Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: WCC Mayfield Mayfield Close Bedworth CV12 8ES 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: Lesley Beadsworth
Date: 1 9 1 2 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. that people have said are important to them: They reflect the things 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 31 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 31 Information about the care home
Name of care home: Address: WCC Mayfield Mayfield Close Bedworth CV12 8ES 02476313600 02476315376 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Warwickshire County Council, Social Services Department care home 35 Number of places (if applicable): Under 65 Over 65 0 35 mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 1 0 Mayfield is a Local Authority home for older people, with thirty-five beds. It provides permanent care, phased care (which means that people come in for regular, planned periods) short stay and day care. Four assessment beds are also available for rehabilitation. The home is situated on a housing estate, within easy walking distance of Bedworth town centre. The town is a small but busy community, with a variety of shops, a local market and a civic centre. These are all in a pedestrian zone. The home is close to local bus routes as well as being provided with services from Coventry and Nuneaton. It is also close to the M6 motorway. There is car parking to the front and rear of the home. Mayfield was refurbished in 1995 and provides accommodation on two floors. There are three lounges and a main dining area. There is a day care area with its own lounge with kitchenette, which does not have to be Care Homes for Older People
Page 4 of 31 Brief description of the care home registered and therefore was not inspected. All bedrooms have en-suite toilets and washbasin, and on each floor there are bathrooms and toilets suitable for people who need assistance. The main kitchen, laundry and staff offices are on the ground floor. Access to the upper floors is via either of the two staircases or the passenger lift. The fees are social services rates anddepend on the persons financial standing. Additional charges are made for hairdressing, chiropody, day trips, toiletries and entrance fees whilst on outings. Care Homes for Older People Page 5 of 31 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: The inspection included a visit to Mayfield. As part of the inspection process the registered manager of the home completed and returned earlier in the year an Annual Quality Assurance Assessment (AQAA), which is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service. Information contained within the AQAA, from previous reports and any other information received about the home has been used in assessing actions taken by the home to meet the care standards. Three residents were case tracked. This involves establishing an individuals experience of living in the care home by meeting or observing them, talking to their families (where possible) about their experiences, looking at residents care files and focusing on outcomes. Additional care records were viewed where issues relating to a residents care needed to be Care Homes for Older People
Page 6 of 31 confirmed. Other records examined during this inspection included, care files, staff recruitment, training, social activities, staff duty rotas, health and safety and medication records. The inspection process also consisted of looking at some policies and procedures, discussions with the manager, staff, visitors and residents. The inspection visit took place between 11:15am to 10:30pm. What the care home does well: What has improved since the last inspection? All care plans seen included the needs identified in the persons assessment and had been updated with current information. There had been some improvement in the medication system that increased its safety. That is - Medication charts recorded the current drug regime for that person. The chart was not signed for until the medication had been administered. Medication was transported safely throughout the home. Those people who were able to self administer their own medication had been assessed in order to minimise any risk. Information from risk assessments related to any action required had been transferred Care Homes for Older People Page 8 of 31 to care plans in the care files looked at. All relevant hazards were risk assessed in order to minimise the risk. All of the ground floor corridor was now redecorated so that both sides of the reception area were the same and were bright and clean. A small lounge, some bedrooms and the main dining room had been redecorated. The dining room had a new wood-effect non-slip floor covering and improved lighting. The redecorated bedrooms had been recarpeted. Some bedrooms had also been redecorated and recarpeted. These improvements had added to the comfort for the people living at the home. A part time Activity Organiser had been appointed and progress had been made to improve the activities and occupation offered to the people living at the home. Entertainment and social events had been organised for the Christmas period. There had been an improvement in the attendance of staff at the home therefore providing more consistency and continuity for the people living at the home. Staff supervision had been provided for staff and was on target to be given six times a year. What they could do better: The care plans for a resident using the home for phased care had not been reviewed at each visit. As needs may change between visits the care plans need to be reviewed each time. Only one of the three care plans had been signed by the resident. Where practicable