Care Home: Heron Court

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What the care home does well The home benefits from having an established and competent management team that know the home and residents very well. Feedback about the home from residents, relatives, staff and visiting professionals was generally very positive. One resident said `I am very happy about everything here, the care, the food and the friendly and warm approach of the staff.` A relative said that they rated the home highly, and that `the people there are like family.` A visiting professional said `the care for those who are immobile or unable to make decisions is very good and caring.`Residents at the home can enjoy having visitors at any time. Communication between relatives and management/staff at the home is good. The home also maintains good relationships with other professionals. A visiting healthcare professional said `staff are always helpful and assist with clients as needed making our work easier and pleasant.` What has improved since the last inspection? Heron Court provides care for residents who have dementia. Since the previous inspection the home has tried to improve the service offered to these residents. To provide opportunities for occupation and stimulation a rummage box has been introduced and sensory equipment is about to be provided. A new activity co-ordinator is in post. They are developing a greater range of activities for residents. Care staff at the home are becoming more involved and spending more time with residents to provide them with stimulation and occupation. The purchase of a new medicines trolley has meant that residents` medicines are now stored more securely and safely. A new assisted bathroom has provided bathing facilities for residents in one area of the home where there were previously no facilities convenient to their rooms. All bathrooms in the home have been brightened up with stencils and pictures to provide a more homely environment for residents. Other areas of the home have been decorated and the environment improved for residents. Staff training at the home has improved. This helps to ensure that residents receive care from staff that have the right skills to meet their needs. Staff have now received a better level of training in caring for people who have dementia. Some have received training in aspects of sensory loss, and the levels of training in core areas such as moving and handling, first aid and health and safety has improved. What the care home could do better: There was some feeling from residents, relatives and staff that there can be a variation in the quality of care and support offered, depending on what staff are on duty. The home should look at this, and provide training or other resources to try to ensure that residents receive a consistent quality of care at all times. The home also needs to monitor the number of hours being worked by some staff as a few are working long hours, which is not best or safe practice. So that residents are fully protected, and to ensure that the staff who work in the home are suitable, the home needs to make sure that recruitment processes are carried out to a high and consistent standard.Although the situation is now hopefully being resolved by new furnishings being supplied to the home, the providers have been slow to provide a suitable environment for residents in their private accommodation. The issue of shabby and worn furnishings has been raised at the last several inspections, with no improvement noted at this inspection. The poor quality and safety of furnishings has also been commented on by a number of relatives over recent times. CARE HOMES FOR OLDER PEOPLE Heron Court 198 Brentwood Road Herongate Brentwood Essex CM13 2PN Lead Inspector Ms Vicky Dutton Unannounced Inspection 24th October 2007 08:00 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 Heron Court DS0000018041.V348895.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. Heron Court DS0000018041.V348895.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heron Court Address 198 Brentwood Road Herongate Brentwood Essex CM13 2PN 01277 810236 01277 812560 heroncourt@runwoodhomes.co.uk www.runwoodhomecare.com Runwood Homes Plc 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) Ms Deborah Doyle Care Home 35 Category(ies) of Dementia - over 65 years of age (17), Old age, registration, with number not falling within any other category (35) of places Heron Court DS0000018041.V348895.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th November 2006 Brief Description of the Service: Heron Court provides care and accommodation for thirty-five older people. Currently seventeen of these beds are registered for service users who have dementia. The home consists of an original three storey old house, and two single storey units which are a later addition. The main house accommodates service users on two floors. Access to all areas is maintained by way of a passenger lift. The second floor is for the use of the staff only. There are a variety of communal spaces, in addition to a dining room. The premises are set back from the road and are contained within an ornamental garden, which has a pond, greenhouse and gazebo. There are pubs and a village store close by. The nearest shopping centre is Brentwood where there is also a train station. The home does not have good public transport links. The home has a statement of purpose and service users guide available. Information about the home and most recent inspection report are available to residents and visitors. It was confirmed that the current fees at the home are £407.58 for a shared room, £437.64 for a single room, £450.04 per week for a respite placement and £473.00 per week for privately funded placements. There are additional charges for chiropody, hairdressing, personal items, newspapers/magazines and some transport costs. The manager stated that these charges were fully outlined in the home’s Service Users Guide. Heron Court DS0000018041.V348895.