Care Home: Cary Lodge

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What the care home does well The home has a team of staff who are committed to improving peoples experience of care in the care home. They are friendly and supportive to people as well as encouraging them to do the things they are able themselves. One comment received for a person living at the home stated:- "I stayed for two weeks before deciding to stay. The staff and the atmosphere in the house impressed me. I am still happy with both of these things I had been living here for over two years" The way people`s assessments and care plans are recorded mean that staff have excellent information regarding how they should provide care for people. This means that people can have confidence that their assessed needs will be met by a staff team who have the right information about what their need. The management team are committed to ensuring staff have the training to help them do their jobs well. And staff are encouraged to achieve an NVQ in care. Training staff receive is linked to the needs of the people living at the care home. What has improved since the last inspection? This is the first inspection since the home has been registered with new providers. What the care home could do better: Although new staff work supervised with the manager or a senior carer not all pre employment checks are applied for before they start work. Staff had started work before their police checks had been applied for. This means that people could be put at risk from unsuitable staff. CARE HOMES FOR OLDER PEOPLE Cary Lodge Palermo Road Cary Park Torquay Devon TQ1 3NW Lead Inspector Rachel Proctor Unannounced Inspection 16th June 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 Cary Lodge DS0000071167.V364396.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. Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cary Lodge Address Palermo Road Cary Park Torquay Devon TQ1 3NW 01803 328442 01803 314006 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) Beechcroft Retirement Home Ltd Manager post vacant Care Home 34 Category(ies) of Dementia (34), Old age, not falling within any registration, with number other category (34), Physical disability over 65 of places years of age (34) Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia (Code DE) Physical disability, aged 65 years and over on admission (Code PD(E)) The maximum number of service users who can be accommodated is 34. New Registration change of owners 2. Date of last inspection Brief Description of the Service: A change of ownership and new registration with the Commission has taken place since the service was last inspected. Cary Lodge provides care for up to 34 older people who may have physical disabilities and/or dementia. The premises are a large detached, three-storey house situated in a quiet residential area close to a park and local shops. Accommodation comprises 33 en-suite rooms. There is a large lounge, a small quite lounge and separate dining room. There are two bathrooms with adapted baths and a shower cubicle that is accessible to wheelchair users. There is a shaft lift and chair lift. Cary Lodge has started to provide intermediate care for people who need short-term placement in a care home. They are not registered to provide nursing care. The statement of purpose is provided in the reception area of the home and copies can be provided on request. The fee levels at this inspection were from £338-£405. The actual cost is dependant on the needs of the person. Additional costs include newspapers, hairdressing and chiropody. Cary Lodge DS0000071167.V364396.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 took place over two days 16th and 18th June 2008. The manager provided an (AQAA) Annual Quality Assurance Assessment for the Commission prior to this inspection. This provided information about how the home manager viewed the services provided at the home and what planned improvements would take place in the next 12 months. Three people living at the home had their care followed. Discussion with the manager, staff team and people living at the home took place during the inspection. Surveys were returned from 5 people living at the home, 6 relatives and 2 staff members prior to this inspection. Some comments made in the surveys and some comments made during the inspection have been included in this report. A tour of the home was completed and some records were inspected. What the service does well: What has improved since the last inspection? This is the first inspection since the home has been registered with new providers. Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 6 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. Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 6,Quality in this outcome area is excellent. People are given sufficient information about the home and it’s services that enable them to make an informed choice about whether the home can meet their needs. The way peoples care needs are assessed ensures that they receive the care they need from staff that have clear guidance about the care they need and what is important to them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose and service users guide, which had been up dated for registration in January 2008, was provided in the reception area of the home. The manager advised that she was in the process of up dating this again to reflect the changes that have taken place. She confirmed a copy would be sent to the Commission when this was completed. One resident commented, My son receive the contract within the first week of my stay at Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 9 Cary lodge My son and my sister asked all the relevant questions before I came here. They were given all the right answers Three people had their care followed as part of this inspection. Two had been admitted to the home since the new registration. The information with their care plans included an initial assessment and a full assessment of need. Where social services or the health team had completed assessments their assessments were also available with the persons information. The assessment process included risk assessments. Manual handling, nutrition and risk of falls were completed in the care plans seen. The comprehensive assessment completed for individuals enables staff to provide continuity of care. As well as personal care, care planning is also completed for social care and emotional needs. The personal history recorded for individual’s shows what they have been interested in and what has been and is important to them. This Information allows the carers to get to know the person they are caring for as well as the care they need. Two people spoken to who had been admitted to the home recently said the staff are really helpful and made sure they had all the information they needed about the home. They also said the manager and senior carers had discussed the care they needed with and what was important to them. The manager advised that the home had started to take people who required short-term placement intermediate care before they returned home. She commented that all new residents are assessed before they are admitted to the home where possible. Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is good. The way care was planned and organised through care planning should ensure that people receive the care they need. The staff have clear care plans to follow, which guide them to how a persons care should be given. People can have confidence that the staff providing their care understand their needs and know how they like the care given. Not all the medication records reviewed had been completed fully to identify why a person had not taken a particular medication. This may mean that when the persons GP reviews their medication they may not know the reason why the medication was not taken. This could put people at risk of not receiving the medication they need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three people had their care followed as part of this inspection. Their plans of care were seen and the rooms they occupied with visited. These people were also spoken to during the inspection. Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 11 A new care planning system had been introduced since the random inspection in January 2008. This provided a clear record for reviewing each element of the care plan monthly. Three records seen during the inspection had all been reviewed monthly or sooner when the persons needs had changed. One person who had been living at home long-term had had their plan of care rewritten the last time it was reviewed. The plan of care incorporated the advice given by the community psychiatric nurse (CPN) who had assessed the person. The care plan guided staff how to manage the person’s challenging behaviour and psychological needs. Each of the three care plans had a personal profile completed. These had been completed with the person and their representative. These profiles included what interested them and what their life experiences were. The people that were important to them were also recorded. One person spoken to said, The manager had helped them to settle into the home. They also said the manager had talked to them about what was important to them and what help they needed. Staff observed providing care for people with challenging behaviour were doing so in a sensitive supportive way. One person asked a carer the same question repeatedly. The carer responded with the same enthusiasm each time the person asked the question. During the inspection staff were encouraging people to walk with them to use the toilet rather than use a wheelchair. Staff were patient and kind and gave people encouragement as they walked. Risk assessments were an integral part of risk assessments were an integral part of the care plans seen. These included identifying risk of falls, where a risk of falls had been identified the plan of care recorded how staff should reduce this risk. Nutrition risk assessments had also been completed, these identified people at risk of not having enough food or drink. Manual handling risk assessments were completed these show how staff should assist a person. These identified whether the person needed help from one of two carers and whether any manual handling hoists were needed. One comment received form a relative stated: -because x is in a wheelchair at the moment they are more than meeting their needs, and helping them to walk again with the aid of the frame The care plan’s identified the things the person could to as well as those they needed help with. This gave people the opportunity to maintain their self-care abilities. One person spoken to has had the staff help me with the things I cant do myself and encourage me to do what I can. Visits by health professionals were recorded separately in peoples plans of care. These included specialist nurses, chiropodist, physiotherapists and the persons GP. Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 12 The records of medication kept for three people were viewed. The member of staff administering the medication had signed the records. However two gaps where the reason medication was not given and staff had not signed were found into peoples medication records. The manager advised that she was working with the staff to ensure that medication records are completed properly. A lockable medicine trolley had been purchased since the last inspection. This was being stored in a locked treatment room. The room also contained a locked cupboard for storing creams and other medication for people. The controlled drug (CD) cupboard was contained within these cupboards. However although there was a lock on the CD cupboard when medication stored was checked it was not locked. The senior carer on duty said there had been a few problems with the lock. The manager demonstrated that the lock worked satisfactorily, she advised that she would ensure all staff locked the CD cupboard. The records of controlled drugs administered for one person was checked against the stock held as correct. The controlled drug book had been completed as expected. A system for returning medication no longer required to the pharmacy was in place. A record of medication returns was being kept and had been signed by the person preparing the medication for return. The senior carer in charge of the shift was taking the medication to the people who required it at lunchtime. The records of medication were also taken to the person requiring the medication. Records were being signed as the person received their medication. During the inspection people were receiving personal care in the privacy of their own rooms or bathrooms. Staff were seen to knock on peoples room doors before entry. Three people used the telephone in the reception area of the home to call friends or relatives during the inspection. This is an open area and other people could overhear what the person was saying. The manager advised that they had two phone handsets that could be taken to the quiet room where people could have calls in private if they wished. However one of these had gone missing and the other had stopped working. She advised that she was in the process of getting the phone repaired and this would enable people to receive and make phone calls and private if they wished. Cary Lodge DS0000071167.V364396.