The Haven Care Home Service Idrigill Uig IV51 9XU Inspected by: (Care Commission Officer) Type of inspection: Karen Rose Announced Inspection completed on: 25 July 2006 1/10
Service Number Service name CS2005093628 The Haven Service address Idrigill Uig IV51 9XU Provider Number dummy Provider Name SP2005946156 The Haven Inspected By dummy Inspection Type Karen Rose Care Commission Officer Announced dummy Inspection Completed Period since last inspection 25 July 2006 06/03/2006-4 months dummy Local Office Address Unit 4, 39-41 Harbour Road, Inverness, IV1 1UF. dummy 2/10
Introduction The Haven is a Care Home providing care for older people in Uig, located in the North of Skye. The service provides a range of services and facilities for the residents in their care. The service was registered with the Care Commission on 19 August 2005 and is registered to provide a service for 14 older people. The service aims included: To seek to retain and regain the highest quality of life which each individual is capable of experiencing at any given time To provide a happy caring environment, which enables residents to live as independently as possible. To provide support and care which enhances dignity, promotes independence, allows privacy and minimises stigma. And To support individual and families in their own community and to limit the requirement for institutional care. Basis of Report Before the visit, the service returned a paper copy of the Annual Return containing information about the service prior to the inspection. The Care Commission Officer contacted the manager of the service informing her of when the visit would take place. During the visit which took place on the 25 and 26 July 2006, the Care Commission Officer spoke with the manager, six staff members and 7 of the 14 residents. The Care Commission Officer also looked at a range of policies, procedures and records including the following: Health and Safety including fire safety and records Staff files Residents personal files and reviews Policies and procedures relating to care The Care Commission Officer spent time observing how the staff members related to the residents. The Care Commission Officer took all of the above into account and reported on whether the service was meeting the following National Care Standards for Care Homes for Older People: Standard 4 - Your Environment Standard 5 - Management and Staffing arrangements Standard 13 - Eating Well Standard 19 - Support in Death and Dying Standard 20 - Moving on Action taken on requirements in last Inspection Report There were no requirements as a result of the last inspection. Comments on Self-Evaluation 3/10
The service had not returned the self-evaluation prior to the inspection and report writing process. View of Service Users The service users spoken with were happy with the service provided. One service user raised concerns over not always being consulted regarding decisions made. This was raised with the manager and staff during the course of the inspection. View of Carers One service user's daughter spoke with the Care Commission Officer during the inspection process and indicated that she was happy with the care provided and that her relative had settled in well since moving to the Haven. One concern was raised regarding consulting service users, this was raised by the service user themself and this was discussed as part of the inspection process with the manager. 4/10
Regulations / Principles Regulation : National Care Standards National Care Standard Number 3: Care Homes for Older People - Your Legal Rights The next inspection will focus on the written agreement taking into account the Office of Fair trading report about transparency of information, contract and complaints systems in care homes. National Care Standard Number 4: Care Homes for Older People - Your Environment The service provider had plans drawn up in relation to the provision of single occupancy rooms to meet 4.10 of this standard. These plans were still at the discussion stage, but the provider hoped to have finalised plans by the end of the year. The service provider should ensure that all service users, relatives, representatives and the Care Commission are kept informed of progress. National Care Standard Number 5: Care Homes for Older People - Management and Staffing Arrangements The service had a wide range of policies and procedures including staff training, administration of medication, health and safety including infection control, whistle blowing, environmental health including 'cooksafe', fire safety, managing risk, restraint, and complaints. Records were maintained including the recording of accidents and incidents. The service had a copy of 'Protecting Vulnerable Adults' good practice guidance and procedure 5/10
and this linked to the services policy for Adults at Risk. There was evidence of fire risk assessment, records relating to fire checks were maintained and plans were in place to meet all of the recommendations of the Highlands and Islands Fire Brigade inspection of premises by December 2006. Staff were aware of policies and procedures and were allocated a mentor on starting with the service. There was evidence of training covering a wide range of topics including medication, health and safety as well as evidence of staff undertaking SVQ's level 2 and 3 in Social Care. The service was working towards all staff undertaking SVQ 2 training and plans were in place for staff to continue to level 3, if they wished. The manager and staff were aware of the Scottish Social Services Council and the code of practice as well as the need to register with the council. Training was in place for staff relating to medication and the service had a copy of the best practice guidelines 'the administration and control of medicines in care homes and children's services'. Arrangements were in place for service users to self medicate, but at present the service organised medication for all service users. There was evidence of service users reviews with healthcare professionals. The service kept records relating to service users financial transactions and had a policy in place. The service had a system in place for recruitment of staff, this included the use of application forms, the take up of references and Enhanced Disclosure Scotland Checks. 