Care Home: Wisma Mulia

Similar services:

• Fairfields Country Rest Home
• Poldhu
• Queensmount
• Trevaylor Manor
• Didsbury Court Rest Home
• Belma
• Hunters Care Centre
• Manor Lodge

What the care home does well What has improved since the last inspection? The requirements from the last inspection have been met and medication procedures have greatly improved through staff training and regular monitoring. What the care home could do better: Although the medication procedures have improved greater care and closer auditing is still required to ensure that no errors are made. Explore use of further equipment such as wrist bands/pendants for those residents who wish to maintain their independence safely and ensure that call bells and bedside lighting etc, are positioned in easy reach and are adequate for those wishing to read. CARE HOMES FOR OLDER PEOPLE Wisma Mulia Bridge Road Frampton-on-severn Glos GL2 7HE Lead Inspector Mrs Janet Griffiths Unannounced Inspection 1st July 2008 09:30 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 Wisma Mulia DS0000016654.V365245.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. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wisma Mulia Address Bridge Road Frampton-on-severn Glos GL2 7HE 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) 01452 740432 01452 740084 wismamulia@hotmail.co.uk Fountain Housing Association Limited Mr Philip L James Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Wisma Mulia DS0000016654.V365245.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 service users of either gender whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category (Code OP) The maximum number of service users who can be accommodated is 25 11th October 2007 Date of last inspection Brief Description of the Service: Wisma Mulia is a care home situated in the village of Frampton-on-Severn. The secluded gardens surrounding the home give both peace and privacy to the service users who live there. The core philosophy of the home is based on a spiritual following called Subud. This is an association of people of all races, religion and creeds. Its foundation is the simple worship of God without dogma or teaching. This does not preclude anyone from living there. The extension to the main house comprises of single and double flat-lets on the ground and first floor served by a shaft lift. The ground floor flat-lets have French doors and paved patio areas. The main house has six single, ground and first floor bedrooms. There is also a separate coach house. Communal areas on the ground floor consist of a lounge, dining room, solarium and a spacious room used for prayers and activities. The gardens are well kept and include a fountain and seating area. Information about the service to include CSCI reports is made available by the provider to prospective service users through the homes’ Statement of Purpose and Service Users Guide. At the time of inspection the fees are between £365 and £490 per week. Additional charges are made for hairdressing, chiropody and newspapers. People funded through the Local Authority have a financial assessment carried out in accordance with fair access to Care Services procedures. Local Authority or Primary Care Trust charges are determined by individual need and circumstances. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 5 General information about fees and fair terms can be accessed from the Office of fair trading web site at www.oft.govuk http:/www.oft.gov.uk Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 6 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. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. This unannounced key inspection site visit took place over seven and a half hours on one day in July 2008. On this occasion an Expert by Experience also visited the home and spent time talking with the residents, visiting some of their rooms and joining them for lunch, in order to observe and sample the meals provided. The inspector, during this time, spoke to staff working in the home, one or two residents and the manager of the home. Communal areas and some resident’s rooms were visited on this occasion. Four residents’ files were examined in detail to include their medication records. Other records examined included staff recruitment and training records, accident, and quality assurance records. Survey forms were issued to the residents, relatives and staff prior to the inspection, to complete and return to CSCI if they wished; five responses were received from service users; six surveys were received from relatives and two from staff. An Annual Quality Assurance Assessment (AQAA) was completed and its contents used as part of the inspection process and report writing as was the collation of survey results from service users. The observations from the Expert by Experience were also included in this report. What the service does well: The home offers a calm, peaceful and homely environment in which to live and all of the service users spoken with were happy and contented, felt safe and praised the management and the staff for their efforts. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 7 All felt they had kept their independence and were encouraged to continue with support as requested. One relative stated in a survey received: • ‘We find Wisma Mulia to be ideal for our mother. Staff are kind,caring and willing to discuss any issues/concerns we may have. The home is always clean and tidy and the communal rooms bright and airy. We feel our mother is well looked after and still encouraged to have some independence within a safe regime and within her capabilities’. The AQAA states: ‘Wisma is a caring community embracing all aspects of care and support. It provides a good environment both physically and emotionally We provide a service, which is both professional and homely, in which our residents’ safety and happiness are paramount. We are good employers who care for our staff We are always looking at ways to improve the service we provide’. What has improved since the last inspection? What they could do better: 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. Wisma Mulia DS0000016654.V365245.