Care Home: Sampson Court

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What the care home does well There is a relaxed and homely atmosphere. The people who live in the Service say or indicate by their relaxed manner that care workers are kind and attentive. People say that they receive the support and assistance they need and that this is in line with their expectations. People are served with good quality meals. Complaints are promptly and thoroughly looked into.There are enough staff on duty and care workers know what they are doing. What has improved since the last inspection? The Annual Quality Assurance Assessment says that the staff team has become more stable, with fewer people leaving and joining and with less use of agency staff. It also says that more regular staff meetings are now taking place. What the care home could do better: The range of activities people can do is not well developed. This means that some people might not have the chance to do things that interest and engage them. Although there is a choice at each mealtime, the written menu is not userfriendly for some of the people. This might mean that people end up only having a choice in theory and not in practice. Some bedrooms can be too cool in winter and some bedrooms do not have a reliable supply of hot water at the moment. There is a shortfall in the security checks completed for one care worker. This is not safe. This is because it is important to be confident that care workers are suitable people to be alone with the people who use the Service. There are some shortfalls in the training provided for care workers and team leaders. The Registered Provider is not always using its own system to ensure that these members of staff receive training in key subjects. The quality assurance system is not that well developed. This means that the people who use the Service do not have a clear say in how the place can be improved. There is a shortfall in the fire safety system. This is important because all members of staff need to know what to do if there is a fire safety emergency. CARE HOMES FOR OLDER PEOPLE Sampson Court Mongeham Road Deal Kent CT14 9PX Lead Inspector Mark Hemmings Unannounced Inspection 09:00 30th June 2008 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 Sampson Court DS0000037892.V363133.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. Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sampson Court Address Mongeham Road Deal Kent CT14 9PX 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) 01304 360909 debbie.ford@kent.gov.uk Kent County Council Jennifer Jones Care Home 34 Category(ies) of Dementia (17), Old age, not falling within any registration, with number other category (17) of places Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents to be aged fifty five (55) and over Date of last inspection 8th November 2007 Brief Description of the Service: Sampson Court (the Service) is registered to provide accommodation and personal care for 34 older people. Included in this number are 17 people who have problems with parts of their understanding. The premises are a purpose built single storey property. The accommodation is divided into two selfcontained wings or “units”. One of these is called Poppy and Sunflower. The other one accommodates the people who have special needs and is called Bramble and Bluebell. All of the people who live in the Service have their own bedroom. All of the bedrooms have a private wash hand basin. There is a call bell system and there is a call point in each bedroom. Each of the units has a main lounge that has a kitchenette area attached. Also, the units have their own toilets and bathrooms. The Service is located in a residential area that is about two miles from the centre of Deal. There is a bus stop nearby and there is plenty of off-street car parking. There are some local shops. The fee charged currently for each person’s residence in Sampson Court is £379.02. The fee includes all accommodation, meals, personal care, laundry and in-house entertainment. It does do not cover things such as personal toiletries and hairdressing. Sampson Court DS0000037892.V363133.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 Two (2) Star. This means that the people who use this Service experience good quality outcomes. The commission since 1 April 2006 has developed the way it undertakes its inspection of care services. This inspection of the Service was an unannounced “Key Inspection”. The Inspector arrived at the Service at 09.00 and was in the Service for about seven and a half hours. It was a thorough look at how well the Service is doing. It took into account detailed information provided by the Registered Provider in its self-assessment. This is called the Annual Quality Assurance Assessment (AQAA). Further, it considered any information that the commission has received about the Service since the last inspection. During the inspection visit, we looked at a selection of the records and documents kept in the Service. We spoke with the Manager, one of the team leaders, the support services assistant and with five care workers. We also spoke with five of the people who live in the Service and spent time in the company of others. We looked around parts of the accommodation. We saw the lounges, some of the bathrooms and toilets and some of the bedrooms. We walked around the grounds. Before our visit, we invited people who live in the Service and members of staff to tell us in writing what they think of Sampson Court. Four people and three members of staff wrote back to us. What the service does well: There is a relaxed and homely atmosphere. The people who live in the Service say or indicate by their relaxed manner that care workers are kind and attentive. People say that they receive the support and assistance they need and that this is in line with their expectations. People are served with good quality meals. Complaints are promptly and thoroughly looked into. Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 6 There are enough staff on duty and care workers know what they are doing. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 7 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 Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 8 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): Standards 1, 3 and 6. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People can find out about the Service before deciding about moving in. People who are about to move in are asked about what support they need and how they want this to be done. People who want to stay for shorter periods are helped to go back home. EVIDENCE: People who might want to move can get information about what it is like to live in Sampson Court. There is a brochure called the Service Users’ Guide. This gives lots of useful information about things such as the how the accommodation is laid out, what the bedrooms are like and the support that care workers can give. There is also a more detailed document called the Statement of Purpose. A copy of our most recent inspection report is kept in the Service. This means that people can read what we have said about how Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 9 things are going. The Manager says that she is happy to answer people’s questions. Also, she says that whenever possible people are invited to visit the Service. This is so that they can get a first hand impression of the place. The Manager asks people who are considering moving in about what support they need and want. This is done so that everyone can be confident that moving into Sampson Court is the right thing for them. The Annual Quality Assurance Assessment recognises the importance of this process. We looked at the sorts of things that have been considered for someone who recently moved in. There is lots of relevant information about practical things such as the help the person needs in the bathroom. There is also information about the person’s special needs that come from the problems they have with parts of their understanding. The Manager says that care workers are told about new people before they move in so that they know what to do from the start. We asked three care workers about this and they agree with the Manager. We asked them about the needs of the person mentioned above. They have a good understanding of the support they need to provide. Some people stay for shorter periods of time. This can be on a planned basis or as a one-off. These shorter stays might be because they have been in hospital and are not yet ready to go home. Or, it might be so that a carer can have time to themselves. The Manager says that careful attention is given to helping people to go back home so that their stays do not last longer than is necessary. We looked at the circumstances of someone who is living in the Service on a short-term basis. There was a plan in place to help the person return home when the time is right. This plan has been worked out by the person concerned, by their family, by the Manager and by a social worker. Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 10 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): Standards 7, 8, 9 and 10. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. People are provided with the personal and health care they need. Medicines are dispensed in the correct manner. People are treated with respect. EVIDENCE: The people who live in the Service say that the care workers offer them all the assistance they need. There is a written individual plan of care for each person. These are important because they are one of the ways that people can say what assistance they want to have and how they want it to be done. Also, the plans give information to staff so that they know what to do. We looked at three of these plans. They give a clear account of who needs to do what and why. For example, there is useful information about things such as helping people in the bathroom, about health care and about keeping people safe. One person has special needs. These mean that most of the help received is provided in their bedroom. We asked them about this matter and they say that Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 11 they are quite happy with this arrangement. We asked care workers about this and they have a good knowledge of what is involved. Another person has special needs for help so that they do not loose too much weight. Again, this was described in the plan of care and the care workers know what assistance they need to provide. The plans are kept up to date so that they are accurate. This includes a monthly review. Sensible steps are taken to ensure that people do not have any avoidable accidents. For example, someone can choose to have bed rails fitted if they are worried about rolling out of bed. Other things are also in place. One of these involve measures that are intended to help ensure that people only leave the Service on their own when it is safe for them to do so. As necessary, some of the external doors make a noise when they are opened so that care workers know to check if they are used. Also, the garden attached to Bramble and Bluebell is enclosed. This is so that people do not get lost and can use it safely. People are assisted to maintain their health. Care workers keep a tactful eye open so that medical assistance can be sought if someone is becoming unwell. Since our last inspection a number of people have seen their doctors, some on more than one occasion. Several are also seeing the district nurse for things such as dressings. One person has a routine medical condition that needs to be monitored and managed in a particular way. At the moment there is no