Inspection on 20/10/06 for The Magna Care Centre

This inspection was carried out on 20th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 Magna Care Centre 06/03/08

The Magna Care Centre 07/11/07

The Magna Care Centre 28/02/07

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Magna Care Centre (The) Arrowsmith Road Canford Magna Wimborne Dorset BH21 3BQ Lead Inspector Catherine Churches Key Unannounced Inspection 09:30 20 October and 2 November 2006 th nd 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 Magna Care Centre (The) DS0000067493.V314963.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. Magna Care Centre (The) DS0000067493.V314963.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Magna Care Centre (The) Address Arrowsmith Road Canford Magna Wimborne Dorset BH21 3BQ 01202 601831 01202 691503 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) Caring Homes Limited Care Home 69 Category(ies) of Old age, not falling within any other category registration, with number (69) of places Magna Care Centre (The) DS0000067493.V314963.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 69 persons over the age of 65 may be accommodated as follows: In Segovia, 24 older persons who may require nursing care. In Granada, 24 older persons who do not require nursing care. In Canford, 21 older persons who do not require nursing care. One named person (as known to CSCI) who is under the age of 65 may be accommodated in Segovia unit. 2. Date of last inspection 29th November 2005 Brief Description of the Service: The Magna Care Centre is located in a rural setting approximately two miles from the local shops and amenities of Broadstone. It is a care home offering both nursing and residential care to Older people and provides long and short-term care as well as respite care. The home has 69 registered beds and can provide nursing care to a maximum of 24 people. The home is divided into 3 units; two provide residential care and are staffed with trained care staff and the third provides nursing care and has a qualified nurse on duty at all times. The majority of rooms are on the ground floor, there are twelve rooms on the first floor and these can be accessed by a through floor passenger lift. All rooms are for single occupancy and most have ensuite facilities. The home has two dining rooms, three lounges and a large conservatory as well as specially adapted bathrooms and a hairdressing salon. It sits within beautiful, well-maintained gardens, which have ample parking and a quiet courtyard and summerhouse. At the time of the inspection the current scale of charges per week ranged from £550 to £775. The home changed ownership in August 2006. The new owners are Caring Homes Healthcare Group. Prior to this a private individual owned the home. At the change of ownership the registered manager decided to leave and the home operated with a peripatetic manager from Caring Homes until a new manager could be recruited and appointed. The peripatetic manager was Karen Darlington and the proposed registered manager is Terry Bailey who commenced duties on 16th October 2006. Magna Care Centre (The) DS0000067493.V314963.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which started on 20th October 2006 and was completed on 2nd November 2006. In total twelve hours were spent in the home undertaking the inspection. Terry Bailey, the proposed registered manager and Karen Darlington, the peripatetic manger were both present for the full inspection. The inspection took place as part of the regular, programmed inspection schedule for the home. The last inspection was November 2005. The purpose of this visit was to monitor the homes compliance with National Minimum Standards and with requirements and recommendations made during the previous inspection. Also, to check that the home is run in a satisfactory manner and that the people who are living in the home are properly cared for. The premises were inspected and a number of records examined. Time was also spent time observing routines within the home and talking with residents, visitors and staff. Prior to the inspection survey/comment cards were sent out to residents, relatives, GP’s, healthcare professionals and care managers. Twenty-five responses were received from residents (many of which were completed by relatives), one from a GP and 2 from healthcare professionals such as District Nurses. Analysis is included within the relevant sections of this report. Satisfaction levels have, in general decreased in the year since the last inspection. However, during the inspection it became evident that the home has undergone a period of uncertainty, staff changes and introduction of new management and culture: rumours of the sale of the home were circulating some 8 months before the sale took place and this took its toll on both staff morale and trust. It would also appear that, during the drawn out sale process, there was a lowered level of investment in equipment leading to a number of shortages. Many homes experience a time of turbulence during a change of ownership. It would appear to have been particularly difficult at The Magna Care Centre for residents and staff alike. Caring Homes have now appointed a permanent manager with a good track record in previous homes and it is hoped that standards in the home will improve within a short time. This report refers throughout to “residents” meaning to include persons accommodated in the residential units of the home, patients in the nursing units and the overall term “service users”, which is the preferred term of the Commission. Magna Care Centre (The) DS0000067493.V314963.