Care Home: Cornerways, Paignton

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What the care home does well What has improved since the last inspection? CARE HOMES FOR OLDER PEOPLE Cornerways, Paignton Cornerways 14-16 Manor Road Paignton Devon TQ3 2HS Lead Inspector Stella Lindsay Key Inspection (unannounced) 24th September 2008 09:45 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 Cornerways, Paignton DS0000049076.V363944.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. Cornerways, Paignton DS0000049076.V363944.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cornerways, Paignton Address Cornerways 14-16 Manor Road Paignton Devon TQ3 2HS 01803 551207 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) www.peninsularcarehomes.co.uk Peninsula Care Homes Ltd Care Home 50 Category(ies) of Dementia - over 65 years of age (50), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (50), Old age, not falling within any other category (50), Physical disability over 65 years of age (50) Cornerways, Paignton DS0000049076.V363944.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th June 2007 Brief Description of the Service: Cornerways is a long established detached property, situated on the level to local facilities at Preston and Paignton. The home is a large building over three floors, and is registered to care for up to 50 service users who are older people with or without a physical or mental frailty or disability. The home has three shared rooms, with the others being for single occupancy, and with the majority having en-suite facilities. There is a shaft lift to all floors. There are several lounge areas and a large dining room where service users can choose to have individual tables. The home has limited outside space and no real garden area, but is close to the sea front at Preston beach and local facilities such as pubs, cafes and local shops, and there is seating available on the home’s patio. There is limited parking at the home, but free on-street parking can be found nearby, although some of this may be time limited in the summer due to the closeness of the sea front. Fees range from £337 to £560 per week. The latest inspection report is available on request from the office. Cornerways, Paignton DS0000049076.V363944.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 inspection took place on 24th and 25th September. A second inspector attended on the first day in order to inspect health care in the home. Prior to the unannounced inspection we sent questionnaires to people who live at the home, and to people who work there. Seven residents, some with help from relatives, and two staff completed and returned these. The new Manager sent us their annual quality assurance assessment (AQAA) when we asked for it. It was clear and gave us all the information we asked for. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. During our visit we spoke to fourteen people who use the service and three regular visitors, the Manager, the Care and Operations Manager for the company, and five other staff members. We case tracked four people who use the service. Case tracking means we looked in detail at the care four people receive. We spoke to staff about their care, looked at records that related to the residents, met with them and made observations if they were unable to speak to us. We also met other residents and their visitors, and shared a meal in the dining room. We looked at staff recruitment records, training records and policies and procedures. We did this because we wanted to understand how well the safeguarding systems work and what this means for people who use the service. All this information helps us to develop a picture of what it is like to live at Cornerways. What the service does well: Cornerways is an attractive house close to the sea front. Residents said that the staff are ‘very understanding, and will do anything for you’. Others said the home is ‘comfortable, pleasant and the food is good’, and ‘no complaints, its nice here.’ A newly recruited staff member said that they found the home had a ‘nice atmosphere’. A regular visitor to the home said that the residents ‘have fun here’ – their family member had ‘enjoyed singing, flower-arranging, Cornerways, Paignton DS0000049076.V363944.R01.S.doc Version 5.2 Page 6 and being involved in baking for the coffee morning’. Another said they had joined their friend for Christmas Day lunch and thoroughly enjoyed it. A staff member said that ‘this is a very caring home,’ and that the management - ‘want everything for the residents’. What has improved since the last inspection? What they could do better: All care plans should be reviewed by care staff in the home at least once a month, to ensure that any changes are monitored, and all staff made aware. The Complaints Procedure needed to be displayed in larger print, to enable more people to be aware of what to do if they have any concerns. Cornerways, Paignton DS0000049076.V363944.R01.S.doc Version 5.2 Page 7 All external doors should be checked to ensure that staff would be alerted if residents were to leave. Residents should be provided with a lockable storage space in their room, so that they can look after their own money and other valuables, if they so wish. The registered person should further develop the system for reviewing and improving the quality of care provided, using the feedback that is gathered from residents and other interested parties, to show how the service is developed in the best interests of the residents. A first aider should be available at all times. 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. Cornerways, Paignton DS0000049076.V363944.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 Cornerways, Paignton DS0000049076.V363944.