Care Home: The Turner Home

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What the care home does well The service has staff who have worked in the home for many years, they are given good training that helps the support the people living in the home in a safe manner. Comments such as "they are good at their jobs and pleasant to be around", "staff are here when you need them they don`t get in your face" and "I came to look around the home before I moved in, my family also came to look, we liked what we saw. The staff were very friendly and seemed to know what they were talking about."Medications are particularly well managed and make sure that all the people who live in the home receive the medications that they should in a safe manner. In general people who wish to move into the home have all their needs determined in order to make sure that the staff can support their individual needs and that the service is suitable to meet their needs. The Turner has addressed a requirement from a previous report and no new requirements were made in this report. We made several good practice recommendations only. What has improved since the last inspection? Redecoration has continued in the home and the main areas such as the flooring on the corridors have plans in place to be replaced. This helps to keep the home well maintained and provide the people who live in the home with a welcoming and comfortable environment. Quality assurance that reviews the quality of the service is on going and new audits that look at what the home does well and what areas need to be developed are in place. Questionnaires and meetings for the people who live in the home also provide them an opportunity to say how they want the service to run. What the care home could do better: The service is operating to a good standard and the following are good practice recommendations only. Information in the home is in need of reviewing and developing. Information to people who may wish to move in the home has not been reviewed for some time, care planning that gives information to staff are not always accurate and not always accessed by staff who need to have a clear understanding of how to meet individual needs. Monitoring and direction on the management of wound care also needs to follow best practice guidelines. Further developments that will increase the quality include monitoring on a monthly basis that staffing levels meet the assessed dependency needs of the people who live in the home. Additionally staff supervision that is recorded needs to be in place for all staff and those staff responsible for this need have training in this area. CARE HOMES FOR OLDER PEOPLE The Turner Home Dingle Lane Liverpool Merseyside L8 9RN Lead Inspector Mrs Julie Garrity Key Unannounced Inspection 4th February 2008 10:00 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 The Turner Home DS0000025383.V347693.R02.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. The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Turner Home Address Dingle Lane Liverpool Merseyside L8 9RN 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 727 4177 0151 727 7788 The Turner Home Mrs Alison Charlesworth Care Home 59 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10), Old age, not falling within any of places other category (49) The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 49 (N) (OP) Nursing Care or 49 (PC) (OP) Personal Care for older people (OP)aged from 55 years in an overall total of 49 Male individuals only. 10 (N) or 10 (PC) mental disorder elderly (MD/E) aged from 55 years in an overall number of 10 Date of last inspection Brief Description of the Service: The Turner Home is located in a unique building in the Dingle area of Liverpool, close to the city centre and with local amenities and local public transport routes to the city centre and surrounding areas. The main house was built 1880 a new purpose built extension was added in 1995. The home now provides single room accommodation (most with en-suite facilities) for 59 people. There are several lounge areas, a dining room, a chapel and rooms for recreational activities. A designated smoking area is provided. The building is set in large private grounds that are well maintained. As the home has its own chapel, a weekly service is held for those people living in the home who wish to attend. A number of car-parking spaces are available for visitors at the front of the home. The home is owned by a charity and does not own any other homes. Fees for accommodation at the home range from £281.50 - £599.98 this depends on the needs of the individual. The Turner Home DS0000025383.V347693.R02.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. Prior to the site visit taking place we (the commission) asked the manager to complete a document called an AQAA. This is a document, which gives information about the services strengths and weakness, and future plans for the service to develop. This site visit was carried out over a period of one day. We arrived at the home at 10:15. A total of 7 hours 5 minutes was spent at the site visit. We spoke with 2 relatives, 8 people who live in the home and 9 staff. The inspector completed the inspection by a site visit to The Turner Home, a review took place of many of the records available in home and our offices. Records viewed included care plans, medications, staff files, staff training, individual records records, menus, audits, activities, statement of purpose, service users guide, the homes policies and procedures and daily records. We followed an inspection plan written before the start of the inspection to ensure that all areas identified in need of review were covered. All of the Key standards were covered in this inspection, these are detailed in the report. Feedback was given to the manager at the end of the site visit. The arrangements for equality and diversity were discussed during the visit and are detailed throughout this report. Particular emphasis was placed on the methods that the home used to determine individual needs, promote independence and support to make informed decisions in line with individual choices. What the service does well: The service has staff who have worked in the home for many years, they are given good training that helps the support the people living in the home in a safe manner. Comments such as “they are good at their jobs and pleasant to be around”, “staff are here when you need them they don’t get in your face” and “I came to look around the home before I moved in, my family also came to look, we liked what we saw. The staff were very friendly and seemed to know what they were talking about.” The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 6 Medications are particularly well managed and make sure that all the people who live in the home receive the medications that they should in a safe manner. In general people who wish to move into the home have all their needs determined in order to make sure that the staff can support