clear information about this. Two of the care workers we asked are not sure about the signs that would indicate the need to contact the doctor. The Manager says that this shortfall will be put right by 1 August 2008. None of the people manage their own medication. The Manager says that people will be assisted to do this if this is their wish. There is a system to check that the correct medicines are received from the chemist. Once in the Service, they are stored securely. There is a procedure for administering medicines that is designed to double check that the right medicines are given to the right people at the right time. There is a record that is completed on each occasion that a medicine is dispensed. We examined three sets of these records. They are correctly completed. We looked at three medicines in more detail to see if the remaining stock matched what should have been there. Again, we found things to be in order. We asked five people what they think of the care workers. They praise them saying that they are courteous and attentive. This view is repeated in the written comments we received. One person says, “they are all lovely girls”. Another says, “very helpful. They look after me so very well”. We noted how the care workers chat and joke with people sitting in the lounge. We also noted how people are assisted to use the bathroom in a private manner. They are quietly helped to leave their armchairs. Once in the bathroom the door is closed to give them privacy. People are helped to wear neat and clean clothes Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 12 so that they can present themselves as they wish. One of the visitors said to us, “I call, here everyday to see my wife and I have no complaints at all. She is always neat and clean, her hair is nice and she looks good. She is happy in herself given how her confusion is. I feel quite safe leaving her here, it really is very good”. Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 13 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): Standards 12, 13, 14 and 15. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. The calendar of social activities is not well organised. People are free to receive visitors and to spend the day as they wish. Good quality meals are served. However, some people do not have a real choice. EVIDENCE: Various social events are held in the Service. Some of these are organised for the whole place and involve entertainers coming in. However, most are done by the care workers in their particular units. We asked some of the care workers about how this works out in practice. They say that it can be difficult to find the time to offer a broad range of social activities on a regular basis. We looked in particular at the arrangements in Bramble and Bluebell, given the special needs of the people who live there. We think that little real consideration has been given to offering opportunities that are geared to these Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 14 people’s extra needs. When we were there, two of the care workers were doing a large-piece jigsaw but none of the people were joining in. The television was on in the main lounge but it did not seem that anyone was watching it. It was a nice day and one person was in the garden. However, most people were sitting in their armchairs without appearing to be engaged in anything much. We looked in some detail at the records of the things that two people had done recently. For one person the entries for three consecutive days said that they “walked around the unit and listened to music (day 1), walked around the unit (day 2) and walked around the unit (day 3)”. For the other person, the records show that they “slept all morning and talked to staff (day 1), played dominoes (day 2), asleep all morning (day 3)”. We think that the Registered Provider needs to take a fresh look at this whole matter. This is so that we can be sure that each person is being offered the chance to do things that are likely to interest them and so there is not too much sitting around. The Annual Quality Assurance Assessment says that there it may be possible to have a part time activities coordinator in the near future. We think that this will be a useful first step. People are helped to keep in touch with members of their families, if this is necessary and if it is their wish. Family members and friends are welcome to call to the Service at any reasonable time. The Manager keeps in touch with family members so that they know how things are going. For example, we noted that the relative of someone who had been admitted to hospital and their social worker had been contacted on the day in question. The Annual Quality Assurance Assessment says that people are encouraged to make their bedrooms their own. For example, by brining personal things in with them like small items of furniture, ornaments and photographs. We saw examples of all these in the bedrooms we looked at. People say that they receive good quality meals and that they have enough to eat. They consider meal times to be a relaxed and pleasant affair. The Manager says that there is a choice of dish at each meal. Several people confirm this. However, the records of the meals actually served are not detailed enough for us to know how often people are actually choosing an alternative to the main dish served at lunchtime. In Bramble and Bluebell, the written menu does not help people understand it, for example by using pictures. It is not clear that some of the people who live in this unit have a real choice. This needs to be sorted out. The overall menu does provide people with a normal healthy diet. Meal times are flexible. Special diets can be met. Also, some people are helped by having their food cut up into smaller pieces to make it easier for them to manage. Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 15 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): Standards 16 and 18. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. Complaints are looked into and sorted out. The wellbeing of the people who live in the Service is safeguarded. EVIDENCE: There is a written complaints procedure. This explains how the people who live in the Service and other interested parties can go about raising a concern. We looked at how the Registered Provider has looked into two complaints it has received since our last inspection. On each occasion the complaint was acknowledged in writing. Then they were investigated. This included speaking with members of staff and looking in detail at relevant records. After this was done, the Registered Provider wrote to the people who made the complaints. It explains what has been done to look into the complaints and the conclusions that have been reached. In both cases it explains why some parts of the complaints have not been upheld and why others have. It then says what will be done to make sure that the things that have gone wrong do not happen again. Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 16 We asked three people about how free they feel to raise a concern with the Manager or with other members of staff. All of them say that they are confident to approach them. They also say that there was no need to do so at the moment, because they do not have any concerns. There is a written statement of the Registered Provider’s commitment to making sure that the people who live in the Service are safeguarded from being abused in any way. For example, from being bullied or taken advantage of. Since our last inspection, questions have rightly been asked about the appropriateness of some of the actions of two care workers. The Registered Provider has carefully looked into these matters. It has concluded that the wellbeing of the people who were involved has not been affected too much. The Manager says that the care workers in question have been spoken with so that they know what not to do in the future. Also, she says that they are being closely checked to make sure that there are no similar problems again. We will ask how this has gone when we next call to the Service. The people who live in the Service say or indicate that they feel safe in Sampson Court. Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 17 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): Standards 19, 22, 25 and 26. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. The accommodation in general is homely. However, bathrooms and toilets are rather bare. People are helped to get about. There are some limited problems with the heating and hot water services. EVIDENCE: On the outside, the building is well maintained. The gardens at the front are neat and attractive. At the back, there is a walled garden. This is planted out with various shrubs. There is an interesting walkway that means you can get different views of the garden. Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 18 On the inside, most areas of the accommodation including the bedrooms are homely. The decoration and the furnishings are of a good standard. However, the bathrooms and the toilets are rather stark and bare. Nothing has been done to make them into welcoming spaces. The premises are fitted with an automatic fire detection system. This provides a high level of fire safety protection. The Kent Fire and Rescue Service last checked this out in 2004. Then, there were a couple of items that needed attention. The Manager says that both of these matters were sorted out promptly at the time. Since then, the Registered Provider has prepared a fire risk assessment. This has been done to make sure that there is nothing new that might reduce the level of protection in place. The Manager says that the assessment shows everything to be in order. She says that the assessment has been given to the Kent Fire and Rescue Service who has said that it is okay. The local Department of Environmental Health inspected the kitchen just before our own inspection. It said that three minor things needed to be put right. The Manager says that these have been attended to. We looked at two of them and they are alright. The kitchen is well equipped, clean and well organised. Sensible things are done to ensure good food hygiene. For example, the fridges and freezers are checked each day to make sure that they are cold enough. Also, once food is opened it is covered. Then a date is written on it to make sure that things are not allowed to hang around too long. Suitable help can be given to those people who have difficulties with getting about. There are two special rise and fall baths. These have side doors and so it is much easier for people to step in them. There are also ordinary baths that have fixed hoists. There are two mobile hoists that can be used in the bedrooms. There are moving belts and other things that can be used to help people change position. There are banister rails in corridors. At key places there are assistance poles. These are fitted to the wall and they are there for people to hold onto for extra support. Recently, new toilets have been fitted. For some reason these are a low level design that make it more difficult for people to sit down and to get up in comfort. This is not helpful. The Registered Provider needs to look into this matter. We asked two people how warm the accommodation is kept. They say that they are always comfortable even during the coldest weather. The radiators are fitted with guards. This has been done so that there are no heated surfaces that might burn someone. There are problems in three bedrooms. This is because they are furthest away from the boiler and so they are difficult to heat in the winter months. The Registered Provider needs to keep this problem under careful