Inspection on 04/03/08 for Strand House

This is the latest available inspection report for this service, carried out on 4th March 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Strand House 16/03/06

Strand House 02/08/05

Strand House 18/01/05

Strand House 15/06/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Strand House The Strand Starcross Exeter Devon EX6 8PA Lead Inspector Clare Medlock Unannounced Inspection 4th March 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Strand House DS0000003816.V358481.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. Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Strand House Address The Strand Starcross Exeter Devon EX6 8PA 01626 890880 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) pepigs@starcross.fsnet.co.uk Mr P E Pigott Mrs Pigott Mrs Pigott Care Home 8 Category(ies) of Old age, not falling within any other category registration, with number (8), Physical disability over 65 years of age (8) of places Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd November 2006 Brief Description of the Service: Strand House is a care home located in Starcross, a small seaside village, close to Exeter in the county of Devon. It is set back from the main road and is close to Starcross railway station offering direct access to Exeter, the north, London and Cornwall. The home is registered as a care home for eight older people and was registered and has been run by the present owners since 1988. Strand House is not registered to provide nursing care and it does not provide intermediate care. The owners manage the home and also live on the premises. There are six single bedrooms and one double room. There are toilet facilities close to all bedrooms and communal areas. There are additional bath and shower facilities. There is a chair lift available for those people who need to use it. The home has a large family style kitchen where meals are served, a sitting room and a smaller quiet room. To the rear of the home there is a patio area and small area of lawn that is used by the residents when the weather is suitable. The statement of purpose is available from the manager. The fees range from £305 to £320. The actual fee is dependant on the needs of the resident and the room occupied. Additional charges are applied for hairdressing, chiropody, opticians and any newspapers magazines the residents request. Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was a key unannounced inspection. A visit to the home carried out on Tuesday 4th March 2008. At this visit we spoke with members of staff, five people who use the service, the provider and visitor. We looked at one care plan, medicine records, accident books, looked around the home. was two one and We looked in detail at what it was like living at the home for a person recently admitted to the home. We looked in detail at their records, care plans, and aspects of their life at the home, including what they did during the day. This is referred to as case tracking, and helps us to understand the experience of people living in the home in more detail. We also sent questionnaires to people who use the service, relatives, and health care professionals. One relative questionnaire and three healthcare professional questionnaires were received. Prior to the inspection the manager completed a questionnaire, called an AQAA (Annual quality assurance assessment), which provides information about service users, staffing, fees and confirms that necessary policies and procedures are in place. All this information gives us a picture of what it may be like to live at the home and helps us to form our judgement. What the service does well: People who use the service spoke very highly of life at the home, the manager and staff team. People seemed genuinely happy, relaxed and at ease with staff in the home. The home has a good reputation in the community and the admission procedure used at the home ensures that people have enough information to decide whether the home can meet their needs. People who live at the home are happy about the personal and healthcare they receive and their relatives are also happy with the care provided. Healthcare Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 6 professionals say that staff provide ‘Very personal environment, where people feel happy and secure’. care in a family Communication with the local doctors and nursing team is good to ensure all personal and medical attention is accessed when needed. The staff at the home also access other health care and NHS services so that people living at the home have a full range of support where needed. People using the service are given the opportunity to maintain contact with family and friends and are supported to take part in informal and formal activities of their choice. People at the home also enjoy the high standard of food provided. People do not find the need to complain at the home and say staff are ‘wonderful’ and provide ‘loving care’. People say staff are approachable and make them they feel safe living at the home. The home is well maintained, clean, tidy and has a homely relaxed atmosphere. People who use the service are cared for by staff who have had the necessary pre employment checks, staff induction and training. Strand House is well managed and run in the best interests of the people who live there. Staff at the home are open to change and improvement when it arises. What has improved since the last inspection? The manager continues to provide a good standard of care and is continually looking to change and improve where the need arises. Since the last inspection, several areas of the home have been redecorated. A downstairs toilet and four of the bedrooms have been redecorated. New furniture has also been purchased including ‘touch lamps’ for those people who wanted them. The manager, in response to requests from people, has provided higher backed garden chairs and a larger sun parasol. Routine maintenance has also resulted in the replacement of an outside pathway. The manager has changed the induction programme for new staff. A robust programme is now used which prepares staff for further training and provides staff with the information they need to perform their roles in a safe way. The manager has also introduced a policy on discrimination. Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 7 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. Strand House DS0000003816.V358481.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 Strand House DS0000003816.V358481.