Care Home: The Briars

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What the care home does well The Briars provides people that use the service with a warm, lively, friendly and comfortable environment. The home has a welcoming atmosphere and people that use the service are well looked after. Staff have the skills and experience necessary to meet the needs of people living at the home. Staff were observed to be good listeners and communicated well with people that use the service. People can lead their own lifestyle and choose the things that they want to do. People said that the food is good and that they can choose what they want to eat. One person who uses the service said, "I can choose what I want to eat". The home is well managed and run in the best interest of people who live there. One person said, "I like it here everyone is nice" another said, "It is good here, all the staff help me. My friend comes round to see me". What has improved since the last inspection? The lounge and dining room areas were being redecorated at the time of the inspection visit. The home has purchased a medication cupboard in which to store controlled medication and a medication fridge to store medication requiring cool storage. The manager has updated general risk assessments. What the care home could do better: The homes recruitment procedure is not as robust as it should be. People do not fill out an application form detailing qualifications, employment experience/history and suitability to the vacant post. The manager does not always apply for references herself she has accepted references which staff have obtained/brought to interview. The manager needs to develop a medication competency assessment for staff to help to ensure that care staff handle and administer medication safely. Medicines supplied to the home in a nomad system need to have a description of medication supplied so that staff can check and help to ensure that people get the right medication. Medication Administration Records need to be kept up to date and only detail medication that the person is currently prescribed.The BriarsDS0000000096.V377551.R01.S.doc Version 5.3 The manager should be in receipt of a POVA first check and satisfactory Criminal Record Bureau check prior to commencement of new staff. The manager should ensure that she has the skills, experience and up to date knowledge to be able to provide fire training to staff working at the home. The manager should follow health and safety guidance and take the temperature of hot water outlets on a weekly basis. Key inspection report CARE HOME ADULTS 18-65 The Briars 24 Pearl Street Saltburn-by-Sea TS12 1DU Lead Inspector Katherine Acheson Key Unannounced Inspection 14th September 2009 10:00 The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 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. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 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 The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION Name of service The Briars Address 24 Pearl Street Saltburn-by-Sea TS12 1DU 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) 01287 622264 marin.game1@ntlworld.com Mr V Game Mrs M Game Mrs Marin Game Care Home 4 Category(ies) of Learning disability (4) registration, with number of places The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: 2. Learning disability - Code LD, maximum number of places: 4 The maximum number of service users who can be accommodated is: 4 19th September 2007 Date of last inspection Brief Description of the Service: The Briars is registered to provide personal care to a maximum number of four people who have a learning disability. The home is situated in a residential area of Saltburn. The Briars is a singlefronted, Victorian terraced house, which blends in well with the surrounding properties. There is a small garden to the rear of the property. It is close to shops, community facilities and a short distance from the seafront and Valley Gardens. Accommodation is provided in four large single rooms, each containing a wash hand basin. Communal facilities consist of a comfortable, family style lounge, a dining room and a kitchen. The dining room is a large functional room, which is also used as an activities room and people have access to all domestic facilities. At the time of the inspection the fees charged by the home ranged from £425.65 to £575.98 per week. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Quality rating for this service is two star. This means that people who use the service experience good quality outcomes. We have reviewed our practice when making requirements to improve national consistency. Some regulations from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at risk or harm. In future if a requirement is repeated it is likely that enforcement action will be taken. Before this inspection visit we looked at all of the information that we have received since the last inspection of the service on 19th September 2007, and the last annual service review on 19th September 2008. This unannounced key inspection took place on 14th September 2009. The inspection started at 10:00am and finished at 5:25pm The reason for the inspection was to see how good a job the home does in meeting the national minimum standards set by the Government for care homes. Numerous records were examined including care records of people living at the home, medication records, risk assessments, complaints and staff records. We looked around parts of the home to make sure that it was clean, safe and comfortable. Requirements and recommendations highlighted at the last inspection were revisited to see if improvements had been made. During the visit we talked with people who use the service, the manager and staff. Before the inspection surveys for people that use the service and staff were sent to the home for the manager to distribute accordingly. Surveys sent to people that use the service were asked to comment on care received. Surveys sent to staff were asked to comment on what it was like working at the home and training. We received four surveys from people that use the service; staff had helped to fill them in. We received three surveys from staff. The manager was informed of the findings of the inspection. Requirements and recommendations identified as a result of this inspection can be found at the back of the report. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The homes recruitment procedure is not as robust as it should be. People do not fill out an application form detailing qualifications, employment experience/history and suitability to the vacant post. The manager does not always apply for references herself she has accepted references which staff have obtained/brought to interview. The manager needs to develop a medication competency assessment for staff to help to ensure that care staff handle and administer medication safely. Medicines supplied to the home in a nomad system need to have a description of medication supplied so that staff can check and help to ensure that people get the right medication. Medication Administration Records need to be kept up to date and only detail medication that the person is currently prescribed. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 7 The manager should be in receipt of a POVA first check and satisfactory Criminal Record Bureau check prior to commencement of new staff. The manager should ensure that she has the skills, experience and up to date knowledge to be able to provide fire training to staff working at the home. The manager should follow health and safety guidance and take the temperature of hot water outlets on a weekly basis. 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. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standard assessed 2 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. Assessments of people who are to use the service are carried out before they move into the home to ensure all needs can be met. EVIDENCE: The manager said that people who are to use the service are assessed before coming into the home. They firstly receive an assessment from a Social Worker and/or other health care professional. People are also encouraged to visit The Briars before they move in. The Manager said that this gives the person a chance to meet staff, other people living at the home and have a look round. The manager said that there has been one new person who has come to live at the home since last inspection of the service. She said that this person was invited for tea and then for an overnight stay. People who are to use this service are offered a trial period of up to six weeks. At the end of the trial period a review takes place to make sure that the placement is both successful for the person using the service and the home. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 10 It was highlighted at the last inspection of the service that the manager should produce a guide for people who use the service in a format that can be easily understood. The manager said that she has done this. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 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): Standards assessed 6, 7 and 9 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 us the service are involved in everyday decisions and choices about their lives. Plans of care reflect needs to ensure that people receive the care and support required. EVIDENCE: Care plans are records that are used by all care services to show what sort of help each person needs and how staff will provide that care. The care files of two people that use the service were looked at during the visit. Assessments and care plans examined contained excellent detail about the person, including help needed, areas of risk, likes, dislikes and help needed to promote independence in each activity of daily living. Care plans were The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 12 written in a sensitive and respectful way which promotes the individuality and preferences of each person. Care plans were evaluated on a regular basis. One plan of care looked at during the visit contained good detail on how to support a person when they became anxious. Another plan of care for personal hygiene and grooming detailed the preferred hair styles of the person and clothes that they liked to wear. Care plans were not user friendly or contain pictures to aid understanding and communication. The manager said that people have verbally expressed how they would like to be supported, however, have no interest in looking at the actual plan of care. She said that if a person did express a wish to look at their plan of care staff at the home would help to make the plan of care user friendly so that it could be understood by the person. It is evident following discussion with people that use the service and staff that the manager and other staff working at the home know the people they are caring for extremely well. Indirect observation on the day of the inspection showed that The Briars is a friendly, homely and lively place to live. People who use the service are encouraged and supported to take responsible risks. An example of this being one person goes out independently after tea to a local social club that organises activities for people who have a learning disability. This person is picked up by the Dial a Ride service about 5:15pm and brought home later on in the evening. People living at the home were spoken to during the visit said that they liked the staff and living at the home. Comments made included, “I like it here” and “Everyone is nice to me”. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: Standards assessed 12, 13, 15, 16 and 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are enabled to make choices about their life style and are supported to develop their life skills. Social, educational and recreational activities meet individual’s expectations. Food provided is nutritious, varied and enjoyed by all, this helps to ensure wellbeing. EVIDENCE: Files of people that use the service that were looked at during the inspection contained a care plan about what they liked to do in their leisure time. People spoken to during the inspection visit said that they can spend their leisure time doing what they want to do. One person said how they liked to watch war films and liked to collect memorabilia associated with war. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 14 People are encouraged and supported to maintain practical life skills. The manager said that people like to make drinks, snacks and bake cakes. People are supported and accompanied to go out into the local community. One person likes to go the barbers. People regularly go the library or local pub for a drink and a meal. Two people like to go to the hairdressers in Redcar. The manager said that people that use the service have enjoyed recent trips out to Kirkleatham museum, Whitby, Redcar and Middlesbrough. People that use the service have just returned from a four day/night holiday in Wolsingham. The manager said that everyone had enjoyed staying in a barn conversion. She said that during the four day break people enjoyed a trip out to Beamish Museum and Barnard Castle. Families and friends are made to feel welcome. One person regularly has their friend for tea. A lengthy discussion took place with the manager regarding equality and diversity. The manager demonstrated through discussion an in depth knowledge. She informed how she does and would support relationships in the home. On the day of the inspection visit two people were at their day placements and two residents were at home. During the inspection visit one person went to the library and another for a walk to the sea front. The manager said that staff are helping people to make a puppet theatre and that one person liked to play the game frustration. The manager described the home as, “Happy where people understand each other”. At the time of the inspection visit people that were using the service were not expressing a wish to practice their religion. The manager said that if anyone wanted to go to church staff would support this. People said that they could get up and go to bed when they liked. One person said that they liked to spend time in their bedroom. During the inspection people sat in the kitchen area chatting with staff. Observation showed that staff communicated well with people that they were caring for and understood their needs well. People that use the service are supported to continue their education. One person had been on a cookery course at college. At the time of the inspection staff were looking to find a suitable craft course for a person to enrol on. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 15 One staff member spoken to during the visit said that people enjoy the main cooked meal on a tea time and a snack at lunchtime except for Sunday when everyone has their main meal at lunchtime. The main meal at teatime is chosen on a daily basis by people who use the service. On the day of the inspection visit one person said, “Tonight I have chosen shepherds pie, I like that”. The home keep a record of food served examples of food served included, mince and Yorkshire puddings, chicken and vegetables, fish in sauce, bacon grills and chips and roast beef. One person spoken to said, “I like the beef that is always nice” another person said, “we always have good food”. The home provides people who attend day services with a packed lunch. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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): Standards assessed 18, 19 and 20 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 health and personal care that people receive is based on their individual needs. Support provided is flexible, consistent, reliable and responsive to their changing needs. Some improvement is needed in medication recording and medication competency assessments to ensure safe practise. EVIDENCE: People who use the service are involved in planning their care and enabled to make day to day decisions about their life. Times for getting up/going to bed, meals and other activities are flexible. One person spoken to said, I like to get up at about 6am”. Staff were observed to promote the independence of the people whilst respecting people’s preferences and dignity. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 17 People are supported and enabled to choose and purchase their own clothes and hairstyle which reflects their own personality. People are supported to visit the chiropodist, dentist and GP. The Manager said that all care staff who are responsible for administering medication have received training and have had their competency checked. Discussion with the manager highlighted that the home do not have any formal competency assessment for staff who administer medication. The manager said that she watches staff give out medication and if she thinks that they are competent records so in their supervision records. A discussion took place with the manager about developing a medication competency assessment to assess/test that staff possess up to date relevant knowledge about the actions and uses of medicines in the care home, understand how to handle medicines safely, ensure good record keeping and follow safe practice. Appropriate records of medication coming into the home and that returned to pharmacy are kept. Since last inspection the home have purchased a controlled drugs cupboard and lockable fridge in which medicines requiring cool storage can be kept. Medications are supplied to the home on a weekly basis. Medication is dispensed by the pharmacist in a nomad system. The nomad provides seven days supply of medication in a cassette. When this medication comes to the home from the pharmacy staff need to look on the back of