Care Home: Palm Court

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What the care home does well Residents have their needs appropriately assessed before moving to the home, which, ensures that a service is only offered to people whose needs can be met. Residents` benefit from being able to make trial visits. This assists residents to make a decision about whether the home is right for them. Staff are aware of the needs of residents and how to meet them. Residents spoken with reported that a good standard of care is provided. Some comments made were " Living here is very good. I am happy and well cared for." " The staff are helpful and our needs are seen to. I am happy here." "I have been here for 3 years and I am very well cared for." "Staff are always available. I receive excellent care." "I feel lucky to be here."Relatives and health professionals reported that staff are caring and have a good understanding of the care needs of residents. Some comments made were; "We are delighted with the care provided. Everyone is regarded as special. Staff are friendly and cheerful." The expert by experience said, "the residents are on the whole content. They have a nice environment to live in with apparently caring staff who try hard to accommodate their needs". Observations and discussions with residents indicated they consider they are treated with respect. The wellbeing of residents is promoted by the flexibility of the daily routines, visitors being made welcome to the home and the provision of well balanced, appealing meals. Activities are available for residents to take part in should they so wish. The home has a satisfactory complaints system which residents know how to access. The procedures at the home and training provided to staff around adult protection safeguard residents. The home is clean and well presented and provides a comfortable and pleasant atmosphere. A number of staff have worked at the home for several years and know the needs of the residents well. What has improved since the last inspection? Further information is now being included in the residents care plans, risk assessments and in the reviews of the care plans. This ensures that the staff have clearer information around meeting the needs of the residents. The second and third floor bathrooms have been redecorated making them more pleasant rooms for the residents to use. What the care home could do better: Improvements need to be made to the records of staff recruitment. All staff who have access to the home and the records required for the running of the home must have appropriate recruitment checks before they begin their employment. Records relating to the recruitment of staff and staff training must be held at the home. To provide evidence that staff have been appropriately vetted before they begin work at the home and that they are suitably trained during their employment.Steps need to be taken to ensure that the staff induction training meets the standards of Skills for Care. This will ensure that staff are receiving a thorough induction that assesses their competence and prepares them for their work at the home. CARE HOMES FOR OLDER PEOPLE Palm Court 1 Curzon Road Hoylake Wirral CH47 1HB Lead Inspector Beate Field Key Unannounced Inspection 10:30 13 and 28th February 2008 th 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 Palm Court DS0000018923.V348680.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. Palm Court DS0000018923.V348680.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Palm Court Address 1 Curzon Road Hoylake Wirral CH47 1HB 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) 0151 632 0900 Mr Michael Arthur Burke Mr Anthony Crane Mrs Jacqueline Burke Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Palm Court DS0000018923.V348680.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th January 2007 Brief Description of the Service: Palm Court is registered to provide personal care and accommodation for 19 older people. The home is located close to Hoylake town centre, which has a range of shops, pubs, a post office, bank and other town amenities. A rail network gives easy access to Liverpool and other parts of the Wirral. The home is also within a five-minute walk of the promenade. The accommodation is provided on three floors. All bedrooms are single occupancy some with ensuite facilities. The sizes of the rooms vary considerably. A lift is available to all floors. The communal rooms comprise of a lounge, a snug and a dining room. There is a garden at the back of the property along with patio furniture. The front of the home is mainly taken for parking although this has been made attractive with plants and hanging baskets. At the time of this inspection, the weekly fees for the home ranged from £268.00 to £480.00. Additional charges are made for chiropody, hairdressing, dentist and aromatherapy. A service user guide and a statement of purpose, which describe the services offered is made available to new residents, their relatives and professionals before a resident comes to live at the home. A copy of the most recent inspection report can be obtained from the manager. Palm Court DS0000018923.V348680.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 inspection took place over 8 hours and is based on two visits to the home. The inspection is also informed by information received about the service since the last inspection and by questionnaires completed by the residents, their relatives, staff and health professionals who visit the home. During the site visit to the home time was spent in the office looking at a sample of records and policies and procedures and talking to the deputy manager and owner. A tour of the home was undertaken. The inspector spoke with residents and staff and made observations of the care given by staff. We requested that an Annual Quality Assurance Assessment (AQAA) be completed. It is a legal requirement that this information be made available, as it is the main way that the registered persons let the CSCI know how well a service is delivering good outcomes. The AQAA was not returned to the CSCI. This matter has been addressed with the owner. The term ‘Experts by Experience’ used in