Care Home: The Vintry Residential Care Home

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What the care home does well Potential new residents benefit from a through pre- admission assessment that allows for only those who needs can be met, being admitted to the home. The health needs of residents are well met with evidence of good multi disciplinary working taking place. Staff provide personal support to residents in such a way that promotes and protects resident`s privacy and dignity.Resident`s benefit from a well planned activities calendar that is both stimulating and meaningful and arranged according to their choice. Residents experience mealtimes that are unhurried, whilst all meals are home cooked with an alternative option being available for each mealtime. Resident`s can be assured that there is an efficient complaints procedure in place and that the homes processes and staff training should protect residents in the event of an allegation of abuse. The location and layout of the home are suitable for its stated purpose. All areas of the home are accessible to residents. Resident`s experience the benefits of a staff team that have the necessary skills and experience to the meet their needs. Staff training is on going and is appropriate to the level of needs of current resident`s. The management and administration of the home is good, with evidence of consideration being given to resident`s and/or relatives opinion at all times. What has improved since the last inspection? The Management of the home have taken appropriate measures to ensure that each resident has access to health care services that meet their assessed needs. Staffing numbers and skill mix of qualified/unqualified staff are now appropriate to the assessed needs of the service users, the size, layout and purpose of the home. The content, structure and recording format for staff induction training has been reviewed and significantly improved and complies with the Common Induction Standards. Where policies and procedures have been updated staff have been kept aware and informed of all such changes. What the care home could do better: There is a need for the management of the home to ensure that each individual resident has a care plan that is comprehensive in detail and provides both staff and resident`s, with up to date information relating to resident`s needs and limitations. The Medication Policy is in need of updating to be more reflective of the current good practice conducted in the receipt, recording, storage, handling, administration and disposal of medicines. Current legislation and guidance must also be included in the updated policy.The home`s records, including policies and procedures, are required to be kept up to date and reviewed, where necessary in order to provide staff with relevant, current information about the processes and procedures that occur within the home. An effective quality assurance and quality monitoring systems, based on seeking the views of resident`s needs to be put in place, in order to ensure that the management of the home can measure its success in meeting the aims, objectives and statement of purpose of the home. A formal Quality Assurance process must involve continuous self-monitoring, using an objective, consistently obtained and reviewed and verifiable method, which is also a professionally recognised quality assurance system. The Statutory Requirements made relating to the above have remained outstanding from the previous inspection of March 2007. Though it is acknowledged that some work has already been completed by the Registered Manager to ensure that these Statutory Requirements have been met in part. Recommendations for good practice were also made in that: Consideration must be given to ensuring that all daily care record entries are to be dated, timed, signed and reflective of the service users care plan. The use of white correction fluid in care plans, must cease. Consideration should be given to standardizing one term of reference for service users, in particular documentation that refers to them as patients, clients and residents. CARE HOMES FOR OLDER PEOPLE The Vintry Residential Care Home Farlaine Road Eastbourne East Sussex BN21 1XH Lead Inspector Rebecca Shewan Unannounced Inspection 09:25 25 March 2008 th 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 Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Vintry Residential Care Home Address Farlaine Road Eastbourne East Sussex BN21 1XH 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) 01323 721340 01323 729714 thevintryeastbourne@wanadoo.co.uk Wine & Spirit Trades` Benevolent Society Pauline Mary Edwards Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is seventeen (17) Service users must be sixty-five (65) years of age or older on admission. 6th March 2007 Date of last inspection Brief Description of the Service: The Vintry is a purpose built care home, registered to accommodate 17 older people. The home is situated on the outskirts of Eastbourne, near the Old Town area and close to local shops and facilities. The home is separate from but forms part of a larger sheltered housing complex provided for ex-employees and people associated with the wine and spirits trade. Many people have moved from the cottages to the residential home, as their needs have changed. Ground floor service user accommodation is provided, in single rooms, which is safe, accessible and well maintained. Rooms have en-suite facilities and are fitted with an emergency call bell system. Communal areas consist of a light and comfortable lounge, a spacious dining room and an atrium. To the rear of the main building is a pleasant, well maintained garden. The range of fee’s charged for services