Care Home: Calder View

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What the care home does well There was useful information about the home that helped people to decide whether they would like to live there; it was clear and easy to read. Each resident had a plan of the care and support they wanted so that staff could look after them properly; residents had been involved in making decisions about the care and support they needed. Staff were given training to make sure they had the appropriate skills and knowledge to work at the home. Residents were able to make decisions about how the home was run and how they spent their day; one resident said `I can do what I want and come and go as I please, I just need to let the staff know` and a visitor commented `they support him to live the life he chooses`. There were different activities avilable for residents to choose from; most residents were able to make independent choices and came and went throughout the day. Residents were involved in deciding what meals they wanted and staff helped to make sure the diet was varied and healthy.Residents said they were supported with visits to their doctor or specialist; this made sure they were healthy. One GP (doctor) commented that `health needs are always met` and staff `seek advice to improve health care needs`. People knew how to complain if they were unhappy and were satisfied their complaint would be dealt with properly. Staff had been given training to help them to protect and keep residents safe. There were enough staff to make sure residents received the care and support they needed. People made good comments about the support given to residents at Calder View. One visitor said `staff are easy to talk to and helpful if there is a problem`. A care manager said `staff are appropriate when dealing with clients. They have a good understanding of mental health problems` and `they create a homely environment and give support`. Residents said they were happy with the way the home was run and were involved in the day-to-day running of the home. Equipment had been serviced properly to make sure the home was safe. What has improved since the last inspection? The person in charge had made sure staff had received training to help them to recognise and respond to any signs of abuse and neglect and to protect residents from harm. The new owners planned to improve the home to make it a nicer more comfortable place for residents to live in. CARE HOME ADULTS 18-65 Calder View 6 Keighley Road Colne Lancashire BB8 0JL Lead Inspector Mrs Marie Matthews Key Unannounced Inspection 20th May 2008 09:30 Calder View DS0000009604.V359060.R01.S.doc Version 5.2 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 Calder View DS0000009604.V359060.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 Adults 18-65. 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. Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Calder View Address 6 Keighley Road Colne Lancashire BB8 0JL 01282 868077 01282 868077 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) Pendle Residential Care Limited Mr Thomas Hanna Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Mental disorder excluding learning disability or dementia at Calder View, 6 Keighley Road, Colne. BB8 0JL The service should employ a suitably qualified and experienced person who is registered with the Commission for Social Care Inspection as manager of Calder View, 2 Broken Banks and 284 Burnley Road, Colne 15th May 2006 Date of last inspection Brief Description of the Service: Calder View is the ‘core’ house of a residential homes scheme comprising the core house and two smaller houses in Colne. The registered manager has responsibility for all three houses. Calder View provides 24-hour care, support and accommodation for 6 younger adults who have a mental health problem. The home is a large mid-terrace house located near to Colne town centre. Shops, market and community facilities are within walking distance. There is on-street parking and a small garden at the front. A larger private garden at the back provides outside seating, a lawn and parking for one car. Good local bus and rail links are nearby. Transport is also provided for residents in staff cars. There are six single bedrooms, a bathroom, separate shower and toilet on the first floor. On the ground floor is a toilet, a spacious lounge and a lounge/dining room. Residents have access to the large kitchen and the laundry. Information about the services offered by the home is provided in the form of a service user guide and is available to existing and prospective residents and their relatives. On the day of the inspection the weekly fees ranged from £480.00 to £1019.00. There are no extra charges, but residents are expected to pay for personal effects (such as toiletries, newspapers, clothing and hairdressing). Calder View DS0000009604.V359060.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 stars. This means the people who use this service experience good quality outcomes. The key unannounced inspection, including a visit to the home, took place on 20th May 2008. The inspection process included looking at records, a tour of the home, discussions with the registered manager, one member of care staff and three residents who lived in the home. Information was also included from survey forms filled in by a doctor (GP), a care manager (social worker) and two visitors. The inspection also looked at things that should have been done since the last visit and a number of areas that affect people’s lives. There were five residents living in the home on the day of the inspection. What the service does well: There was useful information about the home that helped people to decide whether they would like to live there; it was clear and easy to read. Each resident had a plan of the care and support they wanted so that staff could look after them properly; residents had been involved in making decisions about the care and support they needed. Staff were given training to make sure they had the appropriate skills and knowledge to work at the home. Residents were able to make decisions about how the home was run and how they spent their day; one resident said I can do what I want and come and go as I please, I just need to let the staff know and a visitor commented they support him to live the life he chooses. There were different activities avilable for residents to choose from; most residents were able to make independent choices and came and went throughout the day. Residents were involved in deciding what meals they wanted and staff helped to make sure the diet was varied and healthy. Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 6 Residents said they were supported with visits to their doctor or specialist; this made sure they were healthy. One GP (doctor) commented that ‘health needs are always met’ and staff ‘seek advice to improve health care needs’. People knew how to complain if they were unhappy and were satisfied their complaint would be dealt with properly. Staff had been given training to help them to protect and keep residents safe. There were enough staff to make sure residents received the care and support they needed. People made good comments about the support given to residents at Calder View. One visitor said ‘staff are easy to talk to and helpful if there is a problem’. A care manager said ‘staff are appropriate when dealing with clients. They have a good understanding of mental health problems’ and ‘they create a homely environment and give support’. Residents said they were happy with the way the home was run and were involved in the day-to-day running of the home. Equipment had been serviced properly to make sure the home was safe. What has improved since the last inspection? What they could do better: Staff needed more clearer instructions to help them to look after residents medicines safely and the person in charge needed to make sure staff had understood the medication training. The safeguarding adults procedures, that would inform staff how to protect residents from abuse, needed changing to make sure staff were clear about the proper action to take. Checks should be done by the person in charge and the owner to make sure the home was running well and residents were being looked after. Staff needed training to help them to react properly in difficult situations; this would make sure staff and others were safe. Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 7 Some areas of the home were in urgent need of improvement to make sure residents lived in a safe and comfortable home; there was a plan to improve the home but dates to begin this work had not yet been agreed. The person in charge needed to make sure that new staff would be suitable to work at the home; there also needed to be clear directions to help staff to do things properly. 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. Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People were given clear information about available facilities and services to be able to decide whether Calder View was suitable for them and whether their needs would be met. Detailed information was collected about residents before they were admitted to the home to determine whether they could be looked after properly. EVIDENCE: Information about the services provided at Calder View had been reviewed so that people could make informed decisions about whether the home was suitable for them although it was noted that the contact information for the Commission for Social Care Inspection was incorrect. There had been no new residents for some time although it was clear from dicussions with the registered manager that detailed assesments had been completed following a recent enquiry; all aspects of his needs had been considered but a decision was made that Calder View was not the right place for him. Letters confirming prospective resident’s needs would be met were not available as yet. Two residents individual plans showed evidence of ongoing assessments and the plan of care had been updated to reflect current needs; this would ensure residents were looked after properly. Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 10 Training records and discussions with staff and residents supported that staff had the appropriate skills and knowledge to meet residents diverse needs. Prospective residents had in the past visited Calder View prior to admission; this enabled staff to determine whether their needs could be met and allowed for residents to meet with each other. Residents were issued with contracts at the point of moving into the home although these had not been updated to reflect current fee rates. The registered manager said new contracts were due to be issued following a change of ownership; this would ensure residents were aware of their rights and obligations during their stay at Calder View. Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were consulted about their care and had choice and control over their lives; staff respected their rights to make independent decisions and take responsible risks. EVIDENCE: Two residents individual plans were looked at in detail. The individual plans covered all aspects of the residents needs and detailed how these would be met. The plans had been reviewed and updated regularly to reflect current care needs and there was evidence on the review sheet that the resident and significant others had been involved in decisions about care. One visiting care manager said ‘they remain in regular contact with me on important issues’. The plans were detailed and included information about the residents preferred routines and likes and dislikes which would help staff to plan care and support Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 12 them on a day-to-day basis; any risks or limitations to choices and freedom were discussed with the resident, recorded on the plan and kept under review. Each resident had a designated key worker who would offer support and guidance whilst at the home; one member of staff who was spoken to was aware of his role as a key worker and said he and the resident had similar interests. From records and discussions with staff and residents it was clear that people were able to make decisions about their daily routines; one resident said I can do what I want and come and go as I please, I just need to let the staff know and a visitor commented they support him to live the life he chooses. Resident’s finances were safe guarded by the systems and record keeping. Residents were involved in the day to day running of the home; they were involved in regular staff and resident meetings, discussions about policies and procedures, completion of annual surveys, individual and group dicussions and had been involved in the selection of new staff. Residents were given support from staff to develop and maintain friendships in the community; one resident said he had made friends at the day centre. Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Flexible routines encouraged residents’ choices and control over their lives and social activities were varied and individually appropriate for the people who lived at Calder View. Residents enjoyed choices of meals that suited their dietary needs and preferences. EVIDENCE: Residents were given opportunities to develop life skills and individual plans detailed specialised treatment and recovery programmes; there was a procedure that stated residents have the right to personal, social and intellectual development and every effort had been made to provide this. There were a number of examples that supported residents were able to participate in a range of suitable activities that met their individual and diverse needs; most residents were able to make independent choices and came and Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 14 went throughout the day. One resident had small pets in a pen in the garden and house pets; staff helped him to look after them. One visiting care manager commented that her client was ‘encouraged to do his own thing, go out shopping and visit cafes when he feels able to do so. They (staff) also facilitate other contact’. Spiritual needs were met; one resident said he visited the local church sometimes and another resident, who no longer lived at Calder View, had been taken to the Mosque of his choice. A group of residents had been on holiday this year and two other residents had arranged their own holidays with friends; residents were able to develop relationships with people who lived outside of the home and staff supported them to maintain contact. Staff were seen respecting residents privacy and only entering rooms with their permission; residents were offered a key to their rooms and had a safety deposit box for personal items. The menu was largely determined by the residents and they were involved in planning, shopping and cooking. The registered manager said residents would make their own breakfasts and suppers at a time of their choice otherwise staff prepared a light meal at lunchtime and the main meal at tea-time. Menus showed residents had been offered a range of nutritious meals and the registered manager said staff always tried to offer healthy options but this had been difficult at times; fresh fruit was available in the lounge area. Two residents said the food was ‘good’. The kitchen area was due a complete refurbishment as it was worn and damaged (see standard 24) and one of the fridges temperatures was still reading high; this meant food was not stored safely and could present a risk to residents health (see standard 42). Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 and 21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal and healthcare needs were met in a manner that respected privacy, dignity and independence. Medicines were managed safely although procedures did not fully support staff with safe practice. EVIDENCE: Records showed that resident’s health care needs were monitored and action had been taken to respond to any deterioration in health. Residents said they were able to visit their doctor or specialist and were accompanied by staff for support if needed. One GP commented that ‘health needs are always met’ and staff ‘seek advice to improve health care needs’. There were procedures to support staff with the safe management of resident’s medicines although these were incomplete. Missing procedures included ordering, error, transcribing (handwritten directions), ‘PRN’ or ‘as needed’ medicines and provision of medicines for leave; the procedures were necessary to ensure staff had access to safe practice guidance. Storage was secure Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 16 although temperatures of storage areas had not been monitored; medicines need to be stored at the correct temperatures to ensure they were effective. Records were accurate and clear and showed that generally staff had managed residents medicines safely. However handwritten directions need to be witnessed and all prescriptions need to be seen prior to dispensing to prevent any errors. Medicines to be given as needed or PRN need to be supported with clear protocols (directions) to support staff with their decision to administer or not. The registered manager was advised to ensure all residents had photographs as a means of identification attached to the medication administration records (MAR). Staff administering medicines had received appropriate training although there were no assessments to support their competency; staff should have assessments of their competency to make sure they had understood the training. The registered manager said staff who were not trained to administer medicines would be supervised by another staff to ensure residents were not put at risk. There were no residents who were managing their own medicines at the time of the visit although a care manager had said there was a structure for people to manage their own medicines. Annual audits were completed by the community pharmacist to identify any areas requiring improvement. Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents had access to a clear complaints procedure and were protected from abuse by staff awareness although policies and procedures need to be reviewed to provide staff with safe guidance. EVIDENCE: The complaints procedure was clear and easy to read; people knew how to complain, whom to complain to and were satisfied that their complaint would be dealt with appropriately. There were no complaints recorded although concerns and complaints were discussed at residents meetings and included in the annual residents survey. The procedure needed minor ammendment to reflect the correct contact information of the Commission for Social Care Inspection; the registered manager advised a further review of procedures was due. Information about ‘advocates’ was displayed for those residents who needed support and advice from someone other than staff or relatives. The safeguarding adults procedures (formerly abuse) had been reviewed and included clear contact information; however the procedure needed minor ammendment to ensure staff were provided with clear and safe guidance. The registered manager advised that the procedure was due for further review. Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 18 Most staff had attended recent safeguarding training and further training was planned to ensure staff were able to recognise and respond appropriately to protect residents from harm. A member of staff spoken to was aware of how to recognise and respond to abuse. There was a ‘whistle blowing’ procedure to enable staff to report concerns without fear of reprisal. There was a procedure to support staff with physical and verbal aggression although not all staff had received training in this aspect; training would help staff to respond appropriately and keep them and others safe. Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 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. The home was clean and comfortable and records supported that further improvements were planned to develop the home however timescales for improvement had not yet been agreed and some areas of the home were in urgent need of attention to provide a pleasant place for residents to live. EVIDENCE: The home was in keeping with the local community and close to local amenities; one resident said the shops and church were close by. The home was bright, clean and comfortable. It was clear that some areas had been redecorated although some areas of the home were in urgent need of attention to provide a pleasant and safe place for residents to live in; areas noted during the inspection included the stair carpet was frayed and presented a trip hazard, the only bath in the home was out of order, the bathroom window restrictor had been removed, the kitchen cupboards and worksurfaces Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 20 were damaged, the kitchen fridge was faulty, bedroom furniture was damaged or had handles missing and most areas were in need of re decoration. There was a planned maintenance and refurbishment programme to develop and improve the home and a budget had been allocated for this purpose although no timescales had been agreed; most areas requiring attention and improvement had already been noted and the registered manager was waiting for permission to commence work to improve the home. A representative of the company was due to visit the home to decide what improvements should be made first. Resident’s rooms were clean and comfortable and most had been personalised with treasured possessions; residents were responsible for keeping their rooms tidy. One resident said it was home from home. All bedrooms had wash basins and the toilet and bathrooms were close by. There were no residents who needed aids and adaptations but these would be assessed on an individual basis. Communal areas were clean and comfortable and quiet sitting areas were provided for those who preferred peace and quiet. There was a small, tidy garden area to the front of the house; the garden and patio area to the rear provided seating, flowerbeds and a smoking shelter. Residents said they enjoyed the garden and were enjoying the sunshine on the day of the inspection visit. One resident had small pets in a pen in the back garden; staff helped him to look after them. There was a small domestic laundry that was used by residents; one of the residents said he looked after his own laundry. Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff team were experienced, well supported, competent and provided in sufficient numbers to meet resident’s needs although safe recruitment procedures had not consistently been followed and this could put residents at risk. EVIDENCE: Rotas showed the home was staffed with sufficient numbers of staff to meet the needs of the residents; it was clear that the ratios of staff had been determined by residents needs. Residents said there was enough staff to give them the support they needed and staff confirmed this; residents were supported by staff of similar ages that shared similar interests. Rotas were clear although the full names of staff and their roles should be recorded. Turnover of staff was low and this ensured residents were supported by staff who knew them. Regular staff meetings were held and showed that staff were kept up to date and able to voice their views and opinions; residents had also contributed to some staff meetings. Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 22 Records showed that staff had received appropriate training to help them to understand the needs of residents in their care. Records showed that staff were supervised and supported although some supervisions were due to be completed to ensure they were up to date. There was no recruitment procedure to support management and staff with a safe procedure that would protect residents. Three staff files were looked at and a safe process had been followed with two of them. One of the more recently employed staff had not had all the appropriate checks in place before starting work at Calder View; appropriate checks were to determine whether a person was suitable to work at the home. One of the existing staff did not have an application form on file although all recruitment checks were in place; not all files included recent photographs for identification purposes. Contracts of employment were in place for most staff although new contracts were due to be issued to ensure staff were aware of their responsibilities. The recruitment process showed an equal opportunities procedure had been followed and the registered manager said residents had been involved in staff selection in the past. One visitor said ‘staff are easy to talk to and helpful if there is a problem’. A care manager said ‘staff are appropriate when dealing with clients. They have a good understanding of mental health problems’ and ‘they create a homely environment and give support’. Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefited from a well managed home and their health, safety and welfare was promoted and protected. People were involved in decisions about how the home was run. EVIDENCE: The registered manager Mr Tom Hanna is qualified and competent to manage the home; he has updated his skills and knowledge and has a mangement qualification which would support him in his current role. One member of staff said the management of the home was open and the registered manager could be approached if there were any issues. Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 24 Residents said they were happy with the way the home was run. They were knowledgeable about policies and procedures and involved in decisions about the home. Results of the annual service user satisfaction survey were displayed and showed positive feedback and the registered manager said relatives and other professionals were to be surveyed to determine whether they were satisfied with the service. The home had the ‘Investors In People’ award; this was a recognised external quality award that monitored the management practices and support given to staff to develop their skills. There were no systems to monitor whether staff were following policies and procedures and meeting peoples needs; the registered manager said these would probably be introduced within the next few months. The current owners had not completed a record of their visits to the home; the visit and a report of their findings should be completed monthly to monitor whether the home is being properly run. Policies and procedures had been reviewed and read by staff; some needed further development, as detailed in the report, to ensure staff had safe guidance. The registered manager said senior management would be introducing new policies and procedures for all aspects. Records showed that staff had received regular safety training to keep them and others safe and records supported that systems were maintained and serviced to ensure peoples health and welfare was protected. It was noted that the temperature of the kitchen fridge had been above the recommended temperature for safe food storage for some time; the registered manager was advised that action needed to be taken to ensure food was stored safely at all times. Calder View DS0000009604.V359060.R01.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 Adults 18-65 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 2 3 3 2 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 2 27 2 28 3 29 N/A 30 3 STAFFING Standard No Score 31 X 32 4 33 2 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 4 3 X LIFESTYLES Standard No Score 11 3 12 3 13 4 14 4 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 3 X 2 X Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 26 NO Are there any outstanding requirements from the last inspection? 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 YA20 Regulation 13 Requirement The medication policies and procedures must reflect current safe practice and include ordering, reporting errors, transcribing, administration of ‘PRN’ or ‘as needed’ medicines and provision of medicines for periods away from the home. A thorough recruitment procedure must be developed to ensure the protection of residents. New staff must commence working at the home only when all satisfactory checks are in place. The registered provider or their representative must visit the home at least each month and prepare a report of their findings to determine whether the home is being well managed. Timescale for action 30/06/08 2. YA34 13 30/06/08 3. YA34 19 30/06/08 4. YA39 26 30/06/08 Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 27 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. 3. 4. Refer to Standard YA1 YA3 YA5 YA20 Good Practice Recommendations The service user guide needs to include the correct Commission for Social Care Inspection contact information. Letters that would confirm prospective residents needs could be met at Calder View should be developed . Resident’s contracts should be updated to reflect current terms and conditions and fee rates. There should be photographs as a safe means of identification with resident’s medication administration records (MAR). Temperatures of medication storage areas should be recorded. There should be clear instructions to support staff with their decision to administer ‘PRN’ or ‘as needed’ medicines. Handwritten directions on the MAR should be recorded in detail and witnessed by another member of staff. All staff that administer medicines should have training in the safe handling of medicines and there should be supporting assessments of their competency available. 5. YA22 The complaints information should be reviewed to include the correct Commission for Social Care Inspection contact information. The safeguarding adults procedure should reflect clear guidance for staff. Staff should be provided with training to enable them to respond appropriately to verbal and physical aggression. 6. YA23 Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 28 7. YA24 A date to commence the planned improvements to all areas of the home, as detailed in the report and in the home’s recent maintenance audit, should be decided upon. The stair carpets should be replaced as a matter of urgency to reduce the risk of trips and falls. The window restrictors should be replaced on the bathroom window or a risk assessment completed for individual residents. 8. 9. 10. 11. YA26 YA27 YA33 Damaged furniture and fittings in resident’s rooms should be replaced or repaired. The home’s bath should be repaired or replaced as a matter of urgency. The staffing rotas should detail the full names and role of each member of staff on duty. Staff files should include a recent photograph as a means of identification. The reasons for obtaining alternative references (other than listed on the application form) should be recorded in the staff file. Systems to monitor whether staff are following procedures and meeting people’s needs should be introduced. The faulty kitchen fridge should be replaced or repaired to ensure food is stored at the correct temperature. YA34 12. 13. YA39 YA42 Calder View DS0000009604.V359060.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Calder View DS0000009604.V359060.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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