this report describes people who have been appointed by Help the Aged, under the direction of the Commission for Social Care Inspection, to take part in the inspection of services for older people. An expert by experience was present at the inspection for 3 hours. This person has experience of services for older people and was asked to visit the home to give their view on how the service is operating. What the service does well: Residents have their needs appropriately assessed before moving to the home, which, ensures that a service is only offered to people whose needs can be met. Residents’ benefit from being able to make trial visits. This assists residents to make a decision about whether the home is right for them. Staff are aware of the needs of residents and how to meet them. Residents spoken with reported that a good standard of care is provided. Some comments made were “ Living here is very good. I am happy and well cared for.” “ The staff are helpful and our needs are seen to. I am happy here.” “I have been here for 3 years and I am very well cared for.” “Staff are always available. I receive excellent care.” “I feel lucky to be here.” Palm Court DS0000018923.V348680.R01.S.doc Version 5.2 Page 6 Relatives and health professionals reported that staff are caring and have a good understanding of the care needs of residents. Some comments made were; “We are delighted with the care provided. Everyone is regarded as special. Staff are friendly and cheerful.” The expert by experience said, “the residents are on the whole content. They have a nice environment to live in with apparently caring staff who try hard to accommodate their needs”. Observations and discussions with residents indicated they consider they are treated with respect. The wellbeing of residents is promoted by the flexibility of the daily routines, visitors being made welcome to the home and the provision of well balanced, appealing meals. Activities are available for residents to take part in should they so wish. The home has a satisfactory complaints system which residents know how to access. The procedures at the home and training provided to staff around adult protection safeguard residents. The home is clean and well presented and provides a comfortable and pleasant atmosphere. A number of staff have worked at the home for several years and know the needs of the residents well. What has improved since the last inspection? What they could do better: Improvements need to be made to the records of staff recruitment. All staff who have access to the home and the records required for the running of the home must have appropriate recruitment checks before they begin their employment. Records relating to the recruitment of staff and staff training must be held at the home. To provide evidence that staff have been appropriately vetted before they begin work at the home and that they are suitably trained during their employment. Palm Court DS0000018923.V348680.R01.S.doc Version 5.2 Page 7 Steps need to be taken to ensure that the staff induction training meets the standards of Skills for Care. This will ensure that staff are receiving a thorough induction that assesses their competence and prepares them for their work at the home. 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. Palm Court DS0000018923.V348680.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 Palm Court DS0000018923.V348680.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): 2, 3 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents only move into the home after their needs have been assessed. This ensures that their needs will be met. EVIDENCE: Prospective residents and their relatives are encouraged to visit the home prior to admission to view the premises and talk to the current residents. They can visit as often as they wish and the deputy manager stated that they are able to have a meal and take part in any of the activities before they decide whether to move in. Residents spoken with and those who returned questionnaires had made visits to the home before moving in where possible. Palm Court DS0000018923.V348680.R01.S.doc Version 5.2 Page 10 A sample of new residents’ files were seen. There was evidence of appropriate assessments being carried out before new residents move to the home. There was also evidence that information is gathered from social workers and health professionals to inform the assessment. New residents spoken with said they had been asked about their needs during the assessment. Contracts between the home and three residents were seen. The contracts cover the rights of the resident, services provided and terms and conditions of residence. Residents spoken with said that they have received a contract. 14 residents who returned questionnaires stated that they had received a contract. The contracts need to be updated as they have the details of the local authority as the agency responsible for regulation and not the CSCI. The home does not offer intermediate care. Palm Court DS0000018923.V348680.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are treated with respect and their health and personal care needs are well met. The management of medication supports the well being of the residents. EVIDENCE: A sample of residents’ care plans were seen. Care plans are directly available for staff to refer to. The care plans provide basic information to staff on what the residents needs are and how to meet them. More detailed information has now been made available in the risk assessments, which provides clearer information for staff to follow. There is also information recorded about the residents’ lives before coming to live at the home. Records showed that the care plans had been reviewed. Palm Court DS0000018923.V348680.R01.S.doc Version 5.2 Page 12 The residents spoken to said that they are well cared for at the home. When asked about the care they receive from staff, residents said they always get the care and support required and staff are always there when needed. Residents who returned questionnaires were very positive about the service provided, some comments made were “ Living here is very good. I am happy and well cared for.” “ The staff are helpful and