with medical professionals to meet the health care needs of residents. Management made appropriate use of an occupational therapist to promote the mobility of residents and address the particular difficulties that individuals were experiencing. Residents benefited from staff who enjoyed working at The Haven and felt supported by their colleagues and management. Residents and relatives commented on the kindness, patience and good humour of staff. Staff showed appropriate skills in communicating with people with dementia, such as engaging their attention before speaking, presenting clear choices or explanations of the help they were giving. The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better:
The registered persons should continue to develop their provision of personcentred activities so that residents spend more time occupied in ways that are personally meaningful and stimulating. The Service User Guide and a programme of events, displayed just inside the entrance to the home, should give a more accurate picture of the activities being provided. Although staff administering medication had received training for this, the practice of decanting medication in particular circumstances (transferring it from the receptacle, in which it had been dispensed by the chemist into a monitored dosage container, held by the home), posed some risk to residents’ safety and should be left to the dispensing pharmacist. Although the presentation of meals on a trolley helped residents to choose from available menu options, some residents benefit from having user-friendly menus in advance, and the associated activity and stimulation of considering and discussing the alternatives. It was noted that the arrangement of chairs along the walls of the new lounge did not encourage residents to communicate with each other or engage with the television. The arrangement and use of communal areas should be
The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 7 reviewed, particularly for the benefit of residents who want to watch television, and to facilitate different activities. Although staffing arrangements had been adjusted to provide extra cover over busy periods, ratios were not always sufficient to allow for the high dependency needs of residents and needed to be reviewed to ensure adequate provision at all times. As a home specialising in dementia care, the registered persons should ensure that staff continue to develop skills in this area through a training programme. One area for development, highlighted by this report, is the provision of person-centred activities. The duty roster did not specify the times of every shift. The manager was advised to show the start and finishing times so that the hours actually worked by each person could be easily calculated. The registered persons must ensure that residents can always gain access to their personal money (held for safekeeping by the home) and that all related records and balances are accessible to anyone authorised to inspect the home under the Care Standards Act 2000. Although the hands-on approach of the registered persons and close monitoring of staff at work was achieving improvements in care practice, the home still had work to do in establishing regular one-to-one supervision meetings with staff, to discuss their practice and professional development. To minimise the risk of residents coming into contact with hazardous substances the registered persons need to ensure that the laundry door is secured, when there is no one in attendance. 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 Haven - Colchester DS0000017966.V305934.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 Haven - Colchester DS0000017966.V305934.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): 1, 2 and 3 (NMS 6 did not apply at the time of inspection) The quality of service in this outcome area has been assessed as good, based on the following judgements: • Decisions about the suitability of the home for prospective residents were based on an appropriate exchange of information, although, in relation to activities offered by the home, residents and their relatives could be misled by the written information they were given. EVIDENCE: The home had revised their Statement of Purpose and Service User Guide. The latter contained useful sections covering the questions prospective residents usually asked and an A-Z quick reference guide, providing useful information about the home. The inspector found that the Service User Guide gave the impression that The Haven promoted lots of activities and outings whereas, in reality, they had some way to go in developing the kind of personcentred activities expected of a specialist dementia care home. The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 10 A sample of three residents’ records showed that decisions to admit them to the home had been based on detailed, individual assessments of need. The Haven - Colchester DS0000017966.V305934.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 The quality of service in this outcome area has been assessed as good, based on the following judgements: • • • • Residents’ health, personal and social care needs were set out in an individual plan of care. Residents’ health care needs were met. The home’s procedures for dealing with medicines were mainly satisfactory but one procedure did not fully protect residents. Residents were treated with respect and their right to privacy was upheld. EVIDENCE: The sample of residents’ care plans were detailed and covered a range of needs and risks with clear instructions to staff as to how these should be addressed. Care plans inspected included screening for pressure sores, nutrition, falls, moving and handling and challenging behaviour. They also covered religious and recreational preferences. The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 12 Records showed that care plans were evaluated monthly. All eighteen respondents (family / representatives) to the Commission’s survey stated that they were kept informed about their relative’s progress and fifteen felt consulted about the care being given. One relative gave good examples of this. In addition to evidence from care plans, comments from medical sources showed that the home worked effectively with medical professionals to meet the health care needs of residents. The day of the inspection was one of the hottest on record. Appropriate arrangements were in place to compensate for the heat, such as a small air conditioning unit in the lounge nearest the kitchen. This benefited people in its immediate vicinity. Elsewhere windows were open, and all residents were being offered extra and alternative drinks to ensure they had taken sufficient fluid. Staff reported that residents had been given the option of resting in their rooms. Arrangements for storing, administering and recording medication were satisfactory, although it was found that, in particular circumstances, staff were decanting medication into monitored dosage boxes. Only the dispensing pharmacist should do this. The Haven - Colchester DS0000017966.V305934.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 The quality of service in this outcome area has been assessed as good, based on the following judgements: • • • • The diversity of residents’ needs was reflected in some of their daily routines but they did not spend much time in activities that were stimulating and related to their earlier experiences and interests. Residents were supported to maintain contact with people, who were important to them. Residents were able or supported to exercise some choice in their lives. Residents benefited from nutritious and appealing meals. EVIDENCE: Residents said they could get up and go to bed when they wished and be themselves. A good example of person-centred planning involved one person remaining in their room, as this had been found to suit them better than a communal setting. People’s diverse needs for sleep and food were also respected; food was prepared separately for them, if they missed a meal through being asleep. The inspector received mixed information about the activities provided in the home. During the morning of the inspection, apart from one person with a
