Care Home: Great Western Court

What the care home does well The home offers people the opportunity to regain their independence to enable them to move back to their own home. Excellent links are maintained with the multi-disciplinary health care team who assist the home in providing this service. Since the last inspection a Community Psychiatric Nurse has joined the multi-disciplinary team. The environment is purpose built to enable rehabilitation and for people who need to use a wheelchair. The arrangements for admission to the home are excellent with input from health care professionals to ensure people are only admitted to the home following a full assessment and assurances that their needs will be met. The home has a low turnover of staff, which results in continuity of care and allows the staff to develop their skills and experience. What has improved since the last inspection? The home has added additions to their Statement of Purpose and Service Users Guide to provide people with more information about the service offered. Improvements have been made to the medications systems used by the home to ensure people are not put at risk. Care staff have undertaken or are booked to undertake training in the local reporting procedures in case an allegation of abuse is made. Once care staff have completed this training the home has plans to book ancillary staff on this course. The home has reviewed the provision for activities and has provided more activities. This is ongoing due to the quick turnover of people who use the service. Management arrangements of the home have now been finalised with two Managers job sharing the role. This ensures the home is now run in the best interests of the people who use the service. The home is now able to demonstrate that staff supervision is taking place. Arrangements for the safe storage of personnel records have been agreed between the home and the Commission. What the care home could do better: The home needs to make two additions to their terms and conditions to ensure people who use the service have all the information about the services provided by the home. CARE HOMES FOR OLDER PEOPLE Great Western Court 33a Millbrook Street Gloucester GL1 4BG Lead Inspector Sharon Hayward-Wright Key Unannounced Inspection 11:00 31 August & 3 September 2007 st rd 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 Great Western Court DS0000031570.V348161.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. Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Great Western Court Address 33a Millbrook Street Gloucester GL1 4BG Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered managers (if applicable) Type of registration No. of places registered (if applicable) 01452 423495 01452330810 angela.neilens@gloucestershire.gov.uk www.gloucestershire.gov.uk Gloucestershire County Council Mrs Angela Rosalyn Neilens and Mrs Joanne Billinghurst Care Home 30 Category(ies) of Dementia (6), Old age, not falling within any registration, with number other category (23) of places Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One respite bed to accommodate service users between the ages of 60 - 65 years. One bed to accommodate service users from the age of 55 years Date of last inspection 16th July 2007 Brief Description of the Service: Great Western Court is a purpose built home for care of older people. The home is now predominately intermediate care or short-term care for people waiting for care packages. The local Primary Care Trust provides the funding for the intermediate care beds and a multi-disciplinary team does the assessment of people suitable for these. The Home comprises of five individual living units linked with a larger central unit, which houses the reception, offices, kitchen, laundry and day centre. The individual units accommodate six residents in each. Each unit has a lounge, dining room, kitchen and bathroom. All rooms are single occupancy, and there are six bedrooms in each unit, with four of these having en suite shower rooms. The day centre provides a service for people in the community as well as for people in the Home, and also holds the Asian Elders Club on a weekly basis. Each room on the intermediate units has an information file that contains useful information about discharge home. Within these files a copy of the homes Service Users Guide is contained. The highest fee for this home is £343.65, however this is dependent on an assessment of finances and other factors. Extras to the fees include hairdressing and newspapers. Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector carried out the site visit, which took place over two days, one day in August and one in September 2007. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Both Registered Managers were available during both days of the inspection as were others members of the staff team. Several people who use the service were spoken with to ascertain their views on the care and services provided. A number of surveys were sent to the home for people who use the service, staff and visitors to the home. All were complimentary about the home. The comments received from people who use the service during the inspection all indicated they are very happy living at the home. The Registered Managers and care staff were spoken with throughout the inspection and were helpful and co-operative. Since the last inspection the home has worked to hard to address the areas that needed improvement. What the service does well: What has improved since the last inspection? Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 6 The home has added additions to their Statement of Purpose and Service Users Guide to provide people with more information about the service offered. Improvements have been made to the medications systems used by the home to ensure people are not put at risk. Care staff have undertaken or are booked to undertake training in the local reporting procedures in case an allegation of abuse is made. Once care staff have completed this training the home has plans to book ancillary staff on this course. The home has reviewed the provision for activities and has provided more activities. This is ongoing due to the quick turnover of people who use the service. Management arrangements of the home have now been finalised with two Managers job sharing the role. This ensures the home is now run in the best interests of the people who use the service. The home is now able to demonstrate that staff supervision is taking place. Arrangements for the safe storage of personnel records have been agreed between the home and the Commission. 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. Great Western Court DS0000031570.V348161.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 Great Western Court DS0000031570.V348161.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, 2, 3 & 6 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has comprehensive admission processes in place to ensure people who use the service have a full assessment of needs and the assurance that their needs can be met by the home. People who are admitted solely for intermediate care are helped to maximise their independence and return home. EVIDENCE: At the last inspection the home was issued with two requirements to make additions to their Statement of Purpose and Service Users Guide to meet the Care Home Requirements. This was completed prior to this inspection. Each room has a folder that contains a copy of the home’s Service Users Guide and other useful information. Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 9 The home’s terms and conditions were examined and two additions are required to meet new Care Home Regulations that came into force last September. These are: • The arrangements in place for charging and paying for any additional services that are not offered as part of the fees. • A statement relating to if the fees of a person are funded in whole or in part by another source would the arrangements be any different. People’s care records examined contained a signed copy of their terms and conditions. People are only admitted to the home for either intermediate care or respite in lieu of domiciliary care. All proposed people have an assessment of their needs undertaken by members of the multi –disciplinary team prior to being admitted to the home. This team includes a physiotherapist, occupational therapist and social worker. A member of the management team will then read through the assessment to ensure the home can meet their needs. If the home feels they need to undertake a further assessment they are able to do this. Once the agreement has been made that the person will be admitted to the home a letter is sent to the person to confirm this. The home is able to facilitate admission very quickly once this process has been completed if required. The majority of people do not visit the home prior to admission due to the speed that this can take place, however several people who use the service said they have stayed at the home previously. The home provides intermediate care and is designed to help people regain skills needed to go back to their own homes. A multi-disciplinary team provide input to enable this to happen. Each person who is receiving intermediate care has a rehabilitation plan in place that the staff in the home follow and this is reviewed and updated as required. The home has access to physiotherapists, occupational therapists, social workers, community nurses to provide any nursing input and they now have access to a community psychiatrist nurse. A Consultant in the Care of the Elderly from the local hospital visits the home each week to review the care of people who use the service. The home does not have a GP assigned to them, therefore people either stay with their own GP if able or are registered as a temporary patient with a local practice. A comment on a survey completed prior to the inspection by a health professional said, “It would be preferable to have a GP attached to the service”. Additional to this the home has a review meeting every week to discuss the care of all people in the home with members of the multi-disciplinary team. The vast majority of questionnaires returned to the Commission prior to the inspection that were completed by people who use the service said they had received enough information about the home prior to moving in to make the decision it was the right place for them. Great Western Court DS0000031570.V348161.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 and 10. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs, however the home needs to ensure the safety of medication at all times. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The care of two people was examined in detail and this includes speaking to the person, examining care records and speaking to staff. One person was receiving intermediate care and the other person was waiting for a domiciliary care package. Both people had assessments of needs in place and from this care plans had been devised. One person had a rehabilitation care plan in place as part of their intermediate care. Reviews were seen for each person and they had signed their care plans. Daily records are maintained. Detailed moving and handling assessments were in place that also covers the environment. Each person also had a ‘Waterlow’ pressure sore assessment. Weight charts are in place. Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 11 The home operates a ‘key worker’ system where each person is allocated a member of staff. A number of surveys completed by people who use the service or have recently used the service said that five people ‘always’ received the care and support they need, three said ‘usually’ and one said ‘sometimes’. Relatives/visitors to the home were asked in their survey if they felt the home meets the needs of their relative/friend and four said ‘always’ and two said ‘usually’. Comments received include “so much TLC from the staff” and “the care is excellent”. People who use the service have access to a number of health professionals. These include members of the multi-disciplinary team, continence advisor and GP’s. One person was discussing with a member of staff about arranging to visit an optician. Each week a Consultant Physician that specialises in the care of the older person visits the home to review people who use the service and a multi –disciplinary review meeting where all people are discussed also takes place once a week. People who use the service are able to stay with their own GP if within the catchment area otherwise they are registered as a temporary patient with a local GP surgery. People who use the service or have done so recently were asked in their survey if they received the medical support they need, five people said ‘always’, four people said ‘usually’ and one said ‘sometimes’. An inspection by the Commissions Pharmacist took place in July 2007 therefore a full detailed assessment of the medication systems was not carried out. A number of Medication Administration Records (MAR) were examined in each unit and these were randomly selected. Gaps were found in the recording on one MAR in where a member of staff had not signed for the previous days morning medication. Another person did not have directions against a prescribed cream and build up drink. One of the Registered Managers said this would have been picked up at the next audit of medications. It was noticed that in one unit the member of staff had left the keys to the medication cabinet on top; whilst this was a genuine error staff must be reminded about the importance of keeping the keys to these safe at all times. Records were seen for medication received into the home, administered and returned to the local pharmacy when required. The majority of people who use the service are encouraged to self –medicate following an assessment of need or are assisted as part of their rehabilitation to learn how to take their medication. The appropriate records are maintained. Staff were aware of what help each person requires. Staff confirmed that they have to undertake training prior to administering medication and are supervised until competent. One person had oxygen in use and a sign was in place to inform people about this. Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 12 The home did not have any controlled medication but are storing night sedation in this cupboard and records relating to this were seen. The home has made changes to their homely remedy list as directed by the Commission’s Pharmacist. One requirement issued at the last inspection was to ensure medications are stored at the correct temperature. The expiry date for this requirement is the end of September, therefore could not be followed up. However one of the Registered Managers said the home has purchased an air conditioning unit to be fitted by the end of September and all trolleys will be stored in this room. People who use the service said the staff respect their privacy and dignity. Staff were observed knocking on doors prior to entering people’s rooms. Two surveys completed by health professionals prior to the inspection said that the staff ‘always’ respect the privacy and dignity of people who use the service. Great Western Court DS0000031570.V348161.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are able to make choices about their life style and are encouraged to maintain links with family and friends. People are offered a wholesome and appealing balanced diet that meets their tastes and choices. EVIDENCE: Since the last inspection the home has been working hard to look at ways of improving the activities for people who use the service. Records were seen relating to activities and trips that had been undertaken by people who use the service. One person visits a day centre away from the home. The home has introduced monthly coffee mornings for people who use the service to attend and discuss any concerns with members of staff. People are encouraged to use the day centre within the home and one person spoken with said they enjoy their time at the day centre. A number of people who use the service were spoken to and some felt that they are happy to make their own activities, others felt they are busy with rehabilitation and the days go quickly and one person said they find the home very quiet and at times are bored. This person said they enjoy mealtimes as everyone in the unit sits in the dining room and are able to have a chat. The homes Annual Quality Assurance Assessment Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 14 (AQAA) says they have plans to continue to listen to people who use the service and arrange activities making use of local facilities. The results in the surveys sent to people who use the service prior to the inspection were that eight people felt that ‘usually’ activities are arranged by the home they can take part in and three said ‘sometimes’. Visiting to the home is not restricted and visitors were seen during the inspection. One Registered Manager said that the staff help one person to use the local shops. People spoken with said they are able to make choices about their daily lives within the constraints of a home environment. People are encouraged to take control of their medication, meals and personal care especially if they are receiving intermediate care. The home also has facilities for people who use the service to make their own drinks and snacks in the kitchens in each unit. Since the last inspection the home has had a change of cook. The new cook has been at the home for about six weeks and is just completing their induction period. The cook has plans to review the menus and is in the process of trying out new dishes with people who use the service. The home has ‘5 