Care Home: St Leonards Residential Home

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What the care home does well The home carries out assessment visits to prospective residents to ensure that they can meet the needs of the individual. The home has care plans which describe the needs of the individual and what they are able to do independently. The plans describe the support staff have to give. St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Daily routines in the home were flexible and people who use the service being encouraged to make choices for themselves and exercise personal autonomy as far as was reasonably possible. People who live at the home were generally positive about the food that the home provided and the condition of the accommodation that they occupied. There is a continued refurbishment programme at the home and each time a bedroom is vacated the room is redecorated. The home`s current recruitment process protects people who use the service. Staff have undertaken training in most mandatory areas and training that helps support individual needs. The home safeguards people`s monies with their recording and storage. What has improved since the last inspection? Not applicable. This is the first visit to the service following the change in provider. What the care home could do better: The management and administration of medication for those unable to do this for themselves, must be robust to ensure that people receive their prescribed medication safely and in a timely manner. All staff must receive fire safety training to protect those that work and live at the home. All staff must receive training in moving and handling to protect both themselves and people that use the service. Key inspection report CARE HOMES FOR OLDER PEOPLE St Leonards Residential Home 123 Victoria Drive Bognor Regis West Sussex PO21 2EH Lead Inspector Val Sevier Key Unannounced Inspection 15th June 2009 10:00 DS0000072993.V375738.R01.S.do c Version 5.2 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. St Leonards Residential Home DS0000072993.V375738.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 St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Leonards Residential Home Address 123 Victoria Drive Bognor Regis West Sussex PO21 2EH 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) 01243 823552 Enquiries@stleonardshome.co.uk Cheylesmore Ltd Manager post vacant Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (0) of places St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 12. Date of last inspection New Service Brief Description of the Service: St Leonards is situated in a quiet residential area in Bognor Regis. It is registered to accommodate 12 older persons. All rooms are single occupancy. Toilets are accessible for service users and two are located near the lounge and dining rooms as well as being in close proximity to the client’s room. The home has two bathrooms one on each floor. Four communal toilets, two on the ground floor and two on the first floor. The home consists of a lounge and a dining room. There is a garden and outside sitting area. St Leonards Residential Home DS0000072993.V375738.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 2 star. This means the people that use this service experience good quality outcomes. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The visit was carried out on the 15th June 2009 between the hours of 10:00 am and 4:00 pm Prior to the visit to the home we reviewed, information received from the home since it was registered in December 2008. The Annual Quality Assurance Assessment (AQAA) was returned to the Commission by the due date before we visited the home. The AQAA is a document that we send to a service once a year, in it they are able to comment on improvements they have made, any barriers to improvement to meeting the standards and how they feel the service is meeting the needs of people who live at the home. The manager was present throughout our visit. On the day of our visit there were seven people living at the home and one person in hospital. We met with three staff, a visitor and there were three people who use the service involved in the inspection visit. We have sent ten surveys to staff, people who use the service and five to other professionals. At the time of writing the draft report we have received surveys from six staff, one health care professional and three from people who use the service. We looked at one pre admission assessments, three care plans, medication records, staff files and training records and fire prevention testing and training records. Following the inspection before we published the report we were informed by the Responsible Individual that the manager had left and that they were endeavouring to recruit a manger who would apply for registration with the commission. What the service does well: The home carries out assessment visits to prospective residents to ensure that they can meet the needs of the individual. The home has care plans which describe the needs of the individual and what they are able to do independently. The plans describe the support staff have to give. St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Page 6 Daily routines in the home were flexible and people who use the service being encouraged to make choices for themselves and exercise personal autonomy as far as was reasonably possible. People who live at the home were generally positive about the food that the home provided and the condition of the accommodation that they occupied. There is a continued refurbishment programme at the home and each time a bedroom is vacated the room is redecorated. The home’s current recruitment process protects people who use the service. Staff have undertaken training in most mandatory areas and training that helps support individual needs. The home safeguards people’s monies with their recording and storage. What has improved since the last inspection? What they could do better: 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. St Leonards Residential Home DS0000072993.V375738.