Care Home: Little Heaton Care Home

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What the care home does well Before a prospective resident is admitted to the home, a pre-assessment of their needs is undertaken to make sure that the person`s needs can be met. Residents spoken to were complementary about the staff. One resident said "the staff here are wonderful and very kind," another resident said that the staff look after him very well. Visitors are welcome in the home at any time and can visit in the resident`s own room or in any of the communal areas of the home. Systems are in place to support people to raise any concerns they have and details of how to make a complaint are on display in the main reception and on the back of residents` bedroom doors. The returned comment card from the resident indicated that they knew who to speak to if they were not happy and that staff do listen and act on what you say. This was reinforced by the residents spoken to during the visit There are a variety of activities that include outside entertainers, a trip to Blackpool, cheese and wine afternoons, baking and one resident spoken to during the visit said she particularly enjoyed the birthday celebrations. There is a choice of meals and residents spoken to confirmed this. resident said that the food was "tasty" and there was always plenty of it. OneResidents are encouraged to have a say in how the home is run, with regular monthly meetings being held and questionnaires being circulated to residents, relatives and visiting professionals to find out whether they are happy with the service being provided. All the returned comment cards from staff indicated that they were receiving appropriate training and staff spoken to during the visit confirmed this. One comment from a member of staff was "training is better than it has ever been". What has improved since the last inspection? As required in the previous inspection report, the newly fitted radiators and central heating piping had been covered to reduce possible risk to residents. Since the last inspection visit new lighting has been installed in the dining room and lounge with the lowering of the lounge ceiling. New dining chairs have been purchased and an arch has been installed to create a division between the lounge and dining room. The corridors and the majority of bedrooms have been redecorated and a new wet room has been made. CARE HOMES FOR OLDER PEOPLE Little Heaton Care Home Little Heaton Walker Street Middleton Manchester Greater Manchester M24 4QF Lead Inspector Geraldine Blow Unannounced Inspection 8th September 2008 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 Little Heaton Care Home DS0000064013.V371618.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. Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Little Heaton Care Home Address Little Heaton Walker Street Middleton Manchester Greater Manchester M24 4QF 0161 655 4223 0161 654 0200 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) Little Heaton Care Limited Sandra Beatrice James Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following conditions of service only: Care home only - Code PC, to service users 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. The maximum number of service users who can be accommodated is: 25. 25th September 2007 Date of last inspection Brief Description of the Service: Little Heaton is a converted church building, situated in a quiet street off the main road into Middleton and Manchester. It is registered to provide care for up to 25 older people. There are 21 single and two double bedrooms available. The home is on a main bus route, with easy access to the motorway network. Local shops are situated close by. Disabled access is provided by ramps and a passenger lift. There is one lounge/dining area and a separate smoking lounge. Whilst there is no garden, residents can sit outside in the car parking area or in a small area of the church grounds. The charges for fees range from £352.82 to £362.82 per week. Additional charges are made for private chiropody, hairdressing and newspapers. Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This report is based on information gathered by the Commission for Social Care Inspection (CSCI) and supporting information received in the Annual Quality Assurance Assessment (AQAA) submitted by the manager prior to this visit. Some people living at the home and staff were sent comment cards. At the time of this visit, one resident and six staff comment cards had been received by CSCI. Some of their comments have been included in the body of this report. This visit was unannounced, which means that the manager and staff were not told that we would be visiting. This visit forms part of the overall inspection process and took place on Monday, 8 September 2008. The opportunity was taken to look at all the core standards of the National Minimum Standards (NMS). This report is an overview of what the inspector found during the inspection. As part of the visit we (the commission) spent time examining relevant documents and files. We also spent time talking with the manager, several people living at the home, members of staff and a tour of the building was undertaken. Feedback was given to the manager during the course of this visit and on conclusion of the visit. The opportunity was taken to look at all the core standards of the National Minimum Standards (NMS). This inspection was also used to decide how often the home needs to be visited to make sure that it meets the required standards. What the service does well: Before a prospective resident is admitted to the home, a pre-assessment of their needs is undertaken to make sure that the person’s needs can be met. Residents spoken to were complementary about the staff. One resident said “the staff here are wonderful and very kind,” another resident said that the staff look after him very well. Visitors are welcome in the home at any time and can visit in the resident’s own room or in any of the communal areas of the home. Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 6 Systems are in place to support people to raise any concerns they have and details of how to make a complaint are on display in the main reception and on the back of residents’ bedroom doors. The returned comment card from the resident indicated that they knew who to speak to if they were not happy and that staff do listen and act on what you say. This was reinforced by the residents spoken to during the visit There are a variety of activities that include outside entertainers, a trip to Blackpool, cheese and wine afternoons, baking and one resident spoken to during the visit said she particularly enjoyed the birthday celebrations. There is a choice of meals and residents spoken to confirmed this. resident said that the food was “tasty” and there was always plenty of it. One Residents are encouraged to have a say in how the home is run, with regular monthly meetings being held and questionnaires being circulated to residents, relatives and visiting professionals to find out whether they are happy with the service being provided. All the returned comment cards from staff indicated that they were receiving appropriate training and staff spoken to during the visit confirmed this. One comment from a member of staff was “training is better than it has ever been”. What has improved since the last inspection? What they could do better: Although the standard of the care plans remain as they were at the previous inspection it was found that some identified care needs did not have a plan of care to meet those needs. A requirement has been made to address this. Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 7 It is also recommended that the plans of care are further developed on a more person centred approach and contain more details of people’s personal needs and preferences. An unsafe moving and handling practice was observed when a resident was transferred from his armchair to his wheelchair. This was discussed with the manager during this visit. CSCI was informed following the visit that an appropriate hoist sling had been purchased for this particular person. During the visit some concerns were raised that the hoist is stored on the ground floor and does not fit in the passenger lift. Therefore the hoist is unavailable for use if a person falls or if it is needed at any time on the first floor. It is recommended that a hoist is available for use on the first floor. To ensure that people are not put at any unnecessary risk, a risk assessment must be completed for the people who use the stair lift that has been fitted to the short flight of steps providing access to some rooms. To ensure people are receiving medication as prescribed by the GP, it is recommended that medication is accounted for at all times by means of an audit trail. During a tour of the building it was noticed that one of the plastic bath panels was cracked and broken. To ensure that people are not placed at any unnecessary risk, this must be replaced. 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. Little Heaton Care Home DS0000064013.V371618.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 Little Heaton Care Home DS0000064013.V371618.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): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Systems are in place to make sure that people’s needs are assessed before admission. EVIDENCE: Prospective residents and/or their relatives are encouraged to visit the home before making a decision to move in. The returned comment card from the person living at the home stated that they had received enough information about the home before moving in. A documented pre-admission assessment form is in use to ensure all people’s assessed needs can be met prior to admission. The files looked at during this visit all contained a care manager assessment and the home’s own preadmission assessment. Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 10 An intermediate care service is not provided at Little Heaton. Little Heaton Care Home DS0000064013.V371618.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. The health and personal care needs of people living at the home were being met. EVIDENCE: A sample of care plans were seen and three people were case tracked. The care files examined all contained a plan of care and were organised and easy to use. The team leaders undertook monthly audits of the care plans and fed back any shortfalls during supervision sessions. There were various pre-printed assessments with boxes to tick to indicate the person’s needs. The manager stated if a care need was identified, a written care plan was generated. However, it was noted that not all of the residents’ identified care needs had been incorporated into the care plan. Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 12 For example, one care file identified that the person was occasionally incontinent of urine and another file identified that the person was sometimes agitated, had difficulty concentrating and were disorientated to time and place. None of these identified care needs had generated a plan of care. To ensure that the health and welfare of people are fully met, a detailed plan of care must be implemented for each identified care need. Some areas of the care plan contained person centred information, although other parts of the plans were vague and did not clearly set out the actions which needed to be taken by staff to ensure that the person’s personal preferences, health and personal care needs are met. For example, one care plan just stated ‘needs assistance with cleaning her teeth’ and another care plan stated ‘give assistance as required’. The manager was able to clearly describe exactly what help was required and what the person’s personal preferences were but the information was not included in the care plan. It is recommended that all care plans are developed on a person centred approach and contain sufficient detail for staff to meet all the identified needs and personal preferences of people living at the home. Care plans were seen to be reviewed on a monthly basis. Appropriate risk assessments had been included and they had been regularly reviewed, e.g., nutrition, moving/handling, falls, general risks and skin care (Waterlows). However, some people use the stair lift to access some of the bedrooms. The manager stated that some people are able to use the lift unaided and some people require the assistance of care staff. To help reduce any unnecessary risk to people, a risk assessment must be implemented prior to its use. During this visit staff were seen to lift a person, under each arm, out of his armchair into his wheelchair. This is an unsafe moving and handling practice, which puts the staff and the resident at risk. The manager was immediately informed who stated she would review his plan of care and ensure that he was measured for a suitable hoist sling. Following this visit CSCI received confirmed that the sling had been delivered. Each resident was registered with a General Practitioner and evidence was seen of referrals to other specialised services according to individual assessed needs, for example, Speech and Language Therapist, the District Nurse and the Dietician. Residents spoken to all stated that they felt they were well looked after and staff helped them when they needed assistance. The returned comment from the person living at the home stated that they usually receive the care and support needed and staff do listen and act on what you say. Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 13 The records regarding medication were examined. There were no gaps in the recording of medication and medication had been signed into the home. Medication being returned was also recorded and signed when picked up by the pharmacy. The manager confirmed that in most cases the GP’s original prescription comes to the home but a copy is not kept. It is recommended that there is a copy of the GP’s original prescription so that the medication received into the home can be checked against medication prescribed. The manager confirmed that all staff responsible for the administration of medication had received training. A tablet count for several boxed medication was undertaken and found to be accurate. The manager stated that she was in the process of looking into revising her medication record sheets and introducing the NOMAD system because, at the time of this visit, medication was in individual boxes. The manager confirmed that, at the time of this visit, there was no system of auditing medication. To ensure that people are receiving medication as prescribed by the GP, medication should be accounted for at all times by means of an audit trail. From talking to residents and staff it appears that residents are encouraged to make choices around their daily lives. Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Activities are provided and people are able to maintain contact with family and friends. EVIDENCE: The manager described various activities that were provided, some of which included baking, board games, shopping trips, cheese and wine afternoons, clothes parties. A trip to Fleetwood and Blackpool had been organised for two days after this visit. The residents spoken to were excited about the forthcoming trip. The manager confirmed that some of the organised activities were advertised in poster format and in the monthly newsletter, as well as 1:1 discussions with people. An activities book is kept where staff record what activities have taken place and who has participated. To ensure that the activities provided are what the people living at the home want to do, a social history is taken on admission and activities are discussed in the monthly meetings. Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 15 People spoken to were happy with the activities provided and one man said he really enjoyed the outside singers. People’s religious needs were recorded in the files looked at. The manager confirmed that some people attended the local church service on a weekly basis, with staff accompanying and returning for them at the end of the service. In addition, some residents received Holy Communion in the home on a monthly basis. At the time of this visit there were no other specific religious or cultural needs. The manager sated that these needs would be assessed pre-admission. A copy of the menus was seen, which were varied and nutritionally balanced. The menus evidenced that a choice of meals are available and people spoken to during this visit confirmed this. There was a daily menu on display and alternatives were available. The returned comment card for the person living at the home stated that they usually liked the food. One resident spoken to said that the food was “tasty enough and the supper is always”. All the people spoken to said there was “more than enough food”. People living at the home and staff spoken to confirmed that there is open visiting and visitors are made welcome. Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Systems are in place to enable people to raise concerns and policies and procedures are in place to protect people from abuse. EVIDENCE: The complaint procedure is on display in the main reception area and is also included in the service user guide and statement of purpose, which are both available in the main entrance hall. It was encouraging that these had been updated to include the regional address and contact telephone number of the CSCI. In addition, there is also a copy of the procedure on the back of people’s bedroom doors, although these had not been updated with the amended address and contact telephone number of the CSCI. The manager confirmed that it was her intention to update these. All the residents spoken to said they knew who to speak to if they had any worries or concerns and all the returned comment cards for staff indicated that they knew what to do if somebody had concerns about the home. A complaints file was in place and one anonymous complaint had been logged that CSCI had received and referred to the manger to investigate. The manager had investigated and appropriately responded to CSCI. Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 17 As detailed in the previous report, there was a copy of the Rochdale interagency protection procedure in place, together with a whistle blowing procedure, both of which are available to staff. In addition to the procedure, staff are given a condensed booklet of the procedure produced by Rochdale Council for quick reference. The manager confirmed that all staff, with the exception of one new starter, had attended Rochdale Social Services Protection training. Staff files showed that Criminal Record Bureau checks were being undertaken and that if staff started work before these had been obtained, that POVA first checks were being done, with staff working under supervision until full checks were received. Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22 & 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. A clean and comfortable environment is provided. EVIDENCE: As already detailed in this report, since the last inspection visit new lighting has been installed in the dining room and lounge with the lowering of the lounge ceiling. New dining chairs have been purchased and an arch has been installed to create a division between the lounge and dining room. The corridors and the majority of bedrooms have been redecorated and a new wet room has been made. During a tour of the building it was noted that the plastic bath panel in bathroom two, on the first floor, was split and broken. To ensure that people are not placed at any unnecessary risk this must be replaced. Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 19 The home was clean and appropriately furnished and feedback from people spoken to during the visit was positive regarding cleanliness. During the visit some concerns were raised that the hoist is stored on the ground floor and does not fit in the passenger lift. Therefore the hoist is unavailable for use if a person falls or if it is needed on the first floor. To ensure that people are not put at any unnecessary risk it is recommended that consideration is given to the provision of a hoist for the first floor and that safe moving and handling procedures are followed at all times. The laundry is in full operation and the outstanding work identified in the previous report had been completed. The manager confirmed that there were infection control policies and procedures in place and she had obtained the new guidelines. Liquid soap and paper towels were available in bedrooms, bathrooms and toilets. Staff were seen to wear blue aprons when assisting people with meals and white ones when assisting with personal care tasks. Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The number and deployment of staff available appeared sufficient to meet the needs of the residents. EVIDENCE: At the time of this visit 23 people were accommodated and the manager confirmed that there are usually four staff on the morning shift, three staff on the afternoon and evening shift and two staff covering night duty. The manager stated that 18 care staff are employed. One senior carer has successfully completed NVQ Level 4, nine members of care staff have successfully completed NVQ Level 2, two members of staff are currently due to finish Level 2 and two carers are currently working towards NVQ Level 2. There was structured induction in place and the manager stated she was in the process of registering with Skills for Care. The manager confirmed that all new members of staff must complete induction and evidence of this was seen in the files looked at. Copies of the General Social Care Council’s “Code of Practice” were given to new staff as part of their induction process. Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 21 There was an individual training record and copies of certificates held on staff files and there was an overall training matrix. A sample of staff files were looked at to see whether the required documentation was in place and if the necessary checks had been made. Three staff files were looked at, two of which had been recruited since the last inspection. Some short falls were seen. For example, two files did not have a photograph or proof of identity. It was noticed that some of the references were not obtained from the referees documented on the application form. The manager was able to explain the reasons why but there was no written evidence of this. A recommendation has been made. The files looked at contained some photocopied documents and there was no evidence that the original documents had been seen. It is recommended that all photocopied documents are signed and dated to indicate that the original has been seen. In addition, in the files looked at, there was no evidence that a set interview format had been used or that notes were taken. It is recommended that a set interview format is used and notes are taken during the interview process. Little Heaton Care Home DS0000064013.V371618.