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Assessments of residents prior to admission must improve in order that the home can show it is prepared in advance, and able, to meet all care needs. The assessment process must clearly show that the resident and/or their representative have been involved and consulted and written confirmation must be given by the home that they are able to meet a residents needs. Care plans must clearly evidence each persons needs and how these are met by the home. They must be regularly reviewed and residents should be involved in the construction of their care plan. Actions taken as a result of assessments or observations must be clearly recorded, for example if a person is identified as having a high risk of developing pressure sores, then the preventative action taken must be recorded or if a person has a continuous significant weight loss then the action taken to investigate this must be recorded. Despite the difficulties staff have experienced, it is important that residents dignity continues to be promoted: residents should be assisted to remove spilt food and to keep spectacles clean etc. It would also be helpful if residents were not left to worry about members of staff who are disgruntled: it is understandable that friendships occur between residents and staff but the professional line should not be overstepped when sharing news and worries. Communication between staff as well as between staff and residents and staff and visitors needs to improve: numerous examples of staff sharing information between shifts and relatives feeling unable to find staff to talk to were found during the inspection. Magna Care Centre (The) DS0000067493.V314963.R01.S.doc Version 5.2 Page 7 The provision of meals within the home has become a big issue with high levels of dissatisfaction from residents. This matter had already been identified, along with the weak programme of activities, and was being addressed at the time of the inspection. Orders for new equipment need to be expedited, as it is unacceptable that residents should have to use pillows without covers and use frayed or thin bedding and towels. An assessment/audit of equipment as well as consultation with staff as to the equipment they need to carry out tasks efficiently should be undertaken. Although staffing levels remain the same as with previous owners, a number of staff have left the home and consequently a number of shifts have to be covered by agency staff. This means that there are often staff working in the home who are unfamiliar with the building and residents care needs. A number of comments were received from residents, relatives and staff themselves that they were short staffed and it would appear that this is due to agency staff taking longer to carry out duties due to unfamiliarity etc. The management were already aware of this issue and were taking steps to recruit permanent staff as well as introduce an improved staffing structure within the 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. Magna Care Centre (The) DS0000067493.V314963.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 Magna Care Centre (The) DS0000067493.V314963.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): 3 Quality in this outcome area is poor. This judgement is made using available evidence including a visit to the service. The admissions process is inconsistent and does not always enable the home to thoroughly assess a person needs or establish whether in fact the home can meet these needs. EVIDENCE: Admission assessment records of two residents who have moved to the home since the last inspection and one resident who moved from the residential to the nursing wing were examined. Assessment information for one resident demonstrated that the person’s personal care needs, mental and physical health and general welfare had been considered in order to make a decision regarding the home’s suitability. An assessment had been undertaken for the second person but this was not dated and lacked detail so the home could not demonstrate that they would be able to provide suitable care for the person once admitted to the home. Magna Care Centre (The) DS0000067493.V314963.R01.S.doc Version 5.2 Page 10 No assessment had been undertaken for the resident that moved from residential to nursing so the home was not able to demonstrate that such a move was suitable for the person concerned. There was no evidence that either the resident or their representative had been involved in the assessment process in two out of the three assessments. Magna Care Centre (The) DS0000067493.V314963.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 poor. This judgement is made using available evidence including a visit to the service. Systems for resident consultation and participation in the assessment and care planning process are poor with little evidence that resident’s views are sought or acted upon. There is a care planning system in place but staff are not using this effectively. This means that staff, especially those who are unfamiliar with residents, may not be aware of what care needs are and how they are to be delivered. The home is also not able to properly evidence that appropriate care is provided. Healthcare issues are not always recorded and there is little evidence that any monitoring or proactive care takes place. Evidence was found that indicated that resident’s dignity is not always respected and staff do not always recognise the boundary between professional chat and gossip. Magna Care Centre (The) DS0000067493.V314963.R01.S.doc Version 5.2 Page 12 EVIDENCE: Documentation for four residents was examined as part of the case tracking procedure used during this inspection. A number of issues with regard to care planning, health care and lack of dignity were found as detailed below: 1. New Caring Homes care planning documentation was in place but not properly completed. 2. Resident had been in nursing unit for 10 days and no care plan had been created. 3. No evidence of resident involvement in the care plans that were in place. 4. Some care plans were in place but it was evident from daily recording that not all needs were recorded in the care plans. 5. Some information had been recorded but then archived rather than transferred to the new system. 6. Risk assessments had been carried out identifying high levels of risk but any outcome/action from the assessment had not been recorded. 7. No photographs of residents were available in the files. 8. Monthly reviews of care plans had not been carried out since June or July 2006. 9. Resident’s weights had not been recorded on a regular basis since July 06. 10. One person had had their weight recorded more recently than this and this showed a considerable weight loss but no evidence of any action that had been taken. 