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Inspection on 03/01/08 for Anglesea Heights Nursing Home

Also see our care home review for Anglesea Heights Nursing Home for more information

This inspection was carried out on 3rd January 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.

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 pre-admission assessment for new residents is well documented and gives the service a good understanding of the person`s needs and abilities. The residents` plans of care provide sufficient information to enable staff to understand the way in which they can best support the needs of residents. The meal provision is of a high standard with residents able to access meals and snacks on a 24-hour basis. There is a great range of choice at each mealtime for residents to choose from. The employment of hostess staff to encourage and enable residents to have drinks throughout the day works well. The complaints process is open and responsive with all complaints responded to in a positive and timely manner.The employment of staff is robust with necessary checks made in relation to the suitability of the applicant. The induction, training and development of staff are well set out with a progressive development of their skills and abilities. The management of resident`s monies is clearly accounted and audited, and provides individuals with a good understanding of how their money is spent. The quality assurance systems enable the service to understand how their customers view the service provision. There is ongoing development of the QA system with a more robust audit of the operations being introduced in 2008.

What has improved since the last inspection?

The issues raised at the previous inspection surrounding the safe moving and handling of laundry to and from the bungalows has been improved. Additionally the maintenance of the laundry and equipment has been addressed.

What the care home could do better:

Care plans could be further developed to ensure they provide a holistic understanding of the person`s abilities to ensure they support the individual`s independence. Although there is evidence of staff supervision taking place, there were issues with the consistency of opportunities for staff to have formal one to one supervision with a line manager. This is important as it provides staff with an insight into how their performance in their role is perceived and to identify with their line manager any areas of development they may benefit from. The staffs perception of the staffing numbers was fairly negative at the inspection with several members of staff approaching the inspectors to make their views known. The manager did not agree that there was an issue with staffing. Records relating to the deployment of staff across the units over a two month period evidenced that staff numbers were maintained according to the assessed needs of the residents living in the units at the time. However the affect this issue has had on staff morale should be further explored.

