Care Home: Butterley House

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What the care home does well This home provides care that is much appreciated by its residents, and does so in a pleasant rural setting. All residents enjoy single room accommodation, the majority with en-suite facilities. The life enjoyed by the home`s residents is encouraged by a committed staff group, who work in flexible ways to meet individual preferences and choices. Residents reported that everyone at the home was very friendly and that the home operates around the needs of the people who live there. All the people living at the home spoken to reported that they felt comfortable about speaking out about the care being given and there family members supported this. They described how staff are always welcoming and that the home`s manager and owner are always available if they want to speak to them. The staff group are supported by an effective care planning system and many have achieved the recognised qualification to do their work better. The Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 administrative systems in place at the home are well managed and safe and the home links in well with the wider local care networks. What has improved since the last inspection? The home`s management have carried out all the legal requirements made at the last inspection and the processes for assessing care needs and activities are now working well, particularly when people first come to live at the home. A substantial financial investment has been made in the physical fabric of the home and it now projects a very welcoming and comfortable atmosphere. Medicines management was found to be safe and without weaknesses on the day of the inspection. What the care home could do better: One legal requirement has been made at this inspection that relates to the need for a fully safe system for recruiting staff and there are a number of quality recommendations that are about the indirect aspects of the home`s care. Key inspection report CARE HOMES FOR OLDER PEOPLE Butterley House Old Coach Road Ripley Derbyshire DE5 3QU Lead Inspector Brian Marks Key Unannounced Inspection 28th May 2009 09:00 DS0000019955.V375579.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Butterley House Address Old Coach Road Ripley Derbyshire DE5 3QU 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) (01773) 745636 01773 748574 Mrs Patricia Diane Smith Lorraine Tennant Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Plus Five (5) Day Care Places Date of last inspection 19th April 2007 Brief Description of the Service: Butterley House is a large detached building, which has been adapted and extended as a care home. The home is situated on the outskirts of Ripley, set back from the main road, bus route and local amenities, in a rural location. The home provides personal care for up to 37 people aged 65 years and over and is also approved for up to five day places. All bedrooms are single, the majority with en-suite facilities. The home is on two floors and access to the first floor is by stairs and a stair lift. The three lounge areas, conservatory and dining room are on the ground floor. On-site laundry services are provided. The home has well laid out garden areas, which are accessible to service users. The current range of fees for accommodation at the home is £345 - £364 per week. Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was a Key unannounced inspection that took place at the home over a period of a day. Additionally, time was spent in preparation for the visit, looking at previous inspection reports and other relevant documents and preparing a structured plan for the inspection. At the home, apart from examining documents, care files and records, time was spent speaking to the proprietor, manager, and all of the staff working at the home during the early day shift. The care records of four people who live at the home – one recently admitted and three more established – were examined in detail and all of these were personally interviewed, along with four others and two visitors who were at the home during the day. Before the inspection we received ten completed written surveys from people living at the home and nine from staff working there. The information supplied was analysed and the outcomes included in the inspection process and reflected in this written report. No other inspection visits have been made to the home since the last Key unannounced inspection on 19 April 2007 and the assessment was made against the key National Minimum Standards (NMS) identified at the beginning of each section of this report, as well as other Standards that were felt to be most relevant. What the service does well: This home provides care that is much appreciated by its residents, and does so in a pleasant rural setting. All residents enjoy single room accommodation, the majority with en-suite facilities. The life enjoyed by the home’s residents is encouraged by a committed staff group, who work in flexible ways to meet individual preferences and choices. Residents reported that everyone at the home was very friendly and that the home operates around the needs of the people who live there. All the people living at the home spoken to reported that they felt comfortable about speaking out about the care being given and there family members supported this. They described how staff are always welcoming and that the home’s manager and owner are always available if they want to speak to them. The staff group are supported by an effective care planning system and many have achieved the recognised qualification to do their work better. The Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 6 administrative systems in place at the home are well managed and safe and the home links in well with the wider local care networks. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 7 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 and 6. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People do not come to live at the home without the care they need being properly identified, although more attention being paid to their social world and history would help staff provide person centred care for everybody. EVIDENCE: In the AQAA we were told about the home’s arrangements for people wanting to stay at the home and how a structured individual care package is developed for everybody that reflects their needs, wishes and preferences. We were also told how the staff of the home are committed to promoting independence and individuality. The home introduced a new record keeping and documentation system in 2006 and we looked at the care records of four people to assess progress that had been made with this. One of these had come to live at the home very recently whilst the others were established over some years, and we noted that all of Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 10 the files had been completed to the same good standard. The care needs of all had been identified by the manager at the time they came to live at the home, or updated in the case of the established people, and in all cases there were clear pathways identifying staff actions in the key areas affecting people’s lives. These included physical as well as psychological care needs of the person concerned, and the information had been obtained from the person concerned, from their family, or from outside professionals such as a social worker. However the amount of information about the psychological and social worlds of the people concerned was variable and generally brief and abbreviated. This does not fully support the intention to provide person centred care for everybody living at the home. All of the care records looked at contained an assessment of the risks related to people’s lives and the areas covered included safe movement, skin integrity, falls, nutrition, and mobility. Additionally, areas of risk that were specific to the person were identified with indicators for safe management, such as poor psychological wellbeing and risks in the bedroom and in bed. All assessments had been regularly looked at and revised to make sure that staff were working with up-to-date information. The home does not provide intermediate care. Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and10 People using the 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 care of all residents, including health care, is planned and given in ways that respect individuality and privacy and, where appropriate, people living at the home are encouraged to be as independent as possible. EVIDENCE: In the AQAA we were told how the care plans of people living at the home are used as working documents and how they support health and personal care being given in an individual and personal way. We were told that the need for privacy and dignity is respected and how independence is promoted by the provision of suitable equipment and the involvement of outside agencies and professionals, which has been actively encouraged by the home’s management. The four care records that we looked at all contained details of how care is provided by staff and indicated that all elements of support are now looked at on a monthly basis to assess progress or change staff support with changing Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 12 needs. As indicated in the previous section all the documents we looked at were completed to the same standard and as before, none of the records contained detailed descriptions of the persons social care, which would fulfil a more person centred approach. Staff told us that they found the care documentation much more easy to use’ and there was a section for each keyworker to complete a regular update of general progress to sit alongside the monthly evaluation. There were clear records of the medical and health needs of residents being regularly monitored, and also of visits by outside professionals such as G.P and district nurse, and by the chiropodist, optician and dentist. We spoke to a visiting doctor during the inspection and he told us that the home provided ‘good quality care for increasingly dependent people, with appropriate support and communication form the home’s senior people’. In the written records and from the direct comments from people, the staff at the home work hard to care in sensitive and dignified ways, and to keep people as independent as possible: I have good mobility in my electric wheelchair but spend a lot of time in my room; I never have to wait long for staff to answer my buzzer’. ‘I’ve had a bad infection in my foot but they called the doctor to me and it’s much better’. ‘The home meets my needs properly and I help out with the tables and laundry which keeps me active’. ‘Staff are very professional with my personal care and they behave like they’re very interested in us all’. Examination of the arrangements for the receipt, storage and administration of medicines indicated that these were satisfactory and that all entries in the written records had been made properly. Medication is stored securely and the home uses a Monitored Dosage System for organising administration. There were no controlled drugs in use at the home at the time of the inspection. Butterley House DS0000019955.V375579.R01.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at the home enjoy lifestyles and routines that suit them and have opportunities to take part in organised leisure and social activities. EVIDENCE: In the AQAA we were told about people being able to choose their own daily routines and about the welcome given to visitors at all times. We were also told that activities are organised for people every day and that some individuals are encouraged to carry on with simple domestic tasks. The people we spoke to at the home confirmed that they enjoy their own routines and two were seen in their rooms where they spend much of their day; they said they were ‘happy to be here’, and ‘I feel safe in the building, I’m very happy with life here’ and ‘I’m happy and things work well for me here’. One person told us a weekly place at a local day centre had recently been arranged for him and he keeps in contact with his local community that way. Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 14 The weekly activities programme indicated that something happens ever day and there is a coordinator employed for two days a week to support this: craft activities, bingo, dominoes, games and social evening, quiz night and a popular church service. The hairdresser is a twice weekly visitor and has the use of a properly set up room for her ‘customers’. However nothing structured took place during the inspection visit and a number of replies to our written surveys mentioned that the home should ‘provide more entertainment and outings’ and that ‘there are not enough activities for residents to join in with’. Contact with families is encouraged through an ‘open door’ policy, and good numbers are regularly seen at the home during inspections. Some are very regular in their visits and support the care activities of the staff in practical ways. The ones we spoke to mentioned the good welcome they always received from the home’s staff and how well the latter communicate with them and keep them in touch. A brief visit was made to the kitchen and the cook described current arrangements. Good standards in the catering service have continued, and a 4-week menu is being followed. The cook described how a choice at the main meals of the day is available and that a hot option is regularly available for breakfast and sometimes at teatime. People were generally very positive in their feedback about the standard of food at the home with several mentioning good quality and quantity: ‘The food is marvellous and the cook is very good’. ‘The meals are very good, my sort of choice’. ‘The cook knows what I like and I get a lot of fresh fruit’. Arrangements for purchase, storage and stock control are satisfactory. The cook routinely deals with people who have special dietary needs, and at the time of the inspection these included diabetic and softened, the arrangements for which indicated a careful approach to individual needs. Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People using the 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 responds to complaints made by residents and their representatives according to a written procedure, and aims to protect them from harm. EVIDENCE: In the AQAA we were told that all complaints are dealt with quickly and effectively and that people living at the home and their families are encouraged to speak out, with the help of advocacy services if necessary. Records indicated that there had been two complaints in the past twelve months, one of which involved staff behaviour which had been dealt with properly by the home’s manager. In the feedback that we received everybody told us that they knew about getting their problems resolved and were confident that they would be listened to: The management of the home are very involved and approachable‘. If we have any problems we know who to speak to. A copy of the homes complaints procedure is on display and given to people when they move in. The records we looked at indicated that there have been no situations at the home that have required investigation under statutory safeguarding Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 16 procedures since the last inspection. The AQAA told us how there are policies and systems available to staff that encourage awareness of how to protect people living at the home and also that the owner and manager had recently attended awareness training about important new legislation that will affect the running of the home – Mental Capacity and Deprivation of Liberty Acts. Staff receive training in their responsibilities to recognise and alert others to suspected abuse when they complete a National Vocational Qualification (NVQ), but there has been no recent ‘refresher’ within the home to ensure that everybody is fully aware of the local statutory procedures in operation in Derbyshire. Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical aspect of the home has been maintained to a high standard so that people can enjoy an environment suited to their physical needs and comfort requirements. EVIDENCE: In the AQAA we were told about the home’s programme of maintenance and redecoration and how this is an ongoing activity to ensure that people living at the home are safe, clean and warm. From a brief tour of the building with the manager and visits to some of the bedrooms we saw how a substantial investment had been made in the home’s physical fabric since the last inspection and how the improvements now offer a very good level of comfort and facility to the people living there: Carpets throughout the ground floor communal areas have been replaced, Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 18 Entrance hall redecorated and refurnished, Communal areas have been completely redecorated, New chairs have been purchased in all the communal areas, One bathroom has been refurbished and another planned for the near future, A substantial area of the roof has been replaced and the rest to be completed this year, New locks on all bedroom doors, Eighteen bedrooms have been completely redecorated and refitted with modern furniture and colour schemes, The hairdressing room has been refitted. We also noted that bedrooms had good levels of personalisation to suit individual residents and which create a sense of personal space, and that new mobility equipment was seen in various locations around the home for staff to help people with mobility difficulties. Comments from people living at the home and relatives were positive about the standards of comfort and cleanliness offered. All the recommendations made at the last visits by the Fire and Environmental Health Officers have been carried out. On the day of the inspection the home was clean, tidy and free from odours and everybody spoken to was complimentary about the service provided by the laundry. People observed in the home were seen wearing clean and wellpresented clothing. Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People using the 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 adequate numbers of staff to carry out the physical care needs of the people living there and they have been recruited and trained to do their jobs properly and in a professional way. EVIDENCE: In the AQAA we were told how staffing levels and training reflect the changing needs of the people living at the home and how staff are encouraged to undertake qualifications above the standard requirements. We were also told how the recruitment process reflects equality of opportunity and that new staff now go through a new induction programme when they start work. During the inspection we interviewed most of the staff on duty, including a carer who was appointed during 2008. She described how she had received basic instruction and training over an extended period at the start and how, because of her lack of previous experience, she had worked under the supervision of the experienced staff in a ‘shadowing’ capacity. Additionally other staff told us that we have had a lot a training in the past year and this included care of people suffering from dementia and infection control for some, Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 20 as well as regular updates