Care Home: Carrington House

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What the care home does well Clear information is provided to people who are looking for a care home and their relatives. This is available in different formats, so that it is accessible for people with different needs. The manager or her deputy completes a full assessment before a person is admitted to make sure the home can meet their needs.People who live at Carrington House have access to a good range of professionals from other agencies to help with their care, for example GPs, District Nurses and other advisors. People are supported to self medicate when they are able and this helps maintain independence and choice. The staff attend to people in a kindly way. The staff were also praised by relatives for their patience and understanding. People felt safe in their hands. There are good links with the local community and visitors are welcomed, so that the home remains part of the community. The environment is well maintained, clean and warm. People can choose to personalise their rooms with their own belongings and can choose where to spend their time. Staff have access to a good range of training to help them care for people skilfully. Residents are asked for their views and, within the limitations of community living, their suggestions are acted upon. Health and safety is managed effectively, for the safety of all. What has improved since the last inspection? At the last inspection requirements were made with regard to care planning, medication, the storage of oxygen cylinders. The computer care planning system is now fully operational and staff spoken to during the inspection stated that they are now more confident in using this. As a result of this the care planning arrangements have improved. Some minor amendments are still required as detailed in the main body of the report. Medication administration was viewed during this inspection and found to satisfactory. As was the storage of oxygen The last inspection raised issues with regard to a window which was in a poor state of repair. This was not seen to be the case during this inspection with the window having being replaced/ repaired. What the care home could do better: No requirements have been made as a result of this inspection. Advice was given to the manager with regard to storage of one medication for one individual during the inspection. The manager agreed to review this and ensure that medication was stored in line with good practise guidelines and the homes internal policy. The manager stated that`s he would remind staff` of this. Parts of the building and looking worn and the decoration tired in parts. Consideration should be given to ensure that the environment is kept under review and that any remedial action is taken. The health of one individual was deteriorating. The home were advised to contact the community nurse with regard to this individual to ensure that appropriate pressure relieving equipment was available. CARE HOMES FOR OLDER PEOPLE Carrington House Carrington Way Wincanton Somerset BA9 9BE Lead Inspector Justine Button Unannounced Inspection 20th September 2008 10:00 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 Carrington House DS0000016102.V368674.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. Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carrington House Address Carrington Way Wincanton Somerset BA9 9BE 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) 01963 32150 01963 33590 karen.roberts@somersetcare.co.uk Somerset Care Limited Mrs Karen Roberts Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44) of places Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Date of last inspection 20th September 2007 Brief Description of the Service: Carrington House is a detached property located in the centre of Wincanton. The home has been built on a hillside and is arranged over three floors. All areas of the home are accessible by passenger lift. There are a number of small lounges within the home and a large dining room. Service users are able to access a small garden at the rear of the property, and a roof terrace with seating provided. There are appropriate communal areas and bathing facilities to meet service users needs. The home is registered with the Commission for Social Care Inspection to provide personal care for up to 44 service users over the age of 65 years. The home does not provide nursing care. The Registered Provider is Somerset Care Limited. Fees at the home range from £390 - 600 each week, with additional charges made for newspapers, dry cleaning, toiletries and personal items. Carrington House DS0000016102.V368674.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. The inspection was unannounced and completed over the course of one day. The inspector spent the whole day in the home and then a further morning in the home During the inspection we talked to residents. Staff and visitors were also available for discussion. The manager helped with the inspection by providing information and records. Pre-inspection information was received before the inspection in the form of the Annual Quality Assurance Assessment (AQAA). This is now required to be completed every year and sent to CSCI. It was completed in enough detail and gave a good overview of the home’s activities, including what it has done well, what has hampered improvements and what is planned for the future. A tour of the premises was made, interaction between staff and people who use the service observed, as well as care practices that included the administration of medicines and the serving of food. The inspector sampled some of the residents documentation along with records relating to staff and other records required by regulation. Surveys were sent out, 8 surveys were completed by people who live in Carrington House. The responses to these surveys is reflected in the main body of the report. What the service does well: Clear information is provided to people who are looking for a care home and their relatives. This is available in different formats, so that it is accessible for people with different needs. The manager or her deputy completes a full assessment before a person is admitted to make sure the home can meet their needs. Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 6 People who live at Carrington House have access to a good range of professionals from other agencies to help with their care, for example GPs, District Nurses and other advisors. People are supported to self medicate when they are able and this helps maintain independence and choice. The staff attend to people in a kindly way. The staff were also praised by relatives for their patience and understanding. People felt safe in their hands. There are good links with the local community and visitors are welcomed, so that the home remains part of the community. The environment is well maintained, clean and warm. People can choose to personalise their rooms with their own belongings and can choose where to spend their time. Staff have access to a good range of training to help them care for people skilfully. Residents are asked for their views and, within the limitations of community living, their suggestions are acted upon. Health and safety is managed effectively, for the safety of all. What has improved since the last inspection? At the last inspection requirements were made with regard to care planning, medication, the storage of oxygen cylinders. The computer care planning system is now fully operational and staff spoken to during the inspection stated that they are now more confident in using this. As a result of this the care planning arrangements have improved. Some minor amendments are still required as detailed in the main body of the report. Medication administration was viewed during this inspection and found to satisfactory. As was the storage of oxygen The last inspection raised issues with regard to a window which was in a poor state of repair. This was not seen to be the case during this inspection with the window having being replaced/ repaired. Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Carrington House DS0000016102.V368674.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 Carrington House DS0000016102.V368674.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2, 3, 4, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who are considering living in Carrington House and those close to them are provided with enough information about the home in a variety of ways. All people moving to Carrington House have their individual care needs assessed before admission to the home is agreed. EVIDENCE: The registered provider has produced a statement of purpose and service user guide along with other brochure type leaflets that give prospective service users and relatives information on the home and service. A copy of the Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 10 statement of purpose was available in the reception area of the home. The AQAA stated that a copy of the service user guide is given to all service users as it is part of the terms and conditions. It also stated that the guide is available in Braille, written and CD formats. In the surveys of people who live in the home 100 said they received enough information about the home before they decided if it was the right place for them. Admissions to the home are not made until a full needs assessment is made. The registered manager receives the social worker assessment and then carries out her own needs based assessment. A sample of these was seen in the care plans. They were detailed enough for a decision to be made about whether the home can meet the person’s needs. The home can meet the needs of the people who live there in terms of the skills and experience of staff. In the surveys from people who live in the home 50 said they ‘always’ receive the care and support they need and 50 said they ‘usually’ or ‘sometimes’ do. The Home said in the AQAA that people can spend a trial period in the home if they are unsure if they are making the right decision. The home offers short term care which they call “step down, step up” services. The home does not consider these services to be intermediate care as they do not offer any specialised or rehabilitation services to meet the requirements of intermediate care Carrington House DS0000016102.V368674.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans and associated reviews need to accurately reflect the care needs of individual’s, however the care and the support being provided was appropriate. Health needs are met Dignity and privacy are considered by staff at all times Medication administered and storage was well maintained. EVIDENCE: Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 12 All of the care plans examined are based upon information provided from preadmission assessments. Following admission to the home, further assessments are carried out and the home draws up a care plan identifying the needs of each individual and how staff are to meet these needs. The plans that were sampled would benefit from more detail to instruct staff with regards to the care required. The care plans seen lacked detail in some areas. For example one person who’s health had recently deteriorated and as such had a reduced appetite the care plan stated ““encourage to eat more”. This phrase is not specific and the plan should state how staff are going to do this. What they should do if a meal was not eaten. This individual also had a pressure ulcer. To aid healing