the nomad for the description of the medication that has been supplied and make sure that it matches that medication that is contained within the nomad for that week. Nomads looked at during the visit did not detail a description of the medication supplied. It was also observed that some medication detailed on Medication Administration Records (MAR) had not been signed for as given. When staff were asked about this they said that it was because medication had been discontinued. One MAR chart detailed that a person should have a medicine three times daily, however the MAR Chart was not signed three times daily. Staff said that this was because the person was actually meant to have the medicine just when needed not three times daily. The manager said that she would contact GP surgeries to update their computer systems with current prescribed medication for people who use the service. She said that once this had been done the pharmacy would correct the Medication Administration Records. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 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): Standards assessed 22 and 23 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 are confident that their complaints would be listened to, taken seriously and acted upon. Staff working at the home receive adult protection training which will help to ensure the safety of people living at the home. EVIDENCE: The home has a complaints procedure, which is understood by people who use the service. There have not been any complaints made in the last twelve months. People who use the service said that they would feel comfortable in raising any concern that they have with staff and that it would be acted upon. The manager said that the home have an adult protection procedure that details action to be taken and who to contact if abuse is suspected. The manager said that staff have completed adult protection workbooks/training that were provided by Redcar and Cleveland Borough Council. She said that she has provided regular adult protection updates to staff working at the home. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 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): Standards assessed 24 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment is good providing people that live there with an attractive, homely and comfortable place to live. EVIDENCE: The Briars is a single fronted, Victorian terraced house that is situated in a residential area of Saltburn. The home is close to shops, community facilities and a short distance from the seafront and Valley Gardens. The home is registered to provide care to four people who have a learning disability. The manager/provider lives on the premises. There is a good sized lounge, dining room and a separate kitchen. At the time of the inspection visit the lounge and the dining room were being redecorated. The manager said that people The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 20 that use the service had chosen the colour of the paint for the lounge and dining room. Bedrooms for people are on the first and second floor of the home. Each person has their own bedroom. Bedrooms are a good size and individually decorated according to taste. Domestic laundry facilities are available on the ground floor of the home. There is an enclosed garden/patio area for people who use the service. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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): Standards assessed 32, 34 and 35 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. Staff have the skills and experience to meet the needs of people living at the home, however not all staff have received mandatory training as often as they should have. The homes recruitment procedure is not as robust as it should be and as such does not help to protect people living at the home. EVIDENCE: Staff have the skills and experience necessary to meet the needs of people living at the home. Staff on the day of the inspection were observed to be good listeners and communicators. Five out of six care staff working at the home have achieved a minimum qualification of NVQ Level 2 in Care. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 22 The manager said that from Monday to Friday from 7:30am until 3pm she is on duty with another care staff member. She said that at all other times there are two staff on duty all of the week up until 8:00pm. From 8:00pm the manager looks after people who use the service until they go to bed. The manager said that she can be woken by any person if needed during the night. At times when the manager is on holiday another care staff member works. Examination of records highlighted that the homes recruitment procedure is not as robust as it should be. The manager advised that any job vacancies are advertised at the job centre. She said that when people come for interview she completes an interview form and asks them who is their current or who was their last employer. People do not complete an application form, which would inform of the persons qualifications, employment experience/history and detail suitability to post advertised. One Staff file looked at during the visit was that of a care staff member who started working at the home on 1st September 2009 evidence was available to confirm that a POVA first check had been received prior to commencement of employment, however although a Criminal Record Bureau Check had been applied for she had not received a reply. The interview form completed by the manager was not dated; however stated the last employer for the person. Two references were on file for this person. One was that from the last employer; however this was not dated so we were unable to determine if the reference had been received prior to the commencement of employment. The second reference for this person was dated May 2009 which the manager informed the staff member had brought with her. The manager was advised that she must