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. The home is managed in the best interests of the people who live there. EVIDENCE: The manager has the experience and knowledge to effectively manage the home. People living at the home who were spoken to, knew who the manager was and felt they could speak to her if they had a problem. She continued to sometimes cover shifts and work alongside the staff, enabling her to monitor staff practice and be aware of residents’ individual needs and personalities. Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 23 A quality monitoring package had been purchased and the manager confirmed she was in the process of completing the internal audits. In addition to this, other quality assurance monitoring measures are in place, such as a key worker system, monthly resident and staff meetings. Questionnaires are available in the main reception for people to access and the monthly newsletter encourages residents, visitors and visiting professionals to complete the questionnaires. As detailed in the previous inspection report, feedback from the questionnaires was very positive but the manager had not collated the information. A recommendation has been made. There was a policies and procedures folder that was available for staff to access and the manager confirmed that she regularly reviews and updates them. The systems in place for the recording of residents’ finances were in order with income and outgoings being recorded. Where residents received visits, for example, the hairdresser, receipts showed which residents had received the services. Some relatives give money to the manager for safekeeping. It is recommended that the policies and procedures relating to finances are reviewed and updated to clearly set out the systems to be followed. Secure facilities were provided for the safekeeping of money and valuables and receipts retained for any purchases made on behalf of residents. The manager confirmed that, on occasions, staff do purchase items on behalf of a resident. However, there was no record of agreement that people had given their permission for staff to make purchases on their behalf. It is recommended that written agreements be developed between people and the home setting out permission for the staff to purchase personal items for that person and the receipt be signed by the person purchasing items. The information provided in the AQAA demonstrated that the home’s maintenance certificates and records were up to date. Fire safety checks were looked at and found to be up to date. Little Heaton Care Home DS0000064013.V371618.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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 x x x 3 STAFFING Standard No Score 27 3 28 3 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 Little Heaton Care Home DS0000064013.V371618.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 OP7 Regulation 15 (1) Requirement To ensure that the health and welfare of people living at the home are fully met, a detailed plan of care must be implemented for each identified care need. To ensure that people are not put at any unnecessary risk, a risk assessment must be completed prior to the stair lift being used. To ensure that people are not placed at any unnecessary risk, the broken and split bath panel detailed in the body of this report must be replaced. All staff files must include all the details listed in Schedule 2. Timescale for action 07/10/08 2 OP7 13 (4) (c) 07/10/08 3 OP19 13 (4) (c) 07/10/08 4 OP29 19 and schedule 2 07/10/08 Little Heaton Care Home DS0000064013.V371618.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 OP7 Good Practice Recommendations It is recommended that all residents’ care plans are developed on a person centred approach and contain sufficient detail for staff to meet all residents’ identified needs and personal preferences. 1. To ensure people are receiving medication as prescribed by the GP, it is recommended that medication is accounted for at all times by means of an audit trail. 2. It is recommended that there is a copy of the GP’s original prescription, so that the medication received can be checked against medication prescribed. To ensure that people are not put at any unnecessary risk, it is recommended that consideration is given to the provision of a hoist for the first floor and that safe moving and handling procedures are followed at all times. 1. It is recommended that a set interview format is used and notes are taken during the interview process. 2. It is recommended that written evidence be maintained that the original documentation has been seen, the date and by whom. 3. It is recommended that if references are not obtained from the referee documented on the application form, the reason is recorded. It is recommended that the information received in the quality questionnaires is collated and made available for people to see. 1. It is recommended that the policies and procedures relating to finances are reviewed an updated to clearly set out the systems to be followed. 2. It is recommended that written agreements be developed between people and the home setting out permission for the staff to purchase personal items for that person and the receipt be signed by the person purchasing items. 2 OP9 3 OP22 4 OP29 5 6 OP33 OP35 Little Heaton Care Home DS0000064013.V371618.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Area 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. Extracts may not be used or reproduced without the express permission of CSCI Little Heaton Care Home DS0000064013.V371618.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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