older people with tissue damage should be encouraged to eat a diet high in protein. The plan was not reflective of this. It was clear from the records however that this individual had gained some weight following a period of weight loss. In view of this, despite the plan not being specific, it was clear that staff were providing appropriate support. As the plans demonstrate more strengths than weakness and the outcome for people living at the home is positive a requirement has not been made in this area. Some people at the home frail and as such staff had introduced charts to record such things as amount of fluids taken and frequency of positional change. The charts viewed had been accurately completed and demonstrated that staff had delivered appropriate care and support. The health of one individual was deteriorating. The home were advised to contact the community nurse with regard to this individual to ensure that appropriate pressure relieving equipment was available. The GP was contacted during the inspection by staff to request a review of the individual’s condition and needs. Feedback from visiting professionals given via questionnaires and discussion at the time of the inspection informed the inspector of good professional relationships. They further confirmed that the people who use the service attend appointments and have their health care needs met. Interaction between staff and residents were observed as friendly and respectful. Through discussion with the individuals we were informed that the care staff fully respected their privacy and dignity. Residents informed the inspector that they are not made to do anything they did not wish to, such as attending activities or having meals in the dining room. Staff were observed knocking on doors before entering. People who use the service are able to meet privately with visitors in their bedroom or in one of the lounges. They further confirmed that all personal care Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 13 was provided in the privacy of their bedrooms or bathrooms. The care plans and associated documents supported these representations. Medicines are stored well. There was a fridge for medicines needing refrigeration and the temperature was being monitored and recorded. One staff member was observed completing a drug administration round during the inspection. This was completed within good practise guidelines. One issue was raised during the inspection with the homes manager with regard to the expiry date of one medication. The manager agreed to review this following the inspection. Staff had commenced a liquid form of this medication and as such had written the expiry date on the bottle from the date that they had opened it. It was evident however that the community pharmacist had decanted this fro a larger bottle they had in stock. The expiry date of this medication should therefore be the date that this larger bottle had been opened not the date that the staff at the home had opened the smaller bottle. This is clearly documented in the homes policy. The manager agreed to remain staff of this policy. Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 14 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): 12, 13, 14, 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Activities are well advertised. There is a range of social events and for the less able there are opportunities for one to one social contact. Comment cards indicated that not all people found the availability of activities adequate Families were seen to be welcomed and to be part of the home life. The menu is varied. The food on the day of the inspection was of a good standard. EVIDENCE: The care plans viewed during the inspection detailed the preferences of service users. People living at the home or their Relatives & friends provide information relating to their loved one’s social history, previous hobbies/interests, preferences, likes and dislikes if the individual is not able to provide this information. Those staff observed on the day of the inspection Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 15 appeared to have a good knowledge of the people living at the home and what they did and did not like. Those service users able to express a view informed the inspectors that their wishes were respected and that they could choose what time to get up or go to bed. Service users can choose where and how to spend their day. Any restrictions would be identified in risk assessments. Due to mobility difficulties, not all service users can move freely around the home. Throughout the day the inspector observed regular staff presence in each of the lounges. As previously mentioned, staff interacted with service users in a kind and respectful manner. The home employs an activities organiser at the home. The activities records were viewed as part of the inspection. These demonstrated that there is a range of activities on offer when the activities organiser is present. People living at the home particularly enjoy using the newly purchased Nintendo WII. A computer is also available for use by people living at the home. The activities organiser develops computer footage of events such as birthdays and activities for both people living at the home and their families. Other activities included bingo, art, outside entertainment and Holy Communion The home also runs it’s own shop. This enables people to purchase items such as toiletries, sweets and chocolate. Birthdays are celebrated with the home providing a decorated cake and a card from the staff. Pictures of birthdays cakes were available and the cook/chef should be commended for the high quality of these. The home welcomes visitors at any reasonable time in accordance with the wishes/preferences of the service user. Visitors