11. Two people had pressure sores/wounds: recording of care given and plans for treatment were lacking in detail and out of date. 12. Care plans for diabetics did not contain normal blood sugar ranges or information of how and when blood sugars were tested. 13. One person had MRSA but this was only discovered through conversation with staff and not from information in care plans etc. 14. One person was in bed, lying on pillows with no pillowcases, with pureed food still left on them from lunchtime although staff had been in to remove the meal tray. They also had dirty spectacles. 15. Two people with fragile skin should probably have had turn charts but staff were unable to say whether this was either required or done. 16. Discussions with residents evidenced that there is a high level of awareness of staff dissatisfaction and low morale. Whilst it is good that that staff have interaction with residents it is of concern that the residents are being affected in a negative way by some of the things that staff have told them. Magna Care Centre (The) DS0000067493.V314963.R01.S.doc Version 5.2 Page 13 Twenty-six residents responded to a survey conducted by CSCI – the following is an analysis of responses made to questions relating to health and personal care: Question Do you receive the care and support you need? Are staff available when you need them? Do you receive the medical support you need? Yes No Always Usually Sometimes Never Blank 8 7 16 17 18 9 1 1 1 Magna Care Centre (The) DS0000067493.V314963.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 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 is made using available evidence including a visit to the service. Social, cultural and recreational activities are available but do not always meet the needs and expectations of the residents. Relatives and visitors are welcome in the home at any time with no restrictions. Residents have indicated dissatisfaction with the food provided in the home. The management are aware of this and taking steps to improve this area. EVIDENCE: As stated elsewhere in this report the home has been through a period of flux and change that has affected the resident’s lifestyle and experiences in the home. Twenty-six residents responded to a survey conducted by CSCI – the following is an analysis of responses made to questions relating to Daily Life and Social Activities: Magna Care Centre (The) DS0000067493.V314963.R01.S.doc Version 5.2 Page 15 Question Are there activities arranged in the home that you can take part in? Do you like the meals at the home? Yes No Always Usually Sometimes Never Blank 14 3 7 13 2 7 2 3 Since the last report the range of activities has decreased and the quality of food provided for residents has become poorer. The results of the survey and discussions with residents during the inspection confirm this. In addition to the survey questions residents also added a number of comments about the food, a representative sample of these are detailed below: “Breakfasts are good, main meal – lunch time, poor quality” “Food is badly cooked, lacks variety, is not appetising or presentable is sometimes cool” “Meals look unappetising and consist of odd combinations. Meals have deteriorated in the past 18 months and there is always substantial waste” “Poor quality ingredients, lack of variety, tiny meat portions, very dry, often lukewarm or cold” “Food should be one of the highlights of the day not a constant source of complaint” Mr Bailey took up his post on 16th October 2006 and is reviewing activities and catering to ensure that social, cultural, religious and recreational needs are addressed in the future. Magna Care Centre (The) DS0000067493.V314963.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 Quality in this outcome area is good. This judgement is made using available evidence including a visit to the service. The home has a satisfactory system for making complaints. This means that residents and others involved in the home that may wish to make a complaint should feel confident that they would be listened to and matters of concern will be acted upon. Arrangements for protecting residents from abuse are satisfactory: staff have knowledge and understanding of Adult Protection issues and there is a training programme in place. This means that The Magna Care Centre is a safe environment that undertakes to protect its residents from abuse. EVIDENCE: The home has a satisfactory complaints procedure that is displayed in the home as well as included in the updated Service Users Guide. Since Caring Homes have taken over the ownership of the home three complaints have been received at Head Office, made either by residents or their representatives. Records regarding each complaint were examined: all 3 had been suitably investigated, all were substantiated and appropriate action had been taken. Twenty-six residents responded to a survey conducted by CSCI – the following is an analysis of responses made to questions relating to Complaints and Protection: Magna Care Centre (The) DS0000067493.V314963.R01.S.doc Version 5.2 Page 17 Question Do you know who to speak to if you are not happy? Do you know how to make a complaint? Yes No Always 16 Usually 9 Sometimes 1 Never Blank 19 6 1 Responses show that the majority are aware of how to complain. Staff have received training in recognising and preventing abuse as well as the action to take should they believe abuse has taken place. A training programme is also in place to ensure that staff receive regular updates. It was evident from discussion that they were clear about their responsibilities Magna Care Centre (The) DS0000067493.V314963.