these plans should be drawn up with the resident and/or their representative and signed by them to show that this has been the case. Where a resident is unable to be weighed an alternative system for monitoring weight loss or gain should be used. The risk assessments for bedrails should be in more detail, showing all the hazards in their use. The decision to use them should be a multidisciplinary one in order to ensure they are used in the residents best interests. The home needs to be able to show that the room where medication is stored is kept at the temperature required to maintain the stability of the medication. The home continues to be without a safe homely remedy policy to enable residents to receive treatment for minor ailments safely. Although the home carries out frequent audits of medication these do not always identify which member of staff has made the error. The home should therefore implement audits that do so in order that action can be taken to ensure that residents receive the correct medication at the correct time. Care Homes for Older People Page 9 of 31 There were two different keys for codes to be used when administering medication. This is confusing and misleading. This needs addressing to ensure all staff are using the same one. A resident said that they did not have the sandwiches made for tea because having been made earlier in the day and kept in the fridge they were too cold. The manager said that this would be looked at. Some areas of the home, particularly some unused bedrooms, had an offensive odour. This should be addressed in order that people living at the home have a comfortable and hygienic environment. There hand washing facilities provided in communal areas that supported the control of infection. However one area was without a soap dispenser and a lid was missing off the waste bin in the staff toilet. There continued to be no domestic staff employed in the home at weekends. This means that senior and care staff need to carry out any necessary domestic tasks taking them away from time with residents. The home had been without a registered manager since June 2008 and due to absences ther were no permanaent senior staff in the home. In order to provide stable leadership this needs to be addressed as soon as possible. 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 10 of 31 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 11 of 31 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. Pre-admission assessments are carried out to assess if the needs of prospective residents can be met but with minor shortfalls. Evidence: As part of the case tracking process three sets of care files were looked at. All included pre-admission assessments, which were carried out using a format that includes all the necessary headings. Two of the assessments were in sufficient detail for the home to decide if they could meet the persons needs or not. The third had only basic information. One of the assessments did not show the date that it had been carried out. A copy of the letter sent by the home to the prospective resident to inform them of the outcome of the assessment was also on file. Care Homes for Older People Page 12 of 31 Care Homes for Older People Page 13 of 31 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. There are care plans in place that give care staff the instructions they need to meet the needs of the people at the home. Residents have access to health care professionals and are cared for in a respectful manner. The medication system safeguards the well being of residents but some errors had been made. Evidence: Each of the three resident care files looked at as part of the case tracking process contained care plans to advise staff on the care required by that person. One of these care files belonged to a person who visits the home for regular short stays (phased care). This persons care plans had been reviewed but not at each visit. Changes could have occurred whilst the person was at home and therefore care plans should be reviewed each time they return to the care home in order to ensure that all needs are met. The other two sets of care plans had been reviewed monthly and revised as required. All three sets of care plans were in sufficient detail to give staff the information they required to give the necessary care in a person centred manner. Only one of the three care plans had been signed by the resident or provided any other
Care Homes for Older People Page 14 of 31 Evidence: evidence to support that the person had been involved in drawing up the plans. Records for falls, pressure areas and weight checks were in place within the files looked at. Completed risk assessments for nutritional risk screening, pressure sores (a break in the skin due to pressure, which reduces the blood supply to the area) and a manual handling risk assessment were also in place. These should help to minimise any risk to the residents in these areas of care. A resident with a high risk of developing a pressure sore had an appropriate care plan in place so that staff were aware of what steps to take to prevent this occurrence. Preventative measures such as pressure relieving mattresses and cushions were in use for this and other residents at risk. A resident could not be weighed because of their physical frailty. The home had not looked at alternative ways of monitoring this persons weight. Risk assessments were also in place for the use of bedrails for two of the three residents whose care files were looked at. One of these was in better detail than the other but both required more information identifying the risks and about what preventative action should be in place. As bedrails are a form of restraint it needs to be