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): 1, 3 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their care needs will be carefully assessed before accommodation is offered, and a service will be provided to meet their needs satisfactorily. EVIDENCE: The home’s Statement of Purpose and Service User Guide are available on request from the office, in large print if required. It had been up-dated to include information about the new Manager. We saw copies of the home’s brochure in residents’ bedrooms. At the time of this visit plans were being made to admit a new resident. The Manager had visited them in hospital, and received an assessment of their needs from trained staff at the hospital and their care manager. A specialist bed was needed to enable proper care, and their admission was postponed until this was delivered, to ensure their comfort and safety. Cornerways, Paignton DS0000049076.V363944.R01.S.doc Version 5.2 Page 10 The Manager confirmed that after a decision is made, she writes to the new resident or their family to confirm that the home is suitable to meet their needs, and to confirm the room that has been agreed and the fee. She said that she had recently turned down applications when she found that the person’s care needs were beyond the scope of this home. Cornerways, Paignton DS0000049076.V363944.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear care plans had been written to inform staff about the way that peoples’ care should be given, but they had not been up-dated monthly, so not all staff might be aware of changes in care needs. Medication practices are safe. People who live at Cornerways are treated with respect and dignity by the staff who care for them. EVIDENCE: Four people had their care followed as part of this inspection. This involved visiting the person in their own room and speaking to them where possible. The records regarding their care were also seen. The Manager advised that the care plans had been reviewed and the systems updated between May and July this year. The four plans of care seen had been developed from an assessment of the persons needs. Cornerways, Paignton DS0000049076.V363944.R01.S.doc Version 5.2 Page 12 The care plans contained clear information for staff regarding how the persons care needs should be met. The care pans covered the health and personal care needs of the person, which included their personal preferences and choices. Risk assessments for an integral part of the care planning process for all those whose care was followed. Risk assessments included a nutritional risk assessment (MUST tool), this provided information about the dietary needs of the individuals. Manual handling risk assessments were clear and guided staff as to how the person should be handled and what equipment they needed, and the number of staff required to assist them safely. We saw staff moving residents correctly, reassuring them at the same time. Falls risk assessment had been completed and where risk had been identified a plan of care to reduce the risk had been put in place. One person who managed their own medication had a risk assessment completed, which had been signed by the member of staff assessing them and the person. When this person was spoken to the said they had had some problems with the medication. However they were satisfied with the way the new Manager was helping them to maintain their independence with medication. The Manager advised that one person whose care was followed was receiving care from the district nurses. The District Nurses visited this person during the inspection. As well as the home’s plan of care the district nurses care records were also being kept in the home. The person was being cared for in their room. They had a hospital style bed with an airflow pressure-relieving mattress to reduce the risk of pressure sores. The staff were recording when they assisted the person to alter the position in bed. The District Nurses had commented on their records staff maintain one to one and a half hourly turns. The Manager advised that the person had been reassessed as requiring nursing and were awaiting an appropriate home to be identified. One of the staff members spoken to who was providing care for this person during the day advised they ensure that their position in bed was changed regularly. Staff had also recorded the drinks person was taking. One person whose care was followed needed staff to help them manage their diabetes. The care plan and a record of the person’s likes and dislikes of food and the type of diet should be given. A record of visits to a screening clinic had been recorded. The home has its own diabetic annual review plan, however this had not been fully completed this person. The manager advised that the care plan had been updated in July and some of the information had still to be completed. One person whose care was followed had fallen just prior to the inspection. A record of the action staff had taken following for was recorded on the accident form. The person was being cared for in their own room. They said staff had called an ambulance after they had fallen and they had checked to see if they Cornerways, Paignton DS0000049076.V363944.R01.S.doc Version 5.2 Page 13 had any injuries. They said they had asked to stay in the home as they didnt want to go to hospital. They said that staff were making sure they had what they needed in their room. The person had call bell within easy reach and they said staff respond quickly when they use it. The Manager advised that the persons GP was due to see them later that day. The plans of care seen during the inspection had a record of visits by health professionals and the persons GP. When health professionals had made recommendations regarding the persons care these had been incorporated into their plan of care. The Manager was working to implement monthly reviews of care plans, to ensure that the staff team were aware of any changes. This had not yet been achieved. The four people whose care was followed did not have a record that their care plan was reviewed monthly. Three of the Peoples care plans review dates were July 2008. The Manager advised that the timing of the reviews was