Inspection on 09/01/08 for The Maltings Care Home

This inspection was carried out on 9th January 2008.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Maltings Care Home 28/02/07

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE The Maltings Care Home 103 Norwich Road Fakenham Norfolk NR21 8HH Lead Inspector Don Traylen Unannounced Inspection 9th January 2008 10:40 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 Maltings Care Home DS0000068299.V357434.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 Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Maltings Care Home Address 103 Norwich Road Fakenham Norfolk NR21 8HH 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) 01328 856362 01328 863407 the.maltings@fshc.co.uk Four Seasons Homes (No 4) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Mr Robert Leslie Deller Hammond Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Room 21 to be occupied by people who are independently mobile throughout the length of their stay in the home. 28th February 2007 Date of last inspection Brief Description of the Service: The Maltings is a purpose built residential care home close to the centre of Fakenham that was opened in 2000. The home is in a predominantly residential area of the town and is set back from the main road and has a car parking area at the front. It is situated on two floors with 18 single room on the ground floor and 25 single rooms on the upper floor. All rooms have ensuite shower and toilet facilities. The upper floor is accessible by a shaft lift, or by stairs where a chair lift has been installed. The home is spacious and connected by corridor that extends around each floor. Each floor has a dining room and lounge. The home has an entrance lobby and a reception office. The manager’s office and a hairdressing room are also located near to the main entrance area. There is an enclosed rear garden that is paved with brick and has raised flower beds. There is a small decking area at the front. Fees charged are between £368 and £446.50 per week. Copies of CSCI reports are available at the home in the reception area and can be obtained from the CSCI website. The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home completed an Annual Quality Assurance Assessment (AQAA) prior to the inspection. Survey forms were returned from 15 people living at the home, 8 relatives and 11 care staff. One inspector carried out the inspection over 7.5 hours on the 9th January 2008. The manager was present for most of the inspection. Many of the people living at the home were spoken to and five relatives were consulted for their opinion about the home and the standard of care. Two care staff were asked about their experiences and knowledge. Observations were made of the interaction and care provided by care staff. Documentation read included the following: assessments and admission details and care plans of three people; the daily records and message book kept by senior carers; two staff recruitment records and their induction record; medication records and medication storage arrangements; staff training records and various policies. The manager was provided with feedback during and at the end of the inspection and offered his plans and intentions for the future management of the home. What the service does well: The home is warm, very clean and bright and is an inviting environment. The friendliness of staff enhances this environment. Visitors have easy access to the home at all times. The administrator has a desk near to the main entrance makes people feel welcome and attends to their enquiries when necessary. It is the policy of the home to provide care for life, if they are able to do this with the support and intervention of community Health Services. They succeed in doing this by keeping regular liaison with the GP and community Health Service personnel. Routine and regular weekly meetings with community nurses who hold a weekly Tuesday ‘clinic’ at the home, have been arranged to ensure people’s health needs are not overlooked. Attention to personal and health care is good. It was clearly evidenced as being provided in an efficient and kind manner during the inspection whilst being delivered to people with differing needs. People’s needs are focused on and are a priority for the home The home is open and transparent in their communications and dealings. It is a culture that has been set by the manager and is a method that has gained the appreciation and approval of people who live at the home, their relatives and the staff. The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 6 The home has range of publications, in their entrance lobby, that are informative about the home and their activities and provide advise about a range of residential care related subjects as well as CSCI inspection reports. The home has provided details of their complaint policy and procedures at various points around the home, so that it is clear that anybody in the home or visiting the home is enabled to make a complaint known if they wish to. The home employs a suitable number of workers in addition to the care staff. They have a full time maintenance worker; an activities co-ordinator who works 4 days a week; two cleaners who usually work each day although at weekends one cleaner is more frequent than two; a hairdresser who is contracted to makes one visit per week. There are activities to get involved in and periodic outings and trips. A regular ‘resident’s meeting’ is facilitated. Staff treat people with respect and respond to their request for attention to the best of their ability. The outcomes for people living at the home are generally good. The more vocal people living at the home offered their views collectively and individually and stated that their care needs are met by staff whom they are happy with. The meals and food provided is nutritious and plentiful. What has improved since the last inspection? Four of the five requirements made at the last inspection have been met. Medication records were accurate and stocks of old stocks of medication had been returned to the pharmacist. The home is careful to keep control of medicated with dates of issue and the lifespan of the skin creams and eye drops that have been prescribed. An oncoming senior care now checks the medication records for missing entries and accuracy and improving quality. A senior carers’ book is kept to Increases to the staffing levels have been arranged. An increase in staffing levels has been planned for weekends and one extra person will be working at nighttime in the near future. The administrator’s hours have been increased from four days to five days per week. A deputy manager had been appointed three weeks prior to the inspection. The manager stated that an increase in his budget that was announced just prior to the inspection would enable him to make some increase to the staffing levels and to the decorative state of the home. Garden fencing has been added to the rear garden area and this area has been generally improved. During the inspection the dining room on the upper floor was being redecorated. The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Maltings Care Home DS0000068299.V357434.