clearly recorded that the decision to use them was a multidisciplinary one and that the home was acting in the persons best interests. The monitoring of mental health needs was documented in the care plans, where it was appropriate, in order that staff could manage these needs appropriately. Residents on going health care needs were being met with evidence of visits to or visits by the GP, District Nurse, dentist, optician, chiropodist and Community Psychiatric Nurse being identified in the care files looked at. Medication was inspected. The medication policy was still in the process of being revised by senior management of the Local Authority. It was anticipated that this would be implemented in the near future. The home continued to be without a safe homely remedy procedure in the meantime. The home uses a bubble pack multi dose system (MDS) of dispensing medication although some medication, and all liquids, cannot be dispensed in this way and comes from the pharmacist in their original packages. Some short stay residents bring their medication in original packaging and others in an MDS system that differs from the one used at the home. All staff responsible for medication had completed Distance Learning accredited medication training. The member of senior staff spoken with during the inspection of medicines had a good knowledge of medication and of the whole medication system at
Care Homes for Older People Page 15 of 31 Evidence: Mayfield. As in line with the Local Authority homes current practice there are several quality assurance audits when tablets were counted twice a day with the balance of tablets remaining checked against those signed for on the Medication Administration Record Sheets (MARS). These audits would not always identify the person who failed to administer and/or record the medication accurately. Action could therefore not be taken to improve the persons practice. We also carried out an audit of medication at this visit. The majority of these indicated that the correct medication had been given at the correct time to the correct person. However three quantities checked indicated that tablets had been signed for but not given as there were more tablets remaining than calculated from the MARS. Following the inspection the manager advised us that the quantity of one of these medications had been altered over the weekend in order to show that the correct number of tablets remained and was investigating why this had happened. The codes printed on the MARS to denote when and why medication had not been administered differed from the homes list of codes to be used that was included in the MARS folder. This could cause confusion and misunderstanding if different staff followed different codes. A useful list in the MARS described the use of each medicine administered. This would support staff to know why each resident was taking each medicine. Medicine trolleys were in use but were kept in a very small storage cupboard that was also very warm. The temperature of this room was taken during the checking of the medication and at this time was 25 degrees centigrade. The home must demonstrate that the temperature remains at the required level for medicines stored there at all times and take any necessary action to maintain this. There had been some improvements and evidence of good practice in medication. An improved and safer administration procedure had been implemented that removed the need for open tots containing medicines being carried any distance and the MARS were not signed for until the relevant person had taken the medicine. Copies of prescriptions were kept in order to check against the current MARS and the medicines received. This enabled the home to be sure that the medicines dispensed and received were the medicines prescribed and required. A care officer had written a clear procedure for the process of ordering and renewing each medication cycle supply. This would ensure that any member of the senior staff
Care Homes for Older People Page 16 of 31 Evidence: would be able to efficiently carry out this task. All medication brought in by new residents, including for short stay, was now confirmed with the persons GP and a copy of the medication for that person faxed to the home. This ensured that the home were fully aware of the treatment the person should be taking. A second member of staff now countersigned handwritten MARS in order to ensure the accuracy of the recording. Those residents who were self administering their own medication were risk assessed to ensure that they were able to do so safely. This applied to only two residents who self administered their inhalers and nebuliser. Residents were observed to be cared for in a respectful manner ensuring that their dignity and self esteem were maintained. Care Homes for Older People Page 17 of 31 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. Residents were occupied and stimulated. Visitors were made welcome and their needs considered. Residents had choices and control, with limitations to leaving the building, over their daily lives. Residents enjoyed the nutritious and varied meals provided. Evidence: The home now has a designated activity organiser who the manager said was enthusiastic and able to move forward the activities provided at the home. An extensive and varied programme of stimulating activities was displayed in the home to inform residents of forthcoming events and the member of staff was seen to be occupied amongst the residents providing activities. The communal lounge previously known as the library had been converted into an activity room and there were many examples of the craftwork done by the people living at the home. Residents spoken with said that they had enough to do during the day. The home was decorated for Christmas and a programme of entertainment and activity had been arranged, with a Christmas party planned for the day after the visit. Visiting was not restricted and there were areas where visitors could meet with their