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. People who live at Cary Lodge are given the opportunity and encouragement to make choices about their day-to-day lives. Meal times are a pleasant experience for people who live at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The routines of the home had been arranged to allow people some freedom of choice between mealtimes. One person who was able to go out of the home using a mobility scooter went out to meet friends during the inspection. They said the home staff are friendly and supportive and provide a really homely atmosphere. On the day of the inspection people had the opportunity to go to Goodrington Beach for a cream tea. Several people who were able to took up this opportunity. A disabled access minibus capable of taking wheelchairs had been provided to transport people. An external activities provider had coordinated this for the home. A record of the activities the organisation provided and which people had taken part in the activities was being kept. The Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 14 manager confirmed that the organisation provides weekly activities for people living at the home. A senior carer advised that during the afternoons the carers provide some entertainment for people such as bingo, scrabble and sometimes a quiz. Three people spoken to during the inspection said theres always something going on in the lounge in the afternoons if you want to take part the staff always tell you whats going on so you can choose if you want to join in. Other comments received included: - they make sure that x and y live as normal day-to-day life as they would if they were in their own home People were receiving visitors in the privacy of their own rooms and in the communal areas during the inspection. The service users guide was easily available in the reception area of the home is provided information about the home and its services. One relative comment stated: - I feel the care homes does exceptionally well in occupying the residents with lots of opportunities for pursuing hobbies (gardening, knitting ect) and providing activities such as card making, cooking, and various entertainments. These all help to stimulate the residents providing a far happier in atmosphere. People talk to each other far more The way care was seen to be planned for people living in the home was enabling them to exercise some personal autonomy in choice over their daily activities. The manager advised that those people who are able are encouraged to manage their own financial affairs for as long as they wish and are able. People are able to store money in the home safe and have access to it when they want it. Three of these records and the money being kept on behalf of people were checked during the inspection. The lunchtime meal observed was unhurried and people were eating their meals at their own pace. People who needed assistance to eat their food were being given this by staff in a sensitive supportive way. Staff were talking to the people about the meal they were eating and general conversation while they were helping them. One relative commented: -they seem to give great care to X even when changing and helping X to feed themselves. Nothing seemed too much trouble The manager advised that she regularly speaks to people about the meals provided to ask them what they prefer. She confirmed that the menus in use at present had been developed after consultation with the people living in the home. One person said that they had felt hungry but the manager had given them two meals whenever they asked. This person had commented in a survey form that: - not enough food always hungry -- have told staff that and portion size not increased. Has a very good appetite which is not being satisfied Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 15 They said they liked the meals they were given. Another person spoken to said the meals are always good and if we dont like whats on offer something different would be provided. Four people spoken said they really enjoyed having breakfast in bed each morning, they always got the things they liked and staff were always helpful. Drinks were being provided throughout the inspection; tea, coffee or cold drinks were being offered. When visitors arrived they were being offered a drink by staff. Two people who had been out of the home in the morning were offered drinks by staff when they returned. Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. People who live at Cary Lodge can feel confident that their concerns will be treated seriously. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The people asked said they knew who to speak to if they had any concerns. Although all asked said they had nothing to complain about. The manager sorts out any thing they ask very quickly. The complaints policy was available with the Statement of Purpose and Service Users Guide. The manager provided the record of concerns/complaints, which showed the actions taken to address the issues raised. The training records show that staff receive instruction regarding the protection of vulnerable adults when they start work in the home as part of their induction. Policies are in place to guide staff how to recognise and respond to allegation of abuse. One safeguarding referral has been made since the last inspection. The manager was in the process of investigating this with the support of the Care Trusts safeguarding team. She had acted appropriately to protect people living in the home when the alert was made. Cary Lodge DS0000071167.V364396.