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 Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5, Quality in this outcome area is good. People are provided with plenty of information about the home during the admission process, although their full assessment information is not always gathered by the home. This judgement has been made using available evidence including a visit to this service. The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 10 EVIDENCE: The home has written information in their entrance lobby about the home and their activities, their newsletter, advise leaflets about a range of subjects and the CSCI inspection reports. This written information provides a useful reality check for people, their relatives or their representatives who might be making enquiries about this care home and what to expect from the home. Two people’s assessment records were read that had PCT Care Managers and the home had carried out assessments for. The assessment detail provided by the PCT was minimal and the assessments carried out by the home were brief and did not indicate any involvement of the person or their family, or reflect the person’s wider social needs. Further information had been gathered after admission, although some of this information did relate to the routines of the home. The assessment did not indicate any risks, but risks assessments had been conducted after admission to the home. The manager explained that there are difficulties in obtaining other than concise and brief details about a potential admission to the home from the PCT Care Managers and stated that he would ensure that full details were requested when this was considered necessary. Two visiting relatives stated that they were satisfied with the admission process and that they were able to visit and assess the service before making a decision about moving into the home. The home does not provide Intermediate Care. The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11, Quality in this outcome area is good. People benefit from staff who provide care in a respectful and kind manner. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three Care plans were read. The plans contained personal details and assessment details. The planned action to meet needs had been recorded and risks assessments had been recorded. The files contained some unnecessary duplicated information about the actions to meet needs. Assessment details were not always well collated and information was found in different pages of the file and there was not a clear order to the files. Reviews of care had been recorded and details of changes had been noted. In the case of one person whose needs had changed significantly and rapidly the plans did not reveal these changes sufficiently and did not fully describe or make clear the altered care pattern. It was not possible to ascertain the actual story or real needs of this person from the recorded care plan. However, It was clear that the care The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 12 workers and the manager were totally aware of the circumstances and of the rapidly altering care arrangements when they explained the care plan. It was also beyond doubt that this person’s care was being very carefully monitored and with the regular and full intervention of health care professional including the GP and the District Nurses. This person family were aware of the circumstances and had been fully informed and involved throughout. During the inspection two relatives visited this person and they stated they had been made fully aware of the circumstances and had been made to feel included by the home’s approach and attitude. It was discussed with the manager how the home might wish to record a person’s rapidly changing needs and circumstances and keep an accurate record of their care. To ensure that people changing health care needs are known, there is a routine and regular weekly meeting with community nurses who hold a ‘clinic’ at the home each Tuesday. The medication policy was read. It did not refer to the management of prescribed medications that have time span for use. The medication policy did not make clear the responsibility to ensure the directions for medication prescribed as PRN or when required had been obtained or recorded. Prescribed medication in the form of creams and liquid drops were all within a safe date to use. There were not any stocks of older medication being used. A list of medication awaiting return was labelled and individually packaged ready for return. The senior carer was observed administering medication. Medication Administrations Record (MAR) charts were read and these were accurately recorded. They revealed that the use of letters to denote, “social leave” and “in hospital”, by “D”, or “C”, were sometimes not qualified in written notes on the reverse of the chart. This was discussed with the manager how an explanatory written note on the MAR charts must always be written to clarify whether the medication in question had remained in the home or not. Amounts of medication including controlled drugs were checked and found to be accurate and approiately stored. The District Nurse was responsible for administering one controlled drug stored in the home. Another controlled drug was administered by the home and both of these records and amounts of medication were accurate. The manager stated that the District Nurses sometimes needed to store medication in the home that is administered only by a nurse. The Maltings Care Home DS0000068299.V357434.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15, Quality in this outcome area is good. People living at the home experience a suitable and satisfactory lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People reported in their survey forms and when asked that they were generally happy with their life at the home. One person said,“we go to bed whenever we like and get-up when we want”. Another person said, “nowhere better than this”. The Home has a designated staff member solely for activities. The home has posted in the corridors and communal areas, the many photographs of special events and trips out people have enjoyed. Some people play dominoes and bingo. Fourteen people were observed playing Bingo during the afternoon, a session that facilitated by two visiting relatives. Film sessions occur regularly and quiz nights are an important fund raising activity. The home has raised a significant amount of money for the people living at the home. The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 14 It was noted how relaxed and contented people appeared to be. Nine visitors were seen to come and go when they wish during the inspection. Lunch was served in the ground floor dining room and some people were given a meal in their room and this was through their choice. Two people who were confined to bed were assisted with their food. During lunch with people in the large ground floor dining room, everybody confirmed their meal was good when I asked. They confirmed they had plenty to eat. The cook attended and enquired if everybody was satisfied. More food was offered to all. It was noted that almost everybody had eaten all of their meal of roast pork, roast potatoes, mashed potatoes, turnips and carrots. Individual meals were plated up in the dining room after people have been given a final choice for their food and the amount they wanted out onto their plates. Breakfast menus were listed in the dining room as were the likes and dislikes reminders for care staff. The Maltings Care Home DS0000068299.V357434.