Inspection on 29/06/07 for Woolston Mead

This inspection was carried out on 29th June 2007.

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

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

Other inspections for this house

Woolston Mead 22/05/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Woolston Mead 4 Beach Lawn Waterloo Liverpool Merseyside L22 8QA Lead Inspector Mrs Claire Lee Key Unannounced Inspection 29th June 2007 08:30 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 Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woolston Mead Address 4 Beach Lawn Waterloo Liverpool Merseyside L22 8QA 0151 928 3796 0151 9283796 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) Tulip Care Limited Mrs Anne Orme Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only: Code PC, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP. The maximum number of people who can be accommodated is: 28. Date of last inspection 16th January 2007 (Random inspection) Brief Description of the Service: Woolston Mead is registered to provide care to twenty eight older people. The home is privately owned by Tulip Care Limited and the responsible individual is Dr Jaydeep Kantilal Patel. The Commission for Social Care Inspection appointed Mrs Anne Orme as the Registered Manager in May 2007. The home is located in a quiet residential area in Waterloo. From the front of the premises there are lovely views across Liverpool Bay and over to North Wales. The home is also near a number of shops and there is access to local transport. Accommodation is provided over four floors with two lounges on the ground floor and a dining room in the basement. The home is fitted with stair lifts and a passenger lift for residents to access all areas. Residents have the use of a call bell with an alarm facility and there are mobility aids in place to assist those who are less able. There are attractively laid gardens to the front and rear of the property with wheelchair access at the rear. The current fee rate for accommodation is £410.00 a week. Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A site visit took place as part of the unannounced inspection. It was conducted over one day for duration of eight hours. Twenty seven residents were accommodated at this time. A partial tour of the premises took place and a number of care, staff and health and safety records were viewed. Discussion took place with seven residents, four staff, two visitors and the registered manager. During the inspection three residents were case tracked (their care files were examined and their views of the home were obtained). This process was not carried out to the detriment of other residents who also took part in the inspection process. Interviews also took place with two visitors. All the key standards were inspected and also previous requirements and recommendations from the last inspection in January 2007 were discussed. Satisfaction survey forms “Have Your Say About …” were distributed to a number of residents prior to the inspection. Comments included in the report are taken from the resident survey forms and also residents and visitors during the site visit. What the service does well: Woolston Mead presents with a warm, welcoming atmosphere and residents appeared relaxed and comfortable with the staff. There was plenty of laughter and a good rapport was noted between the staff and residents. Visitors were made welcome at various times of the day and offered refreshments. A relative said, “Everyone makes you feel welcome”. Likewise a resident reported, “It is a pleasant home to live in”. Prior to admission the manager assesses residents’ health needs. The information collated is then used to the form the basis for the plan of care. Assessment documentation seen had been completed to a good standard and included key areas regarding the residents’ health and general well being. Care files seen were organised, the information easy to read and care plans identified the relevant care and support required. Attention is paid to recording basic needs such as dental, optical, hearing and foot care, which are so important to the care of an elderly person. Discussion with care staff regarding residents who were case tracked confirmed their knowledge of their care provision and family involvement. Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 6 Staff were observed to assist residents with various activities. This help was given in a discreet and polite manner. All the staff spoken with were enthusiastic and it was evident that they wanted to supply a good standard of care and make sure the residents were happy. They demonstrated a genuinely warm and caring attitude in keeping with their roles as care staff. A relative made reference to the fact that their family member was always treated in a respectful manner and great attention was made by staff to ensuring her comfort and well being. Comments regarding the care provision included: “Very good care” “Good care” “The staff know what they are doing” “The staff are on hand to help and give us care when we want it” “Good level of care” The manager has introduced a more structured social programme, which is organised by the staff. A number of residents were playing dominoes in the lounge and also a staff member was offering massage treatments. Residents interviewed confirmed that the daily routine was flexible and based very much around their wishes. This was evidenced with regard to various aspects of personal care, activities and residents arranging their own trips out with friends. A resident commented on the fact that they could choose what to do during the day. The menu was varied and provided