Inspection on 10/02/09 for Wallfield

This is the latest available inspection report for this service, carried out on 10th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wallfield 01/03/06

Wallfield 31/10/05

Wallfield 18/01/05

Wallfield 25/08/04

Wallfield 25/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2010.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Wallfield 29 Castlemain Avenue Southbourne Bournemouth Dorset BH6 5ES two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Peter Still Date: 1 0 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Wallfield 29 Castlemain Avenue Southbourne Bournemouth Dorset BH6 5ES 01202428048 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : mel.blanch@bournemouth.gov.uk Bournemouth Borough Council care home 14 Number of places (if applicable): Under 65 Over 65 14 0 learning disability Additional conditions: The registered person may provide the following category of service: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability- Code LD The maximum number of service users who can be accommodated is 14. Date of last inspection A bit about the care home Wallfield is a big home for 14 people who have a learning disability. The Manager is Mel Blanch Everybody at the home has their own room Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: What the care home does well What has got better from the last inspection Each person living at the home has a Key Worker to support them with things that are important. There is more activity. There are more staff to be with people and help them do the things they want to. What the care home could do better People living at the home may enjoy shopping for food. Some people have difficulty with the stairs and it would be good to talk about putting a lift into Wallfield. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Peter Still CSCI 4th Floor Colston 33 33 Colston Avenue Bristol BS1 4UA If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People wishing to consider moving into Wallfield are provided with good information and visits to help with decision making. Thorough assessment ensures needs can be met. People who live at the home have a written contract of the terms and conditions with the home. Evidence: We were given a copy of the new Service User Guide, called Guidelines to Living at Wallfield, which was in the process of being published. The guide had been produced in colour format with pictures and symbols to make it more accessible for people, and a large font size had been used for the straightforward text, which was in bold. The Homes Statement of Purpose had also been revised and sent to the Commission prior to this inspection for reference. It was well laid out and included contact details for the Commission for Social Care Inspection. We reviewed three care files and found that each had a Core Assessment of need in relation to the placement. One file reviewed showed a detailed admission process. People considering moving to the Home make a number of visits to Wallfield prior to admission, which includes an overnight and weekend stay. The admission process was considered to be carefully staged so that there is plenty of time for people to make their decision. It was particularly noted that new residents have a member of staff allocated to them, called a key worker. This member of staff ensures the persons Evidence: needs are met and that they are helped to feel secure and comfortable in their new surroundings. Three residents spoken with, talked warmly about their key worker, which showed that positive relationships had been formed. One visiting professional spoken with during the inspection said: There is a good assessment prior to admission and good communication between staff and our organisation. We have a confidence in this service and that people with complex needs can be placed and well cared for. The home is careful in the way people are admitted to ensure individuals needs are fully assessed. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Individual care plans ensure individuals assessed needs are known and met. People are encouraged and supported in making decisions and choices in their lives. Comprehensive risk assessments are provided to protect people and also to recognise responsible risk taking as part of an independent lifestyle. Evidence: At the time of this inspection, staff had just started to implement a new care planning system for people who live at the home, called Essential Life Plans. Two were reviewed and they provide detailed key information and use communication symbols and photos. Each individual receives an annual review with their allocated social worker and recent reviews were seen on files. There was evidence that individuals were involved in decision-making and that they were consulted about their individual plans and goals. It was noted that two people had chosen to produce their Essential Life Plans on DVD. Two people spoken with talked about their plans and were happy that staff had listened to their likes and dislikes; one person had gained confidence in going out to live events in the community. Residents meetings were being held regularly, on a monthly basis and minutes were seen. The notes were written up in an easy to read format, including symbols. There was detail about holidays, activities and other issues important to people. People are encouraged to make choices, for example the cook who was spoken with Evidence: said that there is choice of food and one person living at the home showed us the symbol of a meal they had chosen. The essential life plans also provide detail of likes and dislikes in relation to all aspects of peoples lives, including social activity. Risk assessments were looked at and showed evidence of detailed information, which had been reviewed. One recent risk assessment gave significant detail to support staff in keeping the person safe and detailing key points, which would ensure staff take the correct approach to minimise risk and support the person appropriately. Risk assessments were seen on peoples files and there was an additional Risk Assessment file with copies of all assessments for ease of staff reference. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Individual activity programmes meet peoples preferences and enhance life experience. People who live at Wallfield have a healthy and balanced diet, however involvement in shopping for food is limited by the current purchasing arrangements. Evidence: People, who live at Wallfield, attend local social education centres. Three centres were being used, which demonstrates individual choices were being made. A number of individuals were spoken with on their return to Wallfield and had enjoyed their day. Three people were at the home during the inspection and other people began returning in the early afternoon. One person spoken with talked enthusiastically about the range of things they do and activity the home supports, which they enjoy, including football, music and going to the pub. This person said they also like to go out in the homes vehicle. People living at Wallfield have a written daily programme and the detail on one file reviewed was considered to be excellent, however it was not dated and so it may have led to confusion about which was the up to date programme or when it had been reviewed; other programmes reviewed were dated. Each person living at the home has an individual activity programme and chart to Evidence: record activities. One assistant manager has delegated responsibility for activity and it was noted that activity has been more of a priority since the last inspection. A number of staff spoken with were enthusiastic about the way the home supports a variety of activity and this included a new game called Wii, which is interactive with the television. One individual spoken with talked about how they enjoy it and a member of staff supported another to communicate that whilst they cannot take active part, they enjoy watching the fun of others, which makes them laugh. The home has the benefit of a small sitting room with facilities for making drinks and for doing personal laundry; one resident talked about making coffee. During the inspection, we met with an aroma therapist, who visits people three times a week; a half hour personal session was provided to people who choose aromatherapy. Staff use their skills and interests and one member of staff talked about dancing and the fun residents have. Other examples given included cooking and arts and crafts. The home has a minibus, which people enjoy using, however at the time of this inspection, more drivers were needed to ensure it can be used to its full potential. There was emphasis on supporting people to do things that they wish to on a more individual basis. The home has a computer for people to use but it was not being used very much. Evidence about activity and the lifestyle of residents was found within the daily contact sheets. The kitchen was seen to be very clean and tidy. We spoke with the cook and the assistant, who was said to provide great help to the cook; they work very much as a team. It was clear that there was enthusiasm for the work they do and they said they have good support from staff and the manager. A balanced menu was provided, which includes choice. Food was said to be nearly all fresh cooked, every night. One individual said they enjoy the food, it is wonderful and also enjoy meals out. The written daily programme for one person, provided clear detail about how they liked to be supported with their meals, which included points about personal comfort for the individual and that meals were chosen the night before. Current purchasing arrangements limit the ability of people to be more involved in shopping for food and making decisions about the food they wish to have. It was established that the home is required to purchase all food through the Borough Council. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Staff support people to have their needs met in the way they wish and require. Reviews of healthcare needs and liaison with external professionals ensure individual needs are met. People are protected by good administration of medication practice. Evidence: People who live at Wallfield have their wishes and needs concerning personal care detailed within their Essential Life plans. One member of staff talked about the use of hoists and training they had received, which included using a hoist. A key point for this member of staff was the importance of people not being kept in a hoist for long in relation to their comfort and dignity. The good design of this equipment was also an important factor. Staff who had undertaken this training felt more confident in supporting people who need to use a hoist. Staff were observed during the inspection to be working sensitively with people who live at Wallfield and clearly knew their individual needs well. Health files contained detailed information and records were seen to be updated following intervention and healthcare appointments. One visiting professional said they would wish to place people at the home with more complex needs due to the high quality of care and good support individuals receive; however the lack of a lift results in the service not being as available as professionals would wish. Its a steady service that can be relied upon. A professional responding Evidence: to our survey about what the home could do better, said: Be aware of the ageing process and its consequences and not feel failures if people get old and are less able than previously. Evidence was seen that showed the manager had considered this point, within the Annual Quality Assurance Assessment and it was noted that issues and training in relation to the ageing process had been identified by the manager and was receiving attention. Other professionals said: Wallfield provides a homely environment, lots of activities and social outings on offer. Responds well to complex situations. Provides excellent service to emergency placements. Responds well to emotional and practical needs; Show empathy and tolerance with client group they look after. Not afraid to ask for advice and help when appropriate. Some examples of what staff had to say about the care provided in their surveys, included: Provides a very good standard of care. Listens to people who live at the home and acts on their requests, needs etc; One to one support provided. Promoting independence. Two individuals spoken with said they were very happy at the home and that everything about the way they are supported by staff was very good. Other people were also able to indicate positive feelings about their life at the home. Five people who live at the home returned survey forms and all questions were completed very positively, though there was little detail about how people felt. One person said, I like to live at Wallfield. The work being undertaken by the manager to use external advocates may help to provide a greater insight about the way people feel about their lives at Wallfield. One individual had wanted to speak to us and this individual was very positive about their life at the home and made clear they had no adverse comments and nothing could be improved. Positive comments were made about staff, the home and of their enjoyment of the many opportunities they were supported with. We attended a daily handover meeting with five staff, where individuals and their needs were discussed. Points were made to reinforce specific approaches of support and one change in routine, which had been of clear benefit. Staff were observed to be fully focused on the