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18, Quality in this outcome area is adequate. People are generally safeguarded from abuse but would benefit from a more rigorous management approach to reporting procedures and to training staff in this topic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaint procedure and a whistle blowing policy. Information was posted around the home’s communal areas about how to make a complaint should anybody wish to. Six people living at the home stated they would complain if they felt they wanted to. Each person said they would speak to the manager, who they identified by name. Four visiting relatives stated they would make a complaint to the home if they considered they needed to. The home keeps a complaints logbook that indicates their responsive management to complaints and a transparent approach to listening to people’s concerns. The home had a satisfactory policy regarding abuse. The Local Authority’s guidelines for abuse were not kept by the home and they did not have any contacts for the Norfolk County Council’s lead officers for Adult Abuse, or for their website or published information. There were no available telephone contact numbers for staff or visitors to report abuse to either for an identified lead officer, or for the Police. There was little awareness that Norfolk County The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 16 Council and the Police, when necessary, have the responsibility to be the lead role when abuse is alleged and reported. Two care staff who had received training in preventing adult abuse stated they would immediately report any suspicion or allegation of abuse to the manager, although they did not know the process for investigation, how it would proceed or where any contact details were for reporting. It was discussed with the manager during feedback that staff should be facilitated to report abuse and that additional training should be provided. The manager explained that he was providing the training for staff in this topic, although he does not have any recognised or formal qualification in this topic. It was discussed with the manager that the Local Authority provides extensive and varied training in the subject. The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26, Quality in this outcome area is good. People benefit from living in a warm, clean and well maintained home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was warm, brightly lit and had adequate natural light. A tour of the building revealed the home was very clean and tidy, smelled fresh and was well maintained. Redecoration was being undertaken to the upstairs dining room. Everywhere was clean and tidy. It was clear that there is a high standard of attention to maintaining and improving the environment. The home has two large bathrooms, each fitted with assisted hydraulic seats and specialist baths. Every room has an en-suite toilet and shower. Two cleaners work each day and at weekends. The kitchens were clean. A recent inspection by an Environmental Healthy Officer found the home satisfactory. The Maltings Care Home DS0000068299.V357434.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,39, Quality in this outcome area is good. People living at the home would benefit more if the home’s induction for new care staff was rigorously managed and from some improvements to the training arrangements. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The recruitment details for two recently employed staff were read. One person started work on 11th November 2007 and the other on 19 December 2007. Both records contained application forms appropriately showing a history of employment. Two references had been obtained for both persons. Both had POVA First checks recorded. Only one person had received a CRB disclosure. The one person still awaiting a CRB disclosure had been allowed to start work in a management capacity. There was no record of any arrangement to supervise this person whilst awaiting a CRB disclosure. The induction book for new staff is comprehensive and follows in detail the Skills or Care Standards. There was no record of the induction process or progress for either of the above two persons, although they had each been provided with the home’s induction manual that is the induction record. However, as the record remains with the person it was not possible to track their induction progress. The current arrangement is for the manager to provide training in Adult Protection to staff. He is not a qualified or a recognised trainer in this topic. The manager stated that the person who The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 19 started work on 19th December 2007 had not yet received her induction training in adult protection and was unable to clarify whether the other person who started on the 11th November 2007 had received induction in this topic. There were no records of any induction achievements that could be shown at the time of inspection. Two other care staff were asked for their experiences of their induction and both made comments that it was ineffective and lacked guidance and did not consider it a valued experience. One person who had also recently commenced employment at the home commented her induction was “not good” and that staff did not offer support. When asked about Adult Abuse training the person replied that a brochure was given to her and this was the information she received as her basic training, which she then had to discuss with a senior carer. This training arrangement should be improved upon and is not a quality approach to safeguarding vulnerable adults. Neither of the above two care staff knew of any of their future training arrangements. There was no overall training plan to indicate when any person should receive any refresher, or repeat, training and there was no evidence to measure what training was provided and what had been achieved. There were no supervision records or detail for either person and the manager stated that neither person had received supervision. The manager added that only a few staff had received supervision. A care worker had recently become a qualified