Inspection on 07/09/07 for The Rectory

This inspection was carried out on 7th September 2007.

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

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

Other inspections for this house

The Rectory 27/08/09

The Rectory 14/11/06

The Rectory 09/03/06

The Rectory 07/10/05

The Rectory 21/02/05

The Rectory 26/04/04

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

CARE HOMES FOR OLDER PEOPLE The Rectory SRC Residential Care Home 2 Trinity Road Taunton Somerset TA1 3JH Lead Inspector Gail Richardson Unannounced Inspection 09:30 7 September 2007 th 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 Rectory SRC Residential Care Home DS0000003302.V344501.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 Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Rectory SRC Residential Care Home Address 2 Trinity Road Taunton Somerset TA1 3JH 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) 01823 324145 Maners Care Limited Mr Matthew James Parrish Care Home 23 Category(ies) of Dementia - over 65 years of age (23) registration, with number of places The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Two named service users in category MD to be accommodated in the Home, as agreed with the Responsible Individual. Bedroom 9 must only be used to accommodate fully mobile service users. Admissions must be accompanied by an appropriate risk assessment. The Registered Manager must obtain the NVQ4 qualification in Care and Management by 31st December 2006 14th November 2006 Date of last inspection Brief Description of the Service: The Rectory is a two storey detached property on the outskirts of Taunton town centre. Residents’ accommodation is provided over two floors. All residents’ rooms are single occupancy. A passenger lift, assisted bathroom and call system are provided. There is a garden at the rear of the property that is accessible to residents. The home is registered with the Commission for Social Care Inspection, to provide personal care for up to twenty-three people who have a dementia. The Registered Manager is Mr Matthew Parrish and the Registered Provider is Maners Care Ltd. The Rectory has been approved by Somerset Social Services as a special rate care (specialist residential care) home providing enhanced care for people suffering from dementia. The current fee rate is £450.00 per week, this does not include hairdressing chiropody and toiletries. The Rectory SRC Residential Care Home DS0000003302.V344501.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 took place over 1 day (6 hours) on the 7th September 2007 by inspector Gail Richardson and CSCI Pharmacy Inspector Brian Brown. A tour of the home took place and a selection of bedrooms and all communal areas were seen. There were 23 people using the service currently residing at the home. The inspectors spoke to 8 residents, 1 visitor, 1 visiting health professional and 5 members of staff, the Registered Manager was available throughout the inspection. All people using the service spoken to, and who were able, spoke of the staffs kindness. All residents spoken with stated that they were happy with the care they received. The inspectors spent time talking to people using the service, visitors and staff and observed that on the day of inspection, residents appeared relaxed and comfortable in all areas of the home and the atmosphere was calm. There is an established, well-trained staff team and surveys from staff stated they felt supported by the management of the home. Records relating to care including 5 care plans, staff files, finances and health and safety records were examined. As part of this inspection the inspectors surveyed the opinions of a random selection of residents and their representatives, GP’s, District Nurses and Care Workers, a moderate response was received and their comments will be included in this report. The focus of this inspection visit was to inspect relevant key standards under the CSCI ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are; - excellent, good, adequate and poor. What the service does well: The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 6 The home is a large older building which has an ongoing maintenance programme to maintain the fabric and décor of the home. The home is clean and had no malodour, the décor and furniture was of a good standard. All surveys received and comments made, stated that the staff are very good, very dedicated and hardworking. It is clear from comments received from people using the service and visitors that the home makes every effort to support both the residents and their supporting relatives. Comments received included “I am impressed by the atmosphere and care in the home and the attitude of staff towards my relative” The care needs of people using the service appear well managed with the supporting involvement of visiting healthcare professionals. The manager had a positive leadership style, which reflects on the staff who feel supported by the management of the home. Visitors to the home are always made welcome and can visit at any time. One comment received was ,“I am always made welcome when I visit or phone and staff are friendly and helpful.” Admissions are not made to the home until a needs assessment has been undertaken and the home is clear that they are able to meet the residents’ needs. What has improved since the last inspection? What they could do better: To prevent unauthorised access to medicines the registered manager must ensure that all medicines be stored securely. Furthermore the manager must ensure that when medicines prescribed to be administered “when required” that there are clear rationales and guidance available to staff in order that the people receive these medicines appropriately and safely. The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 7 Consideration should be given on how to ensure residents are involved in care planning and review in as far as they are able and that their relatives/representatives are also consulted to ensure that all care needs are met. It is recommended that the statement of purpose be