spoken to during the inspection were extremely complimentary about the care and support afforded to people living at the home. All meals are prepared and cooked on the premises. Copies of a two-week menu were made available to the inspector. The menu appeared wholesome and varied. The main meal is served at lunchtime with a lighter cooked meal at tea time. This was evident at the time of the inspection. The inspectors were informed that milky drinks and sandwiches were offered in the evening. Special diets are catered for. The inspector observed soft diets being served to those with an assessed need. These were seen to be attractively presented. Sweets were available for those requiring a diabetic diet. Staff were observed assisting service users in a manner which was relaxed, unhurried and respectful. Service users able to express a view were positive regarding the meals available and stated that there was always plenty to eat. Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 16 Drinks were served throughout the day. A range of cakes or biscuits was available. A choice of meal is available at all times. Staff ask people in the morning what they would like to eat at lunch time. Some people living at the home had forgotten what they had ordered. Some people may have difficulty in expressing a preference. Staff were observed to be showing the plates of food to those with communication issues to ensure that a choice could be made more readily. One individual stated that he did not like the choice of food that he had ordered. Staff were very quick to offer an alternative. The tables were set with linen tablecloths, napkins and appropriate condiments. A range of cold drinks was available through the meal. Menus are on display in the dining room. Independence was actively promoted by, for example, allowing people to serve their own vegetables and gravy. It was noted that portion sizes were varied according to people’s appetite. A choice of sweets and puddings were available following the main meal,. Choice was offered as the desserts were served from a sweet trolley. Carrington House DS0000016102.V368674.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): 16, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are dealt with in line with the homes policy and procedures. People living at the home are aware and comfortable in expressing any concerns. People living at the home are protected by the home’s policies and procedures. Staff have received recent training in the prevention and recognition of abuse. EVIDENCE: Feedback forms to people living at the home asked do you know who to speak to if you are not happy? Comments from relatives included “A wonderful home no complaints”. The Home has a complaints procedure that is clearly written and contains the contact details for CSCI. All the complaints are dealt with in line with the homes policy and procedure. Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 18 A range complimentary letters were also held on the file. The policies and procedures regarding protection of residents are of a good standard, which include complaints,recognising signs of abuse and whistleblowing. Abuse training is included in the new staff induction programme. The training matrix was viewed as part of the inspection process and this showed that staff had not recived abuse training, althouhg this is covered by staff who have completed an NVQ and during induction. Since the last inspection the manager has been proactive in welcoming complaints and suggestions about the service, using these positively and learning from them. Staff recruitment files were veiwed during the inspection. These contained all necessary checks. Carrington House DS0000016102.V368674.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): 19, 20, 21, 22, 23, 24, 25, 26. Quality in this outcome area is Adequate This judgement has been made using available evidence including a visit to this service. The home is well maintained and meets the needs of the people who live there. Service users live in a comfortable & clean environment and have access to range specialised equipment. The bathroom facilities are good with a range of both baths and showers offering choice to people who live at the home. The home takes appropriate steps to reduce the risk of the spread of infection. Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 20 EVIDENCE: The inspector toured the premises unaccompanied viewing a number of communal areas. The home was generally clean in all areas observed. It was noted that all toilet and bathrooms were found to be clean and hygienic. The resident’s accommodation is provided over three floors. There is a passenger lift, assisted bathroom and call system available to residents; people commented that call bells are answered promptly. There are a number of communal lounges and one main dining room. Activities can be held in these communal areas. These areas are domestic in nature providing comfortable seating and dining facilities. There is evidence of new seating being provided in the communal areas and the registered manager informed the inspector that more are on order. Although the home was decorated and maintained to a satisfactory some areas are looking a little worn and tired. These will require updating and redecoration in the near future. The manager informed us that in November 2008 the dining room and some bedrooms were due to be refurbished and decorated. The corridors are well illuminated with a number of prints on the walls. There are a number of seats discreetly placed in recesses of the corridors allowing individuals to rest if needed, handrails are also provided to aid independence around the home. There are also areas where people can sit and talk in small groups. One such area has a