being discussed with the person and their representative. A schedule was posted on the office wall showing the dates that had been fixed for discussions with families. On the second day of this inspection two relatives met with the Manager to review their resident’s care. This was seen to be valuable, and the visitors said they were happy to have been consulted. One suggested a change to bathing arrangements, and one discussed a safe and satisfactory way of arranging a visit home for their relative. The medication was being stored in three lockable trolleys. These had been well organised so that staff could easily find medication for people in different areas within the home at the correct time of day. The Manager confirmed that only staff trained to do so would administer medication, and that staff would repeat the training until she was assured of their competence. A record of medication returned to the pharmacist was being kept. The staff member completing the record had signed this. A controlled drug record book was checked for one person and found to be correct. Other entries in a controlled drug book showed that when medication was no longer required it had been returned to the pharmacist and a controlled book had been dated and signed. We staff that staff spoke to people they were caring for in a friendly, supportive, respectful way. The people who were spoken to during the inspection said staff were always friendly and helpful to them. Cornerways, Paignton DS0000049076.V363944.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were involved in meaningful activities according to their diverse needs and individual interests. A good variety of meals were enjoyed. EVIDENCE: Some residents were sufficiently independent to use the lift and go to their rooms when they wished. Others had their preferred routines recorded in their care plans and were assisted by staff. Two new Activity Organisers had been appointed, who were boosting the social life of the home with lively and imaginative activities, and organising a programme for the season leading up to Christmas. There was a notice board in the hallway, with a notice about the regular monthly Coffee Mornings, including an invitation to all residents and their family and friends. There was a list of the week’s activities, written out by hand which showed that it had been written for this week, and we saw activities held accordingly during our visit. Several people told us about a very successful event that had taken place on the Tuesday afternoon. A recording of the ‘Last Night of the Proms’ from the BBC the previous Saturday was played in the conservatory which had Cornerways, Paignton DS0000049076.V363944.R01.S.doc Version 5.2 Page 15 been decorated with bunting. This was accompanied by a glass of sherry, and a sing-along that was evidently much enjoyed. There had been a ‘chocolate fountain’ and a ‘Body Shop make-over’ in the previous week, and an entertainer was booked weekly for music and quizzes. A choir had been established, with choir practices becoming a regular feature, leading up to a Carol Service. As well as popular group activities, staff had visited residents in their rooms, particularly those who were unwilling to join in, and taken people individually on walks along the sea front. One relative who visits regularly told us that the monthly coffee morning ‘was really nice, and that the residents had been involved in baking for it.’ We saw a Communion service held in the conservatory. Five residents were joining in. All residents spoken to said that they enjoyed their meals though they did not know what they would be given. There was a newly appointed chef, who was well received by the residents. Staff found that when they had offered a choice, people did not remember what they had asked for, even a few minutes later. However, the residents who we spoke to thought it would be helpful to have the menu on display on a large board by the entrance to the dining room, where they would be passing by. During this inspection the main meal was cottage pie and fresh vegetables, with gravy served separately. Salad with ham, egg and/or cheese was also available. For dessert, residents could have any combination of apple and ginger sponge, tinned pears, custard cream or ice cream. The Manager had introduced the motto – ‘Every mouthful counts’, as there had been frail residents with poor appetites, whose nutrition was vital for their good health. Weights were being monitored, and improvements had been seen over the past five months. There was a busy but calm atmosphere in the dining room, with staff giving help responsively for differing needs. Cornerways, Paignton DS0000049076.V363944.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management and staff had a good understanding of Adult Protection issues. Concerns are listened to, and ideas acted upon. EVIDENCE: The complaints procedure was on display in the entrance hall, but the print was small, and would not be readable for many people. It was also written in the Service Users’ Guide which is available for new residents, but not in the brochure which was in all rooms. Residents said that they would ‘ask the boss’ if they had a problem, or tell their family. Residents had been worried by recent staff changes, and were building up confidence in the new team. The home had received complaints from relatives who had been concerned by disturbed behaviour of some residents, who have since been reassessed as needing nursing care and moved to a more suitable care home to meet their needs. Safeguarding referrals had been made last winter and spring, which were investigated, and disciplinary action taken in response. Health and social service professionals reviewed care in the home. It was found that the Manager had failed to manage the staff properly, and personal and health care of residents had suffered. The Manager resigned, and the Care and Operations Manager for the company took responsibility for the