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, 22 and 26 Quality in this outcome area is poor. This judgement is made using available evidence including a visit to the service. Residents live in a safe, well-maintained environment with their own belongings surrounding them. Bedrooms, bathrooms and communal areas provide sufficient room for residents. However, the poor quality and quantity of bedding and towels means that the home is not as well maintained as it could be for residents comfort. Management and staff views of the range and suitability of equipment that is available, especially for moving and handling differ greatly and it is of concern that resident’s care is delayed through this possible lack of equipment. Lack of planning and recording as well as communication means that Infection Control policies and procedures are not be followed correctly therefore putting residents, visitors and staff at risk. Magna Care Centre (The) DS0000067493.V314963.R01.S.doc Version 5.2 Page 19 EVIDENCE: A tour of the premises confirmed that the home is nicely decorated and furnished. Dorset Fire and Rescue Service have visited the home and confirmed that it complies with their requirements. Communal areas are well laid out with plenty of choice of seating areas as well as secure gardens and grounds which have been thoughtfully landscaped. All bedrooms have ensuite facilities, some with showers. The home also has a communal bathroom on each unit with assisted baths. As mentioned elsewhere in this report, the home has been through a period of change and instability: the new owners reported that the home was very short of equipment such as bed linen, towels, crockery, cutlery, pressure relieving equipment and kitchen equipment and that a number of other pieces of equipment were in need of repair or updating. They stated that equipment was on order and items were being repaired as necessary. However there appeared to have been a number of weeks since orders were placed for linen etc and deliveries had still not been made. Whilst visiting residents in various areas of the home it was noted that some areas, especially shelves etc in resident’s rooms were dusty, some toilet bowls were stained and towels and bedding were of poor quality. One resident was found to be lying on pillows that had no pillowslips or cases on them. Staff were trying to clear out various storage areas but in the meantime this meant a number of items such as old files, stocks of incontinence pads and unwanted equipment was being stored inappropriately in corridors and communal bathrooms creating a hazard both in terms of fire and possible accidents as well as looking unsightly. Staff on all units reported that there was a shortage of appropriate hoists: they were clear that those available were not of the type needed to meet needs of residents and therefore longer delays than necessary were occurring for some residents. Indeed such comments as “ I wait too long sometimes when I need to go to the toilet” were received during the inspection. The home employs a team of cleaners, managed by a housekeeper, who are also responsible for domestic duties and laundry. The home has an Infection control policy and procedures in place. A recent outbreak of scabies appeared to have been dealt with effectively. However, it was noted that one resident, suspected of having MRSA, may not have been being cared for appropriately as no mention of this matter was in the care plan and no protective clothing was available in the vicinity of the room. Upon questioning staff were unclear about this persons needs and what procedures they should follow and the care plan did not include any information either. Magna Care Centre (The) DS0000067493.V314963.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 Quality in this outcome area is judged as adequate. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met through the provision of a mix of experienced, qualified and unqualified staff. Most staff have experience in caring for the elderly and a number are undertaking training to further develop their abilities and competencies. This means that residents are in safe hands. Recruitment procedures are satisfactory and this gives further protection to residents. The home places great emphasis on continuous professional development and is therefore introducing training programmes to ensure that staff have the necessary skills to enable them to undertake all aspects of their role competently EVIDENCE: Examination of the staffing rota evidenced that ratios of staff to residents have remained the same as prior to the change in ownership. This has previously been satisfactory. However, a number of shifts have recently had to be covered by agency staff as there has been a significant number of resignations in the last few months. Existing staff confirmed that they try to do extra shifts Magna Care Centre (The) DS0000067493.V314963.R01.S.doc Version 5.2 Page 21 when they can to help with continuity for residents but that this is not always possible. Staff have clearly been unsettled by recent changes and this is reflected both in comments made by staff and residents during visits and also in the residents survey. Examples of comments are below: “There does seem to be a shortage in the ratio of staff to residents” “Generally quite content with the service. Members of the nursing staff are very caring and patient” “Recently there seems to have been a shortage of staff and consequently they are unable to react promptly to requests” “I feel that at the moment staff are under tremendous pressure and are unable to perform their duties to the full” “The homes performance in the last few months, during changeover, has not been as efficient but I am hoping this will improve when the new manage arrives” “There are not enough permanent staff and too many agency staff” “The agency staff are not competent compared to the regular staff” Caring Homes Ltd also own a training company as well as employing a training manager in the home. Consequently, comprehensive training plans are being drawn up for all staff to enable them to keep up to date with good practice and improve their competency. Despite all the negative comments about perceived staffing level problems and use of agency almost all people who spoke with the Inspector confirmed that the staff were caring, kind and helpful. Staff records were examined for three members of staff. These demonstrated that appropriate recruitment practices are in place: application forms were completed; interviews documented and appropriate evidence of identity and qualifications had been obtained. References, Criminal Records Bureau and POVA checks had also been completed as required. Mr Bailey confirmed that new staff receive an induction and was able to provide evidence of this. Magna Care Centre (The) DS0000067493.V314963.