stars’ from a recent Environmental Health visit. Records were seen of health and safety checks and food records. The cook said that for people who require a specialist diet for example a diabetic she tries to use alternatives to sugar so everyone has the same dishes. People who use the service who were spoken with during the inspection all said how good the food is and one person said the afternoon cakes are very good especially the scones as they “melt in your mouth”. A question in the surveys asked people if they like the meals in the home and nine people said ‘always’ and two people said ‘usually’. Additional comments include; “very good food and nicely presented” and “the food is excellent”. People confirmed that choices are offered and these were seen on each notice board in the units. Mealtimes were observed in several units and were seen to be a very sociable event. One person who uses the service has different meals to other people due to their culture and as part of their rehabilitation to help them go back to their own home. Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. Arrangements are in place to protect people from abuse. EVIDENCE: The home has received one complaint since the last inspection and the appropriate records and response to the complainant was seen. Since the last inspection the home has obtained copies of the local Councils complaints procedure, which is included in the Service Users Guide, and a leaflet is also available. People who use the service were asked during the inspection if they knew who to make a complaint to and they said yes, however they all said they would not want to make a complaint. Surveys sent to people who use the service and relatives/friends prior to the inspection all said they knew who to speak to if they had a complaint and the vast majority said they know who to make a complaint. Comments received included “I have no complaints” and “to complain about anything would never be considered”. At the last inspection we raised concerns about the staff’s knowledge of the local reporting procedures if an allegation of abuse has been made. Since then the care staff have or are booked to attend the Council’s ‘Alerters’ guide Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 16 training and once this is completed the ancillary staff will also be attending. The Registered Managers and staff in senior positions will be attending the one day enhanced adult protection training. The vast majority of staff have completed an NVQ and this covers the topic of abuse. The home has access to all the Councils policies and procedures and during the inspection they printed a copy of the latest guidance ‘safe guarding vulnerable adults’. Copies of the ‘Alerters’ guide are available in the home. The homes AQAA states that they will be asking questions about the protection of vulnerable adults to new staff at interview and the ‘Alerters’ guide training will be mandatory. All new staff have had a Criminal Records Bureau Disclosure and POVA checks. No staff have been referred to the POVA list. Great Western Court DS0000031570.V348161.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: The home is a purpose built unit that is designed to enable people to remain as independent as possible. Areas of the home are also designed to assist people in regaining the skills needed to move back to their own homes. Prior to the inspection the Registered Managers had completed a tour of the environment and had identified areas that need improvements. A redecoration programme is taking place and one of the communal lounges was being repainted during the inspection. The home has other plans to replace items of furniture. A feasibility study has taken place to change the disabled toilet in Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 18 two units to a shower room and they are hoping funding will be available this year to complete this. A tour of the environment took place with a number of room used by people were seen. Long stay people are able to have their own items on display and each room was very individual. For people on short-term stay they are able to bring in personal items. People who use the service were spoken to and they all felt the home is very clean. Surveys completed by people who use the service or have used the service recently said that the home is ‘always’ and ‘usually’ fresh and clean. Staff were seen using protective clothing when required. Great Western Court DS0000031570.V348161.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is confident that the numbers and competency of staff on duty meet the needs of the people who use the service, and the home provides staff with appropriate training. Safe recruitment practices are in place to ensure people who use the service are not put at risk. EVIDENCE: From discussions with the Registered Managers and from reading duty rotas there are six care staff on an early shift, five on an afternoon shift and three waking night staff. When the Registered Managers and Deputy Manager are on duty they are extra to these numbers. Each member of staff is allocated a unit whilst on the day shifts and on the morning shift the extra staff member helps out on all the units. This remains unchanged from the last inspection. For staff to take a break they need to leave the unit they are allocated to which leaves them without a staff member and people who use the service are encouraged to ring their call bells for assistance at this time. One unit was left unattended during the inspection whilst the member of staff had to attend to another matter. During this time the inspector was in a unit and heard a person call out, on investigation they had fallen in the doorway of the en-suite and did not have access to a call bell. This was the second fall this person had Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 20 that morning. Managers and staff need to be mindful that when leaving a