The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 14 magazine, residents in both lounges were unoccupied. Many of them were asleep but this could have been due to the heat. However, whilst positive about other aspects of their life at The Haven, the three residents, who spoke with the inspector on this topic, indicated that they would like more activity. The television was on in a corner of one of the lounges but, with chairs round the edges of the room, most people were not sitting in a good position to see, or were too far away. They did not appear to be engaging with it. During the afternoon of the inspection, staff organised a ball game in one of the lounges and two residents attended a religious service. The registered provider reported that this had not been a typical day because staff had held back from engaging residents in activity because of the inspection. Staff also reported that activities were varied and included listening to the reading of books and newspapers and various exercises. Records for the previous week showed that the ball game had taken place 3 times and there were single entries for music, movement, dominoes, a board game and a church service. It was not clear how these activities linked to individual care plans or whether residents in one or both lounges had been involved. Although the registered persons had been working towards a more personcentred approach to activities and had achieved some good outcomes for particular individuals, they acknowledged that they were still developing this aspect of the service. From records and discussions it was evident that the 5week programme of activities, displayed in the entrance foyer, was not taking place exactly as stated. The information was therefore misleading. For the same reason, the registered persons should also review the information about activities contained in the Service User Guide. Feedback from a number of professionals and relatives, responding to a survey from the Commission, attested to the positive welcome they received when they came to the home and that they were able to see the resident in private. This was also observed during the inspection. A relative commented on the way residents were treated as individuals and offered choice. Discussion with staff about a particular situation showed their understanding of individual rights and how easily they could be infringed for people with dementia. Meals were nutritious, well presented and mostly home made. Residents spoke positively about their meals although they did not think they were informed about what was on the menu for the day. The menu was not on display. However, food and drink were presented on a trolley, so that residents could choose from available options. Staff were observed assisting residents to make choices and to eat their meals. An anonymous complaint, that residents remaining in their rooms did not get the support they needed to eat their meals, had been thoroughly investigated
The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 15 by the provider, Mrs Nicklin. Although the evidence she found did not substantiate the complaint, she had taken appropriate steps to monitor the situation and encourage good practice. The chef explained how they monitored residents’ intake of food and took appropriate steps to compensate for fluctuating appetite. Food and fluid intake were charted and monitored for anyone who was unwell, needed prompting with eating, or had lost appetite or weight. Meals were also served at times to suit individual needs. The Haven - Colchester DS0000017966.V305934.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The quality of service in this outcome area has been assessed as good, based on the following judgements: • • Complaints were taken seriously by the home and acted upon. Residents were protected from abuse. EVIDENCE: Fifteen out of eighteen relatives, responding to the Commission’s survey, said they were aware of the home’s complaints procedures. These were clearly set out in the Service Users Guide. One person said that their very minor complaints had been dealt with quickly and efficiently. The home took seriously a recent complaint, which the Commission asked the provider to investigate. Mrs Nicklin conducted a thorough investigation, as evidenced by the report, sent to the Commission. Other complaints had been logged in detail, with action taken and safeguards put in place to ensure that the situations did not recur. In the wake of the above-mentioned complaint the provider had advertised for an assistant manager, whose responsibility it would be to closely monitor what went on in the home and promote good practice. In the interim, management and heads of care were conducting spot checks on staff as they worked with residents and providing any necessary guidance. The home’s protection of vulnerable adults and whistle-blowing policies and procedures were satisfactory at the last inspection. The provider reported that she was involved in a local Protection of Vulnerable Adults (POVA) interest
The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 17 group. With a view to promoting awareness of abuse and good care practice in the home, a recent staff meeting had been dedicated to practice issues and POVA training. The emphasis of this training had been on recognising and preventing abuse. Staff confirmed that they had received this training. Residents and relatives commented on the kindness, patience and good humour of staff. One aspect of the anonymous complaint, referred to above, was that residents using Zimmer frames were chivvied and shouted at on their way to the dining room. It was encouraging that, although the provider did not find evidence of this, she arranged for staff to receive instruction in the appropriate way to encourage residents to move along to the dining room and continued to monitor the situation when she was on duty. Staff reiterated the guidance they had been given and, observation on the day of inspection, showed that this guidance was being heeded. The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 18 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, 20 and 26 The quality of service in this outcome area has been assessed as good, based on the following judgements: • • The Haven offered residents a comfortable and mainly safe environment, suitable for their needs. The home was clean, pleasant and hygienic. EVIDENCE: Since the last inspection, new turf had been laid in the garden, restoring it to a state, following the recent extension to the property, where residents could use it again. The owner had also replaced ten windows in the original section of the building. It was noted that the arrangement of chairs along the walls of the new lounge did not encourage residents to communicate with each other. Some residents could not engage with the television (in one corner) from where they were sitting.