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 St Leonards Residential Home DS0000072993.V375738.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 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 that use the service can be assured that their needs will be assessed to ensure that the home has an understanding of their care needs. EVIDENCE: The AQAA for the home stated that: “We encourage any prospective clients to visit the home to look around. The manager will visit the prospective client to carry out a pre admission assessment to ensure that the home will meet the client’s needs to ensure that our home is suitable for the individual. All clients’ files contain details including plan of care and risk assessments to meet the client’s individual needs. We have regular visits from competent professionals to meet the client’s needs including District Nurses, Dentists, Opticians and Hearing Specialists”. St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Page 9 The manager started work at the home in January 2009. Since then she says she has revised the pre admission process. One person has moved into the home since she started work at St Leonards, we were able to see the current pre admission assessment whish was used for this individual. There was information on current needs and previous medical history. We saw that areas had been identified to be followed through in the care plan and as part of the admission to the home. For example ‘body map to be carried out on arrival and pressure sore risk assessment to be put in place’ ‘has glaucoma, eye drops wears glasses, check last eye test’. There was information under ‘requests and comments by client’ and we saw this individual had requested to see hairdresser and chiropodist and their likes and dislikes for meals. We saw that there was a ‘list of arrangement to be in place either before the individual arrived at the home or when they arrived; for example ‘arrange appointments for hair and feet’, ‘check last eye test’, ‘weight and nutritional assessment to be carried out’. On the day of the visit a gentleman was viewing the home prior to the manager going to visit his wife, he was happy with the information that the home had given him. St Leonards Residential Home DS0000072993.V375738.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 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 care plans detail the needs of the individual and support staff are to give. However medication records and administration within the home are not always carried out in safe manner to protect the people who use the service. Staff working practice helped to ensure that the privacy and dignity of people who use the service is promoted. EVIDENCE: The AQAA from the home stated that:”Client’s needs and preferences are regularly assessed to ensure the plan of care meets their needs. Clients have full access to met their health and personal needs including regular visits from hairdressers, district Nurses, speech and language therapists, chiropodist, dentists, hearing specialists and GP’s (clients are given choice of GP). Support given to clients whom have continence issues and whom are at risk and have developed any pressure sores, professional support and advice is obtained from relevant professionals. Clients are treated with privacy and dignity and at St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Page 11 St Leonards we tried to maintain a homely atmosphere whilst ensuring that clients are treated with respect at all times”. Under how the home can evidence the AQAA said: “Records and details are kept of all service visits, GP and DN visits to each individual client. Clients records are detailed with clients care records on continence and pressure sore risk assessments. Care plans are updated on a regular basis and are updated frequently to meet clients changing needs. A client whom has hospital visits for the dentist is supported, by arranging an additional member of staff to accompany and support the client and the family at the appointment”. Where the manager felt the home had improved recently the AQAA said: “Members of staff have been enrolled on the Safe Handling of Medication Course. A centre person approach has been maintained by introducing a key worker system. The key worker placed with the client has been thought through so that the client’s needs are met, as members of staff have differing experience and abilities. Key worker forms have been set up to record any major concerns one of their roles is to provide them with things like shopping that they request or inform members of the family of their requests depending on the financial arrangements of the client”. We looked at three care plans one for the person whose pre admission we had seen and two others. We saw in front of each file a list of staff names, with staff to sign to say that they had seen and were aware of the contents of the care plans. We saw that from the list on the pre admission assessment of issues that were to be in place or undertaken when the individual was there that issues had been followed through. We saw that an appointment had been made for chiropody two weeks after admission to the home. The care plans described what the individual could do independently and areas that they may need support with for example; “will walk using walking frame, can walk unassisted and independently – does however require support to come down and up using the lift”. We noted that the person had been weighed and that a nutritional assessment had been carried out and the risk was low. We saw that individuals were supported to continue interests for example ‘likes to write letters’ the individual has memory loss and still likes to write it was seen that she had access to a pen and paper. There were risk assessments in place for the individuals for example: slips, trips and falls, hot liquids, moving and handling, medication and mental well being. The risk assessment looked at identified hazard, is client exposed, level of risk measures to reduce risk and further action needed. Following the raising of a safe guarding adults alert recently, social services had been to the home and looked at the recording of needs for individuals; they had recommended that a night care plan be put into place to support both St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Page 12 the individual and staff. The manager had actioned this on the care plans we saw. We saw that the home was supported in caring for individual needs by support from community psychiatric nurses. The manager also has made referral for the home to be assessed for one individual under the Deprivation of Liberty policy, (under the Mental Capacity Act). We looked at the medication storage and administration records. The medication trolley is secured to the wall in the downstairs bathroom. We saw in front of the medication administration records (MAR) that staff sign to accept the handover of the medication trolley and storage keys. We saw that there are assessments in place to support individuals to carry on looking after and administering their own medication and that they had signed the assessments. We saw that one individual is prescribed Gaviscon ‘as directed’ we looked at the bottle it said take ‘as directed’, there were no instructions regarding this medication. We saw that where there was a choice of dosage, for example 10mls or 15mls, it was not always recorded what staff had given. There were gaps where there was no indication of whether the medication had been offered, taken or refused. We saw that for one person had Paracetamol was prescribed to be given i/ii four times a day as required. In black pen it was written that at 08:00 two tablets were to be given and one at 22:00. We saw that a cream was to be administered at night and ‘O’ was recorded which related to ‘other’ on the MAR key, there was no reason written as to why this medication had not been applied. One individual is prescribed a medication to be given weekly we saw that fro 6th 2009 was no signature. The manager said that they currently have no Controlled Drugs at the home. St Leonards Residential Home DS0000072993.V375738.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 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 who use the service participate in activities appropriate to their age, peer group and cultural beliefs as part of the local community. Dietary needs are well catered for with a balance and varied selection of food available that meets individual dietary requirements and choices. EVIDENCE: The AQAA for the home said: “We provide a varied programme of activities such as Music and Movement, music and visits from the local church including seasonal activities such as Easter activities, Bonnet Making, Easter Communion, Designing Easter Eggs with Art and Crafts and having an Easter Party for all clients and their relatives and friends. The latter supports clients to maintain contacts. We have just set up a book case within St Leonards for the use of all our clients we have also obtained large print bibles that have been given to all clients whom wanted one. A copy of this is also in the bookcase. We have an open policy where friends and family can visit at any time; they are given the choice to ensure that their visit is private and can visit their St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Page 14 friend in their own room or in a quiet area of the home if available or with weather permitting in the homes grounds”. The home has access to a hire bus and driver, which comes in two sizes they book the one needed. It has adaptations for ease of access. They recently went to Slindon to see the bluebells people living at the home commented that it was nice to get out and about. At a recent residents meeting, requests were made to go to Scotland, to have Morris dancers at the home and to go to a garden centre. The manager showed that she had tried to get Morris dancers to visit the home for someone’s birthday but had been unsuccessful. She has found a garden centre with restaurant for a visit soon. We saw photos of the trip to the blue bells on the notice board along with photos of Easter bonnets. The notice board had a picture of foods that were eaten at the last international day at the home. We saw a list of dates and international themes, the week of the visit the home was having an American day with hats and foods from the country. A special menu is designed for the days and on display on the dining tables. We spoke with the staff member in the kitchen who said that he had is food hygiene certificate. He explained that whilst the menu does not offer a choice if when people see what is for the meal they can ask for anything lese. On the day of our visit the meal was liver and bacon and chocolate mousse. We saw from the records that one individual requested fish fingers and crème caramel and another asked for ice cream for their pudding. For tea there were fish fingers and tomatoes, cake, fruit or yoghurt we saw that one person had asked for crackers and these would be four with pate and four filled. People at the home said that they liked the food and could have what they wanted. Surveys we received said that: “Care is exemplary with friendly helpful staff”. “The home communicates with residents and relatives. Their attitude is friendly and happy but respectful of residents. Listens to their comments well”. “St Leonards is of a very high standard in every aspect; cleanliness, good nourishing food, caring friendly staff and a homely atmosphere. All receive a god standard of care. None is forgotten and the feeling that they matter a great deal is with them”. St Leonards Residential Home DS0000072993.V375738.