their individual needs and that the service is suitable to meet their needs. The Turner has addressed a requirement from a previous report and no new requirements were made in this report. We made several good practice recommendations only. What has improved since the last inspection? What they could do better: The service is operating to a good standard and the following are good practice recommendations only. Information in the home is in need of reviewing and developing. Information to people who may wish to move in the home has not been reviewed for some time, care planning that gives information to staff are not always accurate and not always accessed by staff who need to have a clear understanding of how to meet individual needs. Monitoring and direction on the management of wound care also needs to follow best practice guidelines. Further developments that will increase the quality include monitoring on a monthly basis that staffing levels meet the assessed dependency needs of the people who live in the home. Additionally staff supervision that is recorded needs to be in place for all staff and those staff responsible for this need have training in this area. The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 7 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. The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 8 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 The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 9 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who want to move into the home are given enough information to help them decide if they want to move in or not. The service makes sure that all people are assessed before they move in to make sure that they can meet their needs. EVIDENCE: Records viewed show that people have their needs assessed before they move into the home. This includes assessments from external professionals that provide the staff with enough information to help them decide if they can meet individual needs. Written information is available that explains what services are available in the home. The manager is intending to update this and make it available in different forms, such as large print to support people with different needs. The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 10 People spoken with told us that, “I came to look around the home before I moved in, my family also came to look, we liked what we saw. The staff were very friendly and seemed to know what they were talking about.” And “ someone came to see me before I came here, I didn’t really want to move to a home, but this is the best of them. I like it here now and am really glad I moved in”. This shows that people are given opportunities and information to make a decision about whether they wish to live at the home and the staff team have enough information to be able to plan their care and prepare for their arrival. The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 11 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Medications are well recorded, maintained and managed in a safe manner that protects the people living in the home. Care plans that provide staff with good instructions as to how to support individuals living in the home are available. These are not all of the same standard and do not always provide staff with individual and specific instructions. As a result of this staff rely on verbal communication and this means they may pass on information incorrectly and will not always meet individual needs. All the people living in the home feel that they are treated with dignity and that they have good support given to them by the staff. The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 12 EVIDENCE: Each person who lives at the home has an individual care plan. We looked at these and found that the person’s needs had been written down. Instructions as to how to meet their needs was available for the staff to follow. Some of the care plans seen were not of the same quality as others and did not have information that was specific to individual needs. The plans were easy to read, up to date and easy to follow. Staff spoken with read the care plans when someone was admitted but did not look at them again unless prompted to read them. Care plans are available that help staff care appropriately for the people living in the home. These are not always read and do not always provide staff with specific information. Records also showed us that the staff at the home involve other health care professionals such as doctors, specialist nurses, dieticians , chiropodists etc in the care received by people who live at the home. The service has an arrangement with a local GP who attends the home each week in order to make sure that their medical needs can be meet. All people moving into the home are asked if they wish to use the services of this doctor. If they wish to continue to receive care from their previous doctor this is continued. This means that all individuals have a choice about the doctor they wish to look after them. Seven people were spoken with, all had a positive opinion on the support that they received living in the home. Surveys sent to the home all contained positive comments about the care received by the people living in the Turner. Comments made included, “very caring staff”, “fantastic place, I am very happy here, staff are really good they know how to look after me” and “I’ve not seen a care plan but I don’t think they need a plan I have my own routine, get on with my day and staff are there if I need them. What more do I need”. Records at the home showed us that staff need to further develop their skills to monitor the care of wounds, care plans in this area were unclear and did not include best practice guidance such as the grade (a measure of skin damage) or size of the wound. There was only one person with a wound and the development of wounds is a rare event. The manager explained that this was not the accepted standard and would make sure that staff monitored wound care better in the future. The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 13 We looked at how the home manages medicines. In general there were very good records that helped staff give out medications properly, these included good instructions to staff regarding peoples medicines. Medication storage was looked at and this was found to be safe and well organised. We looked at medication records, which showed that the home keep a good record of the majority of medications ordered. The record also includes what medication is received from the chemist when and how it is taken and who gave out the medicines. This is good practice and shows that medications are managed safely. One individual has medications as and when they need, clear instructions as to when to give the medicines and in what circumstances were not available. The manager stated that this would be addressed and included in the persons care plan. All the people living in the home spoke positively of how their dignity is maintained. Comments included that staff have a “lovely attitude”, “can’t do enough for me”, “are always very polite and friendly”. The Turner Home DS0000025383.V347693.R02.