unit unattended this can happen. Additional staff are employed for the day centre, cleaning, cooking, maintenance and a driver for the day centre. People who use the service who were spoken to all complimented the staff. The comments received from the surveys by people who use and have recently used the service said the staff are always “professional, polite and caring”. Comments from relatives/visitors to the home on their surveys also reflected the comments received from people who use the service. Staff spoken with all said they enjoy working at the home and a number of them have been there for a number of years. One survey completed by a health professional said, “ intermediate care clients have rehabilitation plans and these are not always cascaded down sufficiently to all the staff”. The home exceeds the recommended 50 care staff trained in NVQ 2 or equivalent. A number of staff have completed both the NVQ 2 and 3 training. The home has their own NVQ assessor and another member of staff is undertaking this training. A total of nine staff are undertaking either the NVQ 2 or 3 awards. Since the last inspection the home has appointed one new member of staff. All the required checks were in place. The Council has written to the us requesting that all personnel records are stored at their main offices. This has been agreed and that we can visit these offices at any time to view these records. The home uses an induction programme provided by the Council that is based on the ‘Skills for Care’. An induction checklist was in place and records confirmed that new staff have completed this training. Since the last inspection the training records for staff have been updated and copies of certificates are kept of these. The home is aware of when staff require updates. Staff can request training other that mandatory training as the Council issues a monthly list detailing training that is available. Staff spoken with confirmed that training is provided and they can request additional training. Another health professional commented on their survey “further training in rehabilitation, assessment of older people, some basic nursing tasks and managing mental illness would help”. Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 & 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect and has effective quality assurances systems in place developed by qualified and competent managers. EVIDENCE: Since the last inspection another manager has been appointed for the job share of Registered Manager and they have put arrangements in place to run the home. Both Registered Managers have completed the NVQ 4 training and from discussions with them they have plans to undertake other training. People who use the service said they could approach the Registered Managers if they had any concerns. Staff felt the Registered Managers were very Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 22 supportive of them and they could also approach them if they had any concerns. The home has a quality assurance system in place that takes into account the views of people who have used the service and who are currently using the service. Monthly meetings are in place with people and questionnaires are sent to people who receive intermediate care once they have left the home and people who are receiving long-term care receive these two monthly. Action plans are devised as one person mentioned a shower on their survey and following this the home have a plan to address this. ‘Thank- you’ cards are displayed in the home. Monitoring systems in place include weekly auditing of medications, care plans, accidents and health and safety checks on the environment, which are undertaken by the Council. Regulation 26 visits also take place monthly and a copy of these is stored at the home and sent to us, however they no longer need to be sent to the Commission. The home manages monies for a number of people who use the service. Secure facilities are provided and records and receipts are kept. Consideration should be given to the home obtaining signatures of two staff when money is withdrawn for safety. At the last inspection the home was not able to provide evidence that care staff were receiving supervision sessions. Since then the Registered Managers have reviewed the systems used to ensure records are kept of sessions. A plan is in place for all staff to receive supervision sessions and senior staff have been allocated other staff to supervise. Staff appraisals take place and then are reviewed six monthly. Staff spoken with and from their surveys confirmed they receive supervision sessions. Evidence was seen of servicing of equipment, fire equipment and checks on water temperatures to ensure people who use the service are not put at risk. A fire risk assessment has been completed for the home and this contains details about evacuation procedures for the home. Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 2 4 X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP2 Regulation 5 (bc) & (bd) Requirement Timescale for action 30/12/07 2. OP9 13(2) The registered person must add extra information to their terms and conditions to meet the Care Home Regulations. This will provide people who use the service with information they need about the services provided. 30/09/07 Further action must be taken to make sure medicines are always stored within the temperature range defined by the manufacturer or pharmacist. This will help to make sure people who live in the home receive medicines that are of the correct potency. The timescale for this requirement has not expired at this inspection, however the home is confident it will be addressed in the timescale given. Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Great Western Court DS0000031570.V348161.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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. 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