good, wholesome well balanced meals. A choice of two hot meals is available at lunch time and a lighter meal prepared in the evening. Resident dietary preferences are noted in the care files and the cook demonstrated a good knowledge of what the residents like to eat. The manager has produced a nutritional manual for staff to read and this highlights the importance of a god health diet for elderly people. A resident said, “The food is always good and we get plenty of good home cooking which we like”. Woolston Mead provides pleasant accommodation. There is a good standard of comfortable furniture in the lounges and dining room. A number of residents attend the dining room for their meals and the tables were attractively laid. The overall standard of cleanliness of the premises was found to be good and residents interviewed confirmed that this standard was consistently maintained. Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: The accommodation is generally maintained to a good standard however two bedrooms carpets and an armchair must be replaced to improve the overall standard of furniture and furnishings for the residents. This will also improve the standard of cleanliness in the rooms. The rooms and chair are identified in the main report. Staff require training in moving and handling and infection control to enable them to provide the necessary care and support to the residents and to undertake the work in a safe manner. At previous site visits a booklet for induction has been seen however there was no written evidence to support this for two new staff employed. A record of induction is required as part of staff training and the induction should be in line with Skills for Care Induction Standards. The inclusion of the principles of care within the induction is an outstanding requirement from the last inspection in January 2007. Good practice recommendations are made in the report to implement areas of best practice for the residents and staff. Please contact the provider for advice of actions taken in response to this Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 8 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. Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 9 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 Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 10 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): Standards 1, 2 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive information to enable them to decide whether they wish to take up residency and the pre admission assessment ensure the staff can meet their needs. EVIDENCE: The Statement of Purpose and Service User Guide are displayed for residents and their visitors to view. The manager stated that these documents are also given to prospective residents and their representatives as part of the admission procedure. Mrs Orme is now the Registered Manager for the service and the Service User Guide needs to be updated to reflect this information. A resident confirmed that they had received a lot of written information regarding Woolston Mead and that it helped them when choosing the right home. Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 11 Contracts for two new residents were viewed. These were dated and signed by the resident and included details of the fee rate for accommodation and terms and conditions of residency. The residents therefore understand their rights and obligations and are made aware of what is included in the fee rate. The manager carries out a full needs assessment for prospective residents to ensure the staff are fully aware of their needs and to deliver the necessary support and care. A social care management assessment was also on file for one resident to assist staff collating the necessary information for the plan of care. Assessments were viewed for three new residents and these identified key areas including, mobility, skin care, personal hygiene, sleep, diet, medicines, social background, communication, chiropody, hearing and optical provision. Personal safety and risks had also identified and this was discussed in relation to falls and residents who wish to administer their own medicines. Standard 6 was not assessed, as intermediate care is not provided. Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 12 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): Standards 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health care needs were identified in a plan of care to ensure their health care needs were met. Medicines were administered safely and residents were observed to be treated in a respectful manner. EVIDENCE: As part of the case tracking process three resident files were viewed for residents who have taken up residency since the last inspection. Residents have an individual care file and the information is easy to read and accessible for the staff and residents. The three files viewed did not have a photograph of the resident for identification purposes and the manager stated that these would be taken as soon as possible. The care plans viewed contained sufficient information on the care and social needs of each resident with clear instructions to staff as to how to provide the necessary care and support. Key areas included mobility, personal care, medical conditions, diet, continence, risk of falls and social information. Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 13 Individual needs had also been assessed with regard to religion, culture and relationships. Plans seen had been reviewed monthly to ensure the information was kept up to date and there was evidence that residents take part with this process. Two residents stated that they did not wish to be involved with their plan of care and were more than happy for staff to take the lead. Staff spoken with say that they look at the care plans regularly and discuss individual care needs with the manager at shift handovers. They were able to discuss a number of residents’ care needs and described how the residents’ rights to independence are encouraged and promoted. It was evident that health care needs were being met and staff and the manager do all they can to help residents manage their own health needs if they are able to do so. There was evidence of risk management for areas such as moving and handling and medication. Residents are asked if they wish to administer their own medicines and they are also weighed to monitor weight gain or loss. Discussion took place with the manager regarding a resident who is currently suffering a number of falls. It is recommended that the risk assessment be completed in more detail with regard to the preventative and control measures. This will ensure staff are fully aware of the risk and its management. A district nurse who was visiting the resident has offered to complete the form with the assistance of the manager. The district nurse visits the resident on a regular basis and is in close contact with the manager to monitor the resident’s condition. The district nurse stated that the staff were very good at contacting the surgery and providing a good standard of care. A district nurse was also providing care to a resident who required wound dressings as part of their clinical treatment. A staff member interviewed was able to describe the dressings being used and also the reason for them application. This demonstrates a good knowledge base to ensure a good standard of care in this area. Daily report sheets recorded the day given over a twenty four hour period by the staff and there was evidence of visits by GPs and district nurses. The manager maintains links with external professionals to ensure residents receive a good the necessary input. A relative on behalf of a resident reported, “When I have needed medical treatment it has always been given on time and if I have needed the optician or chiropodist a home visit has been arranged this also applies to the doctor”. Comments from residents and relatives regarding the care provision included: “Good home and good care” “They look after me very well” “The care is fine” “The staff know what they are doing” “Very good care” (relative) Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 14 The medicines were stored appropriately and administered from blister packs dispensed by a local pharmacist. Ten medication administration records (MARs) viewed had been correctly completed to record the medicines administered by staff. There were no gaps for staff signatures and residents confirmed that they receive their medicines on time. Medication records were not always completed with date and quantity of medicines received this meant that it was not possible to fully audit all items. There was no evidence that checks were undertaken to ensure staff follow the procedure for safe handling, recording and administration of medicines. This meant that the manager could not guarantee the medicines were given out in a safe and appropriate manner at all times. A review of the medication is therefore recommended to evidence this. Consultation with a Commission pharmacist at the time of inspection confirmed this line of action. Staff would benefit from medicine training and the manager to evidence their knowledge and skill base should complete assessments of competency. Medicine training was arranged for May 2007 however the chemist has cancelled this. Further training will be arranged. Residents are supported to administer to administer their own medicines and the manager completes a risk assessment for this practice. Advice was given to the manager on how to complete a disclaimer with the resident and further develop the risk assessment to provide more detail of the assessment, monitoring and review processes. Observations during the day confirmed that residents were treated in a respectful manner. Staff had plenty of time to spend with residents on a one to one or group basis. A resident said, “The staff do come in to my room quite often during the day”. Staff were observed to knock on doors before entering private rooms and addressing residents in an appropriate manner. A resident commented that the staff were always polite. Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 15 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): Standards 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to exercise choice and control over their lives and are offered a choice of well balanced and nutritional meals. EVIDENCE: There was a warm friendly atmosphere and a good rapport was noted between the staff, residents and their visitors. Discussion with the manager and residents confirmed that activities are arranged most afternoons. There is no designated activities organiser however all the staff help with arranging the social programme. Staff were playing dominoes with the residents and also one lady received a foot massage. A resident said that the activities were good and that staff arrange something most afternoons. A staff member interviewed discussed the benefits of reminiscence therapy. A record evidenced the various social events and this should include the names of residents who take part to enable staff to monitor their involvement. The care files contain a care profile, which also records social interests to enable staff to get to know the residents in more detail. Activities include dominoes, quizzes, massage treatment, manicures, reminiscence therapy (all our yesterdays), outings, gentle exercises Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 16 and bingo. An outing took place in June 2007 and proposed events are discussed at resident meetings. The social activity for the day was on display on a board in the hall. Visitors were seen popping in at various times and made welcome by the staff. Holy Communion is offered and clergy visit from different denominations. This enables residents to continue with their chosen worship. Residents have the use of a chiropody service and a NHS diabetic chiropody. Details of a local advocacy service are displayed in the office to residents to view; there may be occasions when their advice is required. A resident reported that the routine was fine and that it was not restrictive. This was discussed in relation to time of meals, getting up in the morning and general assistance with personal care. A relaxed routine enables residents to have certain amount of freedom and to be able to choose how they wish to spend their day. A resident went out with a friend in the morning for a shopping trip and reported that staff do not mind what time she goes out. All the residents spoken with were pleased with the standard, quantity and times meals were served. Lunch was observed to be a social occasion where a number of residents sat together in the dining room. The meal was served in an unhurried manner and residents given plenty of time to enjoy the various courses. Lunch looked appetising and well presented. Dining room tables had been laid and they had small flower arrangements in place. The menu is based over two weeks and residents are offered an alternative at breakfast, lunch and tea. The cook will also prepare something different if requested. The cook was able to discuss resident’s dietary preferences and staff were seen to offer assistance to residents with their meals in a sensitive manner. Staff who enter the kitchen have obtained a certificate in food hygiene and the manager has produced a nutritional manual for staff to read. Environmental health records for the fridge, freezer and hot food temperatures were up to date and there was evidence of fresh fruit and vegetables in store. Residents reported, “The food is first class and the cook is really good” and “If the meal is not to my liking they will always offer me an alternative, that I do like”. Two residents are currently receiving cooked breakfasts. Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Polices and procedures are in place to listen and respond to complaints and to safeguard and protect vulnerable people from abuse. EVIDENCE: The complaint policy and procedure is displayed in the main hall and a copy was seen in the policy and procedure file. Staff interviewed were aware of its location and said that they would report any concern to the senior carer or manager. A complaint log has been seen at previous site visits however there was no log on this occasion as the manager stated that no complaints have been. It is good practice to maintain a complaint log for any concerns, ‘grumbles’ or incidents that may arise and the record to evidence the nature of the incident, investigation, outcome and action required. Residents and visitors interviewed stated that they had no worries at all and would always speak to Anne (manager). The Commission has received no complaints since the last inspection in January 2007. Records show that a number of staff have received training in protection of vulnerable adults (POVA). This should be rolled out to all staff to ensure they are aware of the procedure to be followed in the event of an allegation. Staff spoken with were able to detail what they thought should be reported to the manager and what constitutes abuse. An abuse policy was available and also Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 18 Sefton’s Guide to the Protection of Vulnerable Adults for staff referral. Staff spoken with confirmed their knowledge of the documents. Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,20,21,24, 26 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a pleasant, comfortable home however the replacement of carpets in two bedrooms and piece of furniture in another will improve their overall appearance and cleanliness. EVIDENCE: Woolston Mead is a terraced building, which has been converted into a care home. There are gardens to the front and rear of the property and the home is kept in a good state of repair. There are steps to the main front door however there is wheelchair access at the rear. Residents interviewed stated that they could manage the steps at the main entrance. Plans are in place to have the exterior of the premises painted this year as it has been affected by general wear and tear. The manager is currently obtaining quotes for this work. A maintenance person carries out day to day jobs and decoration of bedrooms. Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 20 Evidence was seen to support this. Apart from one bedroom there were no unpleasant odours in the home and residents interviewed reported that their rooms are cleaned regularly and kept very tidy. A resident said, “My room is dusted and cleaned everyday”. Only one resident commented on the fact that their bedroom could be cleaned more frequently and this was passed to the manager for her attention. A hairdressing room is available for private visits by the hairdresser and residents have private telephone facilities to maintain contact with family and friends. There are two lounges on the ground floor and a dining room in the basement. All communal areas are pleasantly decorated and have comfortable furniture. Bathrooms were clean and had aids to assist those less able. The paintwork surrounding the domestic bath with bath chair hoist needs painting as the heat from the bath has affected this. Bedrooms seen had suitable furnishings and fittings with a call bell for residents to ring for assistance. Bedroom 15 had an unpleasant odour and the chair, which is the source of the smell but be replaced. A new carpet for Room 7 and 9 is also required as the existing ones have been cleaned but remain stained. Replacement of the chair and carpets will improve the cleanliness and appearance of the bedrooms. Residents’ room had been personalised and thought given to making sure there was enough light, warmth and fresh air for maximum comfort. A resident reported, “I like my room very much”. Emergency lighting is provided throughout the building and subject to an in house monthly safety check and annual service contract. Records seen were current. Hot water temperatures are tested to ensure hot water is delivered at safe temperature. These were found to be satisfactory. Residents interviewed were pleased with the general upkeep of the home and said it was comfortable to live in. Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some staff have not completed the necessary training, to confirm they are competent to undertake their roles effectively. EVIDENCE: The staffing rota was viewed for the month of June 2007 and this evidenced sufficient numbers of staff on duty to provide care and support to the residents. Staff and resident reported that staffing numbers are maintained and that the manager sorts out the staffing rota to cover any outstanding shifts. There is currently a staff vacancy for a care assistant on nights to cover maternity leave. A domestic member of staff has been employed as previously care staff were carrying out all the domestic duties. On the morning of the site visit the manager was on duty with four carers, a cook, domestic, maintenance person and laundry assistant. Comments from residents and relatives regarding the staff included: “The manager and staff are excellent I have found them approachable and efficient and will try to do their best for you whenever they can” “Very good care” “Good staff” Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 22 Two new staff have started since the last inspection and their staff files were viewed along with a file from a member of staff who commenced last year. Recruitment is robust to protect the residents and all the necessary police checks and references had been obtained prior to the staff commencing employment. Job application forms listed past employment and the references had been obtained from previous employers where possible. The manager should ensure all references are dated accurately when forms are received from referees. There was evidence of staff contracts on file and a staff member said they received a job description. Photographs are required for new staff for identification purposes. The pre inspection questionnaire evidenced that 40 staff have achieved an NVQ in care. NVQ training is to continue to ensure that 50 have this qualification; the manager has enrolled eight members of staff on an NVQ Level 2 in care. The manager arranges a training programme and staff have a training log to evidence courses attended. Eight training logs were examined and these evidenced training in safe working practices. This included moving and handling, first aid, food hygiene (for kitchen staff), fire prevention and health safety. Infection control is required for a number of staff and also new staff require moving and handling. Moving and handling is also required for a member of staff whose certificate expired in June 2007. Training must be provided to ensure staff have the knowledge and skills to provide the necessary care and support to the residents. The manager agreed to forward dates of the training to the Commission. The induction for new staff is in the form of a booklet and this should be linked to the Skills for Care Induction Standards, which provides a more detail induction regarding care practices and assist with NVQ awards. A basic form of induction has been given to staff in the past however on this occasion there was no written evidence to support the fact that two new staff members had received an induction. A new member of staff interviewed stated that she was shown round the building when she started and fire prevention procedures had been explained. A requirement was raised at the last inspection in January 2007 regarding the inclusion of the principles of care within the induction. This remains an outstanding requirement, as the induction could not be evidenced for the two new staff members. Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,32,33,35,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a manager who seeks the views of the residents and promotes health and safety management to protect people within the home. EVIDENCE: Mrs Anne Orme was appointed by the Commission as the Registered Manger in May 2007 and the Certificate for Registration was displayed in the main office. Mrs Orme has an NVQ Level 4 in Management and Care and undertakes mandatory training with her staff. Since taking up her position as manager for Woolston Mead Mrs Orme has made a number of improvements to the service. Staff interviewed were very Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 24 positive regarding her leadership skills and her willingness to take on new ideas. A resident reported, “The manager is excellent, she is very kind understanding and considerate and does her utmost to ensure everything possible is done to make own stay here a happy one, she chooses her staff very well, the