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home have a lifestyle that can be active and meets many of their needs. They have a choice of food on a daily basis and enjoy the food that they eat. EVIDENCE: People spoken with believe that they are offered enough activities and that there is always something going on for them to take part in if they choose. Observations during the day showed people who live in the home supported to have a daily routine that suited their choice. Examples included individuals visiting local shops as they wanted, sitting in areas of the home that was their choice or resting in their bedrooms when they wanted to. We looked at records, which showed that a variety of activities are offered inside and outside the home either in small groups or individually. People know what’s going on in the home as information about forthcoming events is displayed in a prominent position. This included monthly parties on certain themes. People spoken with all said that they really enjoy these social events and they have “a great time”, “a lot of fun” and “really appreciate the effort that staff put into the parties”. The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 15 An activities co-ordinator has records that show what activities each individual has taken part in and is in the process of making sure all individual choices and preferences are recorded. The purpose of this is to make sure that each individual has a plan that tells staff how the individual likes to life their life. All people spoken with said that they “enjoy” the food. Comments such as “plenty of choice”, “very tasty” and “If I carry on like this I will get fat”. The chef explained that staff ask the people who live at the home what they would like to eat before the meal takes place. Records were looked at which showed this is common practice. One person said, “The food is really good, there’s always a choice but if you don’t like what’s on offer the cook makes sure there’s something else. I often prefer a sandwich and all I have to do is ask and one is made for me”. Menus are available that explain different diets such as diabetic diet and always offer a choice. Food that has to be softened for people who struggle to eat is dealt with very well with the exception of one person whose food needed to be very soft and this had made presenting it nicely difficult. The manager made arrangements to get a special plate that would make this possible in the future. The Turner Home DS0000025383.V347693.R02.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home and staff feel that if they have concerns they will be addressed. The majority of the staff understand how to make sure that vulnerable adults are protected at all times and how to raise any concerns in this area. EVIDENCE: The manager sends surveys to people living in the home four times a year. One of the questions from this is do you know how to make a complaint. When some one is unsure a member of the staff team goes to speak to them and it’s all explained again. A record of the discussion is kept, this acts as a good prompt and makes sure that all people living in the home are aware of how to raise their concerns. People spoken with said “I don’t have any concerns, but if something is bothering me I speak to the staff and they sort it”, “when I did have a problem it was fixed within hours, that was good enough for me” and “If I needed to say something I am sure I could but I’ve never had a reason too”. Staff records showed that the majority had received training in safeguarding adults from abuse. Two staff spoken with were unclear as to the way that this worked and were unaware of the policy that the home has to safeguard the people who live in the home. A lack of proper understanding may result in staff not responding quickly if an allegation of this nature was made. The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 17 The home has not had to deal with an allegation of this nature and does have access to the policies and procedures that would tell staff how to deal with an event of this nature. All staff spoken with would report any concerns to the manager or the senior staff. This is good practice as it means that the manager can respond and address any serious concerns quickly. The Turner Home DS0000025383.V347693.R02.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Turner is a large building, this is maintained very well. The home has a pleasant appearance in many areas. People living in the home feel that is a nice place to live and they can make their personal space their own. EVIDENCE: The home has a lot of different facilities that can be used by the people living in the home, this includes a smoking area, several lounges, games room, a chapel and a dining area. The manager explained that the dining area is a little small and so they have two different sittings at mealtimes. the choice of time is for each individual to make however those that need more assistance often take the second lunch time so staff can give them more support. The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 19 People living in the home gave permission to look at four different bedrooms all those viewed had been personalised by the person living there and included personal items such as pictures and furniture. All the bedrooms viewed had matching curtains and bedding that gave the rooms a well-decorated look. Comments received were all positive with people saying “I really like my room, its got all my stuff in it” and “its clean, tidy and comfortable I don’t need anymore than that. I sleep well of a night and feel safe living here. I have a key to my room so people can’t just walk in and I can shut the door of a night. My room is a really nice place to be and really feels like it’s my bedroom”. This means that people living in the home are supported to make their bedrooms feel like their own space. All areas of the home viewed where clean and tidy. This is an old building and as such it is not easy to maintain. A handyman is readily available and staff keep him up to date in areas that need maintaining or fixing. Investment to maintain the building could be clearly seen, all the corridors are being redecorated and there are plans for new flooring in many of the bedrooms and the main corridors. The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are recruited in a manner that makes sure that they are suitable to work in the home. Training is in place that helps develop staff skills in order for them to support people who live in the home in a way that meets their needs. EVIDENCE: People who live in the home said that there are “plenty of staff”, “they are good at their jobs and pleasant to be around” and “staff are here when you need them they don’t get in your face “. The manager confirmed that staffing levels