Inspection on 18/11/08 for Trelawney House

This inspection was carried out on 18th November 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Trelawney House 21/05/08

Trelawney House 09/07/07

Trelawney House 02/11/06

Trelawney House 06/06/06

Trelawney House 17/11/05

Trelawney House 17/05/05

Trelawney House 04/11/04

Trelawney House 14/05/04

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 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Trelawney House Polladras Carleen Helston Cornwall TR13 9NT     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ian Wright     Date: 1 8 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 33 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 33 Information about the care home Name of care home: Address: Trelawney House Polladras Carleen Helston Cornwall TR13 9NT 01736763334 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Rigas Gatzianidis,Mrs Christine Anne Gatzianidis Type of registration: Number of places registered: care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: To include one named service user with dementia which is outside the registered category. Date of last inspection Brief description of the care home Trelawney Care Home is situated in Polladras, approximately five miles from the town of Helston. The registered persons provide residential care for up to eleven elderly people. Day-care is also available for people living in the community. The home is set in spacious grounds in a very pleasant rural setting. There is sufficient car parking available. Accommodation is on two floors; the first floor can be accessed by a passenger lift. There are two lounges. Meals are cooked in a large kitchen and served in the dining room. Trelawney provide a meals on wheels facility and supplies approximately ten meals to people in the community each day. The registered Care Homes for Older People Page 4 of 33 Over 65 11 0 Brief description of the care home providers are actively involved in the day-to-day running of the home. A team of care staff provide personal care and support. There are opportunities for socialising and visitors are encouraged. A copy of the inspection report is available from management or the Commission for Social Care Inspection. The range of fees at the time of the inspection is £355-£453 per week. There are additional charges e.g. for hairdressing, chiropody, trips out and newspapers etc. Care Homes for Older People Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Two inspectors completed this unannounced key inspection in one day. The methodology used for this inspection was: *To case track people who use the service. This included, where possible, meeting and discussing with the people who use the service their experiences, and inspecting their records. *Discussing with staff their experiences working in the home. *Discussion with other people who use the service and their representatives. *Observing care practices *Discussing care practices with management *Inspecting records and the care environment Other evidence gathered since the previous inspection such as notifications received Care Homes for Older People Page 6 of 33 from the home (e.g. regarding any incidents which occurred) were used to help form the judgements made in the report What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 33 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information provided to people who use the service (e.g. regarding services offered) is satisfactory. For example all people who use the service receive a statement of terms and conditions of residency or contract when they move in. This ensures people are aware of their rights and responsibilities. Pre assessment procedures are satisfactory, although notes of contacts need to be maintained, and documentation needs to be signed and dated. Overall assessment procedures ensure the registered provider checks they can meet the persons needs before admission is arranged. Evidence: The registered provider outlined a satisfactory assessment procedure. For example Mrs Gatzianidis said she visits the persons home/ the hospital, to meet them. She said she also speaks to the relevant people involved in the persons care. The person subsequently will come to the home for a two week respite period, and a meeting is then arranged to agree the placement. We asked the registered provider to keep dated Care Homes for Older People Page 10 of 33 Evidence: and signed notes of these contacts. We inspected files for two people who had moved to the home since the last inspection. Both people appeared to have been assessed by the registered provider. There was also a copy of assessments regarding the people concerned by other agencies such as social services. We were able to inspect contracts / statements of terms and conditions of residency for two people using the service, and information appeared satisfactory. Care Homes for Older People Page 11 of 33 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and personal care needs of people living in the appear to be satisfactorily promoted and met. Although people have care plans, in some cases there needs to be more detail regarding peoples care needs, and staff support required. The management of medication is only adequate; for example the storage and recording of controlled drugs needs improvement. Care staff are viewed positively, and we were told by people using the service that they are treated with respect and dignity. Evidence: A care plan was contained on each persons file inspected. There is evidence care plans are reviewed. Care plans are accessible to staff. People who use the service, who we spoke to were positive about the care they received, but did not appear to be aware of their care plan or any involvement in the process. The registered provider has introduced a new care planning system, in regard to some people who use the service. However the information contained in some care plans needs to give clearer direction to staff regarding individual