apply for references to ensure that a robust recruitment procedure is followed. All new staff complete induction training, however this did not meet with the required standard. The manager was informed that all new staff who are not trained to NVQ level 2 in Care should complete an induction that meets with that set by Skills for Care. The manager advised in an e-mail and telephone call on 17th September 2009 that she had developed the homes induction to meet with that as set by skills for care and that the new care staff member who did not have an NVQ level 2 had commenced the induction. Records were examined to confirm that staff do receive mandatory training such as fire, moving and handling, first aid and health and safety; however some training for some staff was out of date. The manager advised after the inspection that she was in the process of arranging the required training for staff. Fire training is provided by the manager; however the manager has not been on recent training that would qualify her to provide the training. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 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): Standards assessed 37, 39 and 42 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 well run and managed in the best interest of people who use the service. In general the health, safety and welfare of people that use the service is promoted. This could be improved by regular testing of hot water temperature outlets to ensure safety and prevent scalding. EVIDENCE: The owner/manager has many years of experience of working in a residential care home setting. She is both experienced and qualified. People that use the service said that they could talk to the manager if they have a problem. One The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 24 person said, “She is lovely and easy to talk to” another person said, “I can talk to any of the staff about anything”. The manager said that with The Briars being small and her living and working at the home she is able to chat with people who use the service on a regular basis to make sure that they are happy. She said that in the past she has asked people to complete surveys, however does not think that such surveys are necessary or useful in such a small home. People who use the service are encouraged to speak openly about the home and raise any concerns that they may have. The manager said that since last inspection of the service she has reviewed and updated all general risk assessments. Records were available to confirm that on average weekly tests of the fire alarm system are carried out and that regular drills take place which involve both staff and people who use the service. The manager said that all staff and people that use the service are involved. The manager said that water temperatures of bath water is taken before people get into the bath to ensure that it is not too hot, however staff do not take and record temperatures of hot water outlets of sinks, baths and showers. The manager was advised of health and safety guidance in which regular testing of hot water outlets should take place to ensure safety and avoid scalding. A sample of health and safety records were examined and found to be in order. Records were available to confirm that the homes gas boiler and fire extinguishers had been serviced in the last twelve months. The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 X 3 X X 2 X Version 5.3 Page 26 The Briars DS0000000096.V377551.R01.S.doc No Are there any outstanding requirements from the last inspection? 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 YA34 Regulation 17 Requirement The manager must ensure that she follows a robust recruitment procedure. People must complete an application form, which informs of qualifications, employment experience/history, gaps in employment and detail suitability to post advertised. This will help to ensure that people are matched to the correct jobs and help to protect the health and welfare of people living at the home. The manager must apply for and be in receipt of two written references prior to the commencement of new staff. Where possible one reference must be from the last employer. This will help to ensure that a robust recruitment procedure is followed and that people are protected. Timescale for action 14/09/09 2 YA34 19 14/09/09 The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA20 YA20 Good Practice Recommendations The manager should develop a medication competency assessment tool/checklist. To help to ensure that care staff handle and administer medication safely. The manager should ensure that medicines supplied to the home in a nomad system have a description of medication supplied to help to ensure that people get the right medication. The manager should make sure that Medication Administration Records are kept up to date and only detail medication that the person is currently prescribed. The manager should be in receipt of a POVA first check and satisfactory Criminal Record Bureau check prior to commencement of new staff. This will help to ensure that a robust recruitment procedure is followed and people are protected. The manager should ensure that staff working at the home receive regular mandatory training to protect the health and welfare of staff and people living at the home. The manager should ensure that she has the skills, experience and up to date knowledge to be able to provide fire training to staff working at the home. This will help to promote safety. The manager should follow health and safety guidance and take the temperature of hot water outlets on a weekly basis. 3 4 YA20 YA34 5 6 YA35 YA42 YA35 YA42 7 YA42 The Briars DS0000000096.V377551.R01.S.doc Version 5.3 Page 28 Care Quality Commission Care Quality Commission North Eastern Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.northeastern@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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