Care Home: Rastrick Hall

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What the care home does well Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.2 Anyone thinking of moving into Rastrick Hall can go and look around to see for themselves if they think the home is suitable for them. If they decide to move in staff from the home will carry out an assessment to make sure that they can meet that persons needs and arrange a day for admission. Each person has an individual care plan that sets out what care and support they require from staff. The medication system is generally well managed and people get their medication at the right times. People look well cared for. All the people who live in the home spoke well of staff and said they felt that they were kind and caring. Staff arrange some activities to keep people stimulated. People can follow their own routines and relatives and friends are welcome to visit at any time. Relatives told us that they are made to feel welcome when they visit. If people living at the home and/or their relatives are not happy about the service they are getting there is a complaints procedure. People were aware of the procedure and said that they would be able to raise any concerns and that they felt any problems would be resolved. The home is clean, tidy and comfortable. People living at the home and their relatives all said that the home was kept fresh and clean. The staff are friendly and well trained. Staff enjoy working at the home and feel they work well as a team. In the surveys we asked people what the home does well. People living in the home, relatives and staff said the following: ‘Excellent quality of care and a good range of activities for clients.’ ‘The staff work well as a team.’ ‘The needs of the service users are always put first.’ ‘I feel that since the new manager took over the home seems more settled. Residents are aware of who their keyworkers ( a member of staff who takes responsibility for over seeing the care and support for named people living in the home) are and seem to be more content seeing the same staff on a regular basis.’ ‘Having the same carers on each floor is providing better continuity of care for clients and is working well.’ Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.2 Page 7‘As a family we have noticed a lot of improvements big and small since the new manager took over. We are very happy with how things have changed for the better.’ What has improved since the last inspection? Care plans have improved and staff understand the care and support that they need to provide. This means that people’s needs are being met. People living in the home have been consulted about the meals and the menus have been changed to include their preferences. Staff have received training in moving and handling, fire safety, food hygiene, infection control, health and safety and first aid. This means that staff know about safe working practices. The job application forms have been revised so that anyone applying for a job has to declare if they have any caution or convictions. This means that people’s suitability for the job can be explored with them at an early stage. Staff are telling us about events in the home that we need to be told about. This means that we can check that they are taking the right action. What the care home could do better: Some of the paperwork that is given to people needs to be updated so they have the details of the Care Quality Commission and how to contact us if they need to. Staff need to make sure that the daily records reflect the care and support they have given people and whether or not the outcomes of that persons care plan have been met. This will make sure staff can check that people’s needs are being met consistently. Staff need to make sure that they sign the medication administration records to show that they have applied any topical creams or lotions that have been prescribed. This will make sure that people are receiving them as directed.Rastrick HallDS0000070125.V377944.R01.S.doc Version 5.2 A redecoration and refurbishment programme must be drawn up and implemented. This will make sure the accommodation is maintained to a good standard. An audit of money that is held on behalf of people living in the home must take place. This will make sure that records are accurate and there is no risk of any financial abuse. The long term management arrangements for the home need to be confirmed and a manager needs to register with us so that there is someone legally responsible for the management of the home. Key inspection report CARE HOMES FOR OLDER PEOPLE Rastrick Hall Close Lea Avenue Rastrick Brighouse HD6 3DB Lead Inspector Paula McCloy Key Unannounced Inspection 7th October 2009 09:45 DS0000070125.V377944.R01.S.do c Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rastrick Hall Address Close Lea Avenue Rastrick Brighouse HD6 3DB 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) 0845 6037752 rastrickhall@orchardcarehomes.com www.orchardcarehomes.com Orchard Care Homes.Com Limited Manager post vacant Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC; to service users of the following gender: Either; whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is: 40 15th April 2009 2. Date of last inspection Brief Description of the Service: Rastrick Hall is a purpose built home. It offers residential care for 40 older people. The accommodation is arranged over three floors. All of the bedrooms are single and have en-suite toilets and showers. There are lounges and dining rooms on each floor. All of the rooms are comfortable and nicely decorated. There is a garden area at the side of the building that can be used in fine weather. There is a car park to the front of the building. The current weekly charges range from £520 - £570 per week. Additional charges are made for hairdressing, chiropody, dry cleaning, newspapers, personal toiletries and private phone installation and calls. Rastrick Hall DS0000070125.V377944.