The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 19 Discussion with management showed that they had made appropriate use of an occupational therapist to promote the mobility of residents and address the particular difficulties that individuals were experiencing. The home was clean and fresh on the day of inspection. A relative said this was always the case and they had never encountered unpleasant odours. Laundry facilities were suitable for the needs of residents, including a machine with a sluice facility. The matter of the laundry door being open during the inspection, with potentially harmful cleaning products on display, has been addressed below, under the section headed, Management and Administration. The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 20 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 The quality of service in this outcome area has been assessed as adequate, based on the following judgements: • • • In the main, staff were employed in sufficient numbers to meet residents’ needs but, at particular times, residents’ safety and quality of life could be compromised staff being in short supply. Residents were protected by the home’s recruitment practice. Staff continued to develop competence in their jobs through appropriate guidance and training. EVIDENCE: Four out of eighteen respondents to the Commission’s survey thought that there were insufficient numbers of staff on duty; one person stated that they had experienced difficulty finding staff free when they visited the home; two said that staff always seemed overstretched and gave staff sickness as the reason. The duty roster sampled showed that there were 4 or 5 staff covering the morning, 4 from 3.00 pm until 9.00 pm, 2 from 9 pm until 10 pm and 3 covering the night shift. Staggered shifts meant that additional staff were on duty to support residents getting up and over the lunch period. These ratios excluded cooking and cleaning duties, which were undertaken by ancillary staff. Although the number of hours provided per week had been calculated using a recognised formula (Department of Health, Residential Forum), it is
The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 21 unlikely, given the high dependency levels of people with dementia and the fact that the home is split in two by an interior door, that the home could operate safely with only two staff on duty. It is also clear that, when numbers occasionally dropped to 3 (plus the manager) during the day, staff would have to concentrate on the main events of the shift and lack the flexibility to support people with meaningful occupation or activity. The rosters did not specify the times of some of the shifts and the manager was advised to include these so that it was clear how many hours staff had actually worked. Residents benefited from the way staff communicated with them. Staff were observed engaging the attention of residents before speaking, explaining the assistance they were offering and asking questions clearly. Three relatives made a point of mentioning the caring attitude of staff. Inspection of records for the newest members of staff showed that recruitment procedures had met regulatory requirements. Although staff were not being placed on the roster before their full Criminal Records Bureau disclosure had been returned, the registered persons must, whenever possible, postpone employment until full and satisfactory checks have been completed. All new staff were expected to make a commitment to training for the National Vocational Qualification in care, Level 2. Induction training packages, for new staff, prepared by Skills for Care (organisation, which sets standards for social care training) were available for use but the registered persons had continued to use their own induction programme, which included (as for more established staff) close monitoring and supervision of specific tasks and guidance for improving practice. This process was reported and observed during the inspection. The registered persons were informed about the new Common Induction Standards, recently introduced by Skills for Care. At the time of inspection, four staff were involved in a programme of health and safety training; others had recently attended health and safety refresher courses. Training in moving and handling, first aid, fire safety, protection of vulnerable adults and dementia care had also taken place. As The Haven specialises in dementia care, the registered persons should ensure that staff continue to develop related knowledge and skills through appropriate levels of training. One area for development, highlighted by this report, is the provision of person-centred activities. The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 22 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, 36 and 38 The quality of service in this outcome area has been assessed as good, based on the following judgements: • • • • The registered persons had a conscientious approach to their roles and showed commitment to raising standards at The Haven. By reviewing and monitoring care provision, the home was achieving better outcomes for residents. Staff supervision was in line with the aims and objectives of the home but was not always a two-way process. In the main, the health, safety and welfare of residents and staff were promoted. EVIDENCE: Both the registered manager and provider were involved in the day-to-day management of the home and spent time working alongside staff and