reviewed to reflect that the lunchtime menu choices are provided from an outside catering provision and re heated on site to ensure clear and accurate information is provided to prospective people using the service. The registered manager is recommended to develop the recording of activities to provide evidence of input and preferences to support the development of person centred activity provision. The registered manager is recommended to include in the whistle blowing policy the contact details for CSCI. Consideration should be given to further development of the induction programme in line with the Skills for Care common induction training to give all new staff a thorough understanding of the role of the care worker. The registered manager is recommended to implement monthly testing of all bathroom hot water outlets and also to include the water temperature of the outlets in en-suites or other areas accessible to service users 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 Rectory SRC Residential Care Home DS0000003302.V344501.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 Rectory SRC Residential Care Home DS0000003302.V344501.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 4 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home continues to be able to provide prospective people using the service and relatives with sufficient information in the format of the Service User Guide and Statement of Purpose for them to make an informed decision about the home, review in the areas described is recommended. All prospective residents receive a pre admission assessment by the registered manager to ensure the home can meet the assessed needs identified. EVIDENCE: The homes AQAA states that “The home provides a terms and conditions of residency /contract that includes all the required information. The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 10 Prospective residents and their families/representatives are invited to visit the home and spend time there before they make a decision on residency. Short term respite care is available. Placements are made via Somerset Social Services who have block purchased all of the beds at the home.” This continues to be the case. At the previous inspection it was noted that the Statement of Purpose tells readers that the home provides fresh, homely food. The current meal provision within the home at lunchtime is frozen ready meals provided by an external company. This statement has not been reviewed and it is recommended that the statement of purpose be corrected to reflect that the lunchtime menu choices are proved from an outside catering provision and re heated on site. 5 care files were examined, pre admission assessments had taken place to ensure that the home could meet the prospective persons social, health and care needs. One person using the service confirmed that their family had chosen the persons bedrooms and another confirmed that they had been offered a change of room when a vacancy had occurred. 4 Residents surveys received stated that 3 people felt they had received enough information prior to admission, about the home to make an informed decision. Contracts were not examined at this inspection. The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person using the service has a care plan, the assessed areas of need were reflected in this plan of care and the detail recorded ensures that staff can provide a good standard of care. The development of further risk assessments is recommended. Staff were observed to treat service users with dignity and respect at all times and residents fell well cared for. The lack of clear guidance for the use of medicines prescribed to be taken when required may place people living in the home at risk of harm. EVIDENCE: The inspectors case tracked 5 people using the service, from pre-admission to care planning and included documents relating to medication, accidents and finances. The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 12 The care plans seen were mostly of a good standard and provided staff with the details of identified risks and made a plan of care to meet these risks. These were written in a clear and concise manner, some areas need further development and these included risk assessments for people who left the home on a regular basis unescorted by staff and those people using the service who were previously assessed as not needing a call bell lead who may require reassessment. Residents and relatives were not currently involved in monthly care plan reviews, however the manager informed inspectors that there are future plans to address this using the key workers to undertake reviews with the person using the service. When asked do you receive the care and support you need, 4 surveys said always and 1 said usually, 4 responded that staff listen and act on what the residents say and 4 felt they received the medical support they needed and 1 said usually. 6 staff surveys received, confirmed that these staff were involved in care planning for residents. 2 surveys were received from visiting health professionals, who confirmed that the home communicates clearly and works in partnership with them. One visiting health professional confirmed that all issues raised with the home were dealt with promptly and one survey commented, “I have always found that the staff work to a high standard-maintaining the dignity of the residents. Only find evidence of high quality care”. Another stated, “Care staff have good skills and are well supported by the Specialist Care Development Nurse and Care Co-ordinators”. One relative survey said that they were never kept informed of their relatives health and that they only found out when visiting, other comments received stated that they were kept well updated of changes. 4 surveys were received for relatives and visitors when asked, Are you kept up to date? 3 said always. 