Care Home: Watson House

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What the care home does well We found the home provides care in a flexible way, so that people living in the home have the opportunity to live their daily lives as they choose to. Comments included, "Its just like one big family here, many people living in the home have been here for a long time and there are no rules", "I`ve lived here for a long time and I come and go as I please, but I always tell the staff when I will be coming back". Watson House DS0000072662.V374981.R01.S.doc Version 5.2 We saw staff speaking to people in a relaxed way, and a dignified way so that they felt comfortable. They told us all the staff are very good and will do anything for them. "They put themselves out for us, nothing is too much trouble". We talked to the staff team on duty who confirmed they have a good knowledge of the individual care needs, social and cultural needs of people living at the home so that they are not disadvantaged in any way. Comments included, "This is a fairly small home residents get to know us and we know them and their needs", "the atmosphere is always good here with something going on most of the time and the staff are always around to help", "the manager is really supportive and we just all get on really well and work together really well". What has improved since the last inspection? This is a new service therefore there are no previous requirements or recommendations to consider. What the care home could do better: We looked at two files of people living in the home and found that in one instance there was no assessment plan from the placing authority. We talked to the senior member of staff about this who said they had found it difficult to obtain the assessment information for some time after the admission had taken place. The home should show in the records they have attempted to obtain this information at the time of the admission so that there is information relating to the needs of people during the professional assessment process. Files looked at had in place risk assessment procedures. In one instance the date between reviews was twelve months. This must be reduced so that the level of risk is being monitored and changes made on a more regular basis, for the health and welfare of the resident. The records we looked at recorded in the daily notes health professional visits, however it is recommended there is a suitable record for these visits to be recorded on each file so that any emerging patterns can easily be recognised, as well as for good auditing processes. The policies and procedures we looked at for the management of medication is dated and should be updated so that procedures are being followed based upon current British Pharmaceutical Society good practice guidelines. We looked at how medication is stored and would recommend a metal trolley specifically for medication administration and/or a metal locked cabinet which is bolted to the wall, so that drugs are stored securely at all times.Watson HouseDS0000072662.V374981.R01.S.doc Version 5.2 We looked at the homes policies and procedures for safeguarding and protection and found them to be dated, with some guidance advising the home to investigate in some circumstances. The home must have in place current guidelines based upon good practice procedures regarding referral to relevant organisations for investigation so that people are protected. There are staff recruitment records for all staff working in the home. We spoke to the manager who said they are being reviewed so that there is a tenyear employment history on all applications so that applicants have the opportunity to show a full employment history. Key inspection report CARE HOMES FOR OLDER PEOPLE Watson House Watson House 50 Station Road South Shore Blackpool FY4 1EU Lead Inspector Mrs Jackie Riley Unannounced Inspection 1st April 2009 09:30 DS0000072662.V374981.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Watson House Address Watson House 50 Station Road South Shore Blackpool FY4 1EU 01253 341550 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) Pilling Care Homes Limited Mrs Jennifer Horton Care Home 9 Category(ies) of Old age, not falling within any other category registration, with number (9) of places Watson House DS0000072662.V374981.R01.S.doc Version 5.2 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 people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category- Code OP The maximum number of people who can be accommodated is: 9 Date of last inspection Brief Description of the Service: Watson House is registered to provide residential care for up to nine older people. The home is situated in the central area of Blackpool, close to all amenities including tourist and leisure facilities. The aim of the home is to provide a comfortable environment, which helps residents maximise their individual lifestyles whilst receiving a good standard of care, in order to meet individual needs. The home is designed to provide a comfortable well maintained domestic environment. There are nine single rooms and two ensuite. Aids and adaptations are in place to meet the needs of older people living at the care home. There is a statement of Purpose and Service user Guide, which is given to all prospective residents/relatives. This written information explains the care the home will provide, the services it can provide and whom the owners and staff are so that the resident knows can make an informed decision about living at the home. At the time of the site visit the range of fees were £295.19 to £357.35. Additional charges are incurred for Hairdressing, Newspapers and additional toiletries. Watson House DS0000072662.V374981.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 stars. This means the people who use this service experience good quality outcomes. This was the first key inspection of the service since change in registration in October 2008. The Inspection included an unannounced visit to the home which took place over a four-hour period, on 1st April 2009. We spoke to the senior care staff on duty as well as two other care staff. The registered manager was on holiday at the time of the inspection, however we did talk to the registered manager following the site visit to clarify pieces of information. During the inspection we spoke to nine people living at the home. We spent time in and around the communal areas of the home making general observations to get a flavour of how the home operates on a daily basis. As part of the inspection process we talked to people using the service and asked staff about those peoples needs. We also looked at their rooms, care plans, records and daily notes this is called case tracking. We also invite others using the service to pass on their opinions if they wish. We had a good response from questionnaires sent to people who use the service for their views on how they experience the service. Comments were positive and some are included in this report. Every year the person in charge or manager is asked to provide us with written information about the quality of the service they provide, and to make an assessment of the quality of the service. We use this information, in part, to focus upon our inspection activity. We looked at recruitment and training records of two staff members. We walked around the building and watched people living and working in the home to see how everyone supported and talked to each other. What the service does well: We found the home provides care in a flexible way, so that people living in the home have the opportunity to live their daily lives as they choose to. Comments included, Its just like one big family here, many people living in the home have been here for a long time and there are no rules, Ive lived here for a long time and I come and go as I please, but I always tell the staff when I will be coming back. Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 6 We saw staff speaking to people in a relaxed way, and a dignified way so that they felt comfortable. They told us all the staff are very good and will do anything for them. They put themselves out for us, nothing is too much trouble. We talked to the staff team on duty who confirmed they have a good knowledge of the individual care needs, social and cultural needs of people living at the home so that they are not disadvantaged in any way. Comments included, “This is a fairly small home residents get to know us and we know them and their needs”, “the atmosphere is always good here with something going on most of the time and the staff are always around to help”, “the manager is really supportive and we just all get on really well and work together really well”. What has improved since the last inspection? What they could do better: We looked at two files of people living in the home and found that in one instance there was no assessment plan from the placing authority. We talked to the senior member of staff about this who said they had found it difficult to obtain the assessment information for some time after the admission had taken place. The home should show in the records they have attempted to obtain this information at the time of the admission so that there is information relating to the needs of people during the professional assessment process. Files looked at had in place risk assessment procedures. In one instance the date between reviews was twelve months. This must be reduced so that the level of risk is being monitored and changes made on a more regular basis, for the health and welfare of the resident. The records we looked at recorded in the daily notes health professional visits, however it is recommended there is a suitable record for these visits to be recorded on each file so that any emerging patterns can easily be recognised, as well as for good auditing processes. The policies and procedures we looked at for the management of medication is dated and should be updated so that procedures are being followed based upon current British Pharmaceutical Society good practice guidelines. We looked at how medication is stored and would recommend a metal trolley specifically for medication administration and/or a metal locked cabinet which is bolted to the wall, so that drugs are stored securely at all times. Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 7 We looked at the homes policies and procedures for safeguarding and protection and found them to be dated, with some guidance advising the home to investigate in some circumstances. The home must have in place current guidelines based upon good practice procedures regarding referral to relevant organisations for investigation so that people are protected. There are staff recruitment records for all staff working in the home. We spoke to the manager who said they are being reviewed so that there is a tenyear employment history on all applications so that applicants have the opportunity to show a full employment history. 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. Watson House DS0000072662.V374981.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 Watson House DS0000072662.V374981.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are given information, and have their needs assessed before deciding to move into the home so they know that their needs can be met. In some instances the home does not receive assessment information from professionals thereby having the potential to limit the knowledge they may need for any one resident. EVIDENCE: We looked at the records of two people living at the home. We saw they had assessments made by the homes manager, however in one instance there was no placing authority assessment which may limit information the home requires. We spoke to the manager about this and were told they endeavour to gain the information but it often takes time. They told us they are informed verbally by the social worker of the residents needs prior to admission, so they have essential information as to the specific needs of the person. Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 10 We found many people have lived at the home for a number of years. The most recent admission had in place assessment made by the home covering all areas of need. Staff spoken to say they use this assessment information to determine the level of care people need. Comments received said, the staff sat with me when I came to sort out everything I needed, We try to work closely with social workers and other health professionals to make sure we have all the information we need before somebody is admitted to the home but sometimes this takes time. People we spoke to said they got all the information they needed about the home prior to coming in and some had made visits to the home before they were admitted, so they knew what to expect. Watson House DS0000072662.V374981.R01.