running of the home, eventually appointing a new Manager. Cornerways, Paignton DS0000049076.V363944.R01.S.doc Version 5.2 Page 17 These changes in the home had made the staff aware of safeguarding processes, and the importance of bringing problems into the open. They were aware of the vulnerability of residents who were unable to make a complaint for themselves. There was a robust policy on dealing with abuse, and the Alerters’ Guidance was available in the office and the staff room. The Manager and a Senior Carer were booked to attend training on the Deprivation of Liberty Safeguards during the week following this inspection, in order to understand new legislation and how it should be implemented in the home. There is a robust recruitment procedure, in order to protect residents form potential harm, and a whistle-blowing policy to enable staff to report if necessary. Cornerways, Paignton DS0000049076.V363944.R01.S.doc Version 5.2 Page 18 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, 22, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Cornerways provides an attractive, comfortable and safe home for the residents. EVIDENCE: The house had three floors with a passenger lift to access the upper levels. The top floor was level, while the first floor had some steps to certain rooms. Ramps were available where necessary to enable wheelchair access, and the patio was accessible via the conservatory. There had been a major programme of refurbishment internally and externally. The house was looking smart, and there was a new front door, patio doors, and windows all ensuring safe opening restriction. The dining room, lounges and conservatory had been refurbished. The dining room was bright, and had an archway giving one corner a sense of privacy. Cornerways, Paignton DS0000049076.V363944.R01.S.doc Version 5.2 Page 19 There were two lounges where residents were sitting in small groups. There were assisted bathrooms and toilets or wheelchair accessible showers on each floor. New carpets had been laid in the two lounges and the ground floor corridors, and new flooring in the dining room and conservatory. The hall and stair carpets were badly in need of replacing as they were stained and discoloured. Management were in agreement with this, and had a programme of replacing carpets and floorboards. The maintenance worker had a programme of replacing skirting boards that were damaged by wheelchairs. Bedrooms were comfortably furnished and were being updated. Some en suite toilets had unused showers removed, in order to give enough space for the resident to use their mobility aids to get to the toilet. There were call bells in each room, and a long lead had been provided where residents needed, for instance to have their alarm beside them at a chair, or clipped to their clothing. A long lead had been provided that morning for a resident who had fallen the previous day and needed to stay in their chair. One resident was seen to have an alarm that would be sounded if they stood to get up, as they were not able to call for help. An alarm had been fitted to the door of one resident, to alert night staff if she were to leave the room. A fire escape beside the shower on the first floor did not have an alarm fitted, so if a resident went out that way, they would be out a hard staircase with no alert made. Suitable locks had been fitted to bedroom doors, to provide privacy without danger of a resident locking themselves in. Lockable facilities were not available in every room for residents to keep their valuables. This was being addressed according to individual requirements. The laundry was arranged to avoid any risk of contamination, and a laundry worker was employed to ensure that residents’ clothes were well cared for. A new OTEC system including a sluicing facility had been installed. Handling belts and hand sanitizer were provided on each landing. The house was found to be clean throughout. The only place where there was an odour on both days of the inspection was in the toilet by the conservatory. The Manager said that the extractor fan was inadequate, and there were plans to install a more powerful fan. An Environmental Health report of January 2008 had required improvements to standards in the kitchen. Kitchen refurbishment had been booked to start in November. Cornerways, Paignton DS0000049076.V363944.R01.S.doc Version 5.2 Page 20 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are well organised, motivated and competent. A robust recruitment procedure protects residents from potential harm. EVIDENCE: A written rota is kept which shows that as well as the Manager who works normally from Monday to Friday, there is at least one Senior Carer on duty with four or five. Staff were allocated two to each floor, so they were able to work in pairs where necessary for safe working practices. In the care office a chart showed how tasks were to be allocated at lunch-time – who was to help resident who needed help with feeding, who would make sure residents got any supplements they needed, and who would take trays to those who prefer to eat in their room. Two Activity organisers had been appointed, additional to the care staff. A clerical assistant was employed to assist the Manager. At night there are two care staff, plus one on sleeping-in duty. Hotel Services employed a chef, kitchen assistant, and a cleaner for each floor. A maintenance worker was employed 8.30 – 2pm Monday to Friday. At the time of this inspection there were 20 care staff. Of these 16 had achieved at least NVQ2 or were working towards it. This is good progress towards achieving a qualified workforce. Cornerways, Paignton DS0000049076.V363944.R01.S.doc Version 5.2 Page 21 We examined the files of two recently appointed staff, and found that all checks necessary to protect residents from potential harm had been carried out, and the required documents were kept on the premises. They confirmed that they had received induction training, and had the opportunity to work three shifts supernumerary, in order to get to know the residents, read care plans, and familiarise themselves with the policies and working practices in the home. Training provided over this period included food hygiene, Malnutrition, and Tissue viability, Moving and Handling, and Dementia care. The Manager had compiled a matrix to help her see when staff would need up-dates of their mandatory training, and to record all their achievements. It showed that every staff member had received training in fire safety this year, and almost all had received Moving and Handling training within the past twelve months. Cornerways, Paignton DS0000049076.V363944.