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): 2,3,4 (Strand House do not provide intermediate care) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission procedure ensures that people are able to decide whether the home is where they want to live and staff have enough information to decide whether the home can meet their needs. EVIDENCE: People told us that they were able to visit the home before they decided to move in and were able to have questions answered by staff at the home. One person told us the GP had suggested a care home would be suitable and the family had arranged a trial stay at Strand House. This person said us that they had made their mind up very quickly to stay and not return home. We were told that either they or their families had signed a contract and chosen the room they were to move into. Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 10 The Manager told us an assessment is always performed on people before they move to the home. The manager told us usually she visits the person before they move to the home, but one person had been assessed on a visit to the home to ensure they could manage a small set of stairs, which leads to their room. Records are made of the full assessment with information being obtained from other healthcare professionals where relevant. The assessment used, is written in a way that allows for the individual care needs of the person to be re-assessed on a regular basis and enables staff to identify changes in the care needs of the person. The manager told us trial visits vary according to what each person wants. Some people have lunch, others stay for a day and others have a longer trial. Once a decision has been made a letter is sent to the person or their family confirming the contract details and rate of pay. This letter is then kept in each persons file. Strand House DS0000003816.V358481.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. This judgement has been made using available evidence including a visit to this service. People who use this service are treated with respect, and receive the personal and medical care they need to help them stay well. EVIDENCE: All people we saw and spoke with appeared well cared for with the finer details of care given. For example appropriate footwear, hearing aids and glasses were in place and oral hygiene needs met. When case tracking we looked at one of the six care plans and spoke and spent time with the person it referred to. Care needs were clearly written and stored in an A4 file. Each file contains records and documents suitable to that person, and showed that care had been planned, delivered and reviewed. The record seen showed an improvement in the person’s condition. Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 12 Staff were knowledgeable about the personal and health care needs of people they cared for. When we spoke to staff, they talked about information, including religious beliefs and personal likes/dislikes. We saw examples of good practice, where staff interacted with people in an affectionate and unhurried way. Staff spoke to people with respect and worked at a pace that was correct for the person. People told us that the care could not be faulted and that all staff were very kind and considerate. One person said they liked the fact that staff knew how much they were able to do themselves and encouraged self care where needed. One person told us staff were very thoughtful when clothes were chosen each day, and appreciated small touches like ensuring colour matches were made. People told us that they were treated with kindness and respect. Examples of this were seen during the inspection. People told us that staff knock on their door before entering and call them by their chosen term of address. People who use the service said that when staff assist them in the bath, they make sure their dignity is maintained and allow as much privacy as is appropriate or requested. People told us they saw the doctor when they needed to and received their medicines on time. One person told us they were able to self medicate but staff assist with ordering repeat medications from the chemist. Staff told us they had all received medication training from the pharmacist and that two staff were due updates on new systems. The manager told us the pharmacist inspected the medication system last year, where no issues were found. Records are kept of medication requests and returns. Medication administration records are well maintained. Storage of medication at the home is good and no controlled drugs are kept at the home at present. Staff told us the blister pack system is used and is easy to manage. Surveys from health care professionals told us that care is good at the home. Comments included ‘I cannot speak too highly of Strand house. I have been involved as a GP for many, many years-it’s an excellent care home’ and ‘Very personal care in a family environment where people feel happy and secure’. Relative surveys were also complimentary with one comment that read ‘Strand house values it’s residents and treats them as individuals’. One survey contained a response about quality of care which read ‘There have been occasions where residents have deteriorated rapidly due to their medical condition. Staff have cared for these people with support from the PCT to a very high standard, enabling residents to die in their place of choice’. The manager told us that a local team of district nurses supports the staff at the home, and communication with local General Practitioners is good. The Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 13 manager told us that some NHS services are accessed at the home and this recently has included flu jabs. A visiting chiropodist comes to the home but other healthcare services are accessed in the community. Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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 using the service are given the opportunity to maintain contact with family and friends. They have access to a balanced diet and are supported to take part in informal and formal activities of their choice. EVIDENCE: People who spoke to us all said life at the home ‘could not be faulted’. One person said they were able to go out to various clubs in the community. Another person told us they mostly enjoyed visits from their friends and family. Two people told us of the recent trip arranged to see ‘Holiday on Ice’ (An ice skating show at a local arena) People told us that the manager had organised a local disabled access mini bus which enabled them to reach the front door. Another person told us the manager had helped family organise a surprise 90th birthday party and enabled people from the home to join in with the celebrations. Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 15 People told us that during the summer months they enjoy sitting in the garden under the large sun umbrellas, but during the winter months they prefer to stay indoors to watch TV and listen to the radio. There are large print library books available in the ‘quiet lounge’ which the manager said were changes several times a year. The manager also said some people used to play board games but this is less popular now. We were told the local vicar comes to the home regularly to offer communion to those who would like to receive it. People told us their either ‘go out’ to get their hair done or one person said the person that has always done her hair now comes to the home. Staff told us some people are more independent than others and that one or two residents go to local clubs and nearby towns independently. The manager told us some people ‘go out’ with family and that many visitors are seen at the home. People told us the food is ‘superb’ and ‘wonderful’ with ‘plenty of it around’. On the day of our visit the lunchtime meal was lamb hotpot with broad beans and ice cream with mango puree. The manager told us the menu is planned on a four weekly rota after speaking with people in the home and sometimes changes because of seasonal offers at the local supermarket. Three people told us they did not know what was on offer each lunchtime but that this did not matter because the ‘staff know what we like and don’t like’ and because ‘it is always good’. People told us they were able to choose what they ate for tea and there was always something hot. People told us they are able to have snacks at any time of the day or night. Staff told us there is always plenty of food available. We were told that breakfast was served in each persons bedroom and all other meals were served in the kitchen diner. One person said meal times are sociable times where ‘we catch up on each others news’. One person is assisted with meals in the privacy of their room. Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place so concerns and complaints could be dealt with promptly. Improvements in staff training would ensure all staff are aware of vulnerable adult issues and local procedures. EVIDENCE: People told us they were very happy at the home and have never needed to complain. All people we spoke with said they would feel able to raise concerns with the manager and felt confident that they would be listened to. Surveys also showed that relatives and healthcare professionals are happy with the service provided. Comments included ‘Staff give very personal attention so I have never needed to complain’. The manager has received no complaints since the last inspection. The commission for social care inspection (C.S.C I) have not received any complaints or concerns about the home. Complaint procedures are available within the Statement of Purpose. A complaints book is available for people and their relatives to use. Contact details for CSCI are available on the notice board in the entrance hall. Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 17 People told us they have not had to vote for a long time but would probably opt for postal votes. The manager told us postal votes have been popular in the past but people have been taken to the poling station in the past. The people we spoke with said the staff were ‘wonderful’ ‘kind’ and ‘marvellous’. All people we spoke with said staff were respectful and kind. People told us staff did not rush them and made them feel safe and reassured. One person said ‘staff treat me with such loving care’. One person said she would feel able to report poor treatment but this has never been needed because the staff are faultless. Staff were able to identify what constituted abuse and said they would not let poor practice go unaddressed. Staff said they would make sure poor practice was reported, but were not sure whom allegations should be reported to in the manager’s absence. The manager knew to contact Commission for Social Care Inspection but needed reminding of some local procedures. The manager said the new induction programme is now in place. This contains an in-depth section of recognising, reporting and recording allegations of abuse. Staff told us they had not received training in the protection of vulnerable adults (POVA) but had watched a video some time ago. A local Devon County Council Alerter Guide is available within the home for staff reference if needed. The recruitment procedure in the home protects people who use the service from unsuitable staff. All staff have a CRB and POVA check before starting work. Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are provided with a homely, clean and comfortable place to live. Further improvements to staff practices would reduce the spread of infection. EVIDENCE: Strand House is a well maintained building set back off the main road running through the village of Starcross. The home is close to the train station, bus stop, beach, local shops and a pub. The home is clean, tidy and free from odour in all areas. People told us the home is always clean and well maintained. Several areas of the home have been redecorated including a downstairs toilet and four bedrooms. New Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 19 furniture has also been purchased where needed. The manager told us there are plans for further maintenance which includes replacing carpet, kitchen flooring and repairs to the storeroom. The home has a kitchen dining area where people who use the service eat together. Two lounges are available for people to use. One has a TV and radio, whilst the other smaller lounge area has a wide range of books, which are changed on a frequent basis. The furnishings and fabrics in these lounges are of good quality and domestic in character and suit the needs of the people who live at Strand house. Toilets are easily accessible from communal areas and each person’s own room. The washing and bathing facilities provided meet the needs of the people who use the service. Grab rails, ramps and stair lifts are available in the home to encourage independence. One person told us they are able to manage one or two stairs but the stair lift is ‘wonderful’. The outside of the home is also well maintained and includes a patio area where people can sit outside and enjoy the garden in sunnier weather. Requests have been heard and acted upon for new higher backed garden chairs and a larger sun parasol. An existing pathway has also been replaced. This outside of the home is wheelchair accessible, although none of the current residents require a wheelchair at present. The homes washing machine is sited separately from the kitchen area. The clothes dryer is provided in an external building. Hand washing facilities for the staff using the laundry equipment are available in a nearby bathroom. Staff said that they are ‘always washing their hands’. However staff also told us that gloves and aprons are available but are not always used when emptying commodes, transferring soiled laundry, getting rid of incontinence pads and giving personal care. Discussion was held regarding the importance of the prevention of the spread of infection by staff and the importance of protective clothing. The manager explained that all laundry is washed on the premises, and foul linen is not often handled but sluicing would take place if this occurred. Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. The systems in place mean that people are cared for by staff that have had the necessary pre employment checks, staff induction and training. Improvements to recruitment record keeping will show the correct processes have been followed. EVIDENCE: Staff told us that there are two carers on duty at all times and that when the registered manager is on duty she is usually ‘hands on’. Extra cleaning staff come in to perform routine cleaning, but care staff keep people rooms tidy and help prepare lunch. Staff told us that the staff team work well together to cover the care hours needed for the people living at the home. Staff told us that they cover shifts shortfalls to enable people to have a staff team caring for them that they know. The manager told us that there had been a shortfall of staff last year, which meant that some administration records had been neglected as she had covered shifts. The manager told us new staff have now been recruited. Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 21 People who use the service told us that they thought there were enough staff at all times and never had to wait long to have a bell answered. People said they received their medications on time and were able to get up and go to bed when they chose. The people we spoke to were extremely complimentary about the staff. Surveys from healthcare professionals and relatives were also complimentary about the staff team and included comments such as ‘Very caring staff who act promptly’, ‘They always do their best, even in difficult circumstances’ and ‘Friendly approachable carers’. The manager told us new staff have been recruited and a new induction programme is in place, which prepares staff for NVQ training. This induction programme was seen to contain recognised induction standards, which includes abuse awareness. One member of staff said the manager had supported her to do NVQ training and ensures staff receive the training they need. One newly appointed staff file was inspected. This showed that staff complete an application form, which contains a declaration of criminal convictions and contains details of references. Two references are obtained and CRB and POVA checks performed by the umbrella body. There was no evidence that the health of an application is assessed before work. The manager told us staff are asked if they are fit to work at the home but this information is not recorded. Evidence of ID checks are also not kept although the manager told us these are obtained for the CRB check. Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,37,38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Strand House is well managed and run in the best interests of the people who live there. EVIDENCE: The registered manager has owned and managed the home for several years and is aware of the care needs of older people. She has kept up to date by attending various courses to improve her knowledge and skills. Staff and people who use the service told us there are clear lines of accountability with in the home. One person said the fact that the manager lived at the home meant it kept that ‘home from home’ atmosphere. Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 23 The manager told us the home do not hold or manage the financial affairs of anyone at the home. People who use the service or their families manage any personal money or financial transactions. Surveys told us that the home is ‘well managed’ and ‘provides a secure peaceful environment’ Other comments referred to the home as ‘calm’ with an ethos of ‘valuing people whilst treating them as individuals’. People we spoke to told us to said they thought the home was ‘well run’ and said that any thing asked for is provided. People said they see the manager everyday, so are able to talk about issues as they arise. One person said it feels like being at home with a big family. One person said meetings are not held but with such a small number of people at the home there really was not a need. The AQAA showed the home is open to change and improvement when it arises. Staff said they thought the home was well run with everyone working as a team to provide a good standard of care. Staff said formal supervision is available but that the manager works with them everyday so valuable discussions are not always formally recorded. Staff said they felt supported and part of a stable team. The manger told us the shortage of staff meant administration duties have been secondary to providing continuity of care but now have started being readdressed. The manager told us policies and other documents are being reviewed. However, inspection of medicine records, accident books and care plans have been well maintained. Fire records are maintained by the manager and show routine fire system and emergency checks take place at the home. Staff told us a fire consultant visits the home twice a year to provide fire safety training for staff. The manager and staff told us they have attended training in moving and handling at the Royal Devon and Exeter hospital and are booked on refresher first aid and food hygiene training. The manager told us other routine safety checks take place at the home. These include gas safety, electrical equipment and fire systems, although records for these were not inspected on this occasion. Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 2 18 3 3 3 3 x x x x 2 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 3 3 X 3 3 3 3 Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP18 Regulation 13(6) Timescale for action The Registered Person shall 01/07/08 make arrangements, by training staff, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse The Registered Person shall 01/06/08 make suitable arrangements to prevent the spread of infection at the care home, by ensuring staff wear aprons and gloves when emptying commodes, disposing of pads and providing personal care. The Registered Person shall not 01/06/08 employ a person to work at the care home unless• The person is fit to work at the care home • He has obtained a statement as to his/her mental and physical health Requirement 2 OP26 13(3) 3 OP29 19(1a) schedule 2(6) Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP18 OP26 OP29 Good Practice Recommendations The Registered person should ensure staff have quick access to contact details and correct processes for reporting allegations of abuse. The Registered person should consider conducting an infection control audit at the home. The Registered person should provide evidence of what ID checks have taken place Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection 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 Strand House DS0000003816.V358481.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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