Care Home: Kara House Residential Care Home

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What the care home does well From the information we received, we were able to find out that people were supported to make day-to-day and routine choices for themselves. Residents told us they were well cared for and supported. One person said that `Everything is in order - nothing is out place`. A visitor stated that the person they saw was being `Well looked after.` There is a good rapport with visiting health professionals and one commented that, from what they saw, staff were `Tactile, chatty and respectful towards the residents.` Staff were observed to be meeting the needs of service users in a caring manner. Residents told us that they felt the staff listened to them and that they felt able to raise concerns with the staff or the management team. Comments made by residents included: "They are very amenable and I would go to Gail (the registered manager) if I had any problems``. People who completed surveys told us that they felt able to make complaints to staff. The information we received confirmed that residents know they have a right to make complaints and voice their opinions. The Trinity Merchant management team has ensured that there is a strong management team available to carry forward and sustain the improvements at Kara House. Focus group meetings have been developed which means that people who use the service and their relatives are able to meet in a group with the management and staff of the home. The routines of the home are flexible and people are able to make choices about their lives. What has improved since the last inspection? Since the last inspection the manager at Kara House has taken steps to make sure that medication is always administered as prescribed. This means that people`s health and well-being are not placed at risk. This has been achieved through all senior staff, including night staff, have been trained to give out medication.The manager has successfully completed the CSCI registration. This process confirms that she is suitable to manage the home. Care plans, in the main, reflect the residents` individual personal preferences for care support and details how support should be provided by staff. This has resulted in consistency of care support that is offered in manner preferred by the residents. Independence and choice of food are promoted at meals times. given daily choices off menu. People areSince the last inspection the majority of staff have received training to do their work. Since the last inspection a training calendar has been developed that, if followed, will provide staff with the required knowledge and understanding in the general care and support needs of older people. Since the previous inspection more accurate records have been maintained to demonstrate that the home is following robust recruitment and selection procedures. What the care home could do better: Infection control measures in the home must be improved and should include hand washing and drying facilities in every toilet and bathroom area. This is because effective hand washing is the most important aspect of infection control, and so it is essential that people are encouraged to wash their hands after using the toilet or completing personal care tasks. This action must be supported through hand drying facilities that safeguard against infection. All staff must receive infection control training so that they know what to do to prevent infection from spreading, as this will prevent people from becoming ill unnecessarily. The registered person should ensure that care staff are able to support people in looking well groomed and neat, and that all items of clothing are clean. This is because looking good and wearing clean clothes, including slippers, helps people to feel good about themselves and shows that their dignity is cared about. CARE HOMES FOR OLDER PEOPLE Kara House Residential Care Home 29 Harboro Road Sale Manchester M33 5AN Lead Inspector Michelle Haller Unannounced Inspection 09:30 2 December 2008 nd 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 Kara House Residential Care Home DS0000005617.V373021.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. Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kara House Residential Care Home Address 29 Harboro Road Sale Manchester M33 5AN 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) 0161 973 0754 0161 969 0223 Trinity Merchants Limited Mrs Gail Lorraine Dunwoodie Care Home 35 Category(ies) of Dementia (15), Old age, not falling within any registration, with number other category (20) of places Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: care home only - Code PC, to people of the following gender: either; whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP, (maximum number of places: 20); Dementia - Code DE ( (maximum number of places: 15). The maximum number of people who can be accommodated is: 35. 29th January 2008 Date of last inspection Brief Description of the Service: Kara House is a private residential care home that provides accommodation and care for up to 35 service users. It is owned by Trinity Merchants Limited. The large Victorian property has the main garden to the rear of the property with car parking spaces to the front of the building. The home currently offers service users the use of two lounge areas where they can meet with each other to socialise and have company during the day and evening. There is also a dining room which, when not in use at mealtimes, is used for activities. Currently, there are 32 bedrooms with 16 en-suite, one with shower and basin, one with toilet and basin and 14 with washbasins. A stairlift to the first floor enables service users to reach bedroom and bathing facilities. The home is situated in a residential area of Sale, within easy reach of the motorway network, public transport and the local shops. The total refurbishment and upgrading of Kara House is complete. The current fees for accommodation at the home are £381.43 to £500 per week. The fee structure is dependent upon individual care requirements and type of room. Additional costs may be incurred for hairdressing, dry cleaning and private chiropody treatments. Kara House Residential Care Home DS0000005617.V373021.