The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 23 monitoring practice. They had also given senior staff the responsibility for monitoring particular aspects of care and held weekly meetings with them to discuss areas for improvement. The registered persons had invited relatives to comment on the service they provided by The Haven and introduced a newsletter with responses to issues raised through these questionnaires as well as general information about changes. As stated under the section, headed Complaints and Protection, the registered persons had taken complaints seriously and, irrespective of the findings of their investigations, had used the issues raised as a basis for reviewing and improving current practice. The registered persons had purchased a rather complex quality assurance methodology, which they were intending to use at The Haven and Mrs Nicklin said she had advertised for an assistant manager, to whom the main responsibility for monitoring standards and promoting good practice would be transferred. The home continued to hold small amounts of residents’ personal money, deposited by their relatives, mainly to cover hairdressing and chiropody. Only the Manager and one of the heads of care had access to this money. The manager confirmed that procedures for handling and recording transactions had not changed. Both the Manager and Head of Care gave similar accounts of how the system worked. On 24/8/06, when the inspector made a follow up visit to inspect records, receipts and balances, no one could gain access to the safe in the manager’s absence. Although the manager subsequently explained that residents’ limited awareness of money meant they did not ask for it, and that money was available to lend them in the manager’s absence, records, receipts and balances relating to transactions with residents’ personal money must be available for inspection at all times. Discussion took place with the manager about residents’ rights to have and spend money that was theirs. She said that the home had a mobile shop but that the amount of money available to residents to spend was determined by their relatives and did not amount to their full weekly personal allowance. Staff indicated that they enjoyed working at The Haven. They were positive about their team and the support they received at work from senior staff and management. Each of the junior staff had been allocated a mentor, whom they helped to chose. They indicated that part of their supervision involved being observed doing various aspects of their work and then being taken aside and given any relevant guidance and training. Whilst the hands-on approach of management allowed for staff to be supervised in an informal manner, during the course of their work, the kind of supervision envisaged by National Minimum Standard 36 (a two-way meeting to discuss practice issues and the staff member’s professional development in relation to the philosophy of the home) had not become routine. Discussion took place with the registered The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 24 persons about the key elements to be included in supervision and how the sessions should differ from the appraisals they had done. Observation, evidence of training and records, such as certificates of safety compliance showed that, in the main, appropriate arrangements were in place to promote the health, safety and welfare of people living and working at the home. The laundry door was open during the inspection, with no one in attendance and products on display, which could be hazardous to residents. The provider stated that the door was usually secured and that they were changing the supplier of their cleaning products to a company, which provided training for staff in using them safely. The Haven - Colchester DS0000017966.V305934.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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 17 X 18 3 3 2 X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 2 X 2 The Haven - Colchester DS0000017966.V305934.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. 1 Standard OP9 Regulation 13 Requirement The registered persons must ensure that residents are protected by all the home’s procedures for administering medication. The registered persons must provide opportunities for service users to engage in meaningful or enjoyable activities, which they have helped to choose. THIS REQUIREMENT HAS EXCEEDED AGREED TIMESCALES FOR ACTION SINCE THE INSPECTION ON 26/07/05, ALTHOUGH SOME PROGRESS HAS BEEN MADE SINCE THEN. The registered persons must ensure that at all times there are sufficient numbers of staff to meet the needs of residents. The registered persons must ensure that staff working at the home are appropriately supervised. THIS REQUIREMENT HAS EXCEEDED AGREED TIMESCALES FOR ACTION SINCE THE INSPECTION ON 22/11/05, ALTHOUGH SOME PROGRESSHAS BEEN MADE
DS0000017966.V305934.R01.S.doc Timescale for action 08/09/06 2. OP12 OP30 16 2 (m), (n) 18 30/09/06 3. OP27 18 (1) 30/09/06 4. OP36 18 (2) 30/09/06 The Haven - Colchester Version 5.2 Page 27 5. OP35 OP37 17, Sch 4 CSA 2000 S 31 6. OP38 13 (4) SINCE THE LAST INSPECTION. The registered persons must ensure that residents can have access to their personal money at all times and that all related records and balances are accessible to anyone authorised to inspect the home under the Care Standards Act 2000. The registered persons must ensure that all parts of the home to which residents have access are, so far as reasonably practicable, free from hazards to their safety. 31/08/06 31/08/06 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. 2. Refer to Standard OP15 OP12 OP20 Good Practice Recommendations The registered persons should give residents more information and involvement in relation to menus. The registered persons should review the arrangement of chairs in the lounges, particularly for the benefit of residents who want to watch television, and to facilitate different activities. The registered persons should ensure it is clear from the roster when a shift starts and finishes. The registered persons should ensure that staff continue to develop their skills for dementia care through further training. 3. 4. OP27 OP30 The Haven - Colchester DS0000017966.V305934.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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