needs of people and communicated well as a staff team. The home was developing a documentation system so that when people need to go to hospital, their specific needs can be immediately available so that people can be given the support they need, with appropriate understanding. The medication administration record was examined and found to be correct, the home now uses a blister pack system for medication. It was noted that the local pharmacy had visited in September of last year and had completed a full review of the homes medication system. No recommendations were made. The Borough Council was said to be about to release a new medication policy, which had been produced with the support of the health service. It was understood that the manager undertakes a regular audit of medication, however there was no record of these checks. We were told that staff had recently considered obtaining detail about the final wishes at time of death of people and were about to talk to individuals who would like their wishes to be known, so they can be written down. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live at Wallfield are supported by staff who will listen to their concerns and act on them. Staff are provided with training, to ensure they keep people, who are vulnerable, safe from abuse. Evidence: The home uses their Borough Council complaints policy and procedures. There had been one complaint since the last inspection, which had been appropriately responded to. It was noted that the outcome of the complaint had led to a reinforcement of practice. The home has developed an Easy Read leaflet about how to make a complaint, with their communications team. Two people spoken with were able to say that they do not have any complaints but if they had a concern, they would talk to their key worker or the manager, they said staff would listen them to. Residents meetings were recorded, and symbols were being used for the minutes. These meetings also provide opportunities for issues to be raised and addressed. We reviewed staff training concerning the protection of vulnerable adults and found some staff had received an update to their training. The manager had also undertaken training about the mental capacity act in January of this year. We spoke to one member of staff who did not provide a clear understanding of what Whistle Blowing related to. We were told there had been a poster in the office. The manager said that they would put the information on display for staff and will also raise it at a staff meeting. During the inspection, we observed financial accounting relating to individuals cash, which was undertaken in a methodical way, using a written record and individual wallet for the cash. The accounting was undertaken at the time the money was Evidence: returned; it was checked and recorded before returning the balance of cash to the wallet. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live at Wallfield enjoy a generally good environment however it is considered poor that people who cannot use the stairs have and are needing to move to other care homes. The home is well maintained, clean and hygienic and has the benefit of specialist equipment. Evidence: The home was clean and tidy with no unpleasant smells. Cleaning was underway during the inspection and the domestic person employed was seen to be working hard to maintain a good environment. Since the last inspection, the home now has the benefit of a specialist bath on the ground floor, to meet the needs of people with poor mobility. Major works to the building have also been completed, to provide new water pipe work throughout and the installation of a new boiler and central heating system. The manager has continued to make improvements at the home and recently this has included new furniture in the dining room and lounges, curtains and carpets. Upstairs the shower room has been updated with a new shower, floor and tiles. A visiting professional raised concern about the lack of a lift at the home and negative consequences for people at the home who have difficulty managing the stairs. This matter was also raised by other professionals responding to our survey and by staff from the home. We reviewed the issues surrounding the lack of a lift and were very concerned by what we found. One individual we spoke with has had to move in, as an emergency due to the lack of Evidence: a lift, to the homes second lounge to use as their bedroom until an alternative care home is found. This person had settled at the home and was clearly happy. Staff have an office base, which is accessed through this room and it was not available for use. Another older person had needed to move from the home to another care home. It is considered very poor that people who are happy at Wallfield have had or are having to go through the possible trauma of moving home due to their environment not meeting their needs. The homes admission policy will need to ensure that if there is any concern about mobility, then people should not be admitted. It is also likely that other people will have difficulties with the stairs as they become older and so it is important the matter is resolved. We were told that the provider, who is considering the matter, knows concerns about the need for a lift. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. An effective staff team who understand and do what is expected of them supports people. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Staff are clear about their roles and responsibilities which ensures they are confident in supporting people who live at the home and work in a person centred way. Staff are provided with good training opportunities to support their knowledge and effectiveness with people they care for. A robust recruitment process protects people who live at the home. Evidence demonstrated that staff in general feel positive about the support and supervision they receive. Evidence: People who live at Wallfield benefit from an experienced and stable team of staff. Previously there had been difficulties with staff shortage but these have been largely overcome due to the appointment of extra staff since the last inspection. The imminent recruitment of the equivalent of one and a half additional care staff should make a further positive difference to the care provided. The manager has also been proactive in considering the deployment of staff and has changed staff work rosters to ensure a good level of staffing at key times of the day. Staff undertake a comprehensive induction and have a training and development plan. Staff undertake mandatory training such as manual handling. They also have opportunities to undertake National Vocational Training and training to support their work with people who have a learning disability. One relief member of staff responding to our survey