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26. Quality in this outcome area is good. People who live at Cary Lodge generally have a comfortable and attractive home to live in. The laundry floor looked dusty and was not easily cleanable because of the worn paint surface. This could increase the risk of cross infection if clean clothes/ laundry comes into contact with the laundry floor. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Cary Lodge is situated in a residential suburb of Torquay, close to local amenities. There is ample on-road car parking close to the premises and a driveway which provides close access for the home’s minibus, and if required an ambulance. The main entrance has ramped access. Accommodation is located on three floors, which are served by a shaft lift. There is a stair lift between the ground and lower ground floors. People who Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 18 have rooms on the lower ground floor have direct exterior access. The kitchen, dining room and laundry are sited on the lower ground floor. On the ground floor there is a communal lounge, an office and individual people’s accommodation. There is also a bathroom with an assisted bath and two toilets. Further accommodation for people is provided on the first floor. A bathroom with an assisted bath and shower is also sited on this floor. People’s rooms all have en suite facilities. A tour of the home was completed as part of the inspection. Communal areas, bathrooms and some individual peoples rooms were viewed. Most areas of the home were well decorated. The communal lounge was comfortable, airy and spacious. People’s individual rooms contained items of personal choice they had brought with them. These included pictures, ornaments and many personal items. Some of the chairs in individual peoples rooms appeared worn. The manager advised that some of the chairs were due to be replaced as part of the refurbishments. One comment received from a relative stated: because Cary lodge is under new ownership, e.g. decorations, gardens. And you are aware of things being addressed every week. Repairs and renewals had continued to take place since the random inspection in January 2008. Some rooms had been redecorated and the exterior of the home was in the process of being improved to allow easier access for people to the garden area. The included a level access patio from the dining room on the lower ground floor. The manager advised that she had intended this would be completed for the start of the summer but this had been delayed by other essential building work. One of the people living in the home said they were really looking forward to being able to use the patio and they hoped to be able to help plant some of the pots with summer flowers. An infection control policy was available for staff to guide them how to protect people from infection. Staff observed were using gloves and aprons when providing personal care for people. Staff spoken to knew the importance of hand washing. The laundry on the lower ground floor had been up graded to include a washbasin and sluice sink for staff use. However the painted surface of the floor had worn, which could make it difficult to clean. The laundry floor had dust and washing powder under and around the washing machine. One relative commented when more staff join, it would improve matters more if the laundry was dealt with separately by laundry person, not the care workers”. “This is causing some dissatisfaction among the relatives and residents as it is a costly business having to keep replacing clothes. Cary Lodge DS0000071167.V364396.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. People who live at Cary Lodge are generally well supported by staff that are receiving the training they need to provide good care. The manager is committed to ensuring that the staff have training to improve their knowledge and skills to care for people living at the home. This means that people have a knowledgeable staff team to care for them. Not all staff had a police check before starting work at the home. Although evidence shows staff work supervised until these have been returned. This practice could put people at risk from unsuitable staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was running below full occupancy at the time of the inspection. The manager advised that she was accepting new people once she had assessed them and ensured the staff had the skills to care for them. Staff rotas showed that sufficient numbers of staff were on duty during the day to meet the current peoples’ needs. Two staff are on duty during the night, one awake and one asleep. The staff spoken to said they had sufficient staff on duty to care for people. They also commented that the manager always worked along side them and they really appreciated this. People spoken to said the staff were very helpful, one commenting,” nothing is too much trouble for them”. Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 20 One persons care plan viewed identified that they did not like male carers helping them with personal care. The manager confirmed that the duty rota had been arranged so that a female member of staff would be available for this person. The home employs a cook, domestic and maintenance person in addition to the care staff. During the inspection the cook was not on duty so the manager was preparing the lunchtime meal. The rota showed that one domestic was on duty during the inspection. Care staff spoken to say they all work together to get the work done so that people have what they need. The pre inspection information Annual Quality Assurance Assessment (AQAA) provided information about the number of staff who had or were working towards an NVQ 2 or above. This showed that the home would achieve 53 of its staff trained to this level once those who had started the training had completed it. The manager confirmed that she was committed to ensuring staff received the training relevant to their role in the home. Three staff files were viewed during the inspection. Although all the staff files viewed had copies or proof that a satisfactory police check had been received, the information available showed that the three staff had started work before their police checks were applied for. The manager advised that staff start work to enable them to receive training and she or a senior carer always work along side them before