Care Home: Shevington Court Nursing Home

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What the care home does well The company continues to employ long-standing members of staff who offer great stability to the home. The registered manager has been in post for many years and continues to provide an effective leadership role. Feedback from all parties stated how they were happy at the home. The cook currently caters for different dietary needs e.g. diabetic diets and liquidised meals and has worked at the home for many years and has a good knowledge on the individual needs and requests of the residents. The staff had been provided with necessary ongoing training and had updated staff files. They have produced evidence of all necessary checks being in place prior to staff commencing employment at the home including CRB (police) checks. These files showed good recruitment procedures, which helps to safeguard residents at the home and shows good practice in supporting and training staff. What has improved since the last inspection? Eight staff surveys received prior to our visit were all positive in their responses. Some comments and suggestions made by the staff included: "We have supervision and annual appraisals." "The service meets the needs of the service users." "We would like more time to talk to the service users." "The care plans at shevington court are well kept and easy to read." "Good nursing care." One person suggested they like, "...to keep up-to-date with training and do the best for each service user." "I was given thorough training in the policies and procedures regarding the care home ie health and safety......etc The training plans for the home showed that training had taken place and included a wide range of courses to help staff support residents diverse needs. Various audits were also seen. Some covered health and safety, management of medications, review of accidents, and regular audits of care plans. These tools helped to show how well managed the home was by the manager and what checks were in place to maintain the standards achieved. Some of the comments made in resident/relative comment cards were very positive with some comments saying: "Matron visited hospital to assess me prior to admission." "happy with care." "takes care of residents with care and consideration." "the home standards are excellent." "happy and relaxed atmosphere." What the care home could do better: CARE HOMES FOR OLDER PEOPLE Shevington Court Nursing Home Holt Lane Rainhill Merseyside L35 8NB Lead Inspector Miss Diane Sharrock Unannounced Inspection 25th January 2008 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Shevington Court Nursing Home DS0000005472.V354696.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. Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shevington Court Nursing Home Address Holt Lane Rainhill Merseyside L35 8NB 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 4931345 0151 4308431 shevingtoncourt@highfield-care.com www.schealthcare.co.uk Southern Cross Care Management Limited Mrs Brigid Alexander Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46), Physical disability (46), Physical disability of places over 65 years of age (46) Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users to Include up to 46 (OP), up to 46 PD(E) and up to 46 PD aged 55 years and over. Service users to include up to 5 under the age of 55 out of the total number of 46. 17th November 2006 Date of last inspection Brief Description of the Service: Shevington Court is a care home, which is registered to provide nursing care for up to forty-six older people, including older people with a physical disability. The Registered Provider is Southern Cross Care Management Limited. Mrs Bridget Alexander has been the registered home Manager for the past 8 years and has over 30 years experience of nursing care provision. Shevington Court is located within a suburb of St. Helens and is close to local amenities. The home provides ground floor accommodation to include 46 single bedrooms, 4 lounges, 2 dining rooms, a hair dressing room, 10 toilets, 4 bathrooms with adapted baths and 2 shower rooms. The home is surrounded by a pleasant garden and patio area that is accessible by wheelchair. Car parking space is available at the front of the premises. The fees charged, range from £477.05 to £576.00 per week. Shevington Court Nursing Home DS0000005472.V354696.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 visit took place over one day and was the homes key unannounced inspection. We sent a selection of comment cards to a sample of residents, relatives and staff before our visit. We also had discussions with both staff and residents during this visit. In total 5 resident/relative and 7 staff comment cards have been submitted to the Commission. The service was inspected against key standards for older people to see how well it was meeting a range of needs. These standards cover moving in, the care and support provided, lifestyles, complaints, safety, comfort and cleanliness, how staff are employed and trained, and how the service is managed and developed. We looked around the home and looked at resident care plans and various other records. “Case tracking’ was used as part of the visit to the home. This involves looking at the support and care a person gets when they live at the home and the quality of the staff that provide this. We discussed all areas of the inspection and findings with the nurse in charge at the end of this visit. What the service does well: The company continues to employ long-standing members of staff who offer great stability to the home. The registered manager has been in post for many years and continues to provide an effective leadership role. Feedback from all parties stated how they were happy at the home. The cook currently caters for different dietary needs e.g. diabetic diets and liquidised meals and has worked at the home for many years and has a good knowledge on the individual needs and requests of the residents. The staff had been provided with necessary ongoing training and had updated staff files. They have produced evidence of all necessary checks being