Care Homes for Older People Page 18 of 31 Evidence: friend or relative, including the residents bedroom. A visitor spoken with said that they were always made to feel welcome and the residents who were spoken with confirmed this. The current menu was on display to inform residents of the meals available during the week and these were varied and offered choice. Lunch was taken with the residents and this was well presented, tasty and nutritious. Meals were provided in the large dining room although staff spoken with said that residents could choose to eat in their rooms if they wished. The dining room had been recently decorated and new floor covering had been provided. Suitable and appropriate tableware, condiments and drinking vessels were in use. Orange squash or water was available during lunch and tea or coffee was served at the end of the meal. The residents spoken with after lunch said that they had enjoyed their meal and that they usually enjoyed the food at Mayfield. One resident spoken with in the evening said that sandwiches were often provided for tea but said, I ask for bread and butter because the sandwiches are too cold to eat. These were made earlier in the day and then stored in the fridge until tea time. The manager was advised of this and said that he would look into the concern. Assistance and support in eating was available to residents as required. This was given individually and sensitively. The kitchen was visited and looked clean and well organised. Food was stored appropriately. Care Homes for Older People Page 19 of 31 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 home has appropriate practices, policies and procedures in complaints and to safeguard residents. Evidence: The Local Authoritys complaints procedure was displayed in the home in order that residents and visitors knew how to complain. Residents spoken with knew who to speak to if they had any concerns. The complaints log was looked at and records had been appropriately completed. The home had the Local Authority policy and procedure for protection vulnerable people from abuse (safeguarding) and staff had attended the relevant training in order to give then the knowledge and skills to be able to identify and report any suspected or witnessed abuse and to safeguard residents. There had been no safeguarding referrals made in the past year. All recruitment practices safeguard residents from the employment of unsuitable people. There were appropriate records of transactions, and cash that balanced against these
Care Homes for Older People Page 20 of 31 Evidence: records, for any money held on behalf of residents. Care Homes for Older People Page 21 of 31 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. The home offers the people living there comfortable surroundings, which are clean, hygienic and generally safe and well maintained but with some shortfalls. Evidence: A tour of the home was carried out and the home generally offered comfortable and adequately maintained accommodation over two floors. There were some areas, particularly some vacant bedrooms, which smelt of urine. Carpet in some of the corridor areas was looking worn in the high usage areas. Bathrooms looked clinical but were clean and free of offensive odour. Some improvements had been made in the environment. All of the ground floor corridor was now redecorated so that both sides of the reception area were now the same. A small lounge, some bedrooms and the main dining room had been redecorated. The dining room had a new wood-effect non-slip floor covering and improved lighting. The redecorated bedrooms had been recarpeted. New curtains had been ordered for this room. Some bedrooms had also been redecorated and recarpeted. These improvements had added to the comfort for the people living at the home. As at the previous inspection the home provided hand washing facilities and protective
Care Homes for Older People Page 22 of 31 Evidence: clothing for staff, that helped to maintain infection control although one toilet was missing a soap dispenser and the lid was missing off the bin in the staff toilet, which as this is for used paper towels, hinders infection control. Laundry facilities were satisfactory and remained unchanged from the previous inspection. Care Homes for Older People Page 23 of 31 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient care staff available to meet the needs of the residents but the lack of ancillary staff at weekend may have an impact on this. Satisfactory recruitment practice protects residents from the employment of unsuitable people. The importance of training is recognised. Evidence: The home had experienced a high level of absence amongst the staff teams but this was beginning to improve. Observations, the staff rota and discussion with the senior staff showed that there were sufficient staff to meet the needs of the current number and dependency of residents, although there continues to be no domestic staff employed at the weeken, relying on care and senior staff to carry out any required domestic tasks. This takes them away from time with residents and managing the home. No further information was acquired related to the achievement of the National Vocational Qualifications (NVQ). At the previous inspection 58 of the care staff had achieved this and 24 of the staff were undertaking the training. Three staff files were looked at. They each contained the appropriate Criminal Records Bureau and Protection of Vulnerable Adults First checks that had been received prior to