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 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 complaints procedure enables those people using the service to know that any complaints will be taken seriously and responded to. People living at the home are safe guarded by the homes safe guarding adult’s procedures. EVIDENCE: The AQAA for the home said: “A Copy of the complaints procedure is on display in the main entrance to the home and a copy of the complaints procedure is on the client’s notice board. Ensure that the required paperwork is in place prior to employment of new staff including a POVA Check. We ensure that we keep records relating to clients money that is held at St Leonards. We have copy of the Sussex Procedures for Safeguarding Vulnerable Adults available”. The home has complaints procedure, which are outlined in the Statement of Purpose and Service User Guide and on display in a number of places around the home including on a notice board above the visitors signing in book. It includes the timescale of response and the address of CQC. The home’s safe guarding adult’s policy was observed to have been regularly updated and included the West Sussex Multi Agency Adult Protection flow chart St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Page 16 on how to report suspected abuse. The manager told us that two safeguarding referrals had been made to social services in the past few months. The result has led to what she feels positive action; for one social service advised that night care plans be considered , the manger has put them in place and the second ensured that an individual had their needs re assessed for a more appropriate placement. St Leonards Residential Home DS0000072993.V375738.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 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 clean, well maintained and offers people a comfortable, pleasant, environment to live in. EVIDENCE: The AQAA for the home said under ‘What we could do better’:” Improve the maintenance of the home over a period of time. To ensure that home meets all fire service regulations of which are currently being arranged by the owner to ensure a safe office working environment”. For ‘How we have improved’: “New fencing has been put up around the perimeter of the building. New hand towel and soap dispensers fitted around the home. Fireco door guards to four of our doors. Looked into replacing old call bell system”. Lastly for ‘Plans for next twelve months’: “The contract for a new call bell system has been signed with Courtney Thorne, which will allow clients more flexibility with the new call bell St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Page 18 system as is portable within their rooms. This is yet to be fitted therefore put this in the plans for improvement box. To complete all doors with Fireco guards. Allocate a permanent office space by providing a suitable partition to meet Fire Regulations”. The home was seen to be clean throughout, we noted a strong malodour in whilst we with the manager upstairs in the afternoon staff managed this. When we walked about the home we saw that rooms are centrally heated, all radiators and pipe work are covered. Windows are fitted with restrictors where necessary and emergency lighting is provided throughout the home. Laundry facilities are sited away from areas where food is prepared and stored. We saw records indicating that staff regularly test the water temperatures and that there are risk assessments in place. A cleaner is employed at the home and she works three days a week, care staff clean when necessary at other times and do the laundry at the home. St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Page 19 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): 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. Current recruitment practices at the home help to protect the people who use the service. Staff have not received all the mandatory training that is expected each year, whilst they have in other areas so that people who use the service are not always protected by safe practices. EVIDENCE: The AQAA for the home said: “All staff that we employ have undergone a POVA and CRB check. Staff training is up to date and members of the staff carry out additional training apart from mandatory training. We ensure that there are sufficient numbers of staff on shift that are appropriate to the needs of the clients, and additional staff are put on the staff rota to meet any clients additional needs. All care staff are trained to at least NVQ Level 2 except one member of staff of whom is a retired mental health nurse”. One person has been employed to work at the home recently and we saw that there were two references, from friends, there was evidence that a CRB and POVA First had been carried out and they were dated before the employee commenced work at the home. We saw that the individual had completed a foundation questionnaire and was due to complete the induction questionnaire. St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Page 20 An appraisal had been carried out in June 2009. All staff