balcony accessed through patio type doors. Residents are able to bring personal possessions with them into the home. The rooms the inspector observed had been personalised to reflect the individuals taste. One person who had recently took up residency expressed satisfaction with their room and informed the inspector of the efforts that had been made by staff to ensure that they were comfortable and had opportunities to have their own furniture brought in. Infection control measures were in place to include hand-washing facilities for staff. Staff spoken to were aware of the actions to take to prevent any infection spreading. Staff have received training in infection control. Domestic staff spoken to during the inspection felt that the budget was adequate to keep the home clean and tidy. New equipment was purchased on request. People accessing the home for “day care” have their own sitting and dinning space with in the home. Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 21 Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels appear appropriate to the needs of people currently at the home but these should be kept under review. The home promotes NVQ training for staff and ensures that all staff received training appropriate to their role. The home follows robust procedures for staff recruitment. EVIDENCE: Staff spoken with during the inspection confirmed that they had been provided with the training needed to care for people at the home including NVQ. Staff indicated that they felt confident in their skills and they stated that they were never asked to undertake a task that they didn’t feel trained to carry out. Staff confirmed that, apart from mandatory training, they had received ‘very good’ training. Staff commented that “training is encouraged with all levels of staff’, ‘we have very regular training’. Also staff members identified training as something that the home does well. Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 23 A copy of the homes training matrix was viewed following the inspection. This demonstrated that a number of staff had not completed refresher training in moving and handling as yet this year. This is expected to be completed at least once a year. Staff have until December 2008 to complete this training. A training session for staff however had been organised for the day of the inspection and an additional session for the week following the inspection. As previously stated it could not be confirmed that all staff had received training on the recognition and prevention of abuse. Staffing numbers were considered during the inspection. These appeared sufficient to meet the current needs of the people living at the home. Separate staff are available for those people attending the home for “day care”. The home’s procedures for staff recruitment were examined. Records relating to two staff recently employed were viewed and there was evidence that the home was following robust recruitment procedures which also included appropriate checks with the Criminal Records Bureau (CRB) and Protection of Vulnerable Adults list (POVA). We were able to see evidence that newly appointed staff follow an appropriate induction programme. Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33,35, 36, 37, 38. The quality in this outcome group is good. The home is well managed in an open management style. The home is run with the service users best interests safeguarded by policy, practice and procedures. Attention to the health and safety of service users and staff is of a good standard. A system of staff supervision is in place. Health and safety is well managed. EVIDENCE: Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 25 The manager, Mrs Roberts, has been employed a number of years. The management style of the home is appreciated by staff and service users. All people spoken to were very complementary about her open management style. Mrs Roberts undertakes quality assurance assessment of the home; surveys have been made to assess service user satisfaction. Regular staff and service user meeting are held. Minutes of these were seen. The company complete regular visits to the home in line with Regulation 26. All records seen were stored appropriately and safely. The home currently holds pocket money in the safe for people living at the home. Expenses such as hairdressing, newspapers and minor sundries are invoiced and paid form individuals monies. Receipts are kept for any expenditure. The balances for two people were viewed and found to be correct and in line with the receipts kept. Accident forms are completed and these are audited on a monthly basis. Staff supervision is ongoing and all staff receives regular supervision on a rolling programme. Annual appraisals are conducted for all staff. Servicing and maintenance records were sampled these were found to be in good order. COSHH (Control of Substances Hazardous to Health) advisory sheets are held at the home. Carrington House DS0000016102.V368674.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 3 3 X 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 27 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. Standard Regulation Requirement Timescale for action 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 OP9 OP19 Good Practice Recommendations Staff must ensure that they mark liquid medication with the correct expiry date. This should be in line with the homes policy and good practise guidelines The home should continue to review the general environment and ensure that fabric of home remains attractive Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Carrington House DS0000016102.V368674.R01.S.doc Version 5.2 Page 29 - 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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