our needs are seen to. I am happy here.” “I have been here for 3 years and I am very well cared for.” “Staff are always available. I receive excellent care.” “I feel lucky to be here.” Questionnaires returned by relatives indicated that they are generally very happy with the standard of care provided. Some comments made were; “We are delighted with the care provided. Everyone is regarded as special. Staff are friendly and cheerful.” “My relative is always clean, warm and well fed and they feel safe. Staff are attentive. They are wonderful.” “The home does everything well. Care is wonderful. Residents get good food and excellent entertainment.” One relative said they would like more information provided around the day-to-day well being of their relative. This was brought to the attention of the owner during the visit. The records at the home indicated that referrals are made to health professionals in accordance with the needs of residents. A record is made of visits by health professionals and the outcome is documented. Residents spoken with said that their health needs are well met. Questionnaires were returned by 3 GP’s who said that the staff have a good understanding of the care needs of residents, medication is appropriately managed and that the manager and staff always seeks advice and act upon it. Some comments were, “Care staff are excellent and medication is managed correctly.” “Good care is provided. Home gives a personal touch, staff are polite.” Oxygen was in use in one bedroom. This appeared to be being appropriately managed with warning notices available for staff and visitors to see. The owner was advised to put guidance around the safe storage of oxygen into a written procedure so that staff have this information to refer to. Systems are in place for the safekeeping and handling of medication. A sample of the medicine administration record (MAR) sheets and corresponding medications were inspected and were found to be correctly maintained. Staff who administer medication have undertaken training in the safe handling and administration of medication. A record should be made of the assessed competence of staff to administer medication. In accordance with a recommendation made by the CSCI Pharmacy Inspector following a visit to the home in January 2007, medication policies and procedures should be reviewed in line with Royal Pharmaceutical Society of Great Britain guidelines to cover all aspects of medicines management. Palm Court DS0000018923.V348680.R01.S.doc Version 5.2 Page 13 Staff were observed to speak to residents in a respectful manner and were sensitive when responding to the residents needs. The residents interviewed and those who returned questionnaires said that the staff are “polite” and “respectful.” Palm Court DS0000018923.V348680.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The well-being of residents is promoted by the flexibility of the daily routines, visitors being made welcome to the home and the provision of well balanced, appealing meals. EVIDENCE: Observations and a discussion with staff and residents indicated that the routines of daily living are flexible. Residents said they choose what time they get up and go to bed, whether to socialise or stay in their rooms and what to do each day. A discussion with the deputy manager and records showed that activities are provided around 3 times a week and include an entertainer visiting the home, board games, films and armchair exercises. The expert by experience noted that there were photographs on the wall in the dining room of residents taken during activities. They showed visiting singers, someone who played the organ and an Easter bonnet parade”. Palm Court DS0000018923.V348680.R01.S.doc Version 5.2 Page 15 A number of residents who returned questionnaires said that they are happy with the amount of activities on offer. Residents spoken with generally said that they have their own routines and interests and are satisfied with what is available. Some residents considered that there should be more activities on offer and they particularly said that they would like to go on more outings. The expert by experience commented, “I did feel that more activities could be helpful and some volunteers to take people out sometimes would be very helpful.” Consultation should take place with the residents around planning future activities to ensure that the wishes of all the residents are catered for where possible. The residents’ birthdays are celebrated, as are all special events at the home. The deputy manager said birthdays are celebrated with cake, champagne and a party with presents being given by management. One resident said that she enjoys the birthday celebrations and that there always seems to be a birthday. The residents spoken with said that their friends and relatives are able to visit them whenever they wish and that they are always made to feel very welcome by the staff. Representatives from local churches visit the home, some residents go to religious services, a mobile library and clothes shop visits the home. A number of residents regularly go out with their families and friends. Some residents attend luncheon clubs. Observations of the dining area indicated that a pleasant environment is provided for residents to have their meals. The food being prepared looked appetising. Lunchtime menus are displayed in the lounge for residents and their visitors to view. Visitors may eat with the person they are visiting as long as sufficient notice is provided. Breakfasts are provided following consultation with each resident. A choice of evening meals is provided. The records of menus indicated that a variety of meals that would provide a balanced diet are available. Residents spoken with generally said that they enjoy the food and that any special dietary needs are met. Palm Court DS0000018923.V348680.