8 of 12 staff files were examined; these contained some of the required information. There was some evidence of checks for fitness of employees and some evidence of Enhanced Disclosure Scotland checks. The service had a system in place for recruitment but there was no written policy or procedure to ensure consistency of approach. Not all the staff files contained two references, a medical declaration or Enhanced Disclosure Scotland checks. The service needed to develop a system to ensure Enhanced Disclosure Scotland Checks were recorded and that all staff had evidence of enhanced checks. The service should consider rechecking staff through Disclosure Scotland periodically as a measure of good practice. The service did not have a system in place for checking professional registers and should develop this. Though the service was providing a range of training opportunities for staff, there was limited evidence of supervision leading to continuing professional development. The service did not have a yearly training plan and should link the training plan to the policy on staff training. The training policy was outdated and required review to reflect current practice. The manager should look towards undertaking the Registered Managers Award and should contact the Scottish Social Services Council with view to registration for herself and the staff. The service needs to ensure all staff have up to date fire safety training from a competent person and this training is recorded. Records relating to fire drills should be maintained. The service should ensure they follow best practice guidelines relating to the administration of medication and ensure they see copies of the GP 10 prescription forms prior to the pharmacy dispensing. National Care Standard Number 13: Care Homes for Older People - Eating well Catering and care staff were aware of the service user's preferences, including ethnic, cultural, faith ones and any requirement for special diets. At the time of the inspection there were no service user's on special diets. The kitchen had undergone recent refurbishment and had a visit from the Environmental Health Officer recommendations had been actioned. The 6/10
daily menu reflected the service user's preferences and contained fresh fruit and vegetables. Produce used was obtained locally and measures were in place to ensure service user's nutritional needs were met at all times. Choices were available and snacks and drinks were available on request. Staff were aware of service user's fluid needs and food and fluid charts were maintained if required. There was good liaison with the healthcare professionals relating to service user's dietary and fluid needs. Evidence indicated the use of dietary supplements for specific service user's with the GP's involvement. Meals were well prepared and presented. Food handling followed best practice; all staff had undertaken training relating to food hygiene. Service user's were able to eat in one of two dining rooms or in their own room. Staff assisted service user's to eat meals and food was prepared to enable service user's to enjoy their meals. Staff were aware of service user's needs and obtained assistance from healthcare professionals if service user's ability to eat or drink was affected. The service did not routinely screen for nutritional needs unless requested, but had good rapport with the local healthcare professionals. Plans were in place for the Family Health Nurse to screen all the service users resident in the care home and for this to become routine, using the MUST screening tool. The service was actively meeting the service user's nutritional needs but could further develop by developing care plans to include dietary needs and preferences, including special diets. The service should develop policies relating to food, fluid and nutrition. National Care Standard Number 19: Care Homes for Older People - Support and Care in Dying and Death The service had a very clear policy and procedure relating to the support and care of a service user during this time. Staff had recent experience of supporting a service user and had developed positive relationships with healthcare professionals. Staff were able to meet the wishes of the service user. Though the service did not have separate accommodation for family, arrangements would be made to enable family members to stay with the service user. The service was able to offer support to relatives and friends throughout the formal processes relating to death. The service had a copy of the 'Making good care better' National practice statements for general palliative care in adult care homes in Scotland' and were working towards these statements. The service should further develop the service users care plans to include information relating to service users wishes with regard to their physical. personal and spiritual care in dying, death and funeral arrangements. National Care Standard Number 20: Care Homes for Older People - Moving On This standard was discussed with the manager and a senior member of staff, at present the service had not had any service user's move onto alternative accommodation. The manager 7/10
stated that they would involve service users, family and their representative throughout the process. Information would be shared with the new home and they would liaise with the new service to support the service user through the move. The service should develop a written policy and procedure to reflect this standard, to enable a consistent approach to a service user moving on. 8/10
Enforcement None. Other Information None. Requirements 1. The service needs to develop a safe recruitment system including the development of a written policy and procedure. SSI 114 Regulation 9 Fitness of Employees, SSI 114 Regulation 19 Records 2 (a - e), National Care standards for Care homes for older people Standard 5 - Management and Staffing, SSSC Code of Practice - Employer - 1.1, 1.2, 1.3 Make sure people are suitable to enter the workplace, SSSC Code of Practice - Employee - 2.1 Being honest and trustworthy. 2. The service needs to ensure that 2 appropriate references are obtained for all staff. SSI 114 Regulation 9 Fitness of Employees, National Care standards for Care homes for older people Standard 5 - Management and Staffing, SSSC Code of Practice - Employer - 1.1 Make sure people are suitable to enter the workplace, SSSC Code of Practice - Employee - 2.1 Being honest and trustworthy. 3. Ensure records are kept with regard to staff declaration of their medical fitness. SSI 114 Regulation 9 Fitness of Employees, National Care standards for Care homes for older people Standard 5 - Management and Staffing. 4. The service should develop a system to record Disclosure Scotland Checks and these checks should be enhanced for all staff and volunteers working with vulnerable people. SSI 114 Regulation 9 Fitness of Employees, National Care standards for Care homes for older people Standard 5 - Management and Staffing, SSSC Code of Practice - Employer - 1.2 Make sure people are suitable to enter the workplace. Recommendations 1. The service should develop a system for recording checks with professional registers. SSI 114 Regulation 9 2 (c) fitness of employees, SSI 114 Regulation 19 Records 2 (d), National Care standards for Care homes for older people Standard 5 - Management and Staffing, SSSC Code of Practice - Employer - 1.2 Make sure people are suitable to enter the workplace. 2. The service should review the training policy and develop a training plan linked to staff supervision and continuing professional development to reflect current practice. National Care standards for Care homes for older people Standard 5 - Management and Staffing. 3. The manager should undertake the Registered Manager's Award and contact the SSSC with regard to registration. SSI 114 Regulation 7 fitness of manager, National Care standards for Care homes for older people Standard 5 - Management and Staffing. 4. The service should put in place a written policy and procedure for food, fluid and nutrition to ensure that service users food, fluid and nutrition are supported by clear management guidelines. National Care Standards for Care Homes for Older People Standard 13 - Eating Well. 9/10
Karen Rose Care Commission Officer 10/10