provided are £399/week, which is a standard flat rate for all. Fees do not include hairdressing (£9.50 for a basic cut), Chiropody (£10.00 per session), Newspapers & magazines (varied) and transport such as private taxi’s (varied). Potential new service users can obtain information relating to the home by word of mouth, CSCI inspection reports, placing authorities/care managers, contacting the home direct and by obtaining the homes vacancy list via the Registered Care Home Association website. The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection took place during the morning and afternoon of the 25th March 2008. Incident reports and previous inspection reports, held by the Commission for Social Care Inspection, were read before the inspection. The inspection of the home took six and a half hours. Records such as care plans, staff files and medication records were also viewed. Sixteen service users (known as residents) were accommodated at the home at the time of the inspection. A tour of the whole home was undertaken and the Registered Manager, Deputy Manager, two staff and five residents were spoken with. The CSCI also conducted Service User, Relatives and staff surveys. Of which nil were returned. Comments received included: ‘The food is excellent – always fresh and well cooked. There is no difference to food from weekdays to the weekend.’ The laundry service is exceptional.’ ‘Overall I am very impressed – food is good and the staff are nice. I have no complaints.’ ‘The Manager and staff are excellent, always kind, patient and caring – very approachable.’ What the service does well: Potential new residents benefit from a through pre- admission assessment that allows for only those who needs can be met, being admitted to the home. The health needs of residents are well met with evidence of good multi disciplinary working taking place. Staff provide personal support to residents in such a way that promotes and protects resident’s privacy and dignity. The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 6 Resident’s benefit from a well planned activities calendar that is both stimulating and meaningful and arranged according to their choice. Residents experience mealtimes that are unhurried, whilst all meals are home cooked with an alternative option being available for each mealtime. Residents can be assured that there is an efficient complaints procedure in place and that the homes processes and staff training should protect residents in the event of an allegation of abuse. The location and layout of the home are suitable for its stated purpose. All areas of the home are accessible to residents. Residents experience the benefits of a staff team that have the necessary skills and experience to the meet their needs. Staff training is on going and is appropriate to the level of needs of current residents. The management and administration of the home is good, with evidence of consideration being given to resident’s and/or relatives opinion at all times. What has improved since the last inspection? What they could do better: There is a need for the management of the home to ensure that each individual resident has a care plan that is comprehensive in detail and provides both staff and residents, with up to date information relating to residents needs and limitations. The Medication Policy is in need of updating to be more reflective of the current good practice conducted in the receipt, recording, storage, handling, administration and disposal of medicines. Current legislation and guidance must also be included in the updated policy. The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 7 The homes records, including policies and procedures, are required to be kept up to date and reviewed, where necessary in order to provide staff with relevant, current information about the processes and procedures that occur within the home. An effective quality assurance and quality monitoring systems, based on seeking the views of residents needs to be put in place, in order to ensure that the management of the home can measure its success in meeting the aims, objectives and statement of purpose of the home. A formal Quality Assurance process must involve continuous self-monitoring, using an objective, consistently obtained and reviewed and verifiable method, which is also a professionally recognised quality assurance system. The Statutory Requirements made relating to the above have remained outstanding from the previous inspection of March 2007. Though it is acknowledged that some work has already been completed by the Registered Manager to ensure that these Statutory Requirements have been met in part. Recommendations for good practice were also made in that: Consideration must be given to ensuring that all daily care record entries are to be dated, timed, signed and reflective of the service users care plan. The use of white correction fluid in care plans, must cease. Consideration should be given to standardizing one term of reference for service users, in particular documentation that refers to them as patients, clients and residents. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Vintry Residential Care Home DS0000021267.V359526.R01.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 Vintry Residential Care Home DS0000021267.V359526.R01.