needs. For example Care Homes for Older People Page 12 of 33 Evidence: regarding what assistance staff should give for an individuals wound care etc. People who use the service said they were satisfied with the health care support they receive. This includes visits from GPs, district nurses, chiropodists, dentists and opticians. However medical interventions still need to be more clearly recorded e.g. when somebody last saw a dentist, chiropodist or optician etc. within the care plan. We inspected the medication system. Storage of general prescribed medication is satisfactory. Medication records are appropriately maintained. Staff appear to have received appropriate training regarding handling medication. However several improvements are necessary: * Disposal records need to be available for inspection. * A suitable system needs to be in place if controlled drugs are stored and administered. For example there needs to be a controlled drugs cabinet (in accordance with Royal Pharmaceutical Society Guidelines), and a controlled drugs book. * An up to date copy of the Royal Pharmaceutical Society Guidelines should be kept on the premises. * Records of medication added to pre printed medication charts should be countersigned by a second member of staff. We spoke to several people who use the service who were complimentary about the care they received. People said they felt their privacy and dignity was respected by staff. People said they were always referred to by their preferred name. People said care staff were kind, very good, helpful. The previous requirement to fit foot plates to wheelchairs has been complied with. Care Homes for Older People Page 13 of 33 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Routines, food and opportunities meet the needs of the people living in the home Evidence: People using the service, who the inspector spoke to, said they could get up and go to bed when they wished, and said routines in the home are relaxed. The registered providers have developed a range of activities since the last inspection. For example there are several organised sessions using external providers. These include music therapy and dance. Staff also organise other activities. These have included bingo, quizzes, and exercise sessions. People have also been out on one or two trips. Some people are happy to organise their own time either reading, watching TV or listening to music. We advised a record of group activities is maintained, although the registered provider said participation should be recorded in daily records. Some people receive regular visitors, and some people go out with relatives. People are positive about the food provided. This appears to be to a good standard. There is not a choice of main meal but people said it is always nice. We suggested a small notice board displays what is available for the main meal so people are aware of what it is going to be for the day. There is a choice of evening tea, and people appear Care Homes for Older People Page 14 of 33 Evidence: to have hot and cold drinks / snacks available to them. Suitable records of food eaten are kept. Care Homes for Older People Page 15 of 33 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered provider has satisfactory complaints and adult safeguarding procedures. These should help ensure any complaints, concerns and allegations are investigated appropriately should they occur. Evidence: A copy of the complaints procedure was inspected and this appeared to be satisfactory. The registered provider said they have not received any complaints during this inspection period. The commission has not received any concerns or complaints. We advised the registered provider to include information regarding access to the social services complaints procedure within their procedure. People who are funded by local authorities have a right to use this procedure if they are funded by social services. The registered provider has a satisfactory Adult Safeguarding procedure. Since the last inspection, there was one allegation reported to the home regarding money stolen. However this did not implicate the registered providers, and the matter was unsubstantiated. Some staff have received training regarding adult safeguarding, and other staff will be trained as opportunities become available from Cornwall County Council. Care Homes for Older People Page 16 of 33 Evidence: Old versions of the complaints and adult protection procedures should be removed from the policy file to avoid confusion. Care Homes for Older People Page 17 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Trelawney provides a satisfactory environment for the people living there, although some areas of the home do now require redecoration and other minor works, as outlined in the body of the report need to be attended to. Evidence: The building was inspected. There is suitable shared space, for example, a large lounge, a sitting area in the hallway and a dining room. Communal rooms seem pleasant and homely. Toilet and bathroom facilities are suitable in size and facilities provided. Bedrooms are generally decorated and furnished according to individual tastes, however at least two need to be redecorated due to peeling wall paper and the age of the original decorations. The upstairs hallway also needs some redecoration. All light fittings (e.g. in bedrooms) should have a lampshade. There was not one present in at least one bedroom and in one hallway light fitting. There is also a crack in the ceiling in Room 1 which should be investigated. People who use the service said they were able to bring their own furnishings and belongings with them when they moved in. Care Homes for Older People Page 18 of 33 Evidence: One persons bedroom is used by the hairdresser, when she visits for all of the people living in the home. A communal area should be used for this service as it could compromise the persons privacy and security of their personal belongings. When we spoke to the person concerned they said