Manual Handling trainer and at the time of inspection was awaiting validation before she could provide certificated training to staff in the home. The manager stated that all staff bar one had received this training. The home employs 21 care workers plus the manager and Assistant Manager and an administrator, a maintenance worker, a cook and two cleaners. Four staff have NVQ level 2 and 3 awards in care and six other staff are undertaking NVQ level 2 awards. The administrator has an NVQ level 4 award in administration. There were forty people living at the home on the day of inspection. Staffing levels indicated on the roster for were six staff plus the manager or assistant manager (who works at weekends) for the daytime between 8am and 8pm. Staff working between 8pm and 8 am are usually three. This is a low-geared ratio of staff to people living in the home. The manager stated that he has arranged to increase the night staff to four staff in the near future. An activities co-ordinator and a cook are employed on a daily basis. During the inspection there was a continuous sound of alarms on the call system ringing and buzzing. The manager explained that he encouraged people to ring for assistance rather than put themselves at risk. The number of calls and the fact that a small number of people required high and medium dependency care in bed is an indication of the high demands placed upon the staff. The Maltings Care Home DS0000068299.V357434.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,38, Quality in this outcome area is adequate. People benefit from a manager who promotes their best interests but needs to improve the supervisory element of staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is NVQ 4 qualified in management. He was observed to lead an open and respectful style of management when he was talking to staff and to people living in the home. Staff stated in the surveys they completed that they considered the managers to be good. Relatives considered the home was managed to a high standard and expressed confidence in the manager and staff. “The residents are looked after to a very high standard”, was one written response. The AQAA returned by the home indicated they had looked very carefully at the outcomes for people and for real ways to improve their service. The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 21 The manager had been requested to assist at another care home, although only for short periods. This was of concern when satisfactory supervisory arrangements for staff have not been achieved and that some induction training needed to be managed. Quality is assured in the following practical ways that also demonstrated the manager setting a lead by example and of promoting the best interests of people living in the home: • The home keeps a complaints logbook that indicates their responsive management to complaints and a transparent approach to listening to people’s concerns. • The senior care on each shift checks the medication records for accuracy and addressing mistakes with the manager. The manager records these findings. Weekly “clinic” meetings with Community Nurses are held to ensure that people’s health needs are known. • The management of the ‘residents fund’ is open and able to be examined by relatives and all people living at the home. Regular supervision arrangements had not occurred and the manager stated this had been difficult for him to time manage. The home do hold regular team meetings that the manager felt acted as a group supervision although this was discussed and agreed not to be an individual or group supervisory element and did not address individual or career development. Annual fire alarm systems and emergency lighting had been certificated. The maintenance worker conducts and records the weekly fire alarm tests and emergency lighting checks. Thermostatic valves set at appropriate temperatures control all hot water taps. The lift and the recently installed chair lift on the stairs were working and had been serviced. The Maltings Care Home DS0000068299.V357434.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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 1 X 3 The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 23 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 17(1)(a) & Schedule 3 Requirement Medication Administration Records charts must include a written note to explain whether any medication has been taken out of the home when they record that a person is not at the home, so that people’s Medication Administration Records charts are accurately recorded. There must be clear medical advice and instructions recorded for administering medication prescribed as “PRN”, or “as and when required”, so that people are safe from overdosing and under dosing. Staff must receive appropriate training in the protection of vulnerable adults so that people living at the home are safeguarded. Timescale for action 01/02/08 2 OP9 13(2) 01/02/08 3 OP18 13(6) 01/02/08 The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 24 4 OP30 18(1)(c) 5 OP36 18(2) Newly recruited care staff must receive an induction training programme where their progress is systematically assessed and their competency recorded so that suitable trained and competent staff meets people’s needs. It is required that all staff employed in the Home are appropriately supervised, so that people are safeguarded. The timescale of 01/05/07 was not met. 01/04/08 01/04/08 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 OP3 Good Practice Recommendations Pre-admission assessment details carried out by the home should contain more information than they currently did at the time of this inspection and should concentrate on needs and risks and the written text should be descriptive of the person. The home’s position to working alongside the Local Authority and Police when protecting vulnerable adults should be clarified in their policy or other statements. All staff working at the home should be enabled to have easy access to the contact telephone numbers to report a suspicion or allegation of abuse. The manager should become familiar with Norfolk County Council’s policy and procedures for dealing with adult abuse; the training provided by the authority; and who are the authority’s lead officers dealing with abuse. New care staff who receive induction training should have their progress systematically assessed and measured and their competency recorded throughout the induction period There should be a written training plan for all staff employed by the home. 2 3 4 OP18 OP18 OP18 5 5 OP30 OP30 The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 25 6 7 OP30 OP30 The training arrangements should include training in assessing people’s needs. The training arrangements should be reviewed to include further training in care planning. The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Maltings Care Home DS0000068299.V357434.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!