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Promotion of health is taken seriously. Peoples welfare is monitored and their health needs are identified and met. Medication storage and protocols do not meet current guidelines, which has the potential to pose risk. EVIDENCE: The two care planning records we looked at were accurate and up to date. There was information about individual healthcare needs as well as how Peoples needs are going to be met. Staff we spoke to said, the information tells us what is needed and we follow the plans to support people who live in the home. A person we spoke to said, “ the staff spend time talking to them about what they need”. The records we looked at show there are risk assessments in place which highlight what the risk is, how it can be managed and what the outcome is for the person, however in one instance the review period was twelve months. We spoke to the manager about this and were informed this was a mistake and Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 12 reviews for risk would be carried out on a more regular basis. This is necessary so that peoples risk levels are being monitored. Comments included, Its important to make sure we record residents risks so that we can manage it in the best interest of the resident. By looking closely at the records we found there are links between the home and other healthcare professionals including, doctors district nurses and Chiropodists, however when a person has seen a healthcare professional this is recorded in amongst the general notes. It would be beneficial to record the visits separately so that staff have a good clear record of when visits have been made and identify any trends, which may form so that action can be taken. People spoken to commented on having seen a doctor or district nurse recently. Medication records and observation of practices in administration showed us staff are familiar with the system to ensure it is safe. Only senior staff or the manager administers medication. We looked at two records and found them to be complete and up to date. We looked at how the home stores medication and found it to be in a locked facility, however we talked to the manager about installing a metal cabinet bolted to the wall or a medication trolley specifically deigned for medication storage so that medication is stored securely within current good practice guidance. The manager told us they are reviewing the current procedures. We talked to the manager and staff about training in medication practices and were told all but one staff member has received training. We saw three certificates showing training is being carried out. We looked at the homes current guidance on medication management and found it to be dated. We spoke to the manager about this who said they would implement current guidance based upon British Pharmaceutical Society protocols so that staff have the current information available for safe administration and storage. We saw peoples privacy and dignity was respected during the visit by looking at how staff talk to and respond to their needs. We found staff to be respectful and sensitive to individual needs throughout the inspection. Staff spoken to say, I would only treat people in a way I would expect to be treated. Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Daily life and social activities are flexible to meet individual needs. The nutritional needs are taken seriously with a choice of food on a daily basis. EVIDENCE: We spoke to people living in the home and staff about routine and they were found to be flexible. By talking to people and looking at daily records we could see there are no restrictions in the residents daily lives. Comments included, Residents have their own routines, some like to get up and go to bed early others like to get up late and stay up late. Some people to told us Im an early bird always have been and always will, but I can get myself up without bothering anybody, I need help to get to bed but I will not go to bed early and they know that. We saw people are free to move around the home with no restrictions being in place. A person spoken to said they like the way they can do what they want when they want to and staff respect how they choose to live. We saw there are no restrictions as to how people use their rooms, and staff said they encourage them to use their rooms as they choose, as this is their own personal space, Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 14 which is respected by the staff team. We spoke to three people using their rooms during the visit and they said they like the freedom to use the rooms when they choose, comments included, I like my privacy, Ive got everything I need in here, but I go down and sit with the others we have a good laugh together. People living at the home told us there is always something going on, including board games and quizzes and bingo. We were told there are regular parties and birthdays and special occasions are celebrated. Comments included, we like to have a laugh together and we are always doing something the staff keep us on our toes. The way meals are prepared and served were seen to be good. There is a pleasantly decorated and furnished dining room, which is used by most people although a few told us they like to have their meals in the privacy of their own rooms as seen during the inspection. Staff we spoke to recognised this is personal choice and it is respected. Staff told us there is a daily choice and this was seen to be recorded on a daily basis. People living in the home told us they liked the way they can choose meals on a daily basis so that they are not restricted to a set menu. Comments included, we just fancied chips for lunch today and that’s what we are getting. They told us they liked the meals very much. There are no restrictions on visitors although there were none visiting when the inspection took place. People spoken to said they have visitors coming at various times and this is not seen as a problem. Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for recording and responding to complaints are good making sure people feel listened to. Staff have access to safeguarding training for the protection of users of the service. Safeguarding guidance is dated having the potential to limit current good practice. EVIDENCE: We looked at the homes complaints procedure, which is made available to people living in the home and their relatives or advocates during the admission process. We were told by staff and three people they are aware of the complaints procedures and how to use them. Comments included, I know I can talk to the manager if I am not happy about something. The manager takes complaints seriously if somebody is not happy about something, Ive never had to make a complaint I cant think why I would, but I have been told about who to talk to and what to do. There have been no complaints made to the Commission since the registration in October 2008. We spoke to the staff about how residents are protected they told us they are receiving or have received training in safeguarding people. Three files looked Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 16 at confirmed the training is taking place so that staff are equipped with the knowledge and skills for the protection of people using the service. We looked at the homes guidance for acting on concerns relating to safeguarding people. We found the guidance to be dated and some of the information may mislead staff. We spoke to the manager about this and were told new guidance will be implemented with immediate effect so that staff are equipped with current good practice guidelines so that people are protected at all times. Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is designed to make sure people living there are comfortable and have equipment in place to meet their needs. EVIDENCE: We looked at the homes layout and design, and found to be of a domestic nature homely and comfortable. There is a ground floor lounge area used by most people living in the home. There is a dining room to the rear of the home. People living in the home have there own bedrooms. They were seen to be moving around the home freely with some people using the lounge and dining areas in between meals. Three people choose to use their rooms during the day, although they also spend time in the lounge areas and having meals with some of the other people living in the home. We spoke to them and they told us they are very happy with the facilities they have in their rooms and in communal areas. We saw the rooms have individual pieces of furniture and Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 18 personal items in place, which make it feel homely. Comments included, I like to use my room its got lots of things around that remind me of home, We spend a lot of time in the lounge and we have a good chat and laugh in there. We saw there is a stair lift in place for access to the upper floor. People spoken to said they find this helps them a lot. We were told by the manager that chairs in the lounge are to be replaced and new carpets and decoration of the home is a continuing process, so that it is well maintained and a homely place to live. The home is situated on a main road close to leisure amenities. Two people told us they like going out during the warmer months when visitors are in town. They also told us they like to sit in the front garden during the summer months as they get to talk to visitors passing. We saw there are suitable aids and adaptations in place to assist staff when moving people with limited mobility. They told us most people living there are mobile but some need the assistance of equipment, which helps both staff and people living at the home. Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The procedures for recruiting staff are good, ensuring the safety and protection of people living at the home. Training and deployment of staff is in place so that they are meeting their needs. EVIDENCE: We looked at the duty rotas and discussed staffing levels with the manager. We found the home uses its staff team flexibly so that the needs of people are being met at any time of the day or night. Staff we spoke to said they were happy with the way they are supported and how they work in the home. Comments included, we work well together as a team, we all know what we are doing and help each other out, some of us have worked together for a long time and we all get on, the atmosphere is like a family and we help each other out. We saw staff have access to training in all areas of care. Staff spoken to and two files looked at told us that staff have access to training beyond the home. Comments included, I go on all the courses when they are available, the manager is keen for us all to keep up with the training in all areas. We looked at two staff files. They showed us staff are recruited safely using procedures, which take into account full information about them, including Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 20 application records, references that have been checked, Criminal Record Bureau (CRB). Protection of Vulnerable Adults (POVA)checks to make sure they are safe to work with people who may be vulnerable. We found the application from does not currently ask for a full ten-year employment history, but the manager told us this is being reviewed so that it will be included on all future applications. Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience 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 managed well with systems and policies in place for the safety and protection of people living at the home. EVIDENCE: We saw the manager is running the home on a day-to-day basis in the best interests of people living there and staff. Comments included, we feel really supported by the manager, the manager is always there for you, if you are not sure about anything you can just ask. There is evidence the registered provider makes regular monthly unannounced visits and produces a report for the manager following the visits so that the home is being monitored. People we spoke to said they enjoy the visits and Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 22 they feel they can talk to the owner about any issues, which may be concerning them. We found that records and systems in the home are being reviewed or are at the review stage, so that the information is and up to date. Staff were able to follow clear instructions in the records for the health and welfare of people living at the home. We saw there is a clear line of management responsibility and that staff communicate well with the owner and registered manager. Comments included, we all get on and the manager is here all the time or we can get hold of her when she is not here, she is really supportive, I have worked here for a long time and feel supported by the manager, we share information all the time so nothing gets missed. By looking at records we saw regular tests and servicing of essential equipment including, gas, electric and fire they were safe. Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 24 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. 1. Standard OP3 Regulation 14 Requirement Staff must have an assessment in place on each person to be admitted so that staff are aware of that persons care needs. Prospective staff need to have a full working history so that the manager is aware of their past work experience and can identify any gaps in employment. This makes it less likely that people who should not work with vulnerable residents can gain employment in the home. Timescale for action 01/06/09 2. OP29 19 01/06/09 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 OP7 Good Practice Recommendations A file looked at had a risk review timescale of twelve months. Risk reviews should be more frequent so that the DS0000072662.V374981.R01.S.doc Version 5.2 Page 25 Watson House 2. OP7 3 4. 5. OP9 OP9 OP18 level of risk is being monitored regularly. Visits by healthcare staff were being recorded in the main file, however individual records of these visits would provide a clear audit of any patterns or trends, which may be occurring. Policies and procedures for the management of medication are dated and should be replaced with current good practice guidelines. Storage of medication should be reviewed so that it is being stored in a purposeful facility to ensure safety. Policies and procedures for safeguarding people were dated and should be replaced with current good practice guidelines. Watson House DS0000072662.V374981.R01.S.doc Version 5.2 Page 26 Care Quality Commission Care Quality Commission Unit 1 Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. 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