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced ‘key’ site visit. The visit took place over an eight hour period. At this inspection all the key standards were considered. The home’s compliance with requirements made at the previous inspection was assessed. At the site visit a tour of the premises took place, care records, staff records, medication records and other documentation were selected and various elements of these assessed. Time was spent talking to, and interacting with residents and visitors at the home. Time was also spent observing care practices and how these impact upon the quality of life for residents. Discussions took place with staff and management at the home. Prior to the site visit the home had completed and sent in to CSCI their Annual Quality Assurance Assessment (AQAA). This outlined how the home feel they are performing against the National Minimum Standards, and how they can evidence this. Prior to this site visit a selection of surveys with addressed return envelopes had been sent to the home for distribution to residents, relatives involved professionals and staff. The views expressed at the site visit and in survey responses have been incorporated into this report. The inspector was assisted at the site visit by the home’s manager and other members of the staff team. Feedback on findings provided throughout the inspection process. The opportunity for discussion or clarification was given. The inspector would like to thank the manager, staff team, residents, relatives and visiting professionals for their help throughout the inspection process. What the service does well: The home benefits from having an established and competent management team that know the home and residents very well. Feedback about the home from residents, relatives, staff and visiting professionals was generally very positive. One resident said ‘I am very happy about everything here, the care, the food and the friendly and warm approach of the staff.’ A relative said that they rated the home highly, and that ‘the people there are like family.’ A visiting professional said ‘the care for those who are immobile or unable to make decisions is very good and caring.’ Heron Court DS0000018041.V348895.R01.S.doc Version 5.2 Page 6 Residents at the home can enjoy having visitors at any time. Communication between relatives and management/staff at the home is good. The home also maintains good relationships with other professionals. A visiting healthcare professional said ‘staff are always helpful and assist with clients as needed making our work easier and pleasant.’ What has improved since the last inspection? What they could do better: There was some feeling from residents, relatives and staff that there can be a variation in the quality of care and support offered, depending on what staff are on duty. The home should look at this, and provide training or other resources to try to ensure that residents receive a consistent quality of care at all times. The home also needs to monitor the number of hours being worked by some staff as a few are working long hours, which is not best or safe practice. So that residents are fully protected, and to ensure that the staff who work in the home are suitable, the home needs to make sure that recruitment processes are carried out to a high and consistent standard. Heron Court DS0000018041.V348895.R01.S.doc Version 5.2 Page 7 Although the situation is now hopefully being resolved by new furnishings being supplied to the home, the providers have been slow to provide a suitable environment for residents in their private accommodation. The issue of shabby and worn furnishings has been raised at the last several inspections, with no improvement noted at this inspection. The poor quality and safety of furnishings has also been commented on by a number of relatives over recent 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. Heron Court DS0000018041.V348895.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 Heron Court DS0000018041.V348895.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good level of information about the home is available to help people to make an informed decision about moving in. People can expect that their needs will be assessed before they move into the home. EVIDENCE: Although not examined in detail at this inspection it was seen that the home had an up to date Statement of Purpose and Service Users Guide available to residents. A copy of the Service Users Guide was seen in the room of a resident who was staying at the home on a respite placement. On surveys all respondents said that they had received enough information about the home to help them to make an informed decision about moving in. During the site visit those spoken with said that they had been given information, and had been able to visit the home. During the site visit people arrived to have an initial view the home on behalf of a relative. They said that they had telephoned the home but had been told Heron Court DS0000018041.V348895.R01.S.doc Version 5.2 Page 10 ‘just to turn up whenever they wished.’ This shows that the home has an open approach and encourages people to visit when planning for care. The files of two recently admitted residents showed that a senior member of staff had carried out a pre-admission assessment of needs to ensure that the home was able to meet individual needs. Additional information was also available from Social Services and a local hospital. Intermediate care is not provided at Heron Court. Heron Court DS0000018041.V348895.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to receive good personal and healthcare support that will meet their needs. They can be sure that their medication will be managed safely, and that staff will treat them respectfully. EVIDENCE: Residents and relatives spoken were happy with the level of care received at Heron Court. On surveys the response received to asking people if they received the care and support they needed was mostly ‘always’ with only one variation who responded ‘usually.’ People made positive comments such as ‘we can’t fault the care at all,’ and ‘I am always happy with the care I receive.’ A visiting professional said ‘the care of the clients appears to be extremely good.’ As part of this site visit a number of care plans were viewed. From those viewed it was seen that staff at the home have worked hard to maintain good care planning at the home so that they provide a satisfactory basis for care to be delivered to residents. Care plans and risk assessments were in place to address residents’ assessed individual needs. There is now more emphasis on Heron Court DS0000018041.V348895.R01.S.doc Version 5.2 Page 12 residents’ social and emotional needs. Care plans are kept under regular review and updated to reflect changing needs. One viewed however did need to be updated to reflect a resident’s recently changed needs. Staff spoken with and practice observed showed that staff had a good knowledge of residents’ needs. Staff said that they were involved in using and updating care plans. On staff surveys people felt that they ‘always’ had up to date information about the care needs of residents. Residents said that they always received the health care that they needed. One said ‘I always receive very good and regular medical support from here.’ Documentation and discussion showed that residents’ access services such as doctors, district nurses, chiropody optical and dental services to meet their needs. Residents’ nutritional needs are assessed and monitored to ensure their wellbeing. A number of visiting healthcare professionals surveys were returned, these provided positive feedback. All felt that communication with the home was good and that the home was always keen to seek advice and information over any issue relating to resident care and wellbeing. Medication at the home is mostly managed through a monitored dosage system using a weekly boxed system. The system was sampled and seen to be well managed. Medication is audited on a weekly basis, and staff receive training and monitoring to ensure that their practice is safe. Since the previous inspection the home has improved the security of storage arrangements for medication with the purchase of a new trolley. No residents at the home currently look after their own medicines, but this would be facilitated when possible and wished for by a resident. A visiting professional said ‘Most people are unable to self medicate but occasionally a casual client is able, and encouraged to do this.’ They also said that the home ‘always asks for advice from our professional pharmacy team.’ At the previous inspection it was raised that some residents were receiving their morning medication before they had eaten breakfast, which is not served until 09.00. This was not good practice, as many medicines should not be taken on an empty stomach. The deputy manager said that residents are now always offered cereal when they first get up. Staff were noted to treat residents in a caring and respectful manner during the inspection. Doors were shut when personal care was taking place. This was confirmed by a visiting professional who said, ‘personal care is always done in privacy behind closed doors.’ Heron Court DS0000018041.V348895.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. This judgement has been made using available evidence including a visit to this service. Residents know that Heron Court will offer them some opportunities for activity and occupation. They will always be able to welcome their visitors. Food at the home will meet their needs and expectations. EVIDENCE: Since the previous inspection a new activity co-ordinator has been appointed, and the home have been working to improve this area of resident care. Care plans are now more reflective of residents’ individual social and activity needs. The allocated weekly hours for the activity co-ordinators role are twenty four. Care staff are therefore being encouraged to see offering residents activity, stimulation and emotional support as part of their role. This was observed during the site visit as care staff spent time with residents, and offered appropriate activities. The activity co-ordinator explained how they were committed to making sure that activity, stimulation and occupation was based on individual assessed need, and that these were considered at all times. The needs of residents with dementia now have a higher priority. A ‘rummage box’ has been introduced, plans are in hand to develop a sensory area for residents Heron Court DS0000018041.V348895.R01.S.doc Version 5.2 Page 14 and occupational activities such as laying tables are being encouraged where appropriate. Residents’ views on the level of activity available to them was varied, with some being satisfied and others less so. Some occasional outings are offered, and church services are held in the home on a regular basis. Those residents who could express an opinion felt that routines at the home were flexible. During the site visit residents were noted to follow their own routines and for example go and have a rest in their rooms after lunch. Visiting at the home is open. Visitors came and went during the site visit, were always made welcome, offered a drink and had a good rapport with staff and management at the home. Information on advocacy services was readily available. The home are currently working with advocacy services to provide support for those residents with no or limited family input. In discussions with residents and visitors and on surveys the food provided by the home was praised as being very good. Lunch on the day of the site visit looked appetising, was plentiful and served up on an individual basis. At the previous inspection some concern was expressed about the short spacing between the main meals of the day. The manager said that this had been discussed at a residents meeting with the decision made to leave the times as they were. Residents spoken with seemed happy with the current arrangements. Heron Court DS0000018041.V348895.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be sure that any concerns they raise will be listened to. Residents can also be confident that they will be cared for in a way that protects them from abuse, as staff have been trained and understand this aspect of care. EVIDENCE: The home has clear complaints process in place. People spoken with and responses on surveys showed that people knew how to raise concerns and would feel comfortable in doing so. A relative said ‘I have had nothing to complain about, but if someone did have a problem or question, the manager would be more than interested to listen and deal with the matter as soon as possible.’ The home’s complaints records showed that complaints are recorded and managed appropriately. No concerns have been raised through CSCI since the last inspection. Since the previous inspection two issues have been raised under safeguarding adults procedures. One was dealt with through social services and the primary healthcare trust. The home was not found to be at fault. Another related to the care practice of one member of staff. This was reported under safeguarding procedures and managed appropriately. Since the previous inspection the level of staff training in safeguarding adults has improved. All but the newest staff have now received training in this area. Heron Court DS0000018041.V348895.R01.S.doc Version 5.2 Page 16 Training for the remaining staff is planned. Information on safeguarding adults and whistleblowing was readily available for staff. Copies of a Help The Aged leaflet on elder abuse was also available to staff and relatives. The home is registered to provide care for residents who have dementia. No staff at the home has received training in challenging behaviour, which may assist them in caring for this group of residents. It was seen that this training was due to take place later in the week of the site visit. Heron Court DS0000018041.V348895.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 adequate. This judgement has been made using available evidence including a visit to this service. Residents know that the home will be kept fresh and clean. They cannot however be sure that the rooms they are provided with will be suitably furnished for them. EVIDENCE: Since the previous inspection some aspects of the environment have been improved to benefit residents. A bathroom, now with an assisted bath, has been put back into use so that residents in one area of the home now have a bathroom convenient to their rooms again. Bathrooms around the home have been brightened up by the use of stencils and pictures. Some areas of the home have been redecorated and curtains put up to provide a more homely environment for residents. The leaking windows at the front of the property have been repaired. On the day of the site visit the home’s grounds looked pleasant and were well maintained. Heron Court DS0000018041.V348895.R01.S.doc Version 5.2 Page 18 For the last several inspections, and in the monthly quality reports undertaken by the provider, it has been raised that furnishings/fitments in many residents’ bedrooms are in poor condition. The provider has not addressed this issue in a timely manner and provided residents with well maintained/equipped private accommodation. A relative said that they felt that ‘the premises leaves a lot to be desired.’ At this site visit however evidence was seen that the delivery of ten sets of bedroom furnishings (excepting beds) was expected within the next two weeks, with a further batch to follow. The manager said that people are aware that an expansion of, and full refurbishment of the premises are planned for the near future. This will hopefully address other previously identified issues at the home such as inadequate communal space in the home’s ‘link’ areas, a lack of storage space, and suitable bathing facilities not being readily available in some areas of the home. On the day of the site visit the home smelt fresh and appeared clean. All residents spoken with and responses on surveys said that the home was ‘always’ fresh and clean. A visiting professional said ‘high quality of cleanliness as no offensive odours noticed in all my visits.’ The home’s laundry area is adequately equipped. On surveys staff identified that they had completed training in infection control. Training records confirmed this and it was seen that information was available to support staff practice. Heron Court DS0000018041.V348895.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 adequate. This judgement has been made using available evidence including a visit to this service. Residents know that the staff looking after them will have been trained to understand their needs, and that staff will generally be available to them when needed. EVIDENCE: Feedback from residents and relatives about staff at the home was generally positive with comments such as, ‘they do listen and act with patience and understanding.’ It was recognised by a number of people though that there is variation in the quality and approachability of staff. One resident said ‘some staff are not so good,’ a relative said that ‘if you want something done you have to know who is best to go to, as some staff you know will not do anything.’ During the site visit one new member of staff spoken with was noted to have limitations in their understanding of language. This is not helpful for residents with communication difficulties. There have been no changes in staffing levels since the last inspection, and these are currently maintained at: Heron Court DS0000018041.V348895.R01.S.doc Version 5.2 Page 20 Five care staff and one senior care during the morning. Four care staff and one senior care during the afternoon and evening. Two care staff and one senior care at night. The manager’s hours are normally supernumerary to this. The manager felt that staffing levels were sufficient to meet current residents’ needs. There had been some concern, given the layout of the building that night staffing levels may not be adequate to meet the needs of residents safely. The manager reported that they had recently done a night shift and found that staffing levels at this time were sufficient to meet residents’ needs. Residents spoken with and responses on surveys showed that people felt that there were always staff available when needed. Observations at this inspection showed that staff deployment had improved, and that residents were well supported and supervised. It was reported that currently there are no carer vacancies at the home, yet on the rotas viewed where only six shifts of annual leave and two of sickness were identified, some staff were noted to be working many additional hours, for example 68, 62 and 75. As previously advised to the home this is not good or safe practice. The home still has some difficulties in recruiting adequate housekeeping cover. There