review next winter. There have been problems with the hot water supply in three bedrooms. The hot water taps are fitted with thermostatic valves. These are designed to reduce the temperature to a level that is not likely to scald someone. Unfortunately, they do tend to fur up due the hard water in the area. This then means that the supply is too cool. The Registered Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 19 Provider has already had plumbers in to give advice about how the problem can be sorted out. The Manager says that work on the problem will begin soon. The laundry is equipped with a commercial grade washing machine. This has an extra cycle for items that need an especially hot wash. There is also a large dryer. The laundry is organised and clean. The Registered Provider is going to check that it complies with new regulations about preventing used water from leaking back into the main pipe-work. This will be done by 1 September 2008. Sampson Court DS0000037892.V363133.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): Standards 27, 28, 29 and 30. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. There are enough staff on duty to meet people’s needs. Part of the recruitment system is not robust. There are some shortfalls in the training programme. EVIDENCE: From early in the morning until later in the evening there are three care workers on duty in each of the units making a total of six. There is also a team leader who is in charge. Other members of staff include housekeepers and people who work in the kitchen. There is also a laundry assistant. At night, there are three waking care workers and there is a team leader who sleeps in. We looked at the roster of to see which shifts had been worked in the week before our inspection. We found the Service is being staffed reliably. There are two vacant care worker posts at the moment. These are being filled with people doing overtime and with agency staff. The Manager hopes to fill these posts with permanent staff as soon as possible. There is a total of 33 care workers employed in the Service. Of this number, 23 have completed a relevant National Vocational Qualification in health and personal care. Three more care workers are in the process of doing the award. Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 21 This qualification is important because it is designed to enable care workers to further develop their ability to provide a high quality residential care experience. The Registered Provider completes a number of security checks on new care workers. This is done to ensure that they are trustworthy people who are suitable to have unsupervised access to the people who live in the Service. The Annual Quality Assurance Assessment says that there is a robust recruitment system in place. We looked at the records for Care Worker A. Most of the checks have been completed. However, there are some gaps in the employment history. This means that we cannot be sure that all of the necessary references have been sought. Also, some of the references that should have been sought are outstanding. The Manager says that these shortfalls will be sorted out by 1 September 2008. New care workers receive introductory training before they work without direct supervision. This means that they pair up with someone senior and go through a number of important subjects such as fire safety and keeping people safe. After that, they do more detailed introductory training. This involves them having to read relevant guidance and showing that they can apply this to their work. The subjects covered include things like responding to people who have problems with their understanding and communication, helping people to promote their continence and being alert to people who might need to see the doctor. After this, people are provided with ongoing training. The Registered Provider has a number of set courses that care workers are expected to attend on a planned basis. For example, they are expected to do training once a year on how to help people who difficulty with moving about. Or again, they are expected to do training in first aid every two years. We looked at the records of the training individual care workers have actually done. All of them have done training in how to support people move around safely and in comfort. However, other bits of the system are not working in the intended way. For example, 11 care workers have not done first aid training in the past two years. The Manager will need to look into these shortfalls if this is the system that the Registered Provider intends to continue to use. However, we do note that since our last inspection, the Registered Provider has completed an organised review of the skills and knowledge of each care worker. This has been done using a list of subjects recommended by the Department of Health. It has been done to make sure that each care worker knows what they need to know in order to give people the assistance they need. The Manager says that no significant gaps were uncovered by the review. We looked at some of the records of the review. The things that we looked at confirm what the Manager says. Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 22 We asked four care workers and one team leader in detail about some of the things that they do. They have a good knowledge of a range of relevant things. For example, how to help people take care of their skin, how to respond to people who become anxious and distressed and how to support people who have problems saying what they think and want. Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, and 38. People who use the Service experience good outcomes. This judgement has been made using available evidence including a visit to the Service. The Manager is registered with the Commission. She reliably manages the Service. The quality assurance system does not really ask all of the people who live in the Service what they think. Also, it does tell people what is going to be done to act on any suggested improvements. People are helped to manage their personal spending money. There is a limited shortfall in one part of the fire safety system. Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 24 EVIDENCE: The Commission has registered the Manager. This means that we have looked at how she plans to run the Service. We think that she has the necessary skills. The Manager has one of the two formal qualifications that are recommended for someone in her role. She says that she intends to study for the second award in the near future. This qualification is important because it is designed to extend her abilities to support the delivery of good quality residential care services. Various things are done to get good teamwork. There are handover meetings at the beginning and end of each shift. These are when team leaders and care workers discuss how things are going in the Service so that they know what needs to be done to support people. There are regular staff meetings. These are organised so that both day and nighttime care workers can take part. There are also meetings for kitchen staff. We looked at the records of the last meeting for day care workers. A number of useful subjects were raised. These include some changes to the individual plans of care to make them easier to use. Another thing was a plan to provide easy-to-read clocks in each of the bedrooms. We noticed that these clocks have now been fitted. Several things are done to consult with people about how well the Service is running. These include informal discussions as part of daily life. There is a system of house meetings so that the people who live in the Service can get together to say what they think. We looked at the record of the most recent meeting. Ten people attended and they discussed a number of relevant things to do with their home. These included some alterations to the garden fencing and ideas for new social activities. The people who live in the Service, their relatives and outsiders such as social workers are invited to complete questionnaires about once a year. We looked at a selection of the 17 questionnaires that have been returned this year. About half are from people in the Service and about half are from their relatives. The comments we saw show that people are satisfied in general with the Service. There are some shortfalls in the consultation arrangements. Little consideration has been given to how best to find out the views of those people who have difficulties with their understanding. There is no organised system to tell contributors what is going to be done to respond to any improvements that they may have suggested. The Annual Quality Assurance Assessment recognises the importance of asking people what they think without really having a plan to strengthen how this is done. The Registered Provider now needs to sort out the problems we have highlighted. This should be done in time for us to be told about the results in the next Annual Quality Assurance Assessment. Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 25 Each person who lives in the Service on a longer term basis can have a personal property account set up for them. This normally means that relatives deposit money with the Service. This is then spent on people’s behalf as and when someone needs something. For example, to pay the hairdresser or to buy toiletries. We looked at the records of the transactions completed for one person. Things are in order. The amounts spent are for reasonable things, the expenditure is receipted and the figures add up. The Registered Provider audits the accounts to make sure that everything is correct. The fire safety system is being checked regularly to make sure that it is working normally. For example, the fire bells are set off and the emergency lights are switched on. There are monthly fire drills. The Registered Provider intends that all members of staff attend an annual fire safety lecture. This is so that it can double-check that everyone knows what to if there is a fire safety emergency. We looked at the records of who has done this training in the last year. The system is not working as intended. We found that 24 care workers and team leaders are overdue. The Manager is going to sort this problem out by adopting a new system. This will involve all members of staff having a refresher session in-house at least once every six months. This will be done by 1 September 2008. We asked one team leader and two care workers about points of detail about fire safety. They have a good knowledge of what is involved. For example, they know what the fire bells sound like and they know about the need to keep fire doors shut when they are not in use. We looked at some service documents. They show that things such as the hoists remain in good working order. There are certificates to show that the electrical wiring installation and the gas-fired appliances also are in a good condition. We looked at the record of accidents that have occurred in the Service since the last inspection. There is nothing in their frequency or nature that causes us concern. Most of them are minor things that are to be expected. The Registered Provider and the Manager check the Service to ensure that there are no obvious hazards that might cause someone to have an accident. The Manager says that no significant hazards have been found. We did not notice any. Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 3 X X 2 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 3 X 2 X 3 X X 2 Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Sampson Court DS0000037892.V363133.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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