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are safeguarded. Residents know how to make a complaint. Staff know how to manage complaints and adult protection matters. EVIDENCE: A complaint procedure is in place to ensure residents’ and their carers views and concerns are listened to and acted upon appropriately. This needs to be updated with the correct contact details for the CSCI. The residents spoken to during the visit and those who returned questionnaires knew how to make a complaint but had not needed to. The residents spoken with were happy with the standard of care they received and had no complaints to make. The staff confirmed they knew what action to take in the event of them receiving a complaint. The CSCI has not received any complaints about the service provided at Palm Court and none have been made directly to the home in the last 12 months. A comments book is kept in reception. The last entry was made in September 2007 and states “The home has brilliant staff who are always helpful.” Palm Court DS0000018923.V348680.R01.S.doc Version 5.2 Page 17 Systems are in place to ensure residents are safeguarded from abuse and neglect. A copy of the Wirral adult protection procedure is in place along with supporting documentation, which staff can refer to when necessary. The staff spoken to during the visit demonstrated a basic understanding of this issue and were clear on the action they should take in the event of them suspecting or knowing an incident of abuse had occurred. They confirmed they had undertaken training in this area of care provision. Palm Court DS0000018923.V348680.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, 23, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with a warm, clean and comfortable home. EVIDENCE: The standard of furnishing throughout the home remains high and provides the residents with a very comfortable and attractive environment in which to live. On the day of the visit the home was clean and tidy and pleasantly warm. All of the residents who returned questionnaires said that the home is “always fresh and clean.” Palm Court DS0000018923.V348680.R01.S.doc Version 5.2 Page 19 A programme of routine maintenance and renewal of the fabric and decoration of the building is in place. There were signs of dampness in the bathrooms and some bedrooms on the third and second floor of the home. Staining of paintwork was seen. The owner reported that work to address the dampness in the bathrooms had taken place following the last inspection but further damage had occurred. The owner said that the dampness to all areas seen had been attended to and that drying out time was being allowed before redecorating these areas. On a return visit to the home the bathrooms and one of the bedrooms had been redecorated. The owner reported that the decoration to the two remaining bedrooms, Ulverston and Hawkshead, will be carried out within the next couple of weeks. All bedrooms are single occupancy, which ensures residents privacy. The residents’ bedrooms seen were generally well decorated, nicely furnished and personalised by the occupant. The expert by experience commented on the bedrooms and said “The rooms I saw were quite large, nicely carpeted and comfortably furnished with pieces of personal belongings in evidence.” During the visit residents generally expressed their satisfaction with the quality of the décor and facilities. Where issues were raised they were brought to the attention of the owner to be addressed. A passenger lift is available. Bathing aids are available on each floor of the home. The bathing aid on the third floor of the home was not working at the time of the visit. This needs to be addressed to ensure that the residents on this floor of the home have access to a bath close to their bedrooms. An efficient laundry system is in place which means residents clothes are looked after properly. The door to the laundry room is locked when not in use. Policies and procedures for the control of infection are in place and staff have undertaken training in relation to this aspect of care provision. Palm Court DS0000018923.V348680.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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including visiting the service. The records of staff recruitment and training for some staff where not available at the home. It was not possible to assess if residents are fully safeguarded by the way staff have been recruited and trained. EVIDENCE: There are currently 14 residents living at home. The staff rota indicated there was a minimum of two staff on duty between the hours of 8 am and 5 pm, with three staff being available on some mornings. The staff spoken to during the visit stated there were sufficient staff on duty each day to enable them to carry out their work and care for the residents properly. Staff who returned questionnaires said there were always or usually enough staff on duty. Sufficient ancillary staff are provided to ensure the building is kept clean and tidy. Palm Court DS0000018923.V348680.R01.S.doc Version 5.2 Page 21 At the time of the first visit staff records were being held off site in the administrators home. Staff training records were also there. The owner reported that these records were being held securely and that the administrator works from home, because of limited office space at Palm Court and makes occasional trips to Palm Court. A second visit was made to the home to view these records. The records for two new staff were not available. The owner reported that the administrator had forgotten to send these. Records of staff recruitment and training are required to be kept in the care home and be accessible for inspections. In order to provide evidence that staff have been appropriately recruited and appropriately trained. The records for two staff who have worked at the home for over 2 years were seen. These contained satisfactory recruitment information and training records. The owner reported that he had not carried out any recruitment checks on the home’s administrator. The owner was advised that staff must not be employed until the appropriate employment checks have been completed. All staff are provided with induction training when first employed. This gives staff information on how they should fulfil their responsibilities with regard to the health, safety and welfare of the residents. The Registered Persons must ensure this training is in line with guidelines issued by the Skills for Care. 50 of the care staff at the home have an award at NVQ level 2 in care of older people. 