is no laundry or housekeeping cover in the home during afternoons and evenings and no laundry cover on alternate weekends. This situation may take carers away from their primary duty of caring for residents. The Home’s completed AQAA identified that the home had eleven full time and eleven part time care staff. As confirmed at the site visit five staff have completed a National Vocational Qualification (NVQ) at level two, and three staff are qualified nurses. A further eight staff are working towards NVQ at level two or three. The home have not yet achieved the recommended target of having 50 of care staff trained to NVQ level two or above. The staff files of two recently recruited members of staff were viewed. These showed that in general recruitment practices that protect residents had been maintained. However care needs to be taken to ensure that references are always properly verified. One member of staff had two references in place, One of these was not on the provider’s proper headed paper, as in other cases, showed no signs of having been through the post, and had no covering letter expanding on the proposed member of staff’s suitability as requested. The other had the referee’s signature corrected in two places, which seemed odd. One member of staff had commenced work at the home before a Criminal Records Bureau Check had been received, this is not best practice. Documentation and staff spoken with showed that the home has systems in place to ensure that staff receive a good induction into the home. This ensures that residents receive care from staff that have received initial training to assist them to know the home and care properly for residents. The induction undertaken comprises of an initial four week induction. This programme was seen to be well completed on the files viewed. Staff then go on to work on an induction programme based on Skills for Care Standards. Heron Court DS0000018041.V348895.R01.S.doc Version 5.2 Page 21 Since the previous inspection training at the home has improved. Most staff have received recent training in dementia care, and it was seen that further sessions are planned in the near future. Some staff have also received training in visual and hearing impairment as advised at the previous inspection. Heron Court DS0000018041.V348895.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, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be sure that they live in a home that is well managed, and where they will be able to express their views. EVIDENCE: The home is run by an experienced manager who is registered with CSCI. They hold NVQ at level four and the Registered Managers Award. Residents and relatives spoken with were positive about the management of the home and felt that the manager and deputy were very approachable. A relative said that ‘the manager is a lady who can be approached by anyone and ask her a question, nothing is too much trouble for her. She is always friendly, helpful, efficient and professional.’ Heron Court DS0000018041.V348895.R01.S.doc Version 5.2 Page 23 The registered provider has strategies in place to monitor the quality of the service provided. An annual audit is undertaken over two days by the registered provider’s quality management team. This last took place at Heron Court in April 2007, and showed an overall improvement in the service offered by the home. As part of the quality assurance audit satisfaction questionnaires are used with residents and relatives. The home also completes their own internal quality questionnaires. These were last done in August 2007 and showed a good level of satisfaction with the service. Residents meetings are held on a regular basis and the minutes of these were available. The timetable for residents’ and staff meetings are posted around the home. Monthly visits are undertaken by the registered provider as required by regulation. Copies of the reports from these were available in the home. Residents’ monies and records were sampled and were satisfactory. The AQAA completed by the home identified that systems and services are monitored and maintained so that residents live in a safe environment. The home has had visits from both the fire service and environmental health services this year. Both found that the home was managed effectively in these areas. Fire records viewed were satisfactory, Regular fire drills are held. The home’s training matrix and staff training information showed that the levels of staff training in core areas such as moving and handling, first aid, and health and safety has improved since the previous inspection. Heron Court DS0000018041.V348895.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 X 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 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Heron Court DS0000018041.V348895.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 Requirement So that residents are fully protected robust recruitment procedures and documentation must be maintained at all times. Timescale for action 01/12/07 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 OP12 Good Practice Recommendations So that residents receive holistic care the home should build on progress made so far and continue developing suitable activities for all residents at the home. In particular the needs of residents with dementia to have a greater level of assessment and thought in relation to occupation/activity. The quality and consistency of care offered to residents should be monitored to ensure that residents always receive good care from staff who are approachable and caring. The level of hours worked by staff must be monitored to DS0000018041.V348895.R01.S.doc Version 5.2 Page 26 2. OP27 3. OP27 Heron Court make sure that residents are cared for safely. 4. OP27 The home should continue to try and recruit adequate levels of domestic staff so that care staff are not taken away from caring tasks to complete laundry or other duties. 50 of care staff should be trained to NVQ level two or above. 5. OP28 Heron Court DS0000018041.V348895.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Heron Court DS0000018041.V348895.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. 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