are maintained at good levels and that they increase them if they think they need to. The staffing levels are not set by individual dependency needs, but there are plans to do this in the near future in order to make sure that good staffing levels are always available. Staff surveys showed that staff thought that they were well supported and had been given a good induction into the home. They also thought that they had lots of good training. Staff spoken with talked about the training that they had received in the last 12 months this included things such as moving and handling, dealing with challenging behaviour and fire safety as examples. Three staff said that there is other training that they would like such as better understanding of communicating with people with dementia and diabetes. The manager explained that these areas were to be included in future training. The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 21 Viewing staff files showed that all staff are up to do with essential training to promote peoples health and welfare. Examples of essential training are moving and handling people, fire safety and food hygiene (how to manage food safely). Other topics include how to control infection and the protection of vulnerable adults. Nursing staff have also undertaken further specialist training to enable them to keep up to date with current nursing practices. How the home recruits new staff was looked at. All staff have an induction that tells them about the home and what is expected of them. A review of staff files showed that the manager has carried out all the necessary checks to ensure that the new staff member was suitable. The staff files also showed that no one is employed without checking whether they have a criminal conviction first. This helps to keep the people who live in the home safe. The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home benefit from a manager who is experienced and aware of good practice. The service is managed in a manner that takes into account individual interests and protects their financial and safety needs. EVIDENCE: The manager has worked in the home for a substantial amount of years. People spoken with made positive comments about the managers’ ability to manage and some appreciated that she still provides hand on care as well as carrying out administrative duties. The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 23 People who live in the home were spoken with said “she’s lovely, always ready to talk”, “I think she scares the staff but that’s what a good boss does, she doesn’t take any messing from any of them” and “she makes sure that everything gets done properly and always stops for a chat”. The home also employs a deputy manager who manages the home in the manager’s absence. The manager informs the commission of most events that affect the health and welfare of any of the people who live at the home as required by law. Two instances including an outbreak of an infection had not been reported. The manager stated that she would make sure that any incident that affects the welfare of individuals is reported. Meetings are held with the people who live at the home on a regular basis to gain their opinion of what the service is like and whether they would like to see any changes happening. These meetings influence the way that the home is run. The manager also makes sure that surveys are done four times a year as another way of monitoring standards and gaining the individuals opinion. Senior staff at the home support some people to manage their money. All money is held in a separate bank account for the people who live at the home. Records seen showed that individual’s funds were monitored . This means that it is easy to track who spent what money on which day and for what purpose. These records are also audited as part of the monthly managers audit visit. A variety of records and contracts, which relate to the maintenance of the building and its contents were viewed. This included tests on monitoring water temperatures, electrical appliance safety checks, Fire fighting equipment and gas and electrical supply safety certificates. All certificates viewed were current and all records were up to date. The building is equipped to detect and fight fire and all staff have received fire training. An up to date fire risk assessment is in place, which identifies high-risk areas where fire could occur. Steps have been taken to reduce these risks. Staff make a record of any accident that were looked at and were found to be clear the information from these records on a there is a pattern .e.g. are people falling reflects good practise. occur in the home. These records and detailed. The manager gathers monthly basis to identify whether at the same time of day etc. This The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 x 18 3 3 3 x x 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 2 x 3 The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP1 Good Practice Recommendations The statement of purpose needs to be reviewed and updated to accurately reflect the services that are provided in the Turner. Consideration should be made to the production of this information in different formats to meet the people who live in the home. Care plans need to be reviewed in order to make sure that they are all of good quality. Care plans need to be specific to the individual. Staff need to be encouraged to access care plans at least weekly and to be involved in their review. Care plans should be reviewed on a monthly basis and clearly include the people who live in the home in their development. 2. OP7 The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 26 3. OP8 The management of wound care needs to be reviewed and a policy that details when the home needs to access external professionals. Treatment for pressure ulcers needs to be described fully including prescribed dressings and creams. The wound should be measured height, depth and size and how it is to be monitored included in the care plan. Monitoring should include best practice guidance, such as good photographs or wound mapping. Consideration needs to be made training the staff in tissue viability. The prevention on reporting of abuse training needs to be monitored and all staff’s understanding of the actions that they need to take in the event of an allegation of this nature determined. Staffing levels need to be determined based on the people who live in the homes needs and monitored on a monthly basis. Supervision of all staff needs to be reviewed and formal supervision put into place for all staff. Staff who have the responsibility for supervising staff need to have the training to do so. 4. OP18 5. OP27 6. OP36 The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries.northwest@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 The Turner Home DS0000025383.V347693.R02.S.doc Version 5.2 Page 28 - 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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