10 staff returned questionnaires. Generally they were very positive about working at the home and said that there is always or usually good communication between the staff and always or usually good support provided to them by the manager. The staff were generally positive about the training received, although some said that they would benefit from further training that is relevant to their role. All staff made positive comments about the overall service provided to the residents. Comments included; “Basically the home is very well run.” “High quality care is given to residents.” “Residents needs are paramount.” ”Residents are treated with great care and respect. Nothing is too much trouble.” “The staff give independence and dignity to the residents and the staff are always ready to meet their needs and wishes. Good food and social entertainment is provided.” Palm Court DS0000018923.V348680.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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ benefit from living in a safe, well run home. EVIDENCE: The registered manager is currently sharing the management of the home with one of the deputy managers. The owner reported that the registered manager has reduced her working hours to part time. The rota did not indicate the times that the registered manager works at the service. This needs to be documented. Palm Court DS0000018923.V348680.R01.S.doc Version 5.2 Page 23 The owner reported that he is in the process of appointing a full-time manager. Until such time the Registered Persons are reminded that although the Registered Manager has reduced her hours she remains responsible under the Care Standards Act 2000 for the day to day management of the home and the care and protection of the residents. The Registered Manager is competent and experienced to run the home. The deputy manager who is currently sharing the management of the home also has the necessary skills and experience to manage the service. The ethos of the home is based on ensuring residents receiving a high standard of care and being able to live in a relaxed and comfortable atmosphere. While a formal quality assurance system is not in place, systems have been implemented to monitor different aspects of care provision and to ensure the ongoing efficient running of the home. Residents spoken to during the visit and those who returned questionnaires confirmed their care needs were met and they were very happy with the care they received. Palm Court has a comment book which relatives and health care professionals can record their views on the standard of care provided at the home. Residents are given a questionnaire to complete about their experiences of living at the home. Some further ways of getting information from relatives and health and social care professionals about how the home is operating should be considered, such as using questionnaires. The residents, relatives and health care professionals who returned questionnaires were generally very positive about the service provided at the home. The expert by experience said, “the residents are on the whole content. They have a nice environment to live in with apparently caring staff who try hard to accommodate their needs.” The home’s management team manage only small amounts of money on behalf of a couple of residents. The records of this were seen and were accurately maintained. Deposits were recorded and withdrawals supported by receipts. Systems are in place to ensure the health; safety and welfare of the residents are promoted. Staff have been provided with a range of training in relation to health and safety and plans have been made for further training to be provided this year. Maintenance checks have been carried out on equipment around the building such as the electrical wiring, the lift and gas appliances. Supporting policies and procedures are in place, which have been reviewed since the last visit to the home. Fire safety training was provided to all staff in January 2008. Palm Court DS0000018923.V348680.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 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Palm Court DS0000018923.V348680.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 OP19 Regulation 23 Timescale for action The Registered Persons must 28/03/08 ensure that the bathing aid on the third floor of the home is in working order. The Registered Persons must 28/02/08 ensure that records of staff recruitment and staff training are held at the care home. The Registered Persons must 28/02/08 ensure that appropriate recruitment checks are carried out on any staff before they begin working at the home. The Registered Persons are 28/05/08 required to ensure staff induction training is in line with the guidelines issued by the Skills for Care (this requirement remains outstanding from a previous inspection.) The registered persons must 28/02/08 maintain a record of the times worked by the registered manager. Requirement 2. OP29 17 3. OP29 17 4. OP30 18 5. OP31 17 Palm Court DS0000018923.V348680.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. 2. 3. Refer to Standard OP9 OP9 OP12 Good Practice Recommendations Medication policies and procedures should be reviewed in line with Royal Pharmaceutical Society of Great Britain guidelines to cover all aspects of medicines management. A record should be made of the assessed competence of staff to administer medication. Consultation should take place with the residents around planning future activities to ensure that the wishes of all the residents are catered for where possible. Further opportunities should be made available for residents to take part in activities outside of the home. Some further ways of getting information from relatives and health and social care professionals about how the home is operating should be considered, such as using questionnaires. 4. OP33 Palm Court DS0000018923.V348680.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North West Regional Contact Team 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 Palm Court DS0000018923.V348680.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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