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): 3&6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has processes in place for assessing potential new resident’s with services being offered to only those resident’s whose needs can be met. EVIDENCE: The home’s Registered Manager, Deputy Manager and/or Senior Carer carry out pre- admission assessments. The home obtains a copy of a care management assessment from a placing authority where this exists. Any issues, which are highlighted within this assessment, are addressed by the home and documented records are maintained of all correspondence with the placing authority. Records inspected showed that pre- admission assessments are carried out on all new and potential residents. Intermediate care is not offered by this home. The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are offered a good provision of health care and personal support by the home. All care is administered in way that protects residents privacy and dignity. Medication procedures ensure that all necessary precautions are taken to ensure errors do not occur and that medications are stored and administered safely. The Medication Policy is to be improved, to ensure that it is reflective of the good procedures in place and is written in line with current guidance. EVIDENCE: Following the inspection of March 2007 improvements have been made to ensure that the Statutory Requirement that the management of the home need to prepare a plan of care that fully identifies the support needs of service users and how to support them with their needs. Care plans need to also be regularly reviewed and all risks identified to minimize risk to service users health and safety has been met in part. The newly employed Deputy Manager The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 11 is currently reviewing care plans. Records viewed confirmed that both the old style of care planning and the newly implemented style were basic in content. Each style, if combined, would provide the assessor with a clear overview of the Residents current needs, limitations and required assistance. Risk assessments are also currently being reviewed alongside the care plans. It was also observed that white correction fluid had been utilised in some of the care plans. The form utilised for daily recordings requests a time for all entries but those written were recorded as ‘am’ or ‘pm’. Some entries had been recorded as ‘seems fine’, ‘enjoyed supper’ and ‘was up and down like a jack in a box all night’ and were not care plan specific. Therefore recommendations for good practice have been made. Since the previous inspection of March 2007 the Registered Manager has taken the appropriate action to ensure that the Statutory Requirement that the registered person promotes and maintains service users’ health and ensures access to health care services to meet assessed needs has been met in full. From the records sampled and from discussions with staff, it was evidenced that the health needs of residents are well met with evidence of good multi disciplinary working taking place, on a required basis. Service users are registered with one GP from one of four local practices. The services of the District Nurse, Audiologist, Speech and Language Therapist and Dietician are obtained via the service users GP. The home has access to chiropodists who attend the home on a six weekly or as required basis. Private opticians and dental appointments are arranged for service user, who are encouraged and assisted to attend appointments independently. Private or NHS physiotherapy available to all service users, arrangements for this are such that referrals can be by the GP or private referrals. The home has good procedures in place for the monitoring and recording of all drugs administered, disposed of and those entering and leaving the home. The stores for medication were viewed and these were found to be maintained in a clean and orderly manner. Medication administration records were viewed and these were found to be maintained appropriately. Following the inspection of March 2007 some improvements have been made to address the Statutory Requirement that the registered person ensures that there is a policy and staff adhere to procedures, for the receipt, recording, storage, handling, administration and disposal of medicines has been met in part. Discussions with the Registered Manager highlighted that the Medication Policy has been reviewed and is currently being further updated to include recent regulatory changes and current good practise guidance. Staff were observed providing personal support to service users in such a way that promoted and protected residents privacy and dignity. Residents spoken with said that care staff were ‘kind, caring and patient at all times’. The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides a wide range of social, cultural and recreational facilities, including specialist diets to residents, with resident’s choice and wishes being respected. EVIDENCE: Activities are arranged and altered according to resident’s requests. The home does not have a published list of weekly activities. The Registered Manager said that resident’s prefer to do activities of their own choosing and enjoy the activities provided by the service i.e. exercise to music (conducted by a resident of the bungalows), Music and Motivation, Magician (who attends the home every two months), Music man, and quizzes. Trips and outings to places of local interest are also arranged, weather permitting. Discussions with residents confirmed this. Resident’s religious wishes are observed and arrangements are in place for residents to receive Holy Communion if they wish. The home also has access to PARCHE services, whereby people from the local church attend the home as The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 13 ‘friends’ and sing hymns and conduct prayer readings, which are non denominational. Discussions with the Registered Manager highlighted that although the current residents fell into a specific age group and had similar religious beliefs, the home would welcome any potential new resident