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 1 star. This means the people who use this service experience adequate quality outcomes. We inspected Rastrick Hall in April 2009 and the service was assessed as being poor. We asked the service to send us an improvement plan to tell us what they were going to do to make the service better. We received this and we went back in August 2009 to see what improvements had been made. We found that some of the requirements had been met but also identified some further improvements that staff needed to address. This inspection was carried out to assess the quality of care provided to people living at the home. The inspection process included looking at the information we have received about the home since the last key inspection as well as a visit to the home, which lasted approximately 6 hours. During the visit we spoke to 6 people living in the home, 8 members of staff, the manager and 3 relatives. We also observed staff delivering care, looked at various records and looked around the home. Surveys were sent to 10 people living in the home, 10 staff and 5 health care professionals; these cards provide an opportunity for people to share their views of the service with us. Information received in this way is shared with the home without identifying who has provided it. We received six surveys from staff and one relative wrote to us with their comments. Their comments have been used in this report. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the service does well: Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.2 Page 6 Anyone thinking of moving into Rastrick Hall can go and look around to see for themselves if they think the home is suitable for them. If they decide to move in staff from the home will carry out an assessment to make sure that they can meet that persons needs and arrange a day for admission. Each person has an individual care plan that sets out what care and support they require from staff. The medication system is generally well managed and people get their medication at the right times. People look well cared for. All the people who live in the home spoke well of staff and said they felt that they were kind and caring. Staff arrange some activities to keep people stimulated. People can follow their own routines and relatives and friends are welcome to visit at any time. Relatives told us that they are made to feel welcome when they visit. If people living at the home and/or their relatives are not happy about the service they are getting there is a complaints procedure. People were aware of the procedure and said that they would be able to raise any concerns and that they felt any problems would be resolved. The home is clean, tidy and comfortable. People living at the home and their relatives all said that the home was kept fresh and clean. The staff are friendly and well trained. Staff enjoy working at the home and feel they work well as a team. In the surveys we asked people what the home does well. People living in the home, relatives and staff said the following: ‘Excellent quality of care and a good range of activities for clients.’ ‘The staff work well as a team.’ ‘The needs of the service users are always put first.’ ‘I feel that since the new manager took over the home seems more settled. Residents are aware of who their keyworkers ( a member of staff who takes responsibility for over seeing the care and support for named people living in the home) are and seem to be more content seeing the same staff on a regular basis.’ ‘Having the same carers on each floor is providing better continuity of care for clients and is working well.’ Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.2 Page 7 ‘As a family we have noticed a lot of improvements big and small since the new manager took over. We are very happy with how things have changed for the better.’ What has improved since the last inspection? What they could do better: Some of the paperwork that is given to people needs to be updated so they have the details of the Care Quality Commission and how to contact us if they need to. Staff need to make sure that the daily records reflect the care and support they have given people and whether or not the outcomes of that persons care plan have been met. This will make sure staff can check that people’s needs are being met consistently. Staff need to make sure that they sign the medication administration records to show that they have applied any topical creams or lotions that have been prescribed. This will make sure that people are receiving them as directed. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.2 Page 8 A redecoration and refurbishment programme must be drawn up and implemented. This will make sure the accommodation is maintained to a good standard. An audit of money that is held on behalf of people living in the home must take place. This will make sure that records are accurate and there is no risk of any financial abuse. The long term management arrangements for the home need to be confirmed and a manager needs to register with us so that there is someone legally responsible for the management of the home. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 5 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can get written information and go and look around the home to see for themselves if they think it is suitable. Staff assess people before they move in so they are sure they can meet people’s needs. EVIDENCE: There is a Statement of Purpose and Service User Guide. This means that people can get written information about the home and the service it offers so they can see if it is suitable for them. We did notice that some of the documents still refer to the Commission for Social Care Inspection these need to be updated with details of the Care Quality Commission. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 11 A member of staff from Rastrick Hall will go and assess anyone thinking of moving into the home. There is an assessment document that staff complete, which means that peoples needs are identified and that staff are sure they can meet those needs before people move in. We looked at the files for three people and found all of the assessment information we would expect, together with a care plan for each. We spoke to someone who had moved into the home recently. They told us that a member of staff had visited them and told them all about the home. They were unable to look around themselves so their relatives had done this for them. They were pleased with their move to Rastrick Hall and felt that they had made the right decision. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People’s health care needs are generally being met. Staff need to make sure that they write down the care and support they give so that they can demonstrate people are receiving the care and support they need. EVIDENCE: We looked at three care plans because we wanted to see what individual needs had been identified and what action staff have to take to meet these needs. We found that the care plans were detailed and contained good information. All of the necessary risk assessments have been completed and staff are writing down the action they need to take to reduce or eliminate that risk. For example one person had been identified as being at risk of developing pressure sores. There was a clear plan regarding the specialist equipment that was in place and instructions for staff to monitor closely their skin condition. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 13 Peoples health care needs are being identified and met. Staff are vigilant and GPs and other health care professionals are being involved as necessary. Details of any visits by health care professionals are documented in the individual care plan and most entries show the advice that has been given. Although we noticed that one person had been to the dentist there were no details of what treatment had been given. Staff were able to tell us what had happened but they need to make sure this is written down. We saw that staff dealt with an emergency situation well and took appropriate action. In the surveys staff told us that they are kept up to date about people’s needs. We talked to staff about people’s care and support and they described the care that was written down in the care plans. This means that staff understand what they need to do to make sure people’s needs were met. The daily records, however, do not always reflect the care and support that staff are giving. For example one care plan stated that the person should be showered each morning. It wasn’t possible from the written records to find out if this was happening. It is important that staff write down the care and support they give so they can demonstrate people’s care is being delivered as detailed in the care plan. This will make sure that people’s needs are met in a consistent way. People looked well cared for and we saw that men had been shaved, peoples hair brushed or combed, spectacles were clean and peoples personal hygiene was well maintained. The people we spoke to told us that generally they like the staff and that they respond to their requests. The medication system is well managed and all staff who give out medication have received training. We watched part of a medication round. The senior care spent time with each individual, offering encouragement when needed. People are receiving their medication at the prescribed times and generally records are well maintained. We did note that none of the lotions or creams that have been prescribed are being signed for. We spoke to the acting manager about this and she agreed to make sure this happens in future. Specific medication records will be left in people’s bedrooms so that staff can sign that they have applied any necessary creams etc. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are some activities on offer in the home. Staff are actively trying to make sure people get the food that they want. EVIDENCE: The care plans we looked at all contained a life history and details of people’s personal preferences and likes and dislikes. This is important because it makes sure staff know about people’s past lives and experiences. It also makes sure they know what times people like to get up, go to bed, if they like to stay in their bedroom and what they like and don’t like to eat and drink. We asked people if there were activities on offer in the home. They told us that bingo, dominoes and exercises are arranged and that they can join in if they want to. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 15 Care plans also contained details of people’s social contacts and details of the usual times people visit. This is useful if people need to be reassured when their family or friends are due to come and see them. The relatives we spoke to told us that they are made to feel welcome and can go and make themselves a drink if they wish. People can choose where they see their visitors they can use the communal areas or their own bedrooms if they want privacy. When we inspected the home in April and August 2009 there were a lot of complaints about the food. The home have struggled to recruit and retain cooks. At our last visit in August one cook had been recruited but they only stayed a short time. Another cook has been recruited and is currently completing induction training. The home have been using agency chefs in the interim. The acting manager told us that there has been more continuity because they have used the same agency staff who are getting to know how people like their food cooked and served. We could see from the records that where people have been dissatisfied with the food staff have made sure they are offered an alternative. People living in the home have been asked through surveys about the menus and these have been changed to incorporate people’s suggestions. Staff need to make sure that the fill in the comments books on each floor everyday so that the senior staff can monitor people’s level of satisfaction with the meals and that there are always adequate stocks of food. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints and adult protection issues are being dealt with properly. This means that staff are listening to people and keeping them safe. EVIDENCE: The homes complaints procedure is on display and is in the Service User Guide. We noted that the complaints procedure needs updating with the details of the Care Quality Commission as it is referring people to our old organisation. People told us that the know who to talk to if they are unhappy or if they want to make a complaint. Staff told us that if anyone made a complaint or raised a concern they would report it to the manager or senior in charge. People we spoke to told us that they would be able to raise any concerns with the manager and were confident that any issues would be sorted out. We looked at the complaints log and could see that details of complaints that have been made have been recorded together with the action taken. This showed that complaints have been investigated properly. Whilst we were at the home one relative raised concerns about the management of their relatives money in the home as they had been invoiced for hairdressing charges when Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 17 there was money available in the home. Staff asked them if they wanted to make a complaint, which was declined. Staff need to log concerns as well as more formal complaints as these will help them to see if there are any common themes and help them to improve the service further. The staff we spoke to were able to tell us what they would do if they felt there were any practices in the home that werent in the best interest of the people living there. They also said that they had completed adult protection training. We could see from the training records that all of the staff have done this training. This means that staff are fully aware of all of the different types of abuse and about the reporting procedures. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable, clean, tidy and generally well maintained. EVIDENCE: Rastrick Hall is a purpose built home that opened in July 2007. The accommodation is arranged over three floors. Each floor has its own lounge and dining area. There is a kitchen area in each dining room. All of the bedrooms are singles with en-suite toilets and showers. The bedrooms are well decorated and comfortably furnished. There is a TV in each bedroom and lockable space, so people can keep their possessions safe. There is an assisted bathroom on each floor and an additional shower room. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 19 The kitchen has been inspected by environmental health and was awarded 4 stars for hygiene. This means that hygiene standards in the kitchen are good. We did notice that some areas of the home are suffering from general wear and tear. For example some of the wall paper in the lounges is scraped and scratched around the areas where the hot trolley is parked. Some of the paintwork has also been damaged by wheelchairs. A general redecoration and refurbishment programme needs to be put in place to make sure the accommodation is maintained to a high standard. The laundry is well equipped and people told us that the laundry system is good. People living in the home told us that the standard of cleanliness is good and the home is kept fresh and clean. Staff were wearing protective clothing when needed and infection control procedures were being followed. All of the staff have completed training so that they are aware of infection control issues and what they have to do to stop the spread of infection. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff on duty to meet peoples needs. Staff are well trained and competent to do their job. EVIDENCE: There are two care staff on duty on each floor during the day with at least one additional senior member of staff available in the home. At night there is one member of care staff on duty on each floor with an addition senior carer available to assist where needed. The acting manager is trying to get a dedicated team of staff for each floor so that people living in the home have staff who they know caring for them on a regular basis. People living in the home, staff and relatives are pleased with this arrangement and everyone commented positively about this change. The care team are well supported by cooks, kitchen assistants and house keepers, which means they can concentrate of caring for people living in the home. We looked at some of the records relating to recently recruited staff to see if staff are appropriately checked before they start work at the home. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 21 Recruitment procedures are generally good, references are always taken up and checks are always made with the Criminal Records Bureau and against the Protection of Vulnerable Adults register to ensure that new staff are suitable to work with older people. However, we did find that some references contained very little or no information about people’s character or experience. In these cases the home must try and get another reference. At our last visit in August we asked for the application form to be amended so that it asked people if they had any cautions or convictions. In the most recent improvement plan the organisation told us that this has been done. There are twenty care staff working in the home, 12 have completed their NVQ (National Vocational Training) level 2 or 3 in care. This means that staff are trained and have been assessed as competent to do their job. We spoke to two members of staff who have worked at the home for less than a year. They told us that their induction training had been good and that they had worked with an experienced carer until they felt confident to work on their own. There is a training matrix in place, which clearly shows what training staff have received and what training they need to do. The acting manager has booked staff on the courses they need to attend so that all staff will be up to date in their practice. The acting manager also needs to make sure staff complete Mental Capacity Act and Deprivation of Liberty training so that they fully understand this legislation. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A manager for the home needs to be registered and the management arrangements made permanent so that there are senior staff who are responsible for developing and improving the service. EVIDENCE: There has been no registered manager at the home since it opened in June 2009. Although people have been appointed for various reasons they have left the home. At the current time the registered manager for the adjacent home, Rastrick Grange, is overseeing the general management of Rastrick Hall as well. A Care Manager has been appointed to support her, initially for 6 Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 23 months. There have been improvements in the overall management of the home these now need to be consolidated and built upon in order to take the service forward. People living in the home, staff and relatives made positive comments about the current management arrangements and told us that the acting manager was approachable and was making changes for the better. We asked the service to send us an improvement plan after the inspections in April and August. They did this and from their response we could see what changes they had made to make the service better and to meet the requirements we had made following those visits. There are good quality assurance systems in place. An internal inspection audit has been completed, which is designed to see if people’s needs are being met and that the home is meeting the national Minimum Standards for Care Homes for Older People. The support manager visits the home regularly and once a month writes a report about the service and any points that the manager needs to deal with. Meetings have been held with people living in the home, relatives and staff to get their views about Rastrick Hall. Surveys have also been sent out to people living in the home and relatives. The acting manager is aware that she needs to write a report on the information she has got from the surveys and give people copies of the report so they can see for themselves what the outcome was and what action staff will be taking to address any issues raised. At our last visit in August 2009 we found that staff were not always informing us about certain events in the home that they should do. In the improvement plan they told us that all senior staff have been told what they should report and that our guidance is available. The acting manager does hold people’s money for safekeeping. We looked at the records and listened to the concerns that one relative raised. There was a problem with the electronic records not balancing with the actual cash that was held. We felt that the problem has arisen because staff are not always using the electronic system. Sometimes they are taking money and putting a written note in the money bag and someone else at a later date is entering this onto the electronic record. Recently the care manager has introduced a new record that requires two staff signatures each time money is added or taken out of someone’s funds. This is a better system and should eliminate any errors. Staff need to carry out a thorough audit of all monies held to make sure they are accurate and up to date. There is no one currently living in the home who is subject to a deprivation of liberty authorisation. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 24 There is a written Health and Safety policy. Staff receive moving and handling, health and safety, food hygiene, fire safety, first aid and infection control training. This means that staff understand safe working practices. The service reports for the passenger lift and hoists were seen and were all up to date. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 2 X X 3 Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 (2) Requirement A system must be put in place to make sure that staff sign the medication administration records to show that topical creams and lotions have been applied. This will make sure people receive treatments as prescribed. A redecoration and refurbishment programme must be drawn up and implemented. This will make sure all areas of the home are maintained to a good standard. An audit of all money held on behalf of people living in the home needs to take place. This will make sure that all of the records are accurate and people are not at risk of any financial abuse. Timescale for action 30/11/09 2 OP19 23 (2) 30/11/09 3 OP35 17 30/11/09 Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 27 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 OP1 Good Practice Recommendations The Statement of Purpose and Service User Guide should be updated to give the contact details for the Care Quality Commission (CQC). This will make sure that people know who is responsible for regulating the service. The daily records kept for people should reflect the content of the individual’s care plan and whether or not outcomes of the care plan have been met for the individual. Staff should log any concerns that are raised together with the action they have taken to resolve the problem and outcome. This will make sure concerns are dealt with properly and can be monitored. All staff should complete Mental Capacity Act and Deprivation of Liberty training. This will make sure that they fully understand the implications in their day to day work. The long term management arrangements for the home should be confirmed and an application make to us to register a manager. This will make sure there is someone legally responsible for the management of the home. A report should be produce that informs people about the results of the recent surveys. This will show people what the outcome was and about any action that is being taken to address any shortfalls in the service that were identified. 2 OP7 3 OP16 4 OP30 5 OP31 6 OP33 Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 28 Care Quality Commission Care Quality Commission Yorkshire & Humberside Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.yorkshirehumberside@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 29 Rastrick Hall DS0000070125.V377944.R01.S.doc Version 5.3 Page 30 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!