CARE HOMES FOR OLDER PEOPLE Anglesea Heights Nursing Home Anglesea Road Ipswich Suffolk IP1 3NG Lead Inspector Sara Naylor-Wild Unannounced Inspection 3rd January 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 Anglesea Heights Nursing Home DS0000024326.V358110.R02.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. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Anglesea Heights Nursing Home Address Anglesea Road Ipswich Suffolk IP1 3NG 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) 01473 289810 01473 286908 jonesgrd@bupa.com www.bupa.com BUPA Care Homes (CFHCare) Ltd Mrs Grada Jones Care Home 120 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (60), Learning disability (1), Old age, not falling of places within any other category (60), Terminally ill (3) Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 years and over, who require nursing by reason of old age (not to exceed 60 persons) accommodated in Alexandra House and Christchurch House. Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 60 persons), accommodated in Bourne House and Gippeswyk House. One named person whose name was made known to the Commission for Social Care Inspection in June 2004, aged under 65 years of age, who requires care by reason of dementia, accommodated in Bourne House or Gippeswyk House. The total number of service users accommodated must not exceed 120 persons. Persons of either sex, aged 18 or over, who require care by reason of terminal illness (not to exceed 3 persons) One named person whose name was made known to the Commission for Social Care Inspection in November 2004 who requires care by reason of dementia with a learning disability. 20th February 2007 4. 5. 6. Date of last inspection Brief Description of the Service: Anglesea Heights is owned by BUPA Care Homes and is registered as a care home with nursing, providing care and accommodation to a maximum of 120 service users in the categories of old age and dementia. Situated in a residential area of Ipswich it is close to the town centre. Local shops are within walking distance and the Home is on a local bus route. The building is a local landmark in Ipswich, with the listed Victorian administration block originally forming part of the old Ipswich Hospital. Service user accommodation is, by comparison, modern, purpose built, single story, ground floor accommodation comprising of four separate bungalows named after parks in the town, Alexander, Bourne, Gippeswyk and Christchurch, each unit with 30 beds. Bourne House is registered as a mental nursing home as defined by section 22 of the Registered Homes Act 1984 and provides nursing and care to older persons with mental health needs and challenging behaviour. The PCT has 10 beds under continuing care. These beds are contracted to the NHS. Alexander House provides 25 continuing care beds that are NHS funded and five beds privately funded. Gippeswyk House provides Dementia care as defined by section 21 of the Registered Homes Act. Christchurch House provides general nursing care to older people. Anglesea Heights Nursing Home DS0000024326.V358110.R02.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 unannounced Key inspection was carried out on 3rd January 2008 by Sara Naylor-Wild and Anna Rogers. The evidence contained in this report was gathered from discussions with the manager, deputy manager, staff working in the individual units, a visit to the home, discussions with people living at the home and observation of their interaction with staff. There was also information taken from the Annual Quality Assurance Assessment (AQAA) provided to the Commission for Social Care Inspection (CSCI). This form provides the home with an opportunity of recording what they do well, what they could do better, what has improved as well as future plans for improving the service. The registered manager assisted the inspectors throughout the inspection. Feedback on the findings was given to them during the visit with opportunity for discussion or clarification. The inspectors would like to thank the manager, staff and people living at the home for their help throughout the inspection process. What the service does well: The pre-admission assessment for new residents is well documented and gives the service a good understanding of the person’s needs and abilities. The residents’ plans of care provide sufficient information to enable staff to understand the way in which they can best support the needs of residents. The meal provision is of a high standard with residents able to access meals and snacks on a 24-hour basis. There is a great range of choice at each mealtime for residents to choose from. The employment of hostess staff to encourage and enable residents to have drinks throughout the day works well. The complaints process is open and responsive with all complaints responded to in a positive and timely manner. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 6 The employment of staff is robust with necessary checks made in relation to the suitability of the applicant. The induction, training and development of staff are well set out with a progressive development of their skills and abilities. The management of resident’s monies is clearly accounted and audited, and provides individuals with a good understanding of how their money is spent. The quality assurance systems enable the service to understand how their customers view the service provision. There is ongoing development of the QA system with a more robust audit of the operations being introduced in 2008. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 7 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 Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 8 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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People considering coming to live at the home can be confident that the home will understand their needs and be prepared for their admission. EVIDENCE: The initial assessments of six people living at the service were reviewed during the inspection visit. In each case as well as a health or social care professionals referral assessment the staff from Anglesea Heights had carried out their own assessment using BUPA’s QUEST individual assessment forms. This format contains all the aspects of daily living assessments as set out in the National Minimum Standards, Standard 2. There is a rating scale of ability for which staff provides a score and a further comments box to complete if required. The action column then directs staff to include issues in a personal plan if the score is below 2. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 9 Where there is additional information supplied in the comments box this provides a clearer picture of the actual individual’s abilities rather than a generic picture. As in the case of one assessment the box for “visual impairment – refuse to use aids/aids inappropriate”, marked. Whilst the additional information column had been completed with “x has right maculaptrophy, Right central retinal vein occlusion, watery eyes and blurred vision” that provided greater definition to the actual issue. The intermediate care element of the provision in the home has the same assessment process for admission and dedicated accommodation to support a variety of needs. The manager reported that the majority of people who use this service are awaiting a permanent solution to their care needs and are not requiring therapeutic support. Residents spoken with during the inspection had on the whole been in hospital at the time of their admission and were unable to visit the home prior to moving there. However in all cases their family had visited and reported back to them. They were aware of an assessment discussion about what they liked and didn’t like. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 10 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect the staff to understand how best to support their assessed needs and promote their independence. EVIDENCE: The care plans of six people living at the service were sampled at the inspection visit. All those sampled contained plans of care for each of the elements referred to in the initial assessment process and met the expectation of those elements listed in National Minimum Standards, Standard 2. They refer to the aspects of daily living and a description of the staffs instructions to support these under a ‘Support plan’. The descriptions tended to be problem first orientated in some instances but the best examples contained a description of the abilities of the individual’s strengths and abilities first. The plan of one person stated “X prefers to sit on the side of their bed with their legs down and a table in front of them. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 11 This position makes it easier for them to breath they state. X refuses to sit in a chair and they have pillows placed at their back to prevent them falling backwards if they should fall asleep whilst in this position.” Residents spoken with during the inspection were aware of the initial assessment and that they had been asked for their views on how their care should be provided. They had not on the whole seen their plan of care but understood and believed that staff knew how to meet their needs in a way that they preferred. One person stated “ they know exactly how I like everything, even the ones who are new soon know how I like my drinks without me having to say anything” A resident’s relative spoken with said that they had contributed to the staffs understanding of their relatives plan of care although they had not seen the written plan. They were confident in the staffs ability to support their relative in a way that best meets their needs. The plans of care contained evidence of the assessment and monitoring of individuals health needs. These included risk assessments of their weight, pressure care and nutritional intake with corresponding monitoring sheets to record the progress in these areas. There were also records of health professionals visits to the person and these included the reason and outcome of the visit to provide a full picture. The way in which medication was managed was considered at the visit with examination of the storage and records relating to medication. These demonstrated that the service maintained good Medication management with clear records that contained no omissions and all drugs appropriately stored. This included a controlled drugs cabinet and procedure. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 12 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the service can be assured that they will be offered occupation and stimulation that meets their preferences and abilities. EVIDENCE: The service employs staff dedicated to the provision of activities and they offer a variety of opportunities across the four bungalows. There are notices displaying the range of activities on offer in each of the bungalows and included quizzes, exercise and entertainment over the Christmas period. Those residents spoken with during the visit had mixed views about the activities on offer with some saying there was things to do whilst others preferred their own company and retired to their rooms. The service is particularly proud of its meal provision and has developed an extensive menu that covers a whole 24-hour period. So as well as the main meals of the day and the large range of alternatives on offer at each meal time there is a ‘Nite Bite’ service that offers hot and cold snacks after the main kitchens have closed. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 13 Residents spoken with were aware of the menus and the choices that were on offer, and were complimentary about the standard of the meals provided. During the meal time observed by inspectors staff readily offered residents a choice for their main meal and pudding, and gave support with eating the meal where necessary. The visiting hours for relatives and friends were flexible to ensure that service users received a visit. One relative stated ‘I visit daily and I can come at any time, staff understand that we are part of the care team that support my relative”. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 14 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their view will be listened to and acted upon. and that the staff understand how to protect them from abuse. EVIDENCE: The home has received seven complaints since the last inspection. All complaints were seen to have been logged and investigated fully using the home’s complaints procedure. There was evidence of the complaints procedure in the statement of purpose and service user guide. Residents and relatives spoken with were asked if they knew whom they could make a complaint to and in both cases they identified the senior staff in charge of the bungalow in the first instance, but were aware of the ability to take the matter further if they were not satisfied. Compliments were also received by the service in thanks for the support they gave to residents. These were posted on the notice boards in the bungalows to which they referred to ensure that staff and residents were aware of this feedback. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 15 The home ensures that the safeguarding policy is available for staff to read and refer to. Staff are trained in their induction, to understand the way in which vulnerable adults can suffer from abuse and the responsibilities of staff to protect them. There was evidence in the staff files that were examined that staff had attended the Safeguarding training. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 16 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 and 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 the service can expect to live in a clean environment and can expect to be consulted about the refurbishment programme to ensure it meets changing needs. EVIDENCE: A tour of the four units was made during the inspection visit and the following observed. Generally each unit was clean and tidy although the décor would benefit from being updated. The manager reported that a large scale refurbishment was planned for the service in the coming year. This refurbishment would provide an opportunity to reflect the changing needs of people living at the service and current thinking regarding best practice in caring for older people as well as well as supporting people with specialist needs. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 17 The manager confirmed that a consultant would be working with the home to ensure the planning incorporated the needs of mentally frail people, and the use of primary colours to identify specific facilities such as bathrooms and toilets. The manager said residents would be included in helping choose colours and for those unable to provide an informed decision relatives would be consulted. There was evidence of the ongoing maintenance of the premises with a decorative border being replaced in a bedroom. One toilet was out of use and we were initially informed this was used as storage space but it was confirmed by the deputy matron that it was in need of repair, which would be prioritised because of the location to the communal areas of the unit. Generally the buildings are suitable to meet the needs of those residents living there however, observation of the communal areas during the inspection visit identified an issue with how the varied needs of residents are met in this area. In particular it was noted that in some units there were residents who by reason of their mental frailty were very vocal and caused some distress and agitation to other residents in the room. As there are not alternative communal areas in the bungalows this was discussed with the manager who said that this would be considered to ensure residents who are more vocal do not disturb/bully those who enjoy peace and quiet. There is an issue with storage in the units, with a particular issue to the large bulky items such as laundry trolleys and aids to support people’s mobility. Staff currently used bathrooms and toilets to store this equipment however this presents difficulties in the appropriate use of these rooms. In terms of security the units are accessed by a keypad entry, the bedrooms with patio doors have restrictors to provide security and it was noted also that windows also had restrictors fitted. The residents had taken the opportunity to personalise their bedrooms and many people had televisions and telephones in their rooms for their personal use. In two of the bungalows there are memory boxes placed on the wall outside each room with items relating to the resident inside them. The contents have been identified by relatives and designed to be used by staff and visitors as a means of initiating conversation. The main laundry is located within the administrative block. Four members of staff provide cover seven days a week. Laundry is transferred from each unit in bags, sealed and transported by trolley to the laundry where it is sorted. Previous inspections identified an issue with the weight of the trolley and the health and safety of staff in pushing the weight. Since the last inspection staff reported that the laundry is now sorted into smaller amounts and staff ensure they are not taking a load that is too heavy. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 18 Just prior to the inspection visit the service reported an outbreak of a sickness and diohrrea virus. They reported the outbreak to the CSCI and the Health Protection Agency and their advice to instigate stringent arrangements to ensure the laundry from the units infected were washed in higher temperatures and separate from other laundry. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to be cared for by staff that are able to meet their needs. EVIDENCE: The four units cater for residents with differing primary needs with two units dedicated to the care for people with a physical frailty and the other two units care for people with mental frailty. The manager informed the CSCI through the AQAA return that in each of the four units there are (as a minimum) two trained staff on each day with one at night. Four carers are on each early shift and two or three on each late shift in each of the units to support them. On the day of inspection the manager stated that they ensure staffing levels reflect the needs of service users and confirmed that when each unit has the maximum number of service users there are (including trained staff) six staff on in the morning and five in the afternoon in Christchurch and Gippswych, seven staff on in the early shift and six in the afternoons in Bourne and seven and five staff in Alexandra. The manager also said that they would identify the use of agency or additional staff to these numbers as appropriate when a new service user was to be admitted. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 20 In addition to the care staff there are ‘Hostesses’ in each unit who support residents to access drinks and meals throughout the day. These are relatively new appointments designed to provide care staff with more time to spend with residents in meeting their assessed needs. During the inspection discussion with staff indicated that some feel that the needs of service users have increased within the last three years (residents more frail on admission), which stretches staff resources. They also felt that the current vacancies in staffing shifts were not always covered and this affected their ability to meet the needs of their residents. A review of the rotas indicated that whilst there were some dates where the staff numbers were below those stated, the number of residents was also less that the maximum capacity. However the numbers of staff are dependent not only on numbers but on the dependency needs of residents, and the manager was asked to provide the Commission with evidence of the dependency ratings for the service for the same period, following the inspection. From a selection of staff files there was evidence of an application form being completed, with a POVA 1st check and followed by evidence of satisfactory Criminal Records Bureau (CRB) check, there was also evidence of two references being requested and received. Appointed staff were provided with a staff contract and job description. There was further evidence that the staff files are audited and requested information asked for, for example next of kin, signed job description and confirmation that certain policies have been read and signed. The Deputy Manager is responsible for staff training. They also oversee staff induction, which takes place over 3-5 days. Subjects covered include an introduction to health and safety, infection control, food hygiene, moving and handling, fire safety and for laundry staff housekeeping and laundry. Each subject has a workbook and staff are required to answer questionnaires. A selection of completed questionnaires was available. We also saw that staff are using a self-learning pack titled ‘understanding dementia’. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 21 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect the home to be managed by an experienced manager who ensures that their health and safety needs are protected. EVIDENCE: At the inspection the registered manager informed the Commission that she would be undertaking a seconded to another post within the organisation and the deputy manager is taking day-to-day responsibility of the service during her absence. The deputy manager has many years experience in care settings and has worked for the organisation for a significant period in a management capacity. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 22 The registered manager said that further details of the way in which the deputy manager and the service would be supported during this time would be forwarded to the Commission following the inspection. In addition to the deputy manager a senior sister and a team of carers head each unit. The staff files considered at the inspection contained evidence of staff supervision. Although the services policy states that staff will receive one to one formal supervision every two months, the manager and deputy acknowledged that this is not always consistently happening, but that informal discussions did occur on a regular basis. Some of the files did contain recent supervision notes and these referred to the elements recommended within the National Minimum Standards. As well as supervision there were routine meetings between the various strata of staff working at the home. These included a bi-monthly senior staff meeting, Senior Sisters meetings and unit meetings for staff on the bungalows. While it is clear that there is a system of meetings to support staff these need to be monitored to ensure they occur. The residents’ finances are managed through a central fund and audit system that is maintained by the homes administrator. The records relating to the funds of three residents were viewed during the inspection and these demonstrated a clear audit trail from which individuals can understand the payments in and out of their accounts as well as the amount of interest they have gained. The service is due to introduce a new national quality assurance system in January 2008 that is part of the organisations new developments in this area. The process involves a monthly early audit-warning tool (EWAT) that is used by the regional manager or representative (managers would not inspect their own service) to consider the services performance. The measurement, action required and the response taken will be published and available for residents, staff and relatives to view. The service also operates an annual customer survey as part of the quality assurance. Surveys are sent to residents and families and the responses are audited external to the service and a report providing the ratings in percentage terms is returned to the managers of the service with a requirement that anything that gathers less than good/excellent response must have an action plan developed. The chef also contributes to the quality assurance system through a verbal check with residents about their satisfaction with food on a regular basis. The records relating to the maintenance of equipment and services were viewed during the inspection and included evidence of hoists throughout units being routinely serviced, the electrical systems five year check was within date, a record of fire safety equipment being serviced, and the cleaning of water tanks. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 23 Staff spoken with were clear about what the temperatures of baths and showers should be before used by resident and hot water was within the safe temperature range. Anglesea Heights Nursing Home DS0000024326.V358110.R02.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 X X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 X 3 Anglesea Heights Nursing Home DS0000024326.V358110.R02.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. Standard Regulation Requirement Timescale for action 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 Refer to Standard OP36 Good Practice Recommendations Staff should receive one to one formal supervision at regular intervals. Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Anglesea Heights Nursing Home DS0000024326.V358110.R02.S.doc Version 5.2 Page 27 - 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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