who has special cultural/religious/spiritual beliefs and would make provision to accommodate their needs. The home believes in promoting an equal and diverse culture among staff and residents. Contact with family and friends is positively encouraged with visitors being able to attend the home at any time and in accordance with the resident’s wishes. Residents are treated with respect and there is a good rapport between staff of the home and residents. Residents reported that the home assists them to maintain their independence with their daily living and daily routines. All meals are home cooked with an alternative option available for each mealtime. Mealtimes can be varied upon request and residents guests are also welcome to have meals at the home. Medical, therapeutic or religious diets are provided as needed. Drinks and snacks are available at all times. The meal served during the inspection was ample in quantity and attractively presented. Mealtimes were observed to be unhurried. Residents spoken with reported that ‘the food is very good’ and ‘the food is exceptional’. The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a robust and efficient complaints procedure, whilst the homes procedures, processes and staff training should protect resident’s in the event of an allegation of abuse. EVIDENCE: The home has not received any formal complaints within the past twelve months. The home has an established complaints procedure in place, which is in need of a minor amendment. The current Complaints Procedure states that the CSCI may be contacted in the event of a complaint not being resolved satisfactorily by the management of the service. In the event of any complaint the CSCI can be contacted at any given time. Therefore a Recommendation has been made. Criminal Record Bureau (CRB) checks have been carried out on all existing staff. Both CRB and Protection of Vulnerable Adult (POVA) checks are carried out on all new staff. There have been so Safeguarding Adults alerts raised within the past twelve months. Staff have attended training in the Protection of Vulnerable adults within the last twelve months. This was evident from the staff files that were viewed. Staff spoken with confirmed that they would be confident of the procedures to follow in the event of an allegation of abuse being made. The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides accommodation for residents that is safe, hygienic and odour free, whilst infection control procedures are adhered to at all times. EVIDENCE: The location and layout of the home are suitable for its stated purpose. The home is well maintained and all areas of the home, including the garden, are accessible to residents. The home has an ongoing plan of refurbishment in place. The home has an infection control policy in place and staff are trained in infection control procedures, this was confirmed by staff training records. Staff were observed adhering to infection control procedures. It was evidenced that a clinical waste contract is in place. The home was clean and odour free The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 16 throughout. There is a daily cleaning schedule in place. Residents spoken with said that their bedrooms and communal areas of the home were also maintained in a clean manner. The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a staff team that have the necessary skills and experience to the meet the needs of current residents. EVIDENCE: Following the inspection of March 2007 improvements have been made to ensure that the Statutory Requirement that staffing numbers and skill mix of qualified/unqualified staff are appropriate to the assessed needs of the service users, the size, layout and purpose of the home, at all times has been met in full. A competent staff team, sufficient in number, meets the resident’s current needs, if the level of needs change there are systems in place to provide additional staffing during this period. There is a staff rota in place, which details staff designations and hours of working. The home has a permanent staff team of the Deputy Manager, nine care staff and four ancillary staff. The Deputy Manager and four carers are trained in National Vocational Qualification (NVQ) level 2 in care, whilst another two carers are due to commence training in the near future. This was confirmed by staff records viewed and discussions with the Registered Manager. The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 18 Staff recruitment files were viewed and it was evidenced that these files contain all items required under the Care Homes Regulations 2001. The home has an Equal Opportunities policy in place and is an equal opportunities employer. Staff induction training is conducted in line with Care Skills Sector guidance. Mandatory training consists of Fire Safety, Infection Control, Health & Safety, Protection of Vulnerable Adults, Medication, First Aid Basic food hygiene and Induction. The Registered Manager and staff confirmed that additional training is arranged upon request and in accordance with service users needs. Since the inspection of March 2007 improvements have been made to ensure that the Statutory Requirement that It is required that the content, structure and particularly the current recording format for staff induction training be reviewed and significantly improved has been met in full. The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 & 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents experience the benefits of a home that is well managed and administrated. Consideration is given to resident’s choice and opinion in all aspects of provisions provided. Improvements are required to ensure that residents benefit from a formal