in place Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 6 prior to staff commencing employment at the home including CRB (police) checks. These files showed good recruitment procedures, which helps to safeguard residents at the home and shows good practice in supporting and training staff. What has improved since the last inspection? What they could do better: Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 7 Full feedback was given to the nurse in charge during and on conclusion of this inspection. Some areas were noted to need action taken and further evidence to be in place to meet other standards and regulations including repeated requirements made at the last inspection. Finances must continue to be developed and actions taken to provide clear and easy to read and accurate information for all residents regarding the management of their monies. This will give residents added safety in showing how their funds are managed and in their best interest. Staffing levels must be kept under review in order to make sure that staffing levels are appropriate to the needs of the residents including enough staff to provide domestic duties in the home. These reviews should be included with staff and residents and their opinions should be included in the reviews. The Statement of Purpose should be developed further so that the company’s commitment to the basic number of staff provided to the home each day is openly available. Once updated, steps should be taken to ensure that staff, residents and visitors are aware of the documents and their updates. The statement of purpose must be updated and accurate to explain clearly the support offered to residents in helping them manage their finances. A maintenance, refurbishment and decorating plan must be developed to show a planned approach in refurbishing and decorating the home and include residents/relatives and staff in the development of their home. The company must show evidence of what actions they are going to take in any area in need of repair and refurbishment. Bathrooms and toilet areas still need work and repair to the bathroom floorings and several carpets in bedrooms need further repair to reduce any potential risks and hazards. Their replacement will help develop the environment of the home so it can always provide an adequate and safe standard of décor to the residents living facilities and staff working conditions. The laundry and kitchen flooring and the waste disposal and washing machine need replacing as soon as possible so staff have the necessary equipment to carry out their job. These areas must be reviewed by the company so that steps can be taken to reduce any potential for cross infection. Risk assessments must be in place for worn and ill fitting carpets and smooth flooring, broken appliances in the kitchen and laundry, broken radiator guard, Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 8 stating what actions will be taken by the company to prevent any risks to people at the home. To carry out a review of all the maintenance and contractor checks at the home including those for the periodic electrical test which was noted to be in need of urgent attention following a report carried out in January 07. Activities should continue to be developed so they can meet all of the resident’s social needs and steps should be taken in developing care plans to show what care and support will be given to help all residents with their social needs and requests. Activities should continue to be openly displayed and accessible to all residents so they consistently know what is on offer. Activities are in place and would benefit from a regular weekly-organised activity programme that can be seen and agreed by all Residents 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. Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 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 Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are assessed before coming to stay at the home in order to make sure their needs can be met prior to their moving in to Shevington Court. EVIDENCE: The company have assessment procedures and these show that an assessment of the persons needs are carried out with the person and care manager prior to coming to stay at the home. This makes sure the staff can meet the person’s needs. We looked at four care plans during our visit and one included a recently admitted resident to the home. Care plans had pre-assessments in their file, which showed their needs had been assessed prior to moving in which helps the staff and resident in deciding if Shevington court is right for them. Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 11 One person had said, “Matron visited hospital to assess me prior to admission.” Staff had also carried out an audit of care plans and identified were some needed to be updated to show what care and support was needed. The homes Statement of Purpose gives people various information about the home. This helps people make a decision on what type of home they would like to choose. The homes manager has made sure these documents are accesible to everyone and are freely available in reception so that anyone can read them. This document had no information on the staffing levels. No body was kept informed as to what staffing levels the company will commit to, to provide basic care. This document also had no details of the minimum and maximum fees; this information was given verbally by staff. Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7/8/9/10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff did show they were adequately managing residents health and personal care needs. EVIDENCE: We looked at four care plans during our visit to see what care and support people received while living at the home. All of the care plans seen were detailed and gave a good account of the residents needs and were able to demonstrate they can meet the diverse needs of residents at the home including plans for diabetes, breathing problems, nutrition and communication and supporting a person with their self esteem. Some care plans gave good details how the residents nursing needs could be met but some plans had limited and some no details around social support and detail in how the residents would be supported with their social needs. Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 13 Recent audits of care plans showed that they are regularly reviewed to ensure they maintain all the necessary information needed to meet the resident’s care and support. We received 5 comment cards from residents/relatives prior to our visit. Most of the comment cards offered positive comments such as: “happy with care.” “takes care of residents with care and consideration.” “the home standards are excellent.” “happy and relaxed atmosphere.” We also received 8 staff comment cards that shared various thoughts such as: “The service meets the needs of the service users.” “We would like more time to talk to the service users.” “The care plans at shevington court are well kept and easy to read.” “Good nursing care.” Medications are stored within a separate locked room and safely stored. We looked at a sample of medications, records and storage of medications. The management of medications appeared tidy and organised showing a wellmanaged area. Internal auditing of medications had been developed and showed various audits and actions taken to maintain good practices in the management of medications. Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12/13/14/15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff provide adequate support to residents to meet their social needs. EVIDENCE: The main entrance had a large display telling visitors of all of the events for Christmas and the month of December covering trips out, Christmas meals and party celebrations and various activities organised for the previous week such as, “play your cards right.” However there was no display of any organised activities for the following weeks including the day and week of this visit. One staff member made a suggestion, “To try and be more proactive and look for better things to do with the residents.” We chatted to staff and looked at the staff rotas and it was unclear when staff were supposed to provide activities as one person also provides care hours as well. It was unclear on the duty rota whether anyone else was booked into provide daily activities. Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 15 At the previous unannounced visit staff explained that activity hours would be increased from 13 to 20 per week which would help in updating activity records and in organising more events specific to residents needs. All of the comment cards said they were happy with meals and the residents we met said, “the food is very good here.” Collectively residents said they were fine, those that were able to chat said they enjoyed their lunch and said it was good, they said it was nice here and they were well looked after. The Cook currently caters for different dietary needs e.g. diabetic diets and liquidised meals and has worked at the home for several years and showed a good understanding of residents and their individual choices. The kitchen area was organised however it was noted the kitchen flooring had still not been replaced and this had been identified as necessary to replace at our last visit in 2006. The staff explained that they understood the flooring was being replaced in the following week but did not know why the company had not replaced it sooner. The extractor fans and kitchen tiles were also noted to have a build up of grease and in need of deep cleaning. The waste disposal unit was broken. The current shelves in the kitchen are still wooden and need replacing to a metal type to help keep the storage area easier to keep clean. Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16/18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies, procedures and practices are in place for dealing with complaints and help to protect residents against abuse. EVIDENCE: Residents who chatted to us were generally happy and they said they would always discuss their concerns or queries with staff at the home. We asked some of the residents do they know how to make a complaint, one person stated, “…I go straight to nurse in charge or the matron.” Another person said they had previously contacted head office and was told to go to the staff at the home. One staff member suggested the company should, “….provide training how to deal with complaints from service users and relatives.” The home has a complaints procedure. A copy of the complaints procedure is available to residents in the statement of purpose and there was a small poster giving people details about how to contact the necessary people to make a complaint including the address of the local authority. Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 17 The pre inspection questionnaire gave details of 6 complaints over the past 12 months and the homes complaints records were seen during this inspection. These records showed that any complaint that was made, that staff had followed the company policy and dealt with it appropriately. While speaking to staff they explained they had attended mandatory training and were happy with the training on offer. Staff had received abuse awareness training and had access to the homes policies. Staff are trained and experienced to support and protect residents. Shevington Court Nursing Home DS0000005472.V354696.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): 19/26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment is adequately managed but in need of improvement and investment to the repair and refurbishment of some areas to help improve the residents living areas and facilities were staff work. EVIDENCE: We saw a sample of areas throughout the home during our visit. Some of the bedrooms seen showed personalised rooms were some residents had brought some personal items in to help them settle into the home. Most areas were clean and tidy however one bedroom and one corridor had a strong smell of urine. Staff explained that due to holidays there was just one domestic on duty and the laundry assistant was trying to do both the laundry work and domestic work within their usual working hours, no additional hours were provided for the holiday leave. Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 19 Some rooms had been recently refurbished and were very attractive showing a good standard of décor however some of the carpets showed gaps around the new basins that had been installed which spoiled the décor and gave a potential trip hazard in the room. From the sample of rooms that we saw, just one had a broken radiator cover, which needed repair to make sure the radiator wasn’t exposed and hot to touch. One resident explained that they had recently had to start smoking outside and because of this they felt they should have a shelter outside, as sometimes it was uncomfortable in cold and wet weather. They felt they had brought it up at meetings but didn’t think the company were doing anything about it. Some areas have still not yet been redecorated including bathrooms and toilets. Some flooring in these areas were coming up on the seals and highlighted both a potential trip hazard and a potential risk for cross infection when cleaning these areas. They remained basic and sparse and highlighted the need to be made more comfortable and homely as standards achieved in some other areas in the home. The laundry area was noted to have just one working washing machine, as the second one had been broken for approximately four months, which had added to the workload of organising the laundry. Staff felt it was being replaced the following week with a new machine and were unsure as to why they had not been supplied with a replacement machine much sooner. As mentioned previously the kitchen flooring was noted to have small rips/ marks to the flooring which have continued to make it difficult to keep clean and limit the risks of cross infection in this area. Some areas of repair and maintenance were noted to need attention however the staff did not have any set dates for when they will all receive attention. Some of these areas were noted on the previous visit in 2006 and it is of concern that some actions had not already taken place by the company to improve these areas. Senior staff had documented a lot of areas in the home needing urgent repair and ongoing need for investment to decoration and refurbishment in 15/3/2007, however staff could not find any planned programme showing what actions were being taken to attend to all of these areas. A lot of information during our visit was given verbally by staff explaining what they thought was being replaced and repaired. A sample of maintenance certificates were seen which showed up to date checks as listed in the homes pre inspection questionnaire which helped show what actions were taken to keep the home safe to live in. Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 20 One certificate for periodic electric tests was dated 16/1/07 and had a number of actions needed to be taken to improve the current safety of the facilities. Staff were unsure whether any actions had been taken as stating as needing to be done on the certificate to make sure the electric system was safe. Health and safety arrangements are mainly well managed by the manager however those areas needing major and continual investment were noted to need attention to the environment such as potential trip hazards of old worn flooring in bathrooms/ laundry and poorly fitted carpets with gaps left around basins and broken radiator covers. Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27/28/29/30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are supported by a well-established staff team who have been provided with training to support resident’s diverse needs. EVIDENCE: We looked at 4 staff personnel files which were noted to be organised and were found to contain all relevant information and safety checks including police checks, induction and references. The company have good recruitment and selection procedures that help to safeguard residents. During discussions with staff and in reviewing staff training records it was acknowledged that most people had received their mandatory training and enjoyed all the training on offer. The training plan included training for health and safety/moving and handling/fire/health and hygiene/abuse awareness/ whistle blowing/ cosh/dementia/diabetes/ etc. Staff comment cards made various positive comments such as, “We have supervision and annual appraisals.” “The service meets the needs of the service users.” One person suggested they like, “…to keep up-to-date with training and do the best for each service user.” Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 22 “I was given thorough training in the policies and procedures regarding the care home ie health and safety……” The investment and management of training for staff has continued to help provide a well-trained and competent team able to achieve appropriate standards of care and support and meet the diverse needs of residents. Most of the resident comment cards offered positive comments however all of the cards indicated, staff were only “usually” available when needed. Some comments included, “Could always use extra staff.” Another person suggested the home needed, “more staff.” 4 staff comment cards felt they only,” usually” had enough staff to meet the individual needs of all the people who use the service.” One person said, “We would like more time to talk to the service users.” There was no published staffing notice by the company or evidence to show what staffing level they commit to, to provide basic nursing care. There was no evidence to show that residents, staff and relatives are involved in their opinions in the current staffing levels. There was no evidence or information to show why staffing levels are reduced in the afternoons and evenings and any explanations as to how staffing levels are reviewed. The home employs a large number of duel qualified nurses and support staff. There is always qualified nurse’s on duty 24 hours a day. Shevington Court Nursing Home DS0000005472.V354696.