Inspection on 29/04/09 for Thames Side
Also see our care home review for Thames Side for more information
This is the latest available inspection report for this service, carried out on 29th April 2009.
CQC 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
Similar services:
What follows are excerpts from this inspection report. For more information read the full report on the next tab.
What the care home does well
The home manager transfered to the home in February this year from another home within the same organisation and is preparing an application for registration. He has relevant experience and qualifications to manage the home and was registered prior to his transfer. The deputy manager is also relatively new to the home having also transfered from another home within the group. Discussions with both managers confirmed their awareness of both areas of service strengths and where improvements are necessary and are planned. The recently implemented weekly meetings for departmental managers within the home have been key to recent improvements, also internal quality assurance and auditing systems. We were informed by a team leader that recent reforms had raised standards and that team work and relationships between management and staff had improved. Both the team leader and staff consulted said they felt well supported and described an open management culture. A care assistant expressed the following opinion. " The last manager turned this home around and the new manager has built on her good work and is also very good. I can only speak for myself, but I find the home is a much nicer place to work than it was. If I am not happy about something I am quick to say and it is dealt with". Improvement in the home`s medication procedures and practice had mostly been sustained though a shortfall was identified during this inspection and drawn to the attention of management. Evidence was found of compliance with two requirements made at the time of an unannounced specialist pharmacist inspection we undertook in October 2008. The records sampled confirmed that allergies to medication are now recorded on both medication administration charts and care plans. There was evidence of people using services being administered medication at the dose and frequency prescribed by their general practitioner. The past high rate of staff turnover had subsided. Recent staff recruitment initiatives had been successful in filling most staff vacancies and building up numbers of care bank staff. Reliance on agency staff for maintaining staffing levels had reduced, improving continuity of care. The staff rotas sampled and feedback from people using services, visitors and staff indicated staffing levels were overall consistently maintained and appeared adequate.Other areas looked at included falls prevention risk assessments and management which includes issuing people at risk of falls with pendants to activate the call ball system for assistance. In the bedrooms sampled all but one of the beds were positioned so that people using services can access the call bell. The bedroom of the person who was the exception to this was being rearranged on the day of the visit at the same time as her own furniture was being brought in by her family. She had been reticent to have the room rearranged sooner preferring to wait until her furniture was delivered. She had been issued with a call bell pendant and had this with her in the lounge. Other areas assessed included arrangements for enabling people using services to access healthcare professionals. The home was understood to receive good support from both medical practices. We also examined procedures for enabling self-administration of medication after admission if people wish to retain this responsibility. Discussions with the deputy manager included assessment practice for a person in hospital ready for discharge back to the home. Also the management of a complaint investigation which had been temporarily suspended and was to be resumed. We examined how the home managed to balance the rights and risks of people using services in their access to the wider home environment. We were informed that mental capacity assessments were in the process of being undertaken, where necessary. The deputy manager was also currently reviewing personal evacuation plans for people using services. These detail dependency and mobility needs and contain instructions for their safe evacuation in the event of a fire. Discussions with some people using services individually and in groups identified a good level of satisfaction with the home`s services. Staff were observed to be kind and caring in their approach. Positive relationships evidently existed between individual staff and people using services. The home environment was comfortable, well-maintained, clean and hygienic and the atmosphere was warm and friendly. The expanded social activities programme is affording increased opportunities for social stimulation. We were told by a person using services, " I am well looked after and overall very happy living here. Staff are prompt in giving me the care and help I need. They are very good in the way they care for people with dementia though I feel they should select the activities they are involved in more carefully as they can`t always join in and don`t get the attention they need. I think some of the activities are excellent". The inspection found the home to have robust procedures for promoting nondiscriminatory practice, enabling people to maintain their rights and identities. Personal support practice is based on rights of dignity, equality, fairness, autonomy and respect.
What the care home could do better:
Improvement to the system for notifying us of things that have happened in the home had been sustained. Following a recent omission in a notification to care management the home has recognised the need to extend the scope of notifications to the regulator and care management. The home manager was referred to guidance on notifications under the Care Homes Regulations (amended). The need to ensure staff do not leave unattended medication trolleys with the door left open outside bedrooms whilst they are in the room administering medication was discussed. This practice was observed in one unit only and management confirmed the intention to take immediate remedial action. Onthis basis a requirement has not been made. The home`s management is aware of shortfalls in care records and has put in place a plan for improvement. Care records sampled were not all in sufficient detail to provide an audit trail of care and of significant events.