1 said never. Other comments received from visitors included, “Trained staff are aware of wholeness of my relatives well being.” “I receive telephone calls from staff.” “I am absolutely certain that my relative is well cared for and we are informed. Trained staff are superb.” “Staff have all spoken appropriately to residents whenever we have visited. “ “We are confident that my relative is well looked after within this secure homely setting.” Inspectors spent time observing the care being given and noted that staff treated people using the service with dignity and respect at all times. Staff The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 13 appeared relaxed in the company of the staff and the atmosphere was happy and calm. People using the service were observed to shows signs of well being and contentment. A visiting health professional commented, “A good client centred approach is evident. Care staff present as busy, caring and considerate taking into account individual care needs.” We found that medicines although stored in an office secured with a digital lock were not all kept securely. The medicines fridge was not locked and some medicines for external (Creams, ointments and lotions)use were stored on open shelves, the remainder being kept in a locked cupboard and a locked trolley. We found that for service users prescribed medicines to be taken “when required” that these medicines were often given regularly and rationales or guidance for their use could be found. This may mean that some medicines are not being given appropriately. We also discussed this with a visiting health care professional at the inspection. We looked at the storage and recording of controlled medication and found these to be in order. All staff administering medicines have received training in the safe handling of medicines and the home have planned update sessions to take place over the next two months. The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are opportunities for social stimulation and people are supported to join in with organised activities or pursue their own interests. Further development is needed to audit the quality and content of the activity. The meals in the home are of an adequate quality and a range of choice is available. People are supported to maintain EVIDENCE: The home currently employs an activity co-ordinator 2 days per week and staff have designated activity time between 2pm and 4pm each day. The home undertakes a social history of each person using the service and a program of activities is planned using that information. On the day of inspection some people using the service were involved in cooking and later that afternoon staff and people using the service were observed involved in a ball game or talking. One person was observed going out independently and people were observed moving freely about the home and the garden. The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 15 One person was supported to enjoy lunch in the garden. People using the service who were able, confirmed that they could get up and go to bed when they wanted and that they were supported to undertake activities of their choice such as reading and watching TV. People using the service who were asked felt there was enough activity. Resident’s surveys asked are there activities arranged by the home that you can take part in, 2 always, 2 usually, 1sometimes. Activities audit records maintained by the home record the number of activities that each person has undertaken but there on the day of inspection no evidence was seen of an audit of the quality or content of the activity. It is recommended that further development of activity recording takes place to record if the person participated and enjoyed the activity. This will support the development of a more person centred activity programme A visitor to the home confirmed that they were always made welcome. One comment made was ““all the staff are very helpful and friendly and make you feel welcome.” One relative confirmed that contact with the community is maintained by, “My relative has visits from clergy. And staff have walked them to local church” One relative said that they were concerned about their relative’s appearance and felt that if they were able to understand they would be unhappy with the standard of their appearances, “clothes, hairstyle etc”. A further comment made was “My relative is always neat and tidy when we pick them up and the same if we go in on chance.” On the day of inspection all people using the service appeared appropriately dressed. The previous key inspection had highlighted the need for the home to under take nutritional assessments for people using the service. It was commendable to note the robust approach in which the home had dealt with this issue. Each person had a nutritional assessment, which is reviewed monthly; this includes being weighed and monitoring current weight against previous weight. Those people who were noted to have lost weight or not maintaining an adequate weight are commenced on a diet sheet where all diet including quantity and frequency is recorded. This is reviewed daily and if it is noted that the person has not had sufficient nutritional intake further snacks and enhanced diet is encouraged. Care files observed by inspectors were seen to include monthly weights which had either increased or remained stable , no weight loss was seen. The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 16 On the day of inspection lunch was a choice of chicken casserole or broccoli and cheese quiche with croquet potato and swede. The lunchtime meals at the home are purchased frozen and reheated at the home. The evening meal is a buffet style meal, the choice on the day of inspection included sausage and beans a choice of sandwiches, crisps and desert. Resident’s surveys asked if residents like the meals at the home, 1-always,1usually and 3 - sometimes. Comments from the people using the service about the food were varied and ranged from “The food is very good with enough choice” to “The food is bland with not a lot of choice” One comment received was that a relative was worried that there wasn’t enough staff and time to help to motivate the person to eat the meals’. It was observed that people using the service were supported to eat in an appropriate and discreet manner, staff ensured that