they did not mind the arrangement. The home appeared clean, warm and light enough on the day of the inspection. The registered provider said all carpets have recently been professionally cleaned. One bedroom had an unpleasant odour. The registered provider said this matter was difficult to eradicate due to the individuals needs. We advised the commode is disinfected at least daily, and air freshener is used. The kitchen appeared to be clean. Fly screens should be fitted to the external door of the kitchen. Laundry facilities appear satisfactory. The outside of the building and the gardens appear to be satisfactorily maintained. We have raised concerns regarding the lack of a valid electrical hardwire test certificate, in the management and administration section. This needs to be obtained as a matter of priority so we can be assured the home is safe. Care Homes for Older People Page 19 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels appear satisfactory to meet the needs of people currently accommodated at the home. Recruitment checks have significantly improved although it is essential all staff receive a POVA First check /CRB even if they are family members. Training has also significantly improved, although there is some further training that needs to be delivered. For example it is essential suitable levels of first aid cover are maintained at all times. These measures will ensure people who use the service are supported by suitably knowledgeable and skilled staff. Evidence: On the day of the inspection there were two care staff on duty throughout the waking day from 07:00 to 22:00. There is a waking night member of staff from 22:00 to 07:00. A cook is also employed.The record of staff hours appears to show there is satisfactory staffing levels provided for the people the home is registered for. Personnel records were inspected for seven staff (including staff on duty during the 24 hour period on the day of the inspection). These were generally satisfactory, and much improved since the last inspection. Staff employed since the last inspection had two references, a Protection of Vulnerable Adults First check (POVA First) , a Criminal Records Bureau check (CRB) , a completed application form, evidence of identification and a declaration they were medically fit to work with vulnerable people. Care Homes for Older People Page 20 of 33 Evidence: The registered providers daughter has recently been employed in the home to work in the kitchen. She is currently under 18. However there was not a POVA First or CRB for this person. Although the providers obviously know her very well it is important these checks are performed (so as a regulator we know all staff are fit to work with the vulnerable). The registered provider said they are arranging for a CRB check. Training has significantly improved at the home, and a considerable amount of training has been delivered since the last inspection. By law staff require the following training: * Regular fire training in accordance with the requirements of the fire authority. * There must always be at least one first aider on duty (at appointed person level) *All staff must have manual handling training and regular updates of this (e.g. annually) *All staff must have basic training in infection control. * Staff who handle food receive food hygiene training. * All staff must have an induction and there needs to be a record of this. Despite considerable development of training provided, some improvements are still required: * Everyone must have fire training at least annually. Some staff had only received this on their induction, and one person had last received this in May 2007. * Three staff needed to have food handling training. This included the registered provider who needs to attend a refresher course. * Some staff need to have basic training regarding dementia. * Some staff still need to receive adult safeguarding training. * Some staff need to have a valid first aid certificate. This includes the registered provider whos certificate is now out of date. As the providers complete the waking night duties it is essential that there is satisfactory first aid cover at all times otherwise people using the service could be placed at significant risk. This training therefore must be received as a priority. There appears to be satisfactory access to obtain a National Vocational Qualification in Care. All people who have commenced employment since the last inspection have a record of induction. We spoke to some new members of staff who confirmed they had received an induction. Each member of staff has a record of what training they have received, and when this training requires an update. Care Homes for Older People Page 21 of 33 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered providers have made significant improvement to the service since the last inspection in May 2008. The current standards need to be maintained, and where necessary improved. Improvement is still required to quality assurance and health and safety standards. These measures will assist in ensuring there is a satisfactory system of continuous improvement. They will also ensure people are protected from any necessary risks to their health and safety. Evidence: The registered providers have owned and managed the home for several years. Both Mr and Mrs Gatzianidis have suitable skills, experience and knowledge to manage the home. Since the last inspection, a cook has been employed and Mrs Gatzianidis is working between 9-3 during the week in the home (as well as completing some waking night duties). We are pleased with this development as it provides an increased management presence on a day to day basis in the home. When we last completed an inspection in May 2008 we issued a significant number of requirements. The registered Care Homes for Older People Page 22 of 33 Evidence: providers have now generally taken suitable action to address the majority of these requirements. It is essential the current management presence