girls are very good, nothing is too much trouble”. Mrs Orme is experienced and knowledgeable in running a care service and showed an awareness of new legislation and guidance. This information is disseminated to staff at staff meetings. Senior care also meet separately as part of their supervisory role. Residents are approached to gain their views of the service. Residents attend regular meetings, the last one was held in May 2007 and topics covered included, meals, entertainment, complaints and general suggestions. Survey forms to obtain views of the service are kept in the main hall and residents and/or visitors can fill one in when they want. They are not sent out routinely however this would be beneficial in collating information to review the overall service. A relative survey form from February 2007 evidenced satisfaction in all areas. The owner completes Regulation 26 visits following a monthly visit to the home where he meet with staff, residents, visitors, inspects the premises and views a selection of records. A satisfactory report was seen for the month of March and April 2007. Risk assessments also have not been completed in safe working practices to ensure the ongoing protection of the staff and residents. The financial records for two residents were viewed and these were maintained to a satisfactory standard to protect the residents. Residents are encouraged and supported to look after their own money so enabling them to maintain their own independence. There were staff supervision records in place for a number of staff however this needs to be given to all staff and held more frequently to monitor their work and discuss training needs. Two members of staff stated that they receive supervision with senior staff. Maintenance contracts were viewed for the gas, electric, lift, portable appliances and hoisting equipment. These records were valid to ensure the ongoing protection of residents and staff. A test of the fire alarms was carried out at the time of the inspection and the annual service of the fire prevention equipment took place in June 2007. Residents and staff confirmed that the fire alarm is tested weekly however the records did not evidence a weekly test for May and June 2007. This has however been recorded weekly in the past. Fire alarm testing must be recorded weekly to evidence maintenance of fire equipment. Staff receive fire Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 25 prevention training and this is being arranged for July 2007. A fire risk assessment of the building was undertaken in June 2007 and the manager is waiting for the report of the findings. Accident records were viewed regarding incidents that affected the well being of two residents. Sufficient detail had been recorded to monitor the effects of the incidents and how they were managed. Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 2 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP24 Regulation 16 (2) (c) (k) Requirement The registered manager must provide accommodation for the residents, which is furnished and equipped to assure comfort and privacy. The carpets in Room 7 and 9 and the chair in Room 15 must be replaced to improve the standard of cleanliness and overall appearance of the rooms. The registered manager must ensure that the persons employed to work at the care home receive training appropriate to the work they are to perform. The manager must ensure staff receive moving and handling training to ensure they have the skills and knowledge to undertake this work. The registered manager must ensure that the persons employed to work at the care home receive training appropriate to the work they are to perform. The manager must ensure staff infection control training to ensure they have the skills and knowledge to undertake this work. DS0000065851.V344794.R01.S.doc Timescale for action 24/08/07 2. OP30 18 (1) (c) 10/08/07 3. OP30 18 (1) (c) 24/08/07 Woolston Mead Version 5.2 Page 28 4. OP30 Schedule 4 (6g) The registered manager must keep a record of all training and this includes induction. The principles of care element remains an outstanding from the last inspection in January 2007. Timescale of 9.2.07 not met) 10/08/07 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. 2. Refer to Standard OP1 OP9 Good Practice Recommendations The Service User Guide is to be updated to include details of the registered manager. Staff responsible for medicine administration should receive training. The manager should carry out an assessment of competency to ensure they have the skills and knowledge to administer medicines. A review/audit should be undertaken by the manager to ensure staff follow the procedure for safe handling, recording and administration of medicines. This will ensure that medicines are given out in a safe and appropriate manner at all times. A record of resident attendance should be maintained for the activities to evidence their involvement. A record of complaints and/or concerns should be kept to evidence the nature of the incident, the investigation and outcome. All staff should receive adult protection training to ensure they are aware of the procedure to follow in the event of an allegation being made. NVQ training should continue for care staff to provide a minimum 50 care staff with a qualification at Level 2. To promote the health and safety for the residents and others risk assessments should be carried out and action taken to reduce risks identified. 3. 4. 5. 6. 7. OP12 OP16 OP18 OP28 OP38 Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Woolston Mead DS0000065851.V344794.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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