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 Wisma Mulia DS0000016654.V365245.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): 1,2 and 3. Standard 6 not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their families have all the information they need to make an informed choice regarding placement at the home, and pre-admission visits take place to carry out an assessment and ensure that needs can be met. Residents normally move in on a long-term basis therefore Std. 6 was not assessed. EVIDENCE: It was confirmed by the manager that all prospective residents or their families are provided with a copy of the service users guide and resident’s surveys also confirmed that they had all received enough information about the home prior to admission. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 10 As there are about to be some changes made to the building, the manager did report that he will be reviewing the current Service Users Guide and Statement of Purpose later this year to reflect the changes. Resident surveys also confirmed that they had all received a contract, which the home refers to as a ‘licence agreement’. Copies were seen at the last inspection, but as it was reported that no new residents had been admitted since the last inspection, none were seen on this occasion. All prospective residents are visited prior to admission and a pre-admission assessment completed to ensure that the home could meet their needs. No pre-admission assessments were seen on this occasion but admission assessments were seen and resident and relative surveys both confirmed that they felt their needs were fully met. The Annual Quality Assurance Assessment (AQAA) form completed states: ‘Information is available on the home; visits to the home are encouraged and further details are provided on admission’. ‘We encourage respite care to prospective residents to evaluate more effectively whether or not we can provide the right environment for their needs’. It also states how they have improved over the last 12 months: ‘Raised the profile of Wisma in the locality in order to increase knowledge of the home’. ‘One resident has taken on the role of discussing ‘life at Wisma’ with prospective and new residents’. Staff surveys also confirmed that they received the training relevant to their roles and to meet the residents needs. Wisma Mulia DS0000016654.V365245.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. These judgements have been made using available evidence including a visit to this service by the key inspector. People who live in this home have their personal care and health needs met through individually planned care. They are also protected by the medication administration procedures. Residents are treated with respect and their privacy and dignity are protected. EVIDENCE: A total of four care files of those most heavily dependent service users were examined and most of the residents were spoken with. The Expert by Experience reported that all residents spoken with were happy and contented, felt safe and praised the management and staff for their efforts. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 12 All felt they had kept their independence and were encouraged to continue with support as requested. All the files examined had very full and informative assessments completed to include a moving and handling and general risk assessment and these showed evidence of regular review. Where problems were identified, appropriate care plans were completed and again reviewed regularly with the service user where possible, and these reflected the current needs of the resident. Full and informative daily records were kept, signed and dated and gave a good indication of action followed through when any untoward event was recorded. From the records examined references were made to visits from the doctor and district nurse as well as the chiropodist and other health professionals as required. However the Expert by Experience reported that after talking with a resident they stated that following a fall there was no doctor available as it was weekend and one relative in a survey returned stated: ‘My mother fell a couple of times and I only found out when I visited. She had also visited the doctor as she was having dizzy spells and no one told me. She was well looked after by the staff who were kind and gentle with her’. This was fed-back to the manager to follow-up. He reported that there are doctors and district nurses on call out of hours and at weekends and within the home the manager, deputy and senior carers are also on call evenings and weekends. One other relatives’survey stated: • I would like a regular (every 3 months) report on my mother telling me how her habits may have changed (e.g. sleeping hours during the day) and how she spends her time during a typical week. It would help me monitor better how she is changing ( e.g. visits by the Dr and any medical changes). This was also fed-back to be considered. Specialist equipment such as pressure relieving mattresses and cushions, and hospital beds were also recorded as being used where appropriate, as were pressure mats. Pressure mats were positioned beside beds for those residents who had a history of falls and who, because of short-term memory problems had a tendency to try to mobilise without the aid of a walking frame or stick on occasions. These mats alerted staff to their movement to enable them to take some evasive action. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 13 • Residents surveys completed confirmed that they received the care and support they required and that staff always listened to what they say. They also stated that they receive the medical support they need. Relative’s surveys confirmed that they receive the care they expect for their relatives’ and included the following comments that the home: • • • ‘Encourages residents to still be as independent as possible whilst providing a safe/caring environment for them’. ‘ Provides a home from home when old age really catches up’. ‘It creates a caring and personalised atmosphere that respects each individual resident’. Medication records were checked for those resident’s whose care records were examined. Each resident who receives medication has a care plan for this and also a medication reference form listing current medication, when it was started and when it was discontinued. Medication is dispensed by the local GP dispensing practice. All medication to be administered is held in a locked medication trolley that is held secure in the office when not in use. One medication cabinet has also been moved into the office. There is still a second cabinet on the first floor holding medication for one resident but it was advised that this medication is held with the rest in the medication trolley. The home has no controlled drugs in use but records were checked of previous medication that has since been completed or returned to the pharmacy. Monthly medication records are typed out by the office administrator and double-checked and signed by two senior staff. Medication records seen were accurate, clearly indicating all the specific instructions given by the dispensing pharmacist. Relevant codes are used when a medication is omitted. Most of the requirements made by the pharmacy inspector at the last inspection have been met, but there is still not complete clarity over which residents self medicate and what medication is self medicated. Most of the records seen are now well maintained as the deputy manager carries out regular audits and follows up any gaps in recording. Each medication container is dated to indicate when it has been commenced but there still does appear some confusion over the date recorded which was reflected in one or two discrepancies found. For example someone had been prescribed Atenolol 25 mgs daily-28 tablets dispensed and started 14/6/08 according to the date on the bottle, but instead Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 14 of 10 left in the bottle as there should have been, there were 8 left, which the manager suggested could have been because the wrong date could have been written on the bottle. Overall, medication administration is much improved but greater care and closer auditing is still required to ensure that no errors are made. The training matrix provided indicated that of 28 staff listed, 13 have completed medication training since September 2007 and all but 6 of the remaining staff have completed medication training previously but are due for updates as their training occurred between 2003 and 2005. Observations made confirmed that resident’s privacy and dignity is respected and staff were observed knocking on doors and addressing residents by their preferred name. All of the residents have a single room and en suite facilities. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 15 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 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 are supported to realise their own preferences and expectations, and are able to maintain contact with the larger community, friends and family. They receive a wholesome, appealing and balanced diet in pleasant and comfortable surroundings. EVIDENCE: A weekly newsletter is printed and displayed as well as being available for each resident. A sample provided included shop and coffee morning, visit to garden centres, a concert and a sherry morning. Trips taken or planned for the future include Weston- Super- Mare, Bourtonon- the- Water and Slimbridge. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 16 On the day of inspection several residents visited a local school for a concert. There were mixed reports on their return. Some enjoyed it but others were not so keen. As it was good weather a number were also spending time in the spacious gardens and enjoying scones with cream and jam. Everyone is looking forward to the imminent wedding of the manager, which is being held in the village church with a reception in a marquee on the lawn and residents are busily preparing for this. The Expert by Experience spent time talking with a number of residents and observing activities of the home and reported the following: ‘Mental and physical exercise was encouraged with a good range of activities and excursions arranged. These were well attended and supported by staff and volunteers. One resident commented ` there is always something going on and the staff are so good and very helpful’. There is an in-house cinema and local residents are invited to join in on film nights as with other social events. Outside contact is encouraged as it makes the residents feel part of the community. Personal shopping trips can be arranged with the home using their own transport and driver, the choice of venue made by the resident. Spiritual needs were comprehensively catered for with communion being offered `in house` on a regular basis, services being held weekly. It was residents’ choice to attend. One resident commented ‘ the house has a contented feeling l gain all my spiritual needs from the atmosphere here’. The AQAA states how they have improved over the last 12 months: ‘Appointment of one of our senior carers as a dedicated activities co-ordinator 2 days per week’ ‘More money being spent on both staffing levels and on activities’. Future plans are: ‘To include a review of residents’ social needs in the monthly review of residents’ needs’. Meals are taken in the dining room with the menu being displayed for ordering at breakfast time. If residents are unwell or unable to attend, meals are delivered to their rooms or flats. The meal taken with residents was good and balanced, water being provided on the table. An alternative is offered for those with dietary needs. Salt is not used in the cooking but is available on the table. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 17 All residents seen were well dressed and ‘cared for’. There is an option for inhouse hairdressing and other services including therapeutic massage and relaxation. Staff were very visible and attentive making a good friendly atmosphere but also being respectful of residents needs’. Within the relative surveys received one comment stated: • ‘Besides excellent physical care, Wisma Mulia takes care of the spiritual and emotional welfare of its residents. It has a full programme of outings, events, talks, cultural activities. Because residents have their own small flatlets, many with their own garden they can live more independently and yet have support when needed’. However, another said they needed: • ‘Choice at main meal and more variety; a little more entertainment or activities to stimulate and motivate the residents during the day’. One resident commenting on their life at Wisma Mulia stated: • ‘I have had a marvellous 30 years here and am sure it will continue’. Most stated that they joined in with the activities arranged and that they usually enjoyed the meals provided. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 18 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People in the home are protected by the systems in place. EVIDENCE: A copy of the complaints procedure is on display and available in the Service Users Guide. Resident’s surveys confirmed that knew who to speak to if they were unhappy and how to make a complaint. Relatives’ surveys also all confirmed that they knew how to make a complaint but had not yet had to do so. One stated: • ‘On the whole we are happy with Wisma Mulia and if we were concerned about any aspect wed speak to the manager or a member of staff’. Another said: • ‘I now visit every 2 weeks and I have never heard any resident make any complaint about the care home. The atmosphere is always welcoming and the residents do not moan’. DS0000016654.V365245.R01.S.doc Version 5.2 Page 19 Wisma Mulia All of the staff stated that they knew what to do if a resident or relative had any concerns about the service with one saying: • ‘During my interview this was discussed and the appropriate course of action spoken about’. Another said: ‘When information is passed on I feel that it is dealt with well and quickly’. The manager has an open door policy and throughout the day of the inspection it was observed that residents felt able to wander into the office at any time and discuss any concerns they have with the manager or whoever is in charge. However, one staff survey stated that: • Management could listen to staff issues a little better at times. Management will always please the residents, which is good. Sometimes the ones that are always in the office get what they want (residents) and the quiet ones feel on the back burner at times. But on the whole things are good. The AQAA states when asked ‘what it does well’ with regards to complaints: ‘Residents have open access to the Manager and/or Deputy Manager on a daily basis’. ‘Relatives/representatives are encouraged to contact the Manager with any problems, which are dealt with a matter of priority’. How it has improved over the last 12 months is by: ‘More regular residents meetings and informal gatherings at coffee and sherry mornings opens up communication about any arising issues and improves the ‘feel good’ factor for residents’. It was reported that no complaints had been received. Training records confirmed that staff have attended Protection of Vulnerable Adult training. Policies and procedures are in place and are reviewed annually. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 20 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, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained, clean and hygienic throughout. Equipment is provided to aid mobility and promote independence. Individual bedrooms are decorated and equipped to meet the needs of their occupants. EVIDENCE: The Expert by Experience visited resident’s rooms on this occasion and made no comments about the appearance and general cleanliness of the home. Some health and safety issues were raised and included in the last section of the report. Areas observed by the inspector appeared to be clean and well maintained. There were no malodours detected. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 21 Surveys received from residents mostly stated that the home was always fresh and clean. Relatives’ surveys included the following comments: ‘The cleanliness of my mothers room on occasions is not good and I have had to change her bedding a couple of times as they havent had time or had staffing problems. On the whole they are very good’. • ‘The room is normally kept clean and tidy although the toilet sometimes leaves a bit to be desired’. • ‘The home is always clean and tidy and the communal rooms bright and airy’ . These comments were fed-back to the manager who was aware of some problems with cleaning standards in the past but hopes that this has now been addressed. One relative’s surveys also commented on the lighting in resident’s rooms: • ‘I do feel that the lighting in the rooms is rather poor for elderly residents wishing to read’. This also needs to be followed up to ensure that adequate lighting is provided for not only those who wish to read but also to ensure anyone with deteriorating sight is able to see clearly when walking around their room. The manager also confirmed work completed over the past year and plans for the future which include upgrade of some rooms and the visitors’s centre, new carpets ftted in some areas, an extension to the car-park and plans to extend the existing solarium to become a much larger garden room and also fitting flotex flooring through the dining room into this area on completion. This work was scheduled to commence the week following the inspection. • Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 22 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 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 their needs met by sufficient skilled staff who are able to meet the needs of the current number of people living at the home. They are protected by the homes recruitment system and staff are supported to undertake regular and relevant training. EVIDENCE: On-duty on the day of inspection were the manager and deputy, one senior carer and three carers. In addition to care staff there was a cook and kitchen assistant, cleaning staff, administrative staff and maintenance/gardening staff on-duty. All but one of the surveys received from residents stated that staff were always available when they needed them although when speaking to the Expert by Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 23 Experience two residents commented on the length of time taken to answer the alarms at night. No other residents spoken with or observed voiced or displayed any concerns over having to wait for attention. One relative did state that her mother said they are sometimes short staffed when staff are off sick, but all other comments regarding the staff were very positive and included: • She is treated very sensitively, with respect, tact and understanding. For this I am very grateful. She has a full and rich life, as near to being in her own home as possible, yet with support. I think the spirital ethos of Wisma (even tho my mother does not belong to this) engenders kindness and dignity between staff and residents and between residents. Staff generally felt that they had enough time to meet the needs of the residents. Staff observed during the inspection appeared to be carrying out their work in a professional and organised manner and all of the residents spoken with were very happy with the care provided Nine care staff have NVQ 2 and three have NVQ 3. Domestic staff are also able to obtain and NVQ in cleaning, which one has done. There have been four new staff appointed since the last inspection and their files were examined. All had completed applications and all gave a full career history; a health declaration was completed and all but one had two references with one from the last employer given, although one did not have a reference from their last care employer. Start dates were in place on each file. All had identification documentation to include a photograph in place but no interview record was seen. Criminal Record Bureau (CRB) and Protection of Vulnerable Adult (POVA) checks had also been made prior to appointment. Induction and training records with copies of certificates were also seen and an example of an induction programme was seen. This is carried out in conjunction with Stroud College. Each member of staff has individual training records and recent training updates completed included fire safety, infection control and medication training. Other training has included speech therapy, learning disability, equality and diversity and epilepsy training. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 24 The AQAA states that: ‘We are in the process of reviewing our systems of providing and arranging training courses for staff. We continue to do this by researching alternative training providers and by running more training in-house’. Two care staff were spoken with who had been appointed since the last inspection. Both had previous care experience in Learning Disabilities, but had a good induction into this home, shadowing experienced staff until they felt competent to work alone. Both confirmed that they loved working at this home and both have commenced NVQ training and have received supervision. They were both very knowledgeable about the service users; they are allocated an area to work each day, but have worked in all areas so know all the residents well. They stated that they feel confident to go to the manager or above if they have a problem. Staff surveys received also stated: • ‘The service always provides for the residents, and treats them like family. Its very welcoming and friendly and I feel that it is very approachable both to staff and residents’. • ‘The residents are looked after well. The home has a friendly feel and comfortable surroundings’. • ‘I am always given support if I have any questions related to the needs of the residents’. • ‘I am often asked how I am getting on with my work and if I do encounter any problems I receive the appropriate support. I feel like I can approach and talk to my employer about any subject’. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 25 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): 31,32, 33,35, 36, & 38 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 their best interests met by the manager and staff who are committed to their responsibilities. They and the staff are generally protected by the health and safety systems in place in the home, although some safer systems could be considered. EVIDENCE: The manager is a qualified social worker with experience of running and owning care homes in the recent past and has almost completed NVQ 4 registered managers award. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 26 The home has staff meetings for both day and night staff-last being May 2008 and also resident meetings- the last being 17th February, although there are regular coffee mornings where such things as activities, social events and changes to the home are discussed. Minutes of meetings were seen. The manager is very accessible to the residents when he is on duty as was observed. However one relatives survey stated: • A quicker response to answerphone messages left when telephone not answered by staff. (This is not usually an issue but on occasions, especially weekends, the message has not been passed on). This needs to be looked into. The home has a quality assurance programme in place, which includes Regulation 26 visits with reports that are sent to CSCI and also includes audits of the care plans, medications and the kitchen. Records of these were seen. Satisfaction surveys are also handed out to residents/their families and staff, but this years’ distribution had been delayed because surveys had been sent out from the Commission. The home hold small amounts of money some residents and a record kept of any financial transaction undertaken on their behalf. There are supervision and appraisal programmes in place and evidence was seen of supervision and annual appraisals being completed. Records were provided to show that statutory maintenance/servicing of equipment is arranged in a timely fashion. Fire prevention processes are in place confirmed by training records and the recording of fire alarm and emergency lighting checks. Fire alarms were tested during the inspection. The provider has completed a fire risk assessment as required by the Fire Safety service and has adjusted staff training to take into account evacuation processes from the home in accordance with new fire regulations. Several potential health and safety risks were fed-back to the manager by the Expert by Experience. One was an issue with the pendant worn being in the vicinity of the main call equipment, as a resident had reportedly fallen outside and the equipment was situated in the living room, only a few yards, but she had to crawl to the doorway. It was also suggested by the Expert by Experience that all residents with walking frames should wear pendants or wrist- bands in case of falls and information was given for the manager to contact the Council Falls Prevention Officer for advice/help on equipment now available on alerter equipment, if he wished to do so. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 27 Other issues raised were that a resident’s bed was situated opposite (away from) the alarm cord and bedside lamps were not always within easy reach. It was however discussed that the home does already provide pendants for some of their residents and it must be taken into account that it is resident’s choice as to whether they wish to wear pendants or wristbands and where they wish their furniture placed in their rooms. There will also be a degree of risk taken with each resident, in ensuring that they are able to maintain their independence. Each resident had risk assessments completed to include risks when bathing, when mobilising generally and when walking outside and partaking in other activities. Accident forms are completed in full and regularly audited, showing action taken when someone has been identified as falling frequently. For example pressure mats had been positioned by some beds to alert staff when a resident got out of bed and was moving around their room at night; some are moved to ground floor rooms as they become frailer and reviews of medication has been requested in some instances of frequent falls. Comments from relatives surveys further confirmed the above: • • ‘They have made great efforts to make it easier for my mother with dementia and helped her walk,e.g. moved to a room downstairs when it became available’. ‘Encourages residents to still be as independent as possible whilst providing a safe/caring environment for them’. Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 28 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X 3 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 3 3 X 3 3 X 3 Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 29 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 OP9 Regulation 13(2) Requirement Arrangements must be made to ensure accurate recording of medicines within the care home, through constant auditing processes. This is to protect people from possible harm due to possible medication error. Ensure that anyone applying to work at the home provides two written references, one from their last employer and one from their last care employer where they have worked in care previously. Ensure that any activities in which residents participate are so far as reasonably practicable free from avoidable risks. Timescale for action 01/09/08 2. OP29 19 01/09/08 3. OP38 13(4) 01/09/08 Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 30 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP25 OP29 Good Practice Recommendations Make sure lighting in bedrooms is both adequate and accessible to the people using them. Keep records of all interviews of potential staff Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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. Extracts may not be used or reproduced without the express permission of CSCI Wisma Mulia DS0000016654.V365245.R01.S.doc Version 5.2 Page 32 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!