information is kept at the home in locked cabinet in the manager’s office. We looked at the training file and sampled ten files we saw that five staff had completed training for fire safety, food hygiene, first aid and infection control since February 2009. We saw that some staff had not received fire training since august 2008 and manual handling training was last carried out in April 2008. We asked the manager about the manual handling training and could see in the diary and on a poster that training had been arranged for June 2009. Staff said that they had been expecting to go on training for manual handling and that it had been cancelled. This was confirmed by the manager who said that the registered provider wanted to use a trainer from another home. This training is yet to be arranged. We looked at the rotas for the home and saw that the manager works a variety of shifts depending on the needs of the home. Her contract is for thirty hours the rota indicated that she worked more. We saw a list of staff with first aid and it seemed there was one on each shift. The home does not use agency staff preferring to cover with the homes staff. Staff confirmed that since the manager began work at the home they have undertaken training in mandatory areas and in medication administration, sensory deprivation awareness and three staff including the manager have undertaken a dementia course at the local college. St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Page 21 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): 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. The systems and procedures monitor and maintain the quality of the service provided and which, promote the safety and welfare of those living and working in the home. EVIDENCE: The AQAA for the home said: “St Leonards has a new acting manager who is waiting to be registered, and is completing her NVQ Level 4 with Chichester College. She has updated and introduced new and revised policies and procedures as well as risk assessments. She has improved the recording and reporting system for all clients with records regularly being updated and reviewed. All clients are supported to maintain their financial affairs with the St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Page 22 home holding some of the client’s own money. We ensure that these records are maintained detailing receipts and individual transactions. All policies and procedures have been updated and revised and improvement made to the clients recording and reporting system. All policies and procedures are available to all members of staff and these are located in the office. All clients care plans are available in the office. All clients’ personal money is kept separately and locked away, with each client having their own petty cash tin and relevant books for recording purposes”. We saw that the certificate related to the home’s registration was displayed in the hallway and displays the details of the core registration for the home. The registered providers have appointed a manager for the home and she showed us that she has begun the application to the commission for registration; she is awaiting the return of her CRB. The registered provider for the home is Cheylesmore Ltd with the responsible individual as Trevor Streten. We saw that the manager has undertaken staff and resident meetings. The residents commented on food, staff, activities and the homes environment. The staff meeting looked at the medication administration and care plans. The manager said that she has sent quality assurance surveys to family and representatives of people living at the home. On the day of our visit we saw that the home looks after seven people’s monies with the family looking after the other persons. We sampled three and found that there were receipts and incoming and outgoings were recorded. We saw the policies available to staff and that new ones have been introduced as necessary for example management of violence and aggression and missing persons. We looked at the records for fire safety training and monitoring of equipment we saw records that indicated that fire safety equipment has been tested regularly. Although fire training has been offered every six months, records showed that staff have not received training twice yearly. St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Page 23 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 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 The registered person must ensure that medication is administered at the times and in the amount that it has been prescribed, or are reviewed to ensure appropriate medication is given. This will ensure that the individual receives the correct medication and helps to monitor their health. The registered person must ensure that a record is kept of the amount of medication that is given where there is a variable dosage and why and when an ‘as required’ medication is given and its effect. This will ensure that the individual receives the correct medication and helps to monitor their health. The registered person must ensure that all staff receive training in mandatory areas: moving and handling. The registered person must DS0000072993.V375738.R01.S.doc Timescale for action 13/07/09 2 OP9 13(2) 13/07/09 3 OP30 13(5) 13/07/09 4 OP38 23(4)(d) 13/07/09 Page 25 St Leonards Residential Home Version 5.2 ensure that staff receive training in fire safety to protect staff and people who live at the home. 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 St Leonards Residential Home DS0000072993.V375738.R01.S.doc Version 5.2 Page 26 Care Quality Commission South East The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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