is maintained to ensure the current standard of service is maintained, and where necessary improved. The registered providers should also work towards working less night shifts so they can continue to more effectively manage the business on a day to day basis. If the registered providers are unable to take these actions they need to consider employing a registered manager. We inspected the registered providers Quality Management Policy. This is satisfactory, but needs to be fully implemented. However, the registered providers have made significant improvements since the last inspection in May 2008, and there was a noticeable improvement in the operation of the home. The registered providers have ensured some resident meetings and staff meetings have occurred. These are good fora for ascertaining peoples views, ensuring people feel supported and involving them in the process of bringing about continuous improvement. The registered provider said they were going to introduce a system of audit, and survey various stakeholders who are involved in the service. This would be a welcome development, as long as action plans are developed and implemented from the work completed. The registered providers supplied the commission with an improvement plan following the last inspection. This appears to have been implemented. The Annual Quality Assurance Assessment (AQAA) (an annual dataset, and self assessment required by CSCI) was returned on time and completed to a satisfactory standard. Any notifications, required by the commission (e.g. regarding incidents and deaths) appear to have been received by us. The registered providers have said they do not look after any monies or valuables on behalf of people who use the service. Any additional items or services provided above the weekly fee are invoiced to either the person concerned or their representative. The registered provider has a health and safety policy. There is also a fire risk assessment. Testing of fire extinguishers and the fire system appears to have been completed appropriately by external contractors. Internal checks on the fire system appear to have been completed appropriately by staff (e.g.emergency call points and emergency lighting). We have stated an improvement in fire safety training is required, as outlined in the staffing section of this report. Care Homes for Older People Page 23 of 33 Evidence: Although health and safety risk assessments are completed in relation to individual people who use the service, there needs to be a risk assessment in relation to risks to staff. The Health and Safety Executive produces a useful leaflet (5 steps) on their website. This risk assessment needs to cover matters such as manual handling, slips, trips and falls, legionella, risk of violence, loneworking etc. The risk assessment is required by law. Portable electrical appliances have been tested and appear satisfactory. The electrical hardwire circuit was tested, but documentation deems the circuit unsatisfactory. Part of the circuit, in relation to the kitchen and utility area, was deemed unsafe and dangerous by the electrician conducting the test. The Commission for Social Care Inspection is very concerned about this, and the risk that could be posed to staff and people who use the service. We have written to the registered provider to seek urgent clarification regarding this matter. We have requested, as a matter of urgency, what action will be taken. We also require the registered provider to complete this action as a matter of urgency and to inform us of satisfactory completion that the system is deemed safe. We have informed the fire authority and the Environmental Health Authority regarding this concern as the relevant enforcing authorities. We may need to complete a further inspection regarding this matter if we remain concerned about this issue. If satisfactory action does not occur within the timescale we will consider taking enforcement action regarding this matter. There appears to be a suitable system regarding the prevention of legionella. Manual handling equipment appears to be tested appropriately. The registered provider stated they had difficulty obtaining appropriate documentation from the NHS who owns the equipment. They have made a reasonable request, considering the risks involved if equipment is not tested to a satisfactory standard. If there is difficulty in future it is advisable for the provider to use the NHS complaints procedure and also inform the Health and Safety Executive regarding this issue. It is essential the registered provider and CSCI can be assured that appropriate testing of the equipment is completed. We asked what action is taken to prevent the risk of scalding e.g. from hot water. The registered provider stated a thermometer is always used to test hot water before people have baths. However no record of temperatures is maintained. Mrs Gatzianidis said there are also thermostatic valves on wash hand basins and on baths. If this is the case, a test on all hot water outlets needs to be performed at regular intervals in line with HSE guidance to test the thermostatic valves are working effectively. There is a satisfactory record that the heating system has been serviced. There is also a satisfactory record the lift has been serviced. Care Homes for Older People Page 24 of 33 Evidence: We have stated there needs to be some improvement regarding training in regard to health and safety issues-as outlined in the staffing section of this report. An up to date certificate of insurance is displayed. Care Homes for Older People Page 25 of 33 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action 1 29 7, 10, 12, 13, The registered provider must 01/07/2008 19 ensure suitable checks are performed on all new staff working in the home as outlined in the regulations (for example POVA First check, CRB /POVA check, two written references). Guidance issued by CSCI, and other statutory authorities must be followed. This will help ensure people who use the service