said their induction had been some time after appointment. Another member of staff said: We have an excellent staff training and development department. All staff are given opportunity and encouragement to attend courses. The files of two staff reviewed showed good recruitment practice had been followed, Evidence: including employment history and two references. We found evidence of regular supervision with supporting notes. Staff personal files had been renewed since the last inspection and we found them straightforward to examine. One staff member commenting on the staff team, within their survey response, said: In My experience at Wallfield, I have seen dedication from carers, senior staff and managers who have committed themselves to ensuring people who live at the home lead a healthy and happy life to the best of their ability. I am proud to say I have been and still are part of the team at Wallfield. One staff member said, improvements to ways of boosting staff moral could be made. One member of staff spoken with said the manager was like a ray of sunlight but that they did not have regular supervision and did not feel they had full value from it. It was felt to be more of a formality rather than wanting to hear points the member of staff wished to raise - Sometimes it is a waste of time. Also that staff do not always say what they feel at staff meetings. This member of staff was very positive about the staff team and said, it is very client orientated. Another member of staff spoken with, when asked if they felt valued for their contribution at staff meetings said staff are definitely listened to and gave an example of an issue, where after a staff meeting, the manager had personally thanked the member of staff for speaking up. This had given the member of staff confidence and a very positive feeling about the way the home was run. The member of staff also said that other staff gave support too. Another member of staff said there is a good and very supportive staff team, which recognises strengths and weakness. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home has a management structure, which is effective and supports staff to ensure people have their needs met. Evidence showed that the manager provides a strong sense of leadership and is proactive in developing the home. The manager takes steps to review the quality of care and makes necessary changes to improve the lives of people at the home. People are protected from harm by the homes health and safety policies and procedures. Evidence: The manager has established herself in her role at the home and has made changes, which have had a positive impact on people who use the service and the staff supporting them. Prior to the inspection, the manager had completed and sent the Commission a copy of her Annual Quality Assurance Assessment, which had been completed thoroughly. This provided evidence on the way the home was being run, the many achievements and also plans for the next twelve months. It was clear that the manger has a good understanding of the management needs for the home and has set out key areas where work is required. Staff have been given delegated areas of responsibility and staff spoken with were enthusiastic about their work and spoke of good communication. The manager had expressed the importance of staff feeling confident and being valued and this was very Evidence: evident as we talked with staff during the inspection. We reviewed well-recorded minutes form regular staff meetings. A point raised in one meeting, concerned the need for staff to take advantage of training opportunities. We said it may be helpful for the manager to have a staff training matrix to use as a management tool, where she would be able to list the training she requires, with dates of training and when reinforcement is needed, such as adult protection and whistle blowing. We were told the manager already has such a system in mind. One member of staff responding to our survey said: We have an excellent staff team and development department. All staff are given the opportunity and encouragement to attend courses. We found evidence on staff files of certificates relating to training achievements. The home had three National Vocational Qualification assessors and three staff were working towards achieving their Level Two award. Apart from the Annual Quality Assurance Assessment undertaken by the manager, the home also uses other tools to monitor the work and quality of care and support provided by the home. The home had undertaken surveys of professionals who have contact with the home and had addressed points raised. A staff survey was about to be sent out and negotiations to support people who live at the home by using external advocates was about to proceed. These external advocates will work with individual people to gain feedback on the way people feel about their life and experience at the home and on how things can be improved. It was understood that when all the surveys have been completed, there will be an analysis of the findings built into a report. We considered the way the home maintains its record keeping and documentation systems and found some to be cumbersome and out of date, which may lead to confusion. Key documentation was available, however some was a little difficult to find and some files were very full of documents more than three years old. Staff said that the manager was already aware of this and has plans for an overhaul of the current systems. It was also said that once the transfer to the new Essential life plans file for each person has been completed that this will help. We were told that a significant amount of policy documentation provided by the Borough Council has to be sifted to extract items necessary for the home. This is made difficult because of the access problem to the staff office and use of a computer and has made it more difficult to establish the system the manager wants to achieve. We reviewed files relating to health and safety at the home and found up to date recording of required checks, such as weekly fire checks. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 24 23 30/06/2009 Review the premises to ensure it meets the needs of people living at the Care Home. The lack of a lift means that people with a mobility difficulty may need to transfer to another Care Home Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 17 To promote further choice and independence, consider ways of involving people who live at the home more in shopping for food. This has to bear in mind some flexibility with current purchasing arrangements. It will be helpful to find ways of ensuring all staff feel listened to and valued for their contribution. 2 36 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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