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, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home was vigorously managed in the best interests of the residents. Robust systems had been put in place to assure safe working practices. Management were open to feedback from residents, relatives, staff and other professionals. EVIDENCE: The Responsible Individual, Mr D. Arnold, is CEO for the company. He does not carry out the monthly visits on behalf of the company, preferring to delegate to the Care and Operations Manager, who had been working consistently at Cornerways since the resignation of the previous Manager. The new Manager had applied for registration with the CSCI. She is a trained nurse with experience of residential care at a senior level. We saw that she is Cornerways, Paignton DS0000049076.V363944.R01.S.doc Version 5.2 Page 23 committed to supporting the staff to provide good care for the residents at Cornerways. Staff meetings had been held, for the Manager to share information and to give staff an opportunity to give their views. At a recent meeting in July 2008, many details of good care practice were discussed. A concern raised at the time was the importance of good hand-overs between staff coming in and those going off duty, particularly between day and night staff. Communication between care staff and domestic staff was also raised as a concern. No such concern was raised during this inspection. The management were gathering feedback in order to feed into the quality assurance system. Questionnaires had been sent to some residents, families, and District Nurses. These had not yet been fed back to residents or incorporated into a plan for the home. The home was involved in a project by the University of Kent, which was attempting to find a better way of measuring good care. A notice was posted in the hallway, inviting residents and their families to a meeting at the forthcoming coffee morning, when plans could be shared, and feedback gathered. The home’s administrator took responsibility for dealing with money that was held on behalf of some residents in a safe. All transactions were recorded, and receipts kept. A programme of staff appraisal and supervision had been introduced. The Manager was aiming for staff to have a 1;1 session at two monthly intervals, in order to support staff, give feedback on their performance, and ensure they are aware of any new policies and procedures. Senior staff had started to provide supervision for some care staff. Window restrictors were in place and radiators were covered to protect residents from potential harm. Bedroom doors were seen to shut properly, as part of the fire protection system. Staff training in fire safety had been provided in May 2008. Night staff were required to watch a video at three monthly intervals, to maintain their awareness. The fire precaution system had been professionally checked, and was checked monthly by the maintenance worker. This included checks on the call bell system. Room-by-room fire risk assessments for the home had been completed. We also saw documentation showing that the gas installation and the lift had been serviced, and that the sit-on scales had been recalibrated recently. Staff needed to have their first aid training up-dated, in order to maintain their qualification and be able to assist residents in an emergency. Cornerways, Paignton DS0000049076.V363944.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 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X 3 X 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 X 3 X 3 3 X 3 Cornerways, Paignton DS0000049076.V363944.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. 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. Refer to Standard OP7 Good Practice Recommendations The Manager should ensure that care plans are reviewed by care staff in the home at least once a month. This is to make sure they are accurate, so the staff will know how best to provide care to the residents. The Complaints Procedure should be displayed in larger print to enable more people to see it. All external doors should be checked for safety and security, and alarms fitted if necessary, so that staff are alerted if residents go where they might be at risk of harm. Each resident should be provided with lockable storage in their room, and provided with a key unless risk assessment suggests otherwise, so that they may look after their own money and other valuables, if they so wish. DS0000049076.V363944.R01.S.doc Version 5.2 Page 26 2. 3. OP16 OP22 4. OP24 Cornerways, Paignton 5. OP33 The registered person should further develop the system for reviewing and improving the quality of care provided, using the feedback that is gathered from residents and other interested parties, to show how the service is developed in the best interests of the residents. The home manager should complete a first aid risk assessment for the home. This helps to ensure that the right level of first aid cover is always available. 6. OP38 Cornerways, Paignton DS0000049076.V363944.R01.S.doc Version 5.2 Page 27 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 Cornerways, Paignton DS0000049076.V363944.R01.S.doc Version 5.2 Page 28 - 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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