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, 35 and 38 Quality in this outcome area is adequate. This judgement is made using available evidence including a visit to the service. The manager has a good understanding of the areas in which the home needs to improve and had developed a number of plans to address these matters. The new owners have suitable quality assurance procedures which, once fully implemented, will ensure that residents are consulted about how the home is run and that it is run in their best interests. Sound practices and procedures are in place regarding resident’s finances. The health, safety and welfare of residents and staff is, in general, protected by the systems that the home has in place for staff training, maintenance and risk assessment. Improved recording will further evidence this. Magna Care Centre (The) DS0000067493.V314963.R01.S.doc Version 5.2 Page 23 EVIDENCE: Caring Homes Ltd is a large care provider with a number of homes around the country. As such it has comprehensive management systems in place. A peripatetic manager has been in charge of the home whilst recruitment of the new manager took place: Mr Bailey is yet to be registered with CSCI as manager of The Magna but has previously successfully managed other similar size homes. He is suitably qualified and experienced. Although very newly arrived at the home, he had clearly quickly understood the issues in the home and whilst unable to correct everything immediately, was making appropriate plans to address issues of concern, many of which he had identified prior to the inspection. Caring Homes have a corporate quality assurance system that will be introduced to the home in the near future. Mr Bailey confirmed that residents are encouraged to retain control of their finances for as long as possible. Where they state they no longer wish to or they lack capacity to do so, then the home ensures that appropriate persons are available to take on this role. The home has policies and procedures in place regarding resident’s money and valuables. Examination of fire and accident records evidenced that a number of tests and checks had not been carried out at the required intervals regarding the fire warning systems in the home. Mr Bailey had already identified that and undertaken a comprehensive check himself before instructing the handy man in the checks to be undertaken in the future. Recording of fire drills was lacking in detail; it was not possible to identify the nature of the drill, (i.e. the site of the fire), the time taken or those, other than staff, involved. Accident recording procedures were in place and there was a regular audit of accidents to identify potential problems. However, recording was taking place in more than one document and data protection requirements were not being complied with. Magna Care Centre (The) DS0000067493.V314963.R01.S.doc Version 5.2 Page 24 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 X 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 X 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 2 X X X 1 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Magna Care Centre (The) DS0000067493.V314963.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement The registered person must ensure that new residents are admitted only on the basis of a full assessment undertaken by people trained to do so, and to which the prospective resident, his/her representatives (if any) and relevant professionals have been party. The registered person must confirm in writing to the resident that having regard to the assessment the care home is suitable for the purpose of meeting the resdients needs in respect of his/her health and welfare. All service users must have a plan of care that sets out in detail the action which nees to be taken by care staff to ensure that all aspects of health, personal and social care needs of the service user are met. The plan must be reviewed at least once a month and updated to reflect changing needs. The plan must be drawn up with the invovement of the service user and recorded in a style accessible serviceuser; agreed and signed by the serice user DS0000067493.V314963.R01.S.doc Timescale for action 1 OP3 14(1) 31/12/06 2 OP3 14 31/12/06 3 OP7 14&15 31/12/06 Magna Care Centre (The) Version 5.2 Page 26 4 OP8 12 & 13 5 OP10 12 &16 6 OP15 12 &16 7 OP22 23(2)&13 (15) 8 OP26 13(3) whenever capable and/or representative (if any). Nutritional, tissue viability and psychological assessments must be undertaken and kept up-todate. Any identified issues must be addressed via a care plan. The privacy and dignity of service users must be promoted at all times. The registered person must ensure that service users receive a varied, appealing, wholesome and nutritious diet which is suited to individual requirements The registered person must ensure that suitable equipment, such as hoists, are provided which are capable of meeting the needs of the service users. Infection control policies and procedures must be properly implemented to the spread of infection and toxic conditions in the home. 31/12/06 31/12/06 31/12/06 31/12/06 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard OP12 Good Practice Recommendations It is recommended that further reviews and consultations take place to develop a programme of activities that are flexible and varied to suit service users expectations, preferences and capacities. It is recommended that an assessment of equipment and furnishings within the home is undertaken to establish any shortages and then appropriate action to remedy this must be taken. The registered person must ensure that safe working practices are operated in the home. This should include appropriate record keeping of fire tests, checks and drills. DS0000067493.V314963.R01.S.doc Version 5.2 Page 27 1 2 OP19 3 OP38 Magna Care Centre (The) Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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. 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