are protected from people who are unsuitable to work with the vulnerable. (Previous timescale of 01/08/07 not met. Fourth Notification) 7, 9, 12, 13, 24 Develop the quality 01/09/2008 assurance system to monitor standards in the home for example regarding care planning, medication, staff recruitment, staff training, health and safety etc. Measures taken should be included in the quality assurance policy. This will help improve service quality and help minimise risks to staff and people who use the service. The registered provider must 01/09/2008 Page 26 of 33 2 33 3 38 13, 23 Care Homes for Older People ensure health and safety checks required by law are completed: Satisfactory results of the testing the electrical hardwire circuit. Review health and safety risk assessments e.g. at least annually. Previous timescale of 1/10/2007 not met. Second Notification. Copies of appropriate documentation must be forwarded to the Commission within the timescale set. Satisfactory documentation must always be available for inspection. These measures will help to ensure risks to the health and safety of people living and working in the home are kept to a minimum. Care Homes for Older People Page 27 of 33 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans must contain suitable detail to inform and direct staff to provide care to people using the service. There should be a record of all medical, dental, chiropody and optician etc. appointments. Detailed care plans assist care staff to provide appropriate levels of care for people who use the service. 01/03/2009 2 9 13 The management and storage of medication needs to be improved, with reference to the Royal Pharmaceutical Society Guidelines and Care Homes Regulations 2001. The issues outlined in the body of the report need to be addressed. For example controlled drugs must be stored in a controlled drugs cabinet, and a controlled drugs register must be maintained. 01/02/2009 Care Homes for Older People Page 28 of 33 (Previous timescale of 01/09/08 not met Second Notification) People who use the service can then be more assured their medication is appropriately stored and managed in a secure manner. 3 29 19 The registered provider 01/01/2009 must ensure suitable checks are performed on all new staff working in the home as outlined in the regulations (for example POVA First check, CRB/POVA check, two written references). Guidance issued by CSCI, and other statutory authorities must be followed. (Previous timescale of 01/07/08 not met Fifth Notification. ) This will help ensure people who use the service are protected from people who are unsuitable to work with the vulnerable 4 30 18 The registered provider 01/03/2009 must complete training planned for all staff. For example ensure staff receive training regarding fire safety, food hygiene, first aid and dementia awareness. (Previous deadline of 01/09/08 not met. Second Notification) Care Homes for Older People Page 29 of 33 This will help to ensure people who use the service are supported by suitably trained and skilled staff 5 30 18 There must be satisfactory levels of first aid cover in the home at all times. For example guidance from the CSCI policy should be followed. awareness. This will help to ensure people who use the service are supported by suitably trained first aiders in an emergency. 6 33 24 Develop the quality 01/02/2009 assurance system to monitor standards in the home; for example regarding care planning, medication, staff recruitment, staff training, health and safety etc. Previous timescale of 01/09/08 not met 2nd Notification This will help improve service quality and help minimise risks to staff and people who use the service 7 38 13 Ensure there is an 01/03/2009 appropriate system to prevent the risk of scalding. For example hot water temperatures are monitored, and / or themostatic valves are fitted to baths and wash hand basins. Records need to be maintained to monitor hot water temperatures / 01/02/2009 Care Homes for Older People Page 30 of 33 thermostatic valves are working effectively. This will reduce the risk of scalding to vulnerable people who use the service. 8 38 13 A certificate regarding the 18/12/2008 testing of the electrical hardwire circuit must be obtained deeming the electrical wiring in the home as safe and not a risk to people working and living in the home. The registered providers must confirm in writing what action they will take regarding the current hardwire certificate and when this action will occur. We also require written confirmation when satisfactory work has been completed. This matter needs to be treated as urgent. (Timescale of 01/09/08 not met Third Notification) This will ensure the electrical circuit in the home is safe, and there is less health and safety risk to staff and people who use the service. Ensure there is a suitable system of health and safety risk assessment (e.g. in line with HSE guidelines). (Timescale of 01/09/08 not met Third Notification) This will help to ensure there is a suitable system to ensure health and safety 01/01/2009 9 38 13 Care Homes for Older People Page 31 of 33 risks are minimised in regard to people who use the service, and staff who work in the service. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 3 12 15 Retain all dated and signed notes regarding pre admission assessment contacts. Keep a record of group activities organised. Display the menu for each day so people who use the service are aware of what is the main meal for the day. Provide a choice of main meal. Keep a record of group activities organised. Ensure there is reference to the Social Services Complaints procedure, in the homes complaints procedure, as people funded by local authorities have a right to use this if they have a concern or a complaint. Ensure the adult protection policy is now known as adult safeguarding 4 16 5 18 Care Homes for Older People Page 32 of 33 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 33 of 33 - 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!