Inspection on 26/06/07 for Winchester House

This inspection was carried out on 26th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Winchester House 21/03/06

Winchester House 13/10/05

Winchester House 16/03/05

Winchester House 11/08/04

Winchester House 09/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Winchester House 90 Frinton Road Kirby Cross Frinton On Sea Essex CO13 0HJ Lead Inspector Pauline Dean Key Unannounced Inspection 26th June 2007 10:15 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 Winchester House DS0000017998.V344330.R02.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. Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Winchester House Address 90 Frinton Road Kirby Cross Frinton On Sea Essex CO13 0HJ 01255 678813 01255 679196 lee.saunders@btinternet.com 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) Mr Lee Saunders Mrs Elizabeth June Saunders Mrs Elizabeth June Saunders Care Home 8 Category(ies) of Old age, not falling within any other category registration, with number (8) of places Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 65 years and over, only falling within the category of old age (not to exceed 8 persons) 12th January 2007 Date of last inspection Brief Description of the Service: Mr and Mrs Saunders own Winchester House. Mrs Saunders is the Registered Manager. A large detached property; the home is registered for 8 older people. All accommodation is at ground floor level and all bedrooms are single, with most having en-suite facilities. Winchester House is well decorated and well maintained throughout and is very welcoming and homely in appearance. There are extensive, well-maintained gardens to the rear of the property. The current scale of charges as at June 2007 ranges from £435.00 - £465. 00 per week. The highest fee is for a single en-suite room with a garden view. Hairdressing, chiropody, foot massage, toiletries are all charged at extra at cost. Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Winchester House took place on 26th June 2007 over a 9-hour period. The inspection involved checking information received by Commission for Social Care Inspection (CSCI) since the last inspection in January 2007, looking at records and documents at Winchester House and talking to the senior carer on duty and care staff. The registered manager, Mrs Elizabeth Saunders was on holiday. A tour of the premises was completed. Surveys were left with the home for distribution to all of the people living at Winchester House, but unfortunately none had been returned at the time of writing this report. In addition surveys were left for distribution to family and friends and healthcare professionals and two surveys from relatives have been returned to the Commission. One relative was spoken with at the inspection. These are reflected on in this report. During the site visit four people who live at Winchester House were spoken with. All were pleased with the service and happy about way they are supported and assisted by the staff. They considered staff to be kind and courteous. One person said ‘The staff are good here’. Twenty-two National Minimum Standards were inspected. This included all key standards. Eight requirements and six recommendations were made as a result of this inspection, with all outcomes other than staffing either good or adequate. This is an increase in requirements from the last key inspection when there were none. What the service does well: What has improved since the last inspection? Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 6 Winchester House had introduced a computer for the use of the people living at the home. We have been informed that this facility has only just been introduced and the home are looking for ways of enabling their residents in communication and accessing information on the web. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 7 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 Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 8 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): 3 and 6. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. A comprehensive admissions process ensures that people who come to live at Winchester House are assured that their needs are met. EVIDENCE: On the day of the site visit there were eight people living at Winchester House. The registered proprietors Mr and Mrs Saunders were on holiday. Mrs Elizabeth Saunders is the registered manager. Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 9 The admission procedure and paperwork was sampled and inspected for three of the people living at the care home. Pre-admission questionnaires had been completed by the home prior to admission. The person most recently admitted to Winchester House described how they had got to know the home. They said that they had been able to visit the home before moving in and they had been able to see their room. People who live at Winchester House receive an admission pack when they arrived at the care home. This pack has the Aims and Objectives of the home, the Admissions Policy, Complaints Policy and a Contract. No intermediate care is offered at Winchester House. Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 10 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 and 10. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Overall, people who live at the home can expect to have their care provided in the way they prefer as care plans detail the health and physical care needs although they fall short on social care needs. People who live at the home can expect to have their medication well managed. People who live at the home can be expect to be treated with sensitivity and respect. EVIDENCE: Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 11 The admission procedures in the home provided sufficient introductory information. From this information Winchester House could determine whether they could meet the identified needs and commence an individualised plan of care. Resident Dependency Assessments were seen in place for the three care plans sampled. As part of the case tracking exercise the plans of care for three people who use this service were sampled and inspected at the site visit. Of the three sampled, two were found to be of a similar format whilst the third was different. The third care plan initially completed in April 2005 was found to be written with care needs collated together under the heading – ‘What are the identified care needs?’ Personal care needs covered all personal care needs such as ‘Dresses herself,…. sleeps well without medication.’ This led to collective outcomes such as ‘To maintain independence’ and was therefore very difficult to ascertain what the care need was and what action needed to be taken by care staff. The other two care plans sampled at the site visit were based on a Care Needs Assessment using the ‘Activities for Daily Living’ format. Whilst fifteen goals/outcomes were listed in these care plans, the outcomes themselves did not cover all aspects of the health, personal and social care needs of the individual. An example of this was– Social Care Needs – ‘In need of 24 hour care, unable to manage at home alone.’ There was however no reference to this individual’s personal social care needs in the care plan. It was recognised however, that the home was fully aware of their needs and when spoken to the resident was able to inform us that they enjoyed reading, sitting in the garden, watching evening television, doing word searches and occasional trips out with the home or relatives. All of which were accommodated and encouraged by the home. Daily record keeping was in place. These records however were often brief, giving little information as to the activities during the day and the demeanour of the individual. Examples seen were ‘Good day’ and ‘Appears well and happy’, which give very little information. There was evidence of monthly reviews on each of the sampled care plans. In one care plan record keeping relating to the management of diabetes was seen and whilst it was comprehensive e.g. Blood Test readings, Diabetic Administration Chart – daily records and weight charts it was acknowledged that this file was not in good order and easy to read and access by care staff. The people living at Winchester House use two local doctors surgeries. Records were seen of visits to and by healthcare professionals. Entries were seen on the three files of visits to GPs, Chiropodist and Opticians with recordings made of whether residents were accompanied or unaccompanied on Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 12 these visits. Records were seen of the outcome of these visits and consideration was given to these in care planning. Medication administration, record keeping and storage was sampled and inspected for the three people who were part of the case tracking Medicines were held in a wall cupboard or fridges and there was no Controlled Drug storage although they were holding a Controlled Drug. Overall records and medication were in good order. One exception was found in the case-tracking sample. We were informed that there had been a change to when the medication that was administered. The instructions found on the Medication Administration Record (MAR) sheet however, did not confirm this. Winchester House did not have a Controlled Drug cabinet or a Controlled Drug register. Two people living at the home were prescribed Tamazepam Tablets. These were stored in the medication cupboard. As a Schedule 3 Controlled Drug, Tamazepam requires storage in a Controlled Drug cupboard. A good practice recommendation is for recordings to be made of administration of Tamazepam in a Controlled Drug Register. Records were seen of administration of medicines held in fridges. This included eye drops and insulin. Whilst a monitoring system was in place for the temperature of one of the fridges, no records were found for the other two fridges. As stated earlier in this report Blood Testing recording and Insulin Dose Management was required for the care of one person living at Winchester House. It was evident from discussion with the senior carer that the home has no protocols & procedures for care staff or self-medication by the individual to ensure safe practices are followed. Throughout the day staff were seen to take into account individuals privacy and dignity. They were observed knocking on bedroom doors and waiting to enter. One care staff member spoken to confirmed that this was their practice. Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live at Winchester House are encouraged to make choices with regard to their social, cultural, religious and leisure activities. Family contact and visiting arrangements were open and relaxed, with local community links encouraged and promoted. Winchester House provides a varied and nutritious menu. EVIDENCE: The people who live at Winchester House said that the home does give them opportunities to exercise choice as to what they wished to do. Two people said that they enjoy sitting in the garden. They said that they are able to go out for a walk with a relative in the locality and on these trips they could do a bit of shopping. Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 14 Holy Communion had been booked for the morning of the site visit. Four of the people living at the home had assembled to attend, but unfortunately the minister did not arrive. In the afternoon entertainment was booked. All but one of the people living at the home chose to attend this entertainment of a sing along, quiz and jokes. From the laughter and participation it was obviously enjoyed by all who attended. Four people living at Winchester House were spoken with at the site visit. All four said that they enjoy following individual activities such as reading, (library books are delivered to the home), watching television, walking in the garden, doing word searches, sewing and lace work as they are able. Within the lounge/dining area a computer for the use of the people living at Winchester House had been introduced. We were informed that this project is in it’s infancy, but it is hoped that the people living at the home will use this facility for communication and to access information available on the web. Survey work completed by the Commission resulted in the return of two surveys completed by relatives. One had commented – ‘Perhaps more outings or social activities’ when asked how they though the care home could be improved. In discussion with a senior carer this aspect of care was seen as important and in response to the draft report, the registered manager said ‘On numerous occasions we organise outings which the clients decline.’ Four people who live at Winchester House said that they were aware of and were happy with visiting arrangements in the home. A relative spoken to at the inspection said that they were able to visit as they and their relative wished and they were made very welcome. One survey completed by a relative spoke of the home being ‘very friendly and welcoming and (the home) have created a very comfortable homely atmosphere’. They went on to say – ‘It does not feel like a home for old people, more like a family home with elderly residents. The fact that there are pets and children around is one factor that helps.’ The reference to pets was noted at the inspection – one dog and a cat were present with a second dog on holiday with the proprietors. Residents at the home were seen to take a keen interest in the animals in the home, with two people seen to pat and stroke the animals as they went around the home. From speaking to the people living at Winchester House it was evident that they are enabled to manage their own financial affairs for as long as they are able. One confirmed this when they spoke of continuing to maintain their own home, visiting their home with their housekeeper and managing their own financial affairs with his bank. In the bedrooms there was evidence of personal possessions and belongings. Small pieces of personal furniture, books, artwork and photographs in each room. Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 15 Winchester House has a planned menu, which is displayed in the lounge/dining room. Daily Nutrition Records are kept and evidence was seen of the meals served and the food eaten by all eight people living at the care home. The senior carer said that normally the home serves up one main choice, but alternatives are offered. The people who live at Winchester House were said to be involved in the menu planning with their likes and dislikes taken into account. Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live at Winchester House can expect to have their concerns listened to for the home has both a complaints and adult protection procedures in place. EVIDENCE: Winchester House has a complaint procedure in place and this was found on file in the home’s office. One person living at the care home confirmed that they had a copy of this procedure and they were knew how to make a complaint. A relative spoken to at the inspection said that they would raise any concerns or complaints with the registered manager. They said that they were very happy with the care their relative received. The complaints procedure has the statement – ‘If either parties is not satisfied by a local process, the case should be referred to the Commission for Social Care Inspection (CSCI).’ The home is advised to review and revise this statement to ensure that it is clear that the Commission does not usually Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 17 investigate complaints, but will review the management of complaints through inspection and regulation. Within the home a ‘Policy on Abuse’ was found. This had been reviewed on 18/02/07, but was found to be out of date, for it referred to ‘Social Services Inspection Unit’ and it stated that the Protection of Vulnerable Adults (POVA) register was not in place. The Inspection Unit is no longer in existence and the register has been in place since 26/07/04. The home needs to review and revise this document to update it and remove reference to Protection of Vulnerable Adults (POVA), but make reference to the local authority Safeguarding Adult Unit. Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Overall, Winchester House provides a safe environment that is accessible to the people who live at the home. It is homely and meets individual’s needs. EVIDENCE: Winchester House presents as a homely, bright and light environment. All accommodation is on the ground floor, each person having a single room, with the majority having en-suite facilities. Communal accommodation comprises of a large lounge/dining room, a bathroom with toilet and washing facilities with a bath and a separate toilet and wash hand basin. Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 19 Both internally and externally the decoration and maintenance was of a high standard. At the front of the property there was parking on the forecourt with tidy shrub and flowerbeds. Internally the entrance hall, corridors and all of the rooms seen on a tour of the premises were clean, well decorated and furnished. Four of the people who live at the home said that they were very pleased with their rooms. They had been able to personalise their rooms as they wished and those who had access and views of the back garden were very happy with their rooms. Within the case-tracking sample a need was identified for the provision of a secure facility for the safekeeping of money and valuables for one person. The back garden was large and L-shaped. The bottom of the garden had fruit trees and was divided from the top of the garden by a wall. This wall had fallen down in places and we were told that this wall is to be removed. The garden was laid to lawn with shrubs and flowerbeds. At the top of the garden there were raised ponds and a water feature. Three people living at the home commented on this feature saying how much they enjoyed taking a stroll in the garden and sitting alongside the ponds. Whilst it is acknowledged the pleasure gained from this, the home should consider undertaking a risk assessment with regard to residents accessing the garden and the water feature. Consideration should be given to ensuring the safety of the residents at all times, with particular consideration of the hazards of water. The senior carer on duty was not aware of any risk assessments in place with regard to these matters. Winchester House has a laundry/utility room. The home has one industrial washer and dries clothes on an overhead ceiling dryer or outside in the garden. Laundry duties are covered by care staff during the day, with ironing being completed in the afternoon and evening. Three people spoken to said that the home had a good laundry service, which was prompt and laundry was well managed. Care staff said that as the home was small they were normally able to identify individual’s personal items. These were usually marked to assist with this. Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience poor quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff were roistered in sufficient numbers to ensure the people who live at Winchester House are safe and their individual needs are addressed. The people who live at the home are not protected by the home’s recruitment practices or a staff-training programme. EVIDENCE: Staff rotas were sampled and inspected at the site visit. These detailed that there are two care staff on duty with additional management hours. On the day of this inspection the registered manager was on holiday. A senior carer was on duty with a new member of staff who said that they had started work at the home three weeks previously. The majority of care staff however were found to be of long standing; many working at Winchester House for in excess of ten years. At night there is one awake carer on duty. Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 21 The ratio of care staff to service users was not considered in detail at this inspection. The senior carer on duty was aware of consideration of dependency levels when assessing staffing levels and there was some evidence within care planning documentation of this. On the day of the site visit, sufficient staff were in evidence, and to assist whilst the inspection was ongoing a third member of staff was brought in. Within the survey work completed by the Commission a relative had commented – ‘It is sometimes difficult to organise trips to the hospital, eye clinic etc., although we have not been let down.’ Whilst this is not seen as derogatory comment, it is obviously a matter, which the registered manager has to be aware of when planning staffing levels in the home. There was no evidence of a problem of this nature at the time of the site visit. We were informed that there are ten care staff working at Winchester House and currently three carers have completed a National Vocational Qualification (NVQ) Level 2 in Care. Staff files were sampled for two carers who had been employed since the last inspection. Both had been taken on in June 2007 and record keeping was incomplete. Application forms had been completed by each applicant and in both cases these did not give sufficient detail regarding their employment history. Omissions were found in the dates of the employment, only the year had been noted and the status of the referees given was unclear i.e. whether they were their last employer or whether they were a character reference. One reference was a ‘To Whom it may Concern’ reference and it was unclear as to whether the home had requested this or the applicant had supplied it. For one of the files sampled there was no evidence of either a Criminal Record Bureau (CRB) enhanced disclosure or a Protection of Vulnerable Adults 1st check. A new carer confirmed that they had been interviewed by the registered manager prior to being taken on and had initially ‘shadowed’ the registered manager. They confirmed that a Criminal Record Bureau (CRB) disclosure had been requested, but it had not been completed. This same carer said that they had not completed an induction training record when they commenced work and they were not completing Skills for Care induction training course. The home needs to review staff recruitment practices and procedures as current practices do not ensure the protection of the people living at Winchester House. In the absence of the registered manager, the staff training file of the senior carer (DH) was sampled and inspected. Within this document there was evidence of previous training courses. The most recent training undertaken was in April 2006 when the carer had attended a training course in constipation management and more recently a Protection of Vulnerable Adults Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 22 (POVA) correspondence course completed in January 2007. From speaking to care staff it was not clear as to what other training if any had taken place in 2007. Winchester House DS0000017998.V344330.R02.