people had choice of meal and were able to change their minds if they wanted to. Staff were also observed to ensure that people had the right glasses on for eating and were sat comfortably, one person was observed to enjoy lunch in the garden. The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 17 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 17 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff and residents are confident that the homes management team would appropriately deal with any complaints or concerns. Policies, procedures and training are available to staff to ensure they have the knowledge to prevent service users from the risk of abuse EVIDENCE: The home has policies and procedures in respect of recognising and reporting abuse, making a complaint and whistle blowing, staff training in abuse awareness also takes place and further training is planned. The whistle blowing policy is recommended to include the contact details of CSCI. 7 staff surveys confirmed that they had information about protecting vulnerable adults and how you report any concerns about poor care practice or allegations of abuse The registered manager explained that the home has received one concern, which was dealt with promptly. People using the service told the inspectors that they would be comfortable to approach the manager or a member of staff with any worries or concerns. Staff also confirmed that they were aware of the The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 18 complaints procedure and were able to raise concerns both at the regular staff meetings and supervision sessions with the registered manager. 5 residents surveys and 3 relatives surveys confirmed that they knew how to make a complaint. The complaints procedure has been updated to contain a timescale of 28 days for response to any complaints made. People using the service have access to the TOCH Advocacy service. All 7 staff surveys received confirmed that they had received a Criminal Record Bureau Check and examination of recruitment files confirms that these check were undertaken before staff commenced employment. The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 21 22 23 24 25 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is a large older building which appears to be well maintained, the home provides sufficient and suitable facilities and specialist equipment as assessed need indicates. The standard of hygiene is good. The gardens are attractively laid out and suitable for people using the service use. EVIDENCE: A selection of bedrooms and all communal areas were seen at this inspection. The home was clean and appeared well maintained. Overall the home is pleasantly decorated, the home provides 2 lounge areas, a large light dining room and a small seating area in the corridor. All bedrooms except one were of a good size and were bright and airy. The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 20 There is mostly level access around the home and people using the service have access to other floors via a passenger lift. Where there are steps appropriate risk assessments are in place. The garden area was pleasant and accessible to people using the service and there was ample garden furniture and seating areas. There is access to specialist equipment and adaptations to promote independence. Specialist pressure relieving mattresses were seen were there was an assessed need. There are suitable and sufficient toilet and bathing facilities. The upstairs bathroom and corridor were noted to be dark and may benefit from improved lighting. The inspectors noted that small locks were located on 3 doors, one bathroom, one en-suite and one fire door. The registered manager will assess the need for these and remove as required. The call bells available in each room were noted to not all have leads attached. The registered manager confirmed that each person is risk assessed as to their need for a lead as some people can get out of bed to press the bell on the wall unit. One person using the service who did not have a call bell lead voiced an opinion that they would like one. The registered manager is recommend to regularly review the risk assessments to incorporate the person’s choice and preference. Bedrooms were personalised with service users photographs and some small personal belongings. The general standard of cleanliness was good. Residents surveys confirmed that the home is always clean and fresh, 4- always and 1- usually. One relative commented “The care home is always spotless, no smells.” The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels at the home are adequate to meet the assessed needs of service users and staff training is promoted to support service users. The induction process for staff is recommended to involve the Skills for Care, Common Induction Standards. The recruitment procedures within the home protect the people using the service from risk. EVIDENCE: On the day of inspection there were 4 staff on duty, the registered manager had stepped in to work on the floor due to staff sickness. The registered manager routinely works as part of the staff team. 3 staff are available in the afternoon and 2 staff overnight. Also on duty were 1 housekeeper and kitchen staff. Rota’s examined evidenced a consistent level of staff and discussions with staff confirmed that the home had an established staff team who have worked together for a long period of time. Staff felt there were adequate staff available. Resident’s surveys asked if staff were available when you need them said, 4always, 1 -usually. The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 22 7 staff returned comment cards to CSCI, 6 staff confirmed that they felt they had received adequate induction and supervision when they commenced their job. 7 staff confirmed that they were clear of what the service users needs were and also 6 staff were aware of the duties they must not undertake. The induction programme is recommended to be reviewed to meet the Skills for Care Common Induction Standards, which aims to give all new staff a thorough understanding of the role of the care worker. Staff