they are able to work on their own. One senior carer on duty during the inspection confirmed that new staff don’t work unsupervised until they have got to know the people living at the home and have had training. Records of training staff had completed were being kept with their personnel files. References had been received for all the staff files seen. However one person only had one reference returned and there was not a record that a verbal reference had been sought. The manager has a recruitment policy in place, which when followed should protect people from unsuitable staff. The manager had introduced a new induction programme for new staff. This was a checklist signed by the staff member as each element was completed. The induction checklist included personal care, manual handling, health and safety and protection of vulnerable adults. Two members of staff spoken to during the inspection said they had access to training to help them do their job. One said they had started an NVQ training course. The other said they had attended a training course run by the local Care Trust for adult protection. The senior carer on duty said the manager made sure every one had manual handling training and fire safety training and had regular up dates. One relative commented: -the owner trains the staff very well and shows them how to use any new equipment. She did this with X and she was very professional The manager has introduced a system for supervision and appraisals for staff. She confirmed that she works along side staff to see how they are working as well as individual meetings to discuss work. The staff spoken to said the Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 21 manager was approachable and always willing to speak to them if they had any concerns. Records of supervision staff had received were available. Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37,38. Quality in this outcome area is good. People living at Cary Lodge have benefited from improvements in the management of the home. Records needed to show that the home manager follows a safe recruitment practice were incomplete. This means people may be put at risk from unsuitable staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the new providers were registered with the Commission the manager appointed has left. A new manager has been registered with the Commission who has experience of managing a care home for old people. There are clear lines of accountability within the home and staff feel supported by the new manager. Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 23 The manager advised that she was reviewing how the quality monitoring system could be introduced for the home. When the new providers were registered with the Commission they provided information about the plans to improve the service. The manager confirmed that the quality audit would be completed annually. Feedback received from people living in the home, staff who worked there and visitors confirms that the management actively seek the views of others when planning changes to the service. This shows that the management team are trying to run the service in the best interests of the people who live there. How individual peoples money is managed on their behalf was discussed with the registered provider. He advised that each person has a separate record of money provided for them and expenditure. These were locked in a home safe. The records of three people were checked against the money held. These showed that peoples money would be available to them should they need it. The manager advised that the health and safety issues they had identified when they took over the home had been completed. These included providing adequate lighting in corridors, replacing a worn staircase balustrade and reviewing the environmental risk assessments. The risk assessment processes ensured that each person who required moving and handling had a risk assessment completed, which guided staff how a person should be handled. Staff confirmed that they received manual handling training. The manager confirmed that staff received fire safety, first aid, food hygiene and infection control training to ensure they understood how to maintain peoples health and safety. Chemicals used in the home for cleaning were being stored safely. The people’s rooms on the first floor entered during the inspection had been fitted with window opening restrictors. A system for reporting incidents and accidents was in place. The records of accidents that had occurred were being kept. The manager advised that she reviewed these on monthly basis to see if any areas needed to be changed to reduce risk. The manager has provided a written statement of policy, organisation and arrangements for the maintaining of safe working practices at Cary Lodge. Staff spoken to said their induction and included, manual handling, fire safety and health and safety for people living in the home. Records in the home were generally in order. However shortfalls in staff recruitment records have been identified in the staffing section. Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 24 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 X 4 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 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 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 2 3 Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 25 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(4)(b) Timescale for action Staff employed by the care home 18/06/08 must have a police check applied for and POVA first check returned before they start work. Requirement 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 OP9 OP9 OP26 OP37 Good Practice Recommendations The manager should ensure that all staff are aware of the importance of locking the Controlled Drug cupboard. The manager should ensure that the reasons for medication not being given are always recorded. The laundry floor should be easily cleanable and kept clean. The records needed to prove safe recruitment are practices followed should be available. Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 26 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 Cary Lodge DS0000071167.V364396.R01.S.doc Version 5.2 Page 27 - 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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