Care Home: Landmere Care Home

Similar services:

• Hunter`s Lodge
• Lester Hall Apartments
• Harvey House

What the care home does well The home is purpose built with a number of public areas used by the people who live there and their visitors. Peoples care needs are assessed before they move to the service; records are made and are well maintained as changes occur. People have a number of choices and variety of activities based around their individual needs, promoting their independence, choice and decision-making. The activities co-ordinators have developed an extensive activity programme for each of the units, based on the preferences and interests of the people who use the service, which aims to support their individual leisure needs. People are encouraged and assisted to keep in contact with relatives, and the community. The atmosphere is warm and welcoming and the interactions between staff, people who live at the service and their relatives, are supportive and respectful. Regular checks of medication administration are made by senior management to ensure that people receive medicines correctly and the service has an auditing system to ensure that all the medicines are administered as prescribed at all times. What has improved since the last inspection? There were five requirements set at the last key inspection that took place on the 23rd August 2008. They were all relating to medication issues and have all now been met. No further requirements were made as a result of this inspection. The manager completes regular quality audits in numerous areas of the service, for example, care plans, monitoring of peoples nutrition and weight and complaints. The information gathered by these processes is collated and acted upon, providing a clear audit trail of how the manager has made improvements at the service. This is an ongoing process to ensure that the service continues to improve. Following on from previous inspections there have been considerable improvements in the management of medication. This further enables staff to safeguard the health and welfare of people living at the service. The service operates an improved process for administering medication and appropriate disposal of medicines are made. These improvements meet the outstanding requirements made at the last key inspection that took place in August 2008. What the care home could do better: Although many improvements are evident since the last key inspection, the manager must continue to audit systems relating to all aspects of the service, paying particular attention to medication. Activities also need to continue to develop and the vacancy for a second Activities Co-ordinator (24 hour post) should be recruited to as soon as possible in order for this to be achieved. The service has protected mealtimes, which may mean that some people living at the service receive medication at different times. This must be accurately recorded on the medication administration record sheets. CARE HOMES FOR OLDER PEOPLE Landmere Care Home Ruddington Lane Wilford Nottingham NG11 7DD Lead Inspector Angela Starr Unannounced Inspection 22nd January 2009 09:30 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 Landmere Care Home DS0000026450.V373964.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. Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Landmere Care Home Address Ruddington Lane Wilford Nottingham NG11 7DD 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) 0115 945 5940 0115 982 7341 manager.landmere@lifestylecare.co.uk www.schealthcare.co.uk Southern Cross (LSC) Ltd Mandy Mae Amos Care Home 70 Category(ies) of Past or present drug dependence over 65 years registration, with number of age (70), Dementia (10), Mental disorder, of places excluding learning disability or dementia (10), Mental Disorder, excluding learning disability or dementia - over 65 years of age (70) Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The 10 or fewer service users who may be accommodated in categories MD and DE must be aged between 55 and 65 years. 23rd August 2008 Date of last inspection Brief Description of the Service: Landmere Care Home is a purpose built home divided into four units with a total of 70 places. The home provides nursing care for people over the age of sixty-five with Mental Disorder or Dementia. Ten places can accommodate people from fifty-five with a Mental Disorder or Dementia. The provider remains responsible for reflecting the specific services available within the Statement of Purpose. The accommodation comprises of two floors, with all bedrooms being for single occupancy. There are a number of lounges and sitting areas throughout the home. The main kitchen serves 4 small dining areas. In addition the home has a number of bathing facilities, toilets and extensive garden areas. The home also a hairdressing room; there are plans to adapt the activities room to an area for the Service Users and their relatives enjoyment, with the addition of tea and coffee making facilities. The home is situated in a residential area of Wilford, south of, and on a bus route to, the city of Nottingham. West Bridgford is close by and provides shops, library and leisure facilities. The range of fees is from £348.00 to £801.00 per week; these do not include charges for hairdressing, chiropody and toiletries. Copies of the last Commission for Social Care Inspection report are available from the office and also in the reception area of the service. Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The focus of Inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people who use the services and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. We have introduced a new way of working with owners and managers. We ask them to fill in a questionnaire called an Annual Quality Assurance Assessment, which tells us about how well their service provides for the needs of the people who use it and how they intend to improve their service. We received this back from the manager within the required timescale and the form was completed in a satisfactory manner, providing us with information to assist in planning our visit and deciding what areas to look at. We also reviewed all the information we have received about the service since we last visited and we considered this in planning the visit and deciding what areas to look at. This inspection was unannounced and involved three inspectors, one of which was a specialist pharmacy inspector. Part of this inspection looked at the quality of care people with dementia experience when living at Landmere Nursing Home. Because we are unable to communicate effectively with all of the people with dementia, we have used a formal way to observe people in this inspection to help us understand their experiences of life at the service. We call this the ‘Short Observational Framework for Inspection’ (SOFI). This involved observing people who live at the service, over a two-hour period and recording their experiences at regular intervals. We made judgements about their well-being, and how they interacted with staff members, other people who use the service, and the environment. The main method of Inspection we use is called case tracking which involves us selecting a number of people who use the service and looking at the quality of the care they receive by speaking with them, observation, reading their records and asking staff about their needs. We spoke with three members of staff, three people who use the service and three relatives to form an opinion about the quality of the service being Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 6 provided. We read documents as part of this visit and medication was inspected to form an opinion about the health and safety of people who use the service. What the service does well: What has improved since the last inspection? There were five requirements set at the last key inspection that took place on the 23rd August 2008. They were all relating to medication issues and have all now been met. No further requirements were made as a result of this inspection. The manager completes regular quality audits in numerous areas of the service, for example, care plans, monitoring of peoples nutrition and weight and complaints. The information gathered by these processes is collated and Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 7 acted upon, providing a clear audit trail of how the manager has made improvements at the service. This is an ongoing process to ensure that the service continues to improve. Following on from previous inspections there have been considerable improvements in the management of medication. This further enables staff to safeguard the health and welfare of people living at the service. The service operates an improved process for administering medication and appropriate disposal of medicines are made. These improvements meet the outstanding requirements made at the last key inspection that took place in August 2008. 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. Landmere Care Home DS0000026450.V373964.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 Landmere Care Home DS0000026450.V373964.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): Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. The completion of a full pre-admission assessment for people considering moving to the service confirms that the persons needs can be met. The information given to people and their families helps them to understand what they can expect from the service and contributes to their decision-making. EVIDENCE: The service user guide contained useful information about the home and its facilities and was written in plain language. Copies of the guide were displayed in the reception area of the home. People who may wish to live at the service can expect to have their needs assessed before they move into the home in order to ensure that staff have the experience and skills to meet any identified needs. Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 10 The files we looked at did include an assessment of people’s needs that had been completed by a member of staff from the service prior to the person moving to the home. These assessments were comprehensive and provided enough information for the staff to address a persons needs as soon as they moved to the service. We also saw assessments completed by a social worker or other health professional. Relatives we spoke with told us that they were given a lot of information and visited the service before they made a decision. One person we spoke with told us “I like the fact that the home is purpose built with plenty of space for people to move around.” “It’s near where I live and I visit every day.” “I think I made the right choice.” Another relative said, “The whole family agreed on this home and are all happy with the quality of the care. They are a fabulous set of people.” Two relatives completed questionnaires for us and both said they felt they had enough information to make a decision about using this service. Landmere Care Home DS0000026450.V373964.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): Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. People are treated with respect and dignity and their privacy is upheld. Their care needs are identified in individual care plans and actions set out to meet these needs. EVIDENCE: As part of our case tracking process, we looked at a number of files belonging to people who live at the service. All the files contained thorough and up to date care plans that clearly reflected all the persons needs and the most appropriate way for these needs to be met. All the care plans we saw had been reviewed monthly and these reviews were detailed. Where changes had been identified, the care plan had been amended to meet the need. The manager of the service told us that she audits a random selection of care plans on a weekly basis to ensure that the staff team keep them up to date and relevant. Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 12 Staff we spoke with told us that they have received training in completing care plans and are clear about their individual responsibilities. Risk assessments in areas such as skin integrity, continence, nutrition and moving and handling were also in place and had been reviewed, demonstrating that staff were minimising risks to people and preventative actions were identified where appropriate. Some new equipment had been purchased since the last Inspection such as specialist beds and mattresses. This reduced the chances of people developing pressure sores and allowed staff to move people around more safely. Some of the people we observed were not able to respond verbally, so their interactions with the staff were observed and found to be positive and supportive of the persons well being. Some of these observations were made by the inspector who spent time in one of the lounges of the service. Examples include staff speaking with a person and explaining what was happening when using a hoist to transfer the person into an armchair, people being assisted and encouraged to have drinks and staff spending time to chat with people. Further observations were made when we looked round the home and spoke with people living at the service and their relatives. These observations were also very positive. People told us that staff upheld their privacy and we saw some staff performing their duties professionally and in a manner, which upheld the persons’ dignity. The following information is taken from the specialist pharmacy inspection, which took place on the 4th February 2009. Management and Staff on duty during the inspection had a good understanding of the systems in place to maintain safe practice around medication. Both the staff and the registered Manager spoken with during the inspection had a good knowledge of the medicines they handled enabling them to fully support the people living in the home. Sample audits indicated that the medicines are administered as the doctor prescribed. The managerial staff regularly check that the staff handle medication correctly and this has maintained the improved level of medicine management. The manager completes a weekly audit and we were shown documentation of this process. Medication records are generally up to date for each person using the service and medicines received, administered and disposed of are generally recorded. Sample examinations of Medicine Administration Records (MAR) were signed. Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 13 During the inspection we conducted an audit of some medicines available for administration. There were adequate supplies of medication including pain relief medication and these were found to be correct. The quantities of all medicines received were recorded and any balances carried over from previous cycles were recorded. A clear audit trail was demonstrated, that medicines are administered as prescribed. Staff take time to administer medicines with a drink in a dignified way. The policy and procedures followed during administration were put into practice, however we observed the home had protected meal-times and for example a Metformin 500mg tablet was administered to a person in the service at a later time after 12.00hrs. This was recorded in the MAR chart in the 12.00hrs column. Another staff may administer and not be aware of the time interval when this medicine was actually administered. Documentation showed us that the service regularly send a list to the relevant GP’s of people required to be seen due to a period of refusal of taking medicines and or needing a medicines review. The home was concerned about the advice given to ‘continue to offer medicines’ without a further plan of action. The administration and recording of controlled drugs was in place. All controlled drugs on the premise are safely stored. The controlled drug balances were correct and these reflected accurately in both the CD register and medicine chart. However previous occasional crossing out or deletions were made in the register and MAR charts The manager informed us that systems are in place to support staff and identify training needs. The carer’s previously handling medicines have undergone supervision and staff have received further in-house training. Staff were re-issued a copy of the companies’ medication policy to put into practice. We were informed that all carers handling medicines had medication training and further prearranged medication training was booked for the future. Feedback was provided to the manager and she agreed to action the necessary improvements. We were verbally assured that the home will continue with regular audits to check that staff handle medication correctly and maintain the improved level of medicine management, in order to safeguard the health and welfare of people living at Landmere. Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are enabled to experience a lifestyle that matches their expectations, abilities and preferences. People are enabled to exercise choice and control over their lives. EVIDENCE: During our visit to the service, one of the inspectors carried out a ‘Short Observational Framework Inspection’ where she spent two hours observing practice and interaction between staff, visitors and the people living at the service. The activities co-ordinator was observed asking people if they would like to play a game of dominoes and some did. Staff were observed interacting with people on a one to one basis in a respectful and appropriate manner. People were asked if they wanted the television putting on or if they preferred to listen to music. Their choices were respected. Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 15 As part of our case tracking process we looked at some files with particular reference to daily life and social activity. We saw that people’s preferences and abilities had been assessed and recorded. The Activities co-ordinator had completed a ‘pen picture’ identifying key areas for staff to be aware of including where a person had previously lived and the work they had done, as well as identifying current interests and abilities. Activities are arranged in advance and a schedule is displayed for people to see. The current arrangements are focused for short time periods in each of the areas of the service. There is provision for 48 hours of activities but currently only 24hrs are being used. A second activities co-ordinator will be recruited into the vacant hours. Visitors are welcomed into the home at any time of day and are encouraged to join in any activity. There is a dedicated area where people can sit with their relatives and enjoy a coffee together. One of the questionnaires returned to us by a relative, told us “We can visit our relative anytime day or night as if they were still in their own home. Also, we know we get full support from the manager if any problems occur.” People who were able, were wandering freely around the home but would have been unable to leave the safe environment unaccompanied. Some people spent their time in the lounge and others stayed in their bedrooms. A number of people chose to sit in armchairs in the corridors. People we saw were wearing clean clothing that was appropriate but we observed that a large number of ladies were not wearing tights or stockings. The manager told us that the staff have tried to encourage people to wear these items, but many of the people living at the service, find them uncomfortable and will remove them at the earliest opportunity. Relatives we spoke with told us that the food was good. Comments included ‘food generally well presented and appetising’. On the day of this inspection people told us they enjoyed the food. One said ‘the foods very good – always is’. We observed people being assisted with eating and drinking in a discreet manner. The manager told us that the service has introduced ‘protected’ meal times. This means that all staff are available to provide assistance to people throughout the mealtime period. Relatives are able to visit and provide assistance if they choose to. Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is, good This judgement has been made using available evidence including a visit to this service. People who use the service and their relatives are confident that complaints will be taken seriously, listen to and acted upon. People are protected from potential harm and abuse by the services policies and procedures. EVIDENCE: There was a copy of the services complaints procedure on display in the foyer and this was also included in the information about the home. Some people living in the home were unaware of the formal systems for raising concerns, but people we spoke with who were able, said they would speak to the manager or staff if they had concerns. One relative told us in the questionnaire returned to us “If I go to the manager with a complaint she will respond, but if I tell the staff I might as well talk to myself sometimes.” Relatives we spoke with were all aware of the complaints procedure and all said that they would feel confident to make a complaint. Some told us that they have previously made complaints and that these had been actioned satisfactorily at the time. However, one person felt that the manager is occasionally a bit defensive when they have brought problems to her attention. Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 17 We looked at the records of complaints that have been received by the service since the last key inspection. Four were recorded and three of them had been resolved to the satisfaction of the complainant by the manager, and the fourth was still being processed. We have received one complaint about the service and this was detailed in the records we saw. Staff we spoke with all confirmed that they were familiar with the complaints procedure for the service and they told us that they would support any person wishing to make a complaint. They also stated that they were confident that the manager would investigate and resolve any issues brought to her attention. Training records that we looked at confirmed that staff have received training in ‘Safeguarding Adults’ and ‘Whistle Blowing’ Staff we spoke with all demonstrated a good level of understanding and knowledge in these areas. Safeguarding Adults is a process of identifying and reporting suspected or potential abuse of vulnerable people and provides a framework of consistency to protect those individuals at risk. Whistle Blowing is a means for staff to feel supported to report anything of concern that they may witness. Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. People live in a satisfactorily maintained environment that is clean, pleasant and hygienic. EVIDENCE: We conducted a partial tour of the home and found all areas to be clean, hygienic and well decorated. Most of the areas throughout the service were odour free but the first corridor had a slight unpleasant odour. The manager told us that this area is waiting to have new floor coverings and it is hoped that will solve the problem. People’s bedrooms that we saw were clean and well decorated with most people having their personal belongings around them. A number of people were being cared for in bed and they appeared to be comfortable and warm. Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 19 The beds are of a good quality and are suitable for purpose, providing different height positions, bed rails to be used when appropriate and profiling mattresses to aid the integrity of peoples skin. Each of the four areas of the service has a lounge and dining room. These were all suitably furnished, clean, light and airy. The bathrooms we looked at were also clean and warm and were decorated in a homely manner, creating a relaxing atmosphere. The laundry appeared to be organised and efficient with suitable machines in use. One of the relatives we spoke with told us that their relatives’ clothes are well looked after and they have not experienced any items being lost. Staff have received training in Infection Control and there were plenty of gloves and aprons available for use. We asked staff if they always have plenty of protective items, including protective hand wash gel and they said they do. There are a number of pieces of specialised equipment in use at the service, including hoists and stand aids. These had service labels on them that were out of date but the records we saw informed us that all the equipment had been checked and passed for safe use, in November 2008. One item that had not passed the safety checks had been removed from use and was awaiting repair. A handy person is employed at the service and records showed us that all repairs and maintenance are recorded when a problem is identified and the outcome is then recorded. The manager of the service carries out monthly audits of the maintenance programme and is able to action any necessary expenditure. Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. Staff are trained and competent to do their jobs and people are protected from potential harm and abuse by the homes robust recruitment policies procedures. EVIDENCE: As part of our case tracking process, we looked at the files of four members of staff and we observed that recruitment policies and procedures were being followed. These files all contained records of Criminal Records Bureau checks, professional references and personal identification. They were well organised and the information easily accessible. There was also evidence that staff receive regular supervision and those we spoke with told us that they find this supportive and helpful. They also said that there are opportunities to request any training that would be useful to their work. Copies of training certificates were in the staff files, and included infection control, dementia awareness, moving and handling and a number of other courses. Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 21 The training matrix shown to us by the manager confirmed that there is a comprehensive training programme available to all staff and all mandatory training is in place. The staff we spoke with told us that they had received induction training when their employment commenced and some had achieved a National Vocational Qualification at level 2 or 3, with others working towards this. The duty rota showed sufficient staff on duty to meet the needs of the residents, but staff said, there were still times when they were very busy, particularly at meal times when a number of people needed help with their meals and drinks. Protected meal times had improved this situation, as all staff were available to assist. Staff numbers are decided by the needs of the people living at the service and the manager was able to provide evidence that these needs had been assessed and the staff rota developed in accordance with these needs. An activities co-ordinator is currently employed for 24 hours leaving a further 24 hrs not covered. This post is to be recruited to and will enable further activities to be developed. The service employs designated laundry and domestic staff and a full time handy person. The staff hours in the kitchen have been increased to ensure that the quality of the food and the service to people is maintained. Landmere Care Home DS0000026450.V373964.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): Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the people living there. The health safety and welfare of people and staff are promoted and protected. EVIDENCE: The registered manager has been in post since August 2007. She has many years experience in care and has completed her National Vocational Qualification level four as well as having achieved her registered managers award. Staff we spoke with told us that they feel well supported through regular staff meetings and there was evidence of staff supervision having taken place at Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 23 regular intervals. The manager told us that this is considered to be an important process as it identifies any strengths or weaknesses in the staff team, as well as providing people with opportunities to identify and resolve any problems. We looked at the recent quality assurance survey results from people living at the service and their relatives. These have been collated and displayed and are quite positive. Meetings take place for relatives and people living at the service and people told us that these are useful forums to discuss issues, which may arise and they feel that they are consulted over relevant decisions. There is a suggestion box in the entrance of the service for people to use and this demonstrates the managers willingness to consider peoples opinions in all aspects of the service. The service is run in a way, which puts the interests of the people who use it first. This was evidenced by our observations of people particularly during the short observational framework inspection carried out by one of the inspectors. We looked at the records of people’s personal allowances and observed that these were all correct. Relatives we spoke with said they were satisfied their relative’s money was safely taken care of by the manager and they were able to have their own money whenever they wanted it. The Annual Quality Assurance Assessment returned to us by the manger provided evidence of dates of maintenance and servicing, fire system testing and other health and safety checks to maintain the safety of the people living at the service and staff. Records were seen during the visit to support this information. Relevant maintenance certificates such as the gas, electrics, hoists, waste and fire systems were seen. The fire logbook showed that the fire systems and emergency lights are tested on a weekly basis. Accident and incident records we saw contained significant information and the manager told us that she audits these on a monthly basis. Any injuries to a person are clearly detailed on a body map in the person’s file, where this is appropriate. Landmere Care Home DS0000026450.V373964.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 3 3 x x 3 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 3 x x 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 3 x 3 Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? 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 OP9 Regulation 13 (2) Requirement Records for the administration of Medicines not administered during protected lunch hour must be recorded at the time the medicines are administered. The home must review the administration times with the GP and liaise with the pharmacy to amend mealtime administration ensuring adequate intervals between doses to be administered. No cancellation, obliteration or alteration may be made in the CD register or MAR chart. Correction must be made by: • Dated marginal note or footnote. • A new entry made. Any changes made on the MAR chart MAR: • Cancel the original direction • Write the new directions legibly and in ink on a new line of the MAR • Write the name of the doctor or other prescriber who gave the new instructions Date the entry and sign (including a witness when this is possible). Timescale for action 31/03/09 2. OP9 13 (2) 31/03/09 Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 26 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 OP9 Good Practice Recommendations Further action to be taken of those residents listed with continual long term refusals of medicines with unremarkable outcomes after GP visits ‘to continue to offer medicines’ should be referred to and liaise with the PCT. Action to be taken for the home to make patient information leaflets available for the staff to be familiar with medicines with short shelf life once opened and the use of patches. 2 OP9 Landmere Care Home DS0000026450.V373964.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Landmere Care Home DS0000026450.V373964.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. 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