Appraisal and Supervision records were available and well maintained. The registered manager undertakes all one to one supervisions and confirmed that whilst he and the deputy manager receive no formal supervision they are able to discuss concerns with each other. All staff training records were up to date and action had been taken to ensure that there was available on each shift a carer with a suitable first aid qualification. The registered manager has completed the NVQ Registered Managers Award and 2 staff are currently undertaking and NVQ level 4 in Health and Social Care . The home employs staff qualified in manual handling training and assessment who then ensures all other staff are suitably trained, this staff member also undertakes assessment for staff taking NVQ 2 in health and personal care. The home has over 50 of staff who have completed their NVQ training or have an equivalent. All statutory training is recorded as having been completed and further training has been provided in challenging behaviour and eye care. Recruitment procedures were examined and were adequate to ensure that people using the service were not placed at risk. The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 23 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 37 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is effectively managed and benefits from the positive and proactive management style of the registered manager. People using the service monies are managed in a safe and auditable manner. Systems are in place to ensure the health and safety of service users whilst encouraging and promoting independence. EVIDENCE: The registered manager of the home is Mathew Parrish who has managed the home for several years. Discussions with the inspectors confirmed that he has The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 24 a clear understanding of the needs of the people living at the home and constantly strives to develop a team of staff to provide a high standard of care at all times. Mr Parrish has successfully completed the Registered Managers Award since the last inspection and is currently undertaking a NVQ level 4 in Health and Social Care. One staff commented that “I receive adequate support from the management team”. A visiting health professional commented that “I have confidence in the manager and care staff who work within the home. Good leadership is evident and there is good interaction with carers and professionals alike.” The home undertakes yearly audits of care by surveying the opinions of the residents and their families, regular meetings of people using the service and their relatives also take place and records maintained. Questionnaires received had complementary comments regarding the environment and care given and offered more suggestions for activities. There are established systems in place for dealing with service users finances. The inspector evidenced that each persons personal monies were stored in individual boxes which were securely locked, each had a running total of deposits and withdrawals, 2 randomly selected accounts were audited and found to be correct. All service users records are stored confidentially in line with the Data Protection Act. Seven staff stated on the comment cards supplied that they were receiving regular supervision. The records available supported this. Maintenance records were well maintained and up to date these included ; * * * * * * * * * * Fire Extinguishers Weekly fire alarm tests and 6 weekly staff fire training. Hoist Servicing Emergency lighting PAT Tests COSHH Electrical Hard Wiring Fire System Lift servicing Accident audit. It was noted that the hot water testing undertaken is currently only testing one outlet per month. The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 25 The registered manager is recommended to implement monthly testing of all bathroom hot water outlets and also to include the water temperature of the outlets in en-suites or other areas accessible to service users The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 26 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 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 2 The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP9 OP9 Regulation 13(2) 13(2) Requirement To prevent unauthorised access to medicines they must all be stored securely. To ensure that medicines prescribed to be administered “when required” that there are clear rationales and guidance available to staff in order that the people receive these medicines appropriately and safely. Timescale for action 07/12/07 07/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP1 Good Practice Recommendations It is recommended that the statement of purpose be reviewed to reflect that the lunchtime menu choices are provided from an outside catering provision and re heated on site. Consideration should be given on how to ensure residents are involved in care planning and review in as far as they DS0000003302.V344501.R01.S.doc Version 5.2 Page 28 2. OP7 The Rectory SRC Residential Care Home are able and that their relatives/representatives are also consulted. 3. 4. OP8 OP12 Risk assessments should be reviewed regularly and updated as necessary to reflect residents current needs. The registered manager is recommended to develop the recording of activities to provide evidence of input and preferences to support the development of person centred activity provision. The registered manager is recommended to include in the whistle blowing policy the contact details for CSCI. Consideration should be given to further development of the induction programme in line with the Skills for Care common induction training. The registered manager is recommended to implement monthly testing of all bathroom hot water outlets and also to include the water temperature of the outlets in ensuites or other areas accessible to service users 5. 6. OP16 OP30 7. OP38 The Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Rectory SRC Residential Care Home DS0000003302.V344501.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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