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, 33, 35 and 38. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at Winchester House benefit from a clear management structure. People who use this service do not benefit from a developed quality assurance and quality monitoring system. Safe working practices are promoted through ongoing training. Health and safety certification and insurances promotes a safe working environment. EVIDENCE: Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 24 The registered manager was not present at this site visit and therefore we were not able to discuss managerial experience or qualifications at this time. These are matters that will need to be considered at future inspections to ascertain the level of qualification and experience. It can be said however, that in the absence of the registered manager, senior care staff were both competent and very helpful at the site visit and the home was well run. During the site visit, the registered manager telephoned the home and confirmed that quality assurance surveys had been produced and these were to be sent out. The need for a quality assurance and a quality monitoring system is required. The senior carer on duty at the site visit informed us that the home only manages the financial matters for one person living at the care home. However, on reviewing the arrangements in place it was found that money is sent in via a relative and then passed over to the resident. Currently the home is recording this and recording the expenditure. As the resident has taken on this responsibility there is no need to record the expenditure. There is a need however for the provision of a secure facility or the safekeeping of money and valuables. As commented on earlier in this report, it was difficult to evidence staff training. Staff spoke of fire safety training via a video and a basic food hygiene course, which all care staff had attended, but without a planned training and development programme it was impossible to see what training staff had completed or what was planned. Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A 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 2 17 X 18 2 2 X X X X 2 X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 26 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. Standard OP7 Regulation 15 (2)(b)(c) Schedule 3(1)(b) Requirement People who use the service must be assured that their care plans set out in detail the action which needs to be taken by care staff to ensure that all aspects of their health, personal and social care needs are met. People who use the service must be assured that Controlled Drugs including Tamazepam are recorded on receipt, administration and disposal through a Controlled Drug Register and stored in a secure Controlled Drug cupboard. People who use the service must be assured that protocols and procedures in place for Blood Testing Recording and Insulin Dose management. People who use the service must be assured that they are safeguarded by clear, accurate adult protection procedures. People who use the service must be assured that the grounds are made safe. This is with regard DS0000017998.V344330.R02.S.doc Timescale for action 23/10/07 2. OP9 13(2), Schedule 3(3)(i), 12(2)(3) 23/10/07 3. OP9 13(2), Schedule 3(3)(i), 12(2)(3) 12(1)(a), 13(6) 23(2)(o) 23/10/07 4. OP18 23/10/07 5. OP19 23/10/07 Winchester House Version 5.2 Page 27 6. OP29 19(4)(c) Schedule 2(5) 12(1)(a) (b) 13(4)(c) 18(1)(a) (c) 24(1)(a) (b), (2) (3) 7. OP30 8. OP33 to the ponds and water feature in the back garden. Risk assessments need to be completed and acted upon. People who use the service must be safeguarded by thorough recruitment practices and procedures. People who use the service must be assured that staff are trained and competent to do their job. This is with regard to induction training and basic training courses. An effective quality assurance and quality monitoring system must be introduced to ensure a through review of the care and services offered in the care home. 23/10/07 23/10/07 23/10/07 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 OP9 Good Practice Recommendations People who use the service should be assured that Medication Administration Records (MAR) clearly detail administration instructions as agreed with the GP and on the medication. People who use the service should be assured that the temperature of the refrigerators used to store medicines is monitored daily. This should be between 2 – 8 ° C. Winchester House should look to the expansion of outings and social activities to meet the needs of the people living at the home. Winchester House should look to reviewing and revising their complaints procedure to accurately reflect the role of the Commission. People who use the service should be provided with a DS0000017998.V344330.R02.S.doc Version 5.2 Page 28 2. 3. 4. 5. OP9 OP12 OP16 OP24 Winchester House 6. OP28 lockable storage space for medication, money and valuables. People who use the service should be assured that that 50 care staff have undertaken NVQ level 2 or equivalent. Winchester House DS0000017998.V344330.R02.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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. 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