Care Homes for Older People Page 24 of 31 Evidence: the start if their employment. There was evidence that employment history, and the two written references that are required, in each file had been verified. The residents were therefore safeguarded from the employment of unsuitable people. The staff files showed that new staff were undertaking induction training that would give them the knowledge and skills they would need to carry out their job. All mandatory training related to health and safety issues, including moving and handling, was up to date. Care Homes for Older People Page 25 of 31 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A person with the appropriate qualification and with management experience currently manages the home. There is monitoring and auditing of the service and practices to ensure that all services operate in the best interests of residents. Health and safety practice protects residents and staff at the home. Evidence: The home had been without a registered manager since June 2008. The acting manager, who had just been appointed at the last inspection, had recently resigned from the post. An experienced registered manager, from one of the other Local Authority homes and who has the appropriate qualifications and known leadership and people skills, had been transferred to Mayfield on a temporary basis. The acting manager was able to show that he was aware of the strengths of the home and where improvements were needed to meet the National Minimum Standards. He showed enthusiasm in working to achieve these improvements whilst at the home. Care Homes for Older People Page 26 of 31 Evidence: The remaining senior team was fragmented with the assistant manager and the care officers absent. There were four acting care officers at the home covering for these absences, two from other Local Authority services who were due to return to their usual posts, and two from an agency. The home uses the Local Authoritys Quality Assurance Programme that audits and monitors all areas of the service and a representative of the Local Authority oversees this, making monthly unannounced visits. A report of this visit is written for us and the home manager. These systems indicate that the home is monitoring the service in order to enable growth and improvement. Records of staff supervision were seen in the staff files looked at. These records showed that the previous manager and senior staff had carried this out on a regular basis and that the home was on target for care staff to receive it on the required six times a year. Staff supervision is necessary as it allows the management to meet with staff on a one to one basis to discuss practice, personal development and philosophy of the home issues. It is also an opportunity for staff to contribute to the way that the service is delivered. There were appropriate records of transactions, and cash that balanced against these records, for any money held on behalf of residents. These showed that the residents financial interests were safeguarded. There was evidence from a random check of records, that equipment was regularly serviced and maintained, health and safety checks were carried out and that in house checks on the fire system were up to date. There were no concerns about health and safety during the visit. Care Homes for Older People Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 28 of 31 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 8 13 Risk assessments regarding 25/03/2009 the use of bedrails must demonstrate that the decision to use them has been a multi disciplinary one and include details of all the possible hazards involved in their use. This will ensure that the bedrails are used in the residents best interests and the risks are minimised. 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 7 The date of when an assessment was carried out should be recorded on the completed assessment form. Where practicable there should be evidence to show that the resident and/or their representative have been involved in drawing up their care plan. Care plans for respite, or any other short stay service user, should be reviewed at each visit. 3 7 Care Homes for Older People Page 29 of 31 4 5 8 9 If a person is unable to be weighed an alternative method of measuring weight loss or gain should be used. The home should be able to demonstrate that the temperature of the medication cupboard is maintained at the appropriate temperature. The use of which codes are to be used by staff on medication administration charts should be clarified. A quality assurance audit of medication that assesses the competence of staff practice should be in place and action taken to improve practice where necessary. There should be a homely remedy policy implemented that enables staff to offer safe treatment for minor ailments. All communal areas where residents and staff are expected to wash their hands should have all the appropriate facilities to maintain infection control. The offensive odour in some areas of the home should be addressed. There should be sufficient ancillary staff available to minimise the need for care staff to carry out domestic tasks that take them away from residents care. A stable and permanent senior staff team should be established as soon as is possible. The organisation should appoint a suitable permanent manager as soon as possible and this person should apply for registration with us promptly. 6 7 9 9 8 9 9 26 10 11 26 27 12 13 31 31 Care Homes for Older People Page 30 of 31 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 31 of 31 - 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!