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 would experience good quality outcomes. The inspection report is based on information and evidence gathered by the Commission for Social Care Inspection (CSCI) since the last key inspection, which was completed in January 2008. During the inspection process we gathered information from a number of people, which included talking with and seeking the views of service users. We sent out surveys to service users and members of staff. This gave them an opportunity to tell us their opinions on the services provided at Kara House. On the day of the inspection visit we were able to observe a meal time with service users and observe care and support practices by staff as they went about their daily routines. In October 2008 the manager of Kara House completed a self-assessment form called an Annual Quality Assurance Assessment (AQAA). This told us what the home had been doing since the last key inspection to meet and maintain the National Minimum Standards. We also gathered information through the home’s reporting procedures and through information we received from other people, such as the general public, including concerns and complaints. We looked in depth at records and the care support of four people living at the home. This helped us get a better view about how people living at the home are looked after and supported from admission to present day. Medication administration records were also looked at. This visit was unannounced, the manager and staff were not told that we would be visiting. From the information gathered we made the judgment about how the home was meeting the National Minimum Standards (NMS) and we made the overall judgement on the quality of the service. Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Since the last inspection the manager at Kara House has taken steps to make sure that medication is always administered as prescribed. This means that people’s health and well-being are not placed at risk. This has been achieved through all senior staff, including night staff, have been trained to give out medication. Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 7 The manager has successfully completed the CSCI registration. This process confirms that she is suitable to manage the home. Care plans, in the main, reflect the residents’ individual personal preferences for care support and details how support should be provided by staff. This has resulted in consistency of care support that is offered in manner preferred by the residents. Independence and choice of food are promoted at meals times. given daily choices off menu. People are Since the last inspection the majority of staff have received training to do their work. Since the last inspection a training calendar has been developed that, if followed, will provide staff with the required knowledge and understanding in the general care and support needs of older people. Since the previous inspection more accurate records have been maintained to demonstrate that the home is following robust recruitment and selection procedures. What they could do better: Infection control measures in the home must be improved and should include hand washing and drying facilities in every toilet and bathroom area. This is because effective hand washing is the most important aspect of infection control, and so it is essential that people are encouraged to wash their hands after using the toilet or completing personal care tasks. This action must be supported through hand drying facilities that safeguard against infection. All staff must receive infection control training so that they know what to do to prevent infection from spreading, as this will prevent people from becoming ill unnecessarily. The registered person should ensure that care staff are able to support people in looking well groomed and neat, and that all items of clothing are clean. This is because looking good and wearing clean clothes, including slippers, helps people to feel good about themselves and shows that their dignity is cared about. Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 8 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. Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 9 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 Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 10 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): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The manager ensures that new people are admitted to the home following an assessment of needs that has been carried out by experienced staff. EVIDENCE: In total, four residents’ files were looked at and all contained a detailed assessment of needs that had been completed prior to admission to the home. The most recent admission had been fully assessed and information included likes and dislikes, general health needs, including basic moving and handling needs, mood and emotional well-being, communication and family involvement. Social interests and historical information had also been documented for some people. Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 11 All the staff who returned surveys said that they always had enough information about what people needed. In the information returned to us, the manager stated ‘We always carry out a assessment on potential service users before they move into the home. We invite potential service users and their families to come in and spend a half day or a full day with us so that they can see the way the home is run, this helps us to ensure that we are also able to meet their needs.’ Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People at Kara House benefit from health and personal care based on their individual needs, which is provided with respect, dignity and privacy. EVIDENCE: The care plans and other care records for four people were looked at in detail. This included people who were at risk of developing pressure sores. On the day of inspection the manager stated that there was no-one living at Kara House receiving treatment for pressure wounds. Files showed that risk assessments in relation to developing pressure sores had been carried out. Positional change charts were in place and in use. People who had been assessed as high risk had been provided with pressure relieving equipment, including mattresses. Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 13 This area could be improved; the manager considered completing some specialist assessments such as a simple dietary assessment and pressure area risk before a need was identified. This would help to ensure that people’s weight on admission was routinely recorded, as this was not always the case. These assessments would provide baseline information and help to monitor people’s health and abilities during their time at Kara House. When care plans were developed they were detailed and those seen dealt with pressure are care needs, diabetic care needs, moving and handling and falls prevention. Letters, daily records and other correspondence confirmed that all aspects of routine health care, such as chiropody and dental care, were readily available and that people received visits from the general practitioners, attended outpatient appointments, and received the support of specialist health workers, such as distinct nurse and physiotherapy, when needed. Prescriptions also confirmed that people had their eyes tested. The manager could also consider how other observations, such as weights, could be recorded so that it is easier to monitor changes. A district nurse (DN) who was attending Kara House on the day of inspection was interviewed. She assessed that pressure area care in home was effective. She confirmed that staff rang the DN’s to request additional assistance. She said that she found the staff approachable and co-operative on a day-to-day basis. The nurse confirmed that the DN service was contacted for assistance if people had recurring falls. She also said that staff followed the instructions they were given. The nurse also felt that the manager was able to deal with quite complex instructions and pass on information to care staff as required. Assessments and care plans had been updated regularly, at least monthly, in keeping with people’s needs. In the information returned to us, the manager identified that monthly care plan reviews could be improved further if the resident or their representative was always involved. The information provided in daily records was detailed and gave a good picture of how people progressed each day. The information provided also showed that staff had a caring attitude and would try different tactics to help residents to reach their full potential. The records demonstrated that staff had compassion for the residents. The records are divided into three sections so that each staff team takes responsibility for reporting what has happened during each shift. All reports were written a respectful manner. Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 14 The medication record sheets were examined and no omissions were noted and medication was stored correctly. Previously there had been a problem with having enough staff who were trained to administer medication. This issue has now been resolved, as all senior staff have attended Boots the Chemist medication training Advanced training is also planned for senior staff. The interaction between people and staff was observed throughout the day. It was observed that people are treated with respect and kindness. Staff routinely provided support in a dignified manner, asking people what they wanted and preparing them for things that were about to happen. For example, prior to moving and handling procedures or being supported to eat their meals. People were relaxed with each other and laughed together. In the information she returned to us, the manager told us that one improvement since the last inspection is that ‘All service users’ clothing is now labelled with embroidered name tapes which are ordered when they become permanent.’ When checked we found that people’s wardrobes contained clothes correctly labelled. Some aspects of grooming need to improve, so that people look well groomed even when professional hairdressers are not available. People made positive comments about the health and personal care provided and said: ‘it’s very nice here, I find everybody is very kind, I’ve never heard a cross word if you see what I mean. I find them all very nice and gentle. It’s very relaxing, no pushing or shoving or making you do things, it just suits me nicely.’ Staff identified that the things the home did well included ‘Looking after people, respecting people’s needs and giving them privacy.’ Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People at Kara House benefit from a service that aims to support them to make choices about their lifestyle and provide opportunities to develop life skills and meets their individual social, educational, cultural and recreational needs. EVIDENCE: People at Kara House have access to a variety of activities throughout the week. People said that the physiotherapist visited the home regularly and that they enjoyed different activities, such as skittles, sing-alongs and arts and crafts. A ‘Pat-a-dog’ also visits the home once a week. Comments about activities included: ‘Activities - depends on your interests, we have crafts once a week and a physio comes. We have pat-a-pet once week - it’s something to look forward to.’ Staff said that they had escorted people to a local garden centre and theatre trips. On the day on inspection staff spent time talking to people and organised a game of ball which people enjoyed. Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 16 This area could be improved if the manager could demonstrate that people’s interests and preferences had been taken into account when planning events and activities. Social histories and interests had been completed for some people and so it would be an improvement if activities which were participated in were recorded, as this would help with identifying what people liked and benefited from. The routines in the home are flexible and people were observed receiving visitors throughout the day. People are supported to maintain good relationships and contact with their families and friends, and the best way to promote positive relationships was documented for when needed. People who commented said ‘I visit each week and she always looks quite content. I know she is very settled at Kara House and the staff appear to be very kind and understanding to her.’ The dining area was clean and pleasant and people were supported in a dignified manner and able to eat their meals at a comfortable pace. Different sized plates were used according to the appetite of the individual. We had received an anonymous complaint prior to the inspection regarding the size of portions. This matter was discussed with the manager who stated that a new cook had recently been employed. The lunchtime meal on the day of inspection was chicken or sausage casserole. People also had fish fingers with potatoes and peas and one person had a salmon salad. The menu offered a variety of home made items and ready meals that included hotpots and casseroles, a variety of meat and vegetarian pies and bakes, burgers, fish fingers and roasts. The contents of the larder and fridges were checked and these were filled with a wide selection of fresh meats and poultry, dairy produce, fruit and vegetables. The dry stores held soup mixes, biscuits, famous brand cereals, fruit juice and cordials. People made appreciative comments about the meal, saying that it was hot and tasty. As previously stated, weight records could be improved and this would help the staff to monitor nutritional status more closely. Comments made about the food included: ‘The food is very nice - always found it very nice’, and ‘It can be slow coming but not bad when it comes.’ Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People are confident about how to complain, are listened to and procedures are in place to protect people living in the home from abuse. EVIDENCE: People who commented stated that they were confident about making a complaint and would address any concerns initially to the manager. Comments included ‘I would speak to the lady in the office if I had any complaints.’ All the staff who returned surveys said that they would approach the manager if they had any concerns. During the inspection it was also noted that the complaint procedure was made available throughout the home. The anonymous complaint that we received was discussed with the manager. She confirmed that there had been problems in the areas highlighted and she showed that action had been taken to deal with them. The complaints record was examined and information indicated that people’s concerns were taken seriously, looked into fully and steps taken to resolve problems. Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 18 The training calendar and records indicated that in 2008, ten staff had completed an external course in the protection of vulnerable adults, and letters confirmed that others were due to complete the course. The manager also stated that all staff have completed the Skills for Care Common Foundation course, this is verified by the Trafford Local Authority training unit. Adult protection is one of the topics covered in the course. The manager also said that staff receive a booklet about adult protection. In the information provided to us, the manager confirmed that the home’s safeguarding adults policy was reviewed in January 2008. This will need to be looked at again in 2009 and at this time it must be made certain that this works in keeping with that of the Local Authority. Information should also provide staff with specific details about who to contact depending on the concern. Newly appointed staff and those new to working in the social care sector were interviewed. Each had received POVA training as a part of their induction. There has been one protection of vulnerable adult investigation in the home since the previous inspection concerning the number of falls. This investigation concluded that the falls were general and could not have been avoided. However, as a result of the investigation ,the management team implemented additional risk assessments and investigations into falls prevention. Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Furniture, fixtures and fittings are homely and provide a comfortable place to live, and the home was free of unpleasant odours. EVIDENCE: A tour of Kara House was completed. odours. The home was free of unpleasant The refurbishment plans for the home were discussed with the management team for Kara House and they have taken into account the needs of people affected by dementia in relation to providing an environment that suits their needs. This process has already begun, in that, doors are beginning to be colour coded. Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 20 In the main, people were seen using the facilities safely and with confidence. There was enough space for people to carry out different activities, including a conservatory. All the bedrooms that were looked at were clean and free from stale unpleasant smells. Most had been personalised with people’s own items of furniture, artwork, ornaments or photographs. There are shared rooms and it was noted that privacy curtains were not always in place. This matter was discussed with the manager. During the tour of the inspection it was noted that some toilets and bathrooms did not have full hand washing facilities and that in one area toilet tissue was been used for hand drying. This matter was discussed with the manager at the time of the inspection and just prior to completing this report, and the importance of providing hand washing and drying facilities that are fit for purpose was agreed. People were complimentary about the environment and said: ‘I’m very happy in my room there’s a nice view’ and ‘I love it here surrounded by trees.’ Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People living at Kara House benefit from staff who receive training and who are sufficient in numbers to support them and meet their needs. EVIDENCE: The response from staff, relatives and people living at Kara House indicates that there were usually sufficient staff on duty. They said: ‘Staff are brilliant absolutely.’ On the day of inspection the staff complement was one senior care worker, four carers and the cook on duty to support 32 residents. The manager also came to the home to assist with the inspection and two members of the management team were also involved in the process throughout the day, one of whom attended the feedback session at the end of the site visit. Staff files were examined and each contained job application, references, start date and up-to-date POVA Firsts and Criminal Record Bureau (CRB) checks. One person’s file was incomplete but there was evidence that the manager was taking steps to deal with this. Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 22 Staff application forms were read through and each was easy to understand and written to an acceptable level of English. One element of the anonymous complaint was that staff did not speak good enough English to communicate with the residents. This was discussed with the manager, who agreed that one person who recently worked in the home had a poor command of English, but as this was identified within the probation period, her post was not made permanent. Residents who were spoken to said that they had no problems understanding what staff said to them. The training matrix confirmed that in 2008 staff training included health and safety training, food safety, managing challenging behaviours, moving and handling, infection control, first aid, managing visual impairment, Mental Capacity Act, equality and diversity, oral hygiene, communication and dementia awareness. It was noted that training was also provided at times when night staff could attend. The training calendar was discussed and it was identified that staff may benefit from receiving more in-depth dementia care training, as well as an increase in staff with infection control training as, according to the information provided by the manager, 50 of staff still need this training. Staff who returned CSCI surveys confirmed that the training provided prepared them for the work they did and kept them up to date with new ways of working. Staff who were interviewed felt that they were given plenty of opportunity to improve their skills. The most recent recruit was interviewed and she described the induction process. This included watching the actions of experienced staff, spending time learning about how to find out about what people needed, safety aspects of the home, such as fire safety, moving and handling and protection of vulnerable adult training. This person also said that they were completing Skills for Common Care induction into care workbook. A member of staff said in the survey they returned: ‘Everything was explained to me before I started the job.’ Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 23 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): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People at Kara House benefit from an ethos that aims to promote safety and well-being and takes into account the opinions of those who are involved in the home. EVIDENCE: The manager at Kara House has been in post for over one year and became registered with CSCI in July 2008. She has completed relevant training in management and social care. The information she returned to us in the Annual Quality Assurance Assessment showed that she recognised areas that could be improved in the home and had ideas about how these could be achieved. Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 24 The information also identified areas that had been improved since the previous inspection, such as adult protection and medication training; we were able to confirm these. The manager and the management team co-operated fully with the inspection process and were concerned that people receive the care they need from competent staff who are aware of the conduct expected of them. The manager has established focus group meetings that involve the residents, their families and staff. The notes from a recent meeting showed that people said that they were, overall, happy with the services provided by the home. The notes also showed that the manager had discussed ideas about changes and improvements, and people were able to voice their opinions and make suggestions. Matters discussed included additions to the menus, ideas for activities and the laundry system. People involved with the service at Kara House have open access to the manager, and residents and visitors to the home said that they were aware of the focus meetings and felt able to speak to the manager directly about what happened there. In the information she returned to us, the manager identified that a way of improving the home’s quality assurance and monitoring would be to ‘Have reviews and surveys with service users, families and friends.’ Service users’ money is managed through a spreadsheet system called SAGE. The manager explained that there is a bank account used exclusively for residents’ monies. She said that a statement was available for each person. Residents are invoiced for the money they spend and receipts are available for each transaction. In the information returned to CSCI it was noted that all health and safety equipment checks were within the expected timescale. The fire safety log was checked and all checks had been completed. A report from the fire marshal who inspected the home when the new wing opened in March 2008 was also in place, and no outstanding concerns had been identified. Staff have received health and safety training, such as moving and handling, food hygiene, first aid, infection control and fire safety. This comment from a member of staff summarises the outcomes for people in relation to management of the home: ‘I think they look after our training needs well and we work well as a team, all this gives a better service to the residents.’ Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 25 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 26 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 registered person should make sure that care staff have the skills to ensure that people look well groomed if they are not able to go to the hairdresser. This is so that people have a feeling of self worth and demonstrates people’s dignity is being upheld. The registered person should ensure that suitable hand washing and drying facilities are available in the home. This is so that people are encouraged to wash their hands so that infections that could cause illness are not spread. The registered person should ensure that all staff are able to work in keeping with the infection control training they have received, so that they are certain that staff actions protect people from illnesses. 2 OP26 3 OP38 Kara House Residential Care Home DS0000005617.V373021.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North West Regional office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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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