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): 31/33/35/38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a well run home especially regarding the leadership and management of the home. EVIDENCE: The homes registered manager is a qualified nurse and has many years experience in caring for older people. The manager has been at the home for many years and offers a great stability and rapport to all the residents and staff. In line with quality assurance processes the home is visited at least once per month by a representative of the organisation and a report is produced with the findings of the visit. Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 24 These visits form part of the quality assurance process and form an opinion on the standard of care provided. Most relative’s act as appointees for their relatives with managing finances. The company arrange for the management of residents personal allowances by operating a company account in the name of a “residents account”. Currently interest generated from this pooled account goes straight into a residents funds account used for activities. There is no evidence to show that all of the residents personal monies managed by the company have all given permission for this to be done. Some residents and relatives have signed consent for this to happen but the consent forms do not offer any other choices. One-person records were not easy to understand as staff explained the company were in the process of changing bank accounts to a new system for managing finances. This had meant that the resident was owed a various sum of money, which was known as their personal allowance. The staff felt that once the account was set up that head office would arrange the outstanding monies due to be given to the resident, however the records kept in the home could not clearly identify or calculate exactly how much was owed. Residents finances records do not always give a clear and accurate record to the management of their finances. The manager continues to organise regular staff and resident meetings. This ensures that staff members have a regular forum to discuss issues that may affect the service provided to residents and the implementation of polices, procedures and practices within the home. Staff and resident minutes were seen of recent meetings and showed details of various topics about the home. Some hazards and risks were identified during this visit .Some areas had been identified at a previous visit and senior staff had highlighted areas of risk in March 2007,these included faulty flooring in bathrooms, and the kitchen and gaps to carpets. with no repairs or replacements being made to these areas. Some areas had risk assessments in place however staff could not find them for all areas of the environment including the ongoing risks seen during our visit. Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 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 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 2 Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 26 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 13 4)a b c Requirement All hazards and risks must have updated risks assessments in place to say what actions will be taken to eliminate risks at the home. Assessments must be in place for all risks seen during this visit, eg. Carpets that have gaps around basins and any flooring that is coming away from the joins in the bathroom and laundry, broken radiator guards and broken machinery. (this requirement is repeated from the last inspection) Updated actions and maintenance work must take place as a matter of priority to show that the periodic electric certificate dated 1/07 has been acted upon and all actions carried out to improve the safety of the service. Timescale for action 29/03/08 Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 27 2. OP27 18 1a 3. OP35 20 a b Staffing levels must be kept under review in order to make sure that staffing levels are appropriate to the needs of the residents. These reviews should include staff and residents opinions. Staff must show evidence of how they have covered any staff absences so that enough staff are in place to provide the right support and work needed to be done. (this requirement is repeated from the last inspection) The management of finances must be clear and show that they are managed in the best interest of residents. The financial records and assessments must be easy to read so that residents are supported in making decisions in their best interests. (this requirement is repeated from the last inspection) 29/03/08 29/03/08 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 must be developed further to include details of the companies commitment to a basic staffing notice to help provide basic nursing care which helps to keep everyone informed of what staffing levels to expect. The level of fees must be included to keep everyone informed and enabled to make various choices. To have clear and updated information regarding the management of residents finances. Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 28 2. OP12 Activities should be further planned and developed to meet residents social needs and should be clear in including residents opinions in the development of an activities programme accessible to all residents and openly displayed. Appropriate funds should be provided so staff can arrange suitable activities. All care plans must include details around each person’s social needs and requests stating what actions will be taken to meet their needs. To provide training on complaints for all staff . To update both staff and residents on the complaints procedure so everyone is aware of what support and actions will be taken with their comments. To provide a maintenance decorating and refurbishment programme giving dates of actions taken to improve the safety and living and working conditions at the home. To include any actions taken following residents request in wanting a shelter outside for when they choose to smoke. To make sure that residents have enough choices and information to have their monies managed how they would want it to be. 3 OP16 4 OP19 5 OP35 Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Shevington Court Nursing Home DS0000005472.V354696.R01.S.doc Version 5.2 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. 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