in the ‘core’ health and safety topics. We were able to confirm training achievements from examination of staff records and. discussion with the manager which established achievements in a good range of subjects, including updates in fire safety, general health and safety, safe moving and handling and food hygiene, whilst there were shortfalls in the numbers of staff exposed to instruction in safeguarding vulnerable adults, infection control and dementia care. It is also policy of the home for people to complete the NVQ qualification and all but three new staff have completed this at level 2 with some senior carers having progressed to level 3. This is in excess of the nationally set target. The files of two recently appointed staff that we looked supported that there is a systematic recruitment process in place, with the right checks being made. However we found that for one only one written reference had been sought and for the other a positive certificate from the Criminal Records Bureau (CRB) had been obtained in previous employment not since she had worked at this home. Examination of the duty roster and discussion with staff indicated levels of staff on duty as had been previously set and with one vacancy currently being advertised. In the written feedback we received, most people said that there is always or ‘usually’, enough staff on hand to meet peoples needs but others told us: ‘She would benefit from more staff being around’. ‘I feel carers should be given more time to spend with residents’. The residents, visitors and staff on duty we spoke to expressed this mixed range of views and they said that: ‘They always respond even when they’re busy’. ‘There’s always somebody around the sitting areas and can always find someone if we want them’. ‘Staffing levels are sometimes on the low side’. ‘Some days things don’t work so well’. ‘I occasionally have to wait if they’re with somebody else’. ‘We are always busy but work well as team’. Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. People using the 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 is a well-managed and safe environment in which to live and work. EVIDENCE: The AQAA told us about the working relationship of the home’s owner and manager and how they are available for everybody within the home through an ‘open door’ policy. We were told about the home’s administrative systems and about continuing plans to develop the home. The manager was registered with the Commission in October 2008 after returning to work at the home following the previous manager’s retirement. She has achieved the Registered Manager’s Award having had a wide range of experience in the management of care homes including as registered manager Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 22 at another home; people living and working at the home told us how they were benefiting from the application of that experience: ‘She is always there daily to ask about anything’. ‘We can talk about problems and be listened to. The manager is easy to talk to and sorts things out’. Whilst informal support to staff is a strength of the home’s organisation, examination of records and discussions with staff indicated that planned meetings between manager and individual staff are occurring irregularly and not enough to meet the National Standard. The feedback, both verbally and in writing from people living at the home and their relatives, was positive about of how the home is run, with comments about the welcoming approach and homely atmosphere. The homes owner and manager have started to develop a system of surveying the views of people and their families soon after coming to live at the home, and then on an annual basis. People’s views are further sought through group meetings, irregularly held, and informal day-to-day feedback as both are very visible around the home. An annual plan for 2009 has been completed that outlines the main aims and objectives for the home. The systems in place for looking after residents’ money were found to be satisfactory at the last inspection and remain unchanged. The AQAA told us about good standards of health and safety activity at the home and about the regular servicing of equipment, and we examined records of the latter as part of this inspection, which supported this. Additionally observations made around the building and a look of fire safety activity and equipment records indicate that the home was hazard free at the time of the inspection. Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 23 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 3 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 4 X X 3 X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 24 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 OP29 Regulation 19(1) and Schedule 2 Requirement A positive check by the Criminal Records Bureau (CRB) must be obtained for every new member of staff before they start work at the home, so that the home’s managers can be sure that every body working there is safe and suitable. Timescale for action 31/10/09 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 OP3 Good Practice Recommendations Assessments of the needs of people living at the home should contain more information about their social world and background history so that a more person centred style of care can be developed. The care plans of people living at the home should contain more information about their social world and background history so that a more person centred style of care can be developed. All staff working at the home should receive regular updates about recognising and reporting the abuse of DS0000019955.V375579.R01.S.doc Version 5.2 Page 25 2. OP7 3. OP18 Butterley House 4 OP27 5. OP36 vulnerable people, so that the safety of everybody living at the home is maintained. The levels of staff on duty at the home should be regularly reviewed, so that the home’s management can be assured that all the needs of people living at the home, both social and physical, are being met. All staff should receive formal one to one supervision from their line manager at intervals of every two months. This will ensure the opportunity for regular consultation about and monitoring of their work. Butterley House DS0000019955.V375579.R01.S.doc Version 5.2 Page 26 Care Quality Commission East Midlands Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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. 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