Quality Assurance process being implemented. Policies and procedures are also in need of updating to ensure that staff work in a manner that is reflective of current good practice and legislation. The health, safety and welfare of residents and staff are protected at all times. EVIDENCE: The Registered Manager of the home has many years relevant experience in caring for older people and has achieved the NVQ level 4 qualification in The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 20 Management and is currently undertaking the NVQ level 5 in management course. Residents and staff spoken with said that the Registered Manager is friendly, approachable and always takes their concerns or comments about the home seriously. Following the inspection of March 2007 some improvements have been made to ensure that the Statutory Requirement that the home ensure that it has a effective quality assurance and quality monitoring systems, based on seeking the views of service users, are in place to measure success in meeting the aims, objectives and statement of purpose of the home. There is continuous self-monitoring, using an objective, consistently obtained and reviewed and verifiable method (preferably a professionally recognised quality assurance system) has been partially met. The Registered Manager reported that a formal Quality Assurance package is currently being sought and that once purchased, will be implemented without delay. Quality Assurance at the present time consists of service user surveys being distributed three times a year, with the Registered Manager holding a meeting with service users after this period to discuss the findings of such surveys. Residents meetings are held every two months and staff meetings are held monthly. It was acknowledged by the Registered Manager that these have not been happening as frequently in the recent past, due to having no Deputy Manager in post. Plans are in place to implement these again on a regular basis now a Deputy Manager has been employed. The Registered Manager reported that the management of the home does not take any responsibility for any of the resident’s finances. Most residents have family, friends or representatives who protect their financial affairs. Since the inspection of March 2007 improvements have been made to ensure that the Statutory Requirement that it is required that the homes records, including policies and procedures, be kept up to date has been met in part. Policies and procedures viewed provided evidence that a number of policies and procedures had been updated, though there is still a number which remain out of date and/or in need of review. The Registered Manager reported that research into current good practice, guidance and legislation was being conducted for those outstanding policies and procedures, in order to ensure that they provide up to date information for staff. At the previous inspection a Recommendation for good practice was made that it is recommended that staff be kept aware and informed of updated key polices and procedures through regular discussion, as part of the agenda for team meetings. From discussions with staff it was confirmed that this Recommendation has been met, for those policies and procedures that have been reviewed and/or updated. The home’s maintenance files were viewed and it was evident that fire drills, fire alarm testing and fire equipment checks, health & safety checks and water checks had been carried out. There were no health & safety issues noted at the time of this inspection. The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 21 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 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X 2 3 The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (1) Requirement The management of the home need to prepare a plan of care that fully identifies the support needs of service users and how to support them with their needs. Care plans need to also be regularly reviewed and all risks identified to minimize risk to service users health and safety. (Previous timescales of 06/06/07 not met). Timescale for action 25/04/08 2. OP9 13 (2) The registered person ensures 25/04/08 that there is a policy and staff adhere to procedures, for the receipt, recording, storage, handling, administration and disposal of medicines. (Previous timescales of 08/03/07 not met). 25/05/08 The home ensure that it has a effective quality assurance and quality monitoring systems, based on seeking the views of service users, are in place to measure success in meeting the aims, objectives and statement of purpose of the home. There is continuous self-monitoring, using an objective, consistently DS0000021267.V359526.R01.S.doc Version 5.2 Page 23 3. OP33 33(1) The Vintry Residential Care Home obtained and reviewed and verifiable method (preferably a professionally recognised quality assurance system). (Previous timescales of 13/03/07 not met). 4. OP37 17 (3) (a) It is required that the homes records, including policies and procedures, be kept up to date. (Previous timescales of 31/07/2005, 31/01/06 and 06/06/07 not met). 25/05/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP7 OP7 OP7 & OP37 Good Practice Recommendations That all daily care record entries are to be dated, timed, signed and reflective of the service users care plan. That the use of white correction fluid in care plans, must cease. That consideration is given to standardizing the term used to refer to service users, in particular documentation that refers to them as patients, clients and/or residents. The Vintry Residential Care Home DS0000021267.V359526.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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