Inspection on 09/12/08 for Ashglade Rest Home

This inspection was carried out on 9th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashglade Rest Home 09/01/07

Ashglade Rest Home 11/11/05

Ashglade Rest Home 20/05/05

Ashglade Rest Home 02/11/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashglade Rest Home Ashglade Rest Home 178 SouthBorough Road Bickley Bromley Kent BR2 8AL     The quality rating for this care home is:   two star good service 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: David Lacey     Date: 0 9 1 2 2 0 0 8 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. the things that people have said are important to them: They reflect 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 Older People 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. Care Homes for Older People Page 2 of 31 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. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Ashglade Rest Home 178 SouthBorough Road Ashglade Rest Home Bickley Bromley Kent BR2 8AL 02084670640 02082951740 ashgladecare@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Chislehurst Care Limited care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 15 The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Ashglade is an Edwardian detached house, which has been converted to provide care for up to 15 older people. It is situated in a residential area on a main bus route between Petts Wood and Bromley. There is limited parking to the front of the property. The accommodation for residents is on two floors. A shaft lift provides access between these floors. There is a garden at the back of the home, which can be accessed by a ramp. The homes present fees range from £400-£600 per week (this information given to CSCI December 2008). Care Homes for Older People Page 4 of 31 Over 65 15 0 Care Homes for Older People Page 5 of 31 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection included an unannounced visit to the care home. To gain the views of people living in the home, we spoke with residents and relatives. We toured the premises, met with the registered manager and some members of the homes staff. Documentation was sampled, such as care plans; records of care provided; staff recruitment files; and policies and procedures. An expert by experience was invited to take part in the inspection process and accompanied the inspector on the site visit. An expert by experience is a person who has a shared experience of using services and who can help an inspector get a better picture of what it is like to live in a care home. The expert by experience spent time engaging with a number of people who live at the home. Key parts of the report Care Homes for Older People Page 6 of 31 compiled by the expert by experience have been used as evidence to support the judgments made. We provided comment cards so that people can write to us with their views about the home. Those comments we had received by the time of writing this report have been taken into account. The last inspection of this service was completed on 09/01/07. Since the last inspection, we carried out an Annual Service Review of the home and have used findings from that review in planning this present key inspection. Information from the homes Annual Quality Assurance Assessment (AQAA) has also been used to inform the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: They need to improve the administration of medicines so that residents always get the right medication at the right time, and they need to make sure their cabinet for storing controlled drugs meets current legislation. They must complete the repairs to the upper floor bathroom, so there is a working bathroom on this floor, and repair or replace the broken bath panel in the ground floor bathroom. They need to make sure supervision arrangements are evident for any staff member who starts work before a satisfactory criminal records disclosure is received. They must make sure the home has a gas safety certificate that is up to date. Care Homes for Older People Page 8 of 31 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. Care Homes for Older People Page 9 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. Prospective residents and their families are encouraged to visit the home before making a decision whether to move in. They are given information and advice to help them with this decision. Peoples needs are assessed before admission. All residents receive a contract with terms and conditions. Ashglade does not offer intermediate care, thus the standard for this is not applicable to the home. Evidence: The homes statement of purpose and service user guide were available. The manager confirmed that no changes had been made to these documents. Pre-admission assessments sampled were good. Peoples needs had been assessed before they had moved into the home, to ensure the home is suitable. In most cases, the homes manager had taken the lead with this process. Care Homes for Older People Page 11 of 31 Evidence: During the visit, the inspector met with some relatives who had chosen the home for their mother. The room their mother was to move into was being refurbished and redecorated, and would be ready shortly. The relatives were very positive about the home and the help and advice they had received so far. The homes manager had given them advice about what to look for in a care home, which they had found helpful when visiting other places. They had chosen Ashglade as they liked the atmosphere of the home and felt their mother would receive good care. A relative who provided written comments stated that the manager and staff had taken care at the beginning to find out about her mothers likes and dislikes, and had been kind and willing to help. The relative stated she and her family had visited more than ten care homes before choosing Ashglade and had then waited until a place had become available for their mother. Residents receive contracts with the home that set out the terms and conditions of their residency. Contracts for two residents were checked at random during the inspection visit. Care Homes for Older People Page 12 of 31 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. People living in the home receive the health care they need, are treated with respect and their dignity is maintained. Care plans give staff guidance about how to meet individual residents needs. There are some medication issues that need attention. Evidence: Care documentation for five residents was selected for inspection during the visit. Care plans were sufficiently detailed and had been drawn from assessment of the residents needs. There was some evidence that residents and/or their representatives had been involved in the care planning process. The plans seen had been reviewed regularly. Risk assessments for tissue viability and nutrition had been recorded and continence needs assessed. Residents said they could see a doctor as they needed, and this was also evident from information recorded on their plans. District nursing services are provided to any residents who need nursing input to their care. Other health care services are made available either through the GP or privately. Dental hygienists visit if required. Carers Care Homes for Older People Page 13 of 31 Evidence: who have received training to carry out nail cutting do this for residents who are not able to do it for themselves. A visiting health professional spoke with the inspector as well as provided written comments. This professional was very positive about the standards of care provided to residents, commenting that always on visits to Ashglade s/he has been impressed with the levels of care and with the rapport between staff and residents. A visitor commented that the home is good at keeping a close watch on her relatives diabetic condition. Our expert was told that all staff are trained about the risk of falls. Residents are helped with bathing and dressing if this is required. When our expert met the residents he saw that they were very neatly dressed. Medicines were inspected with the homes manager. The manager said she usually takes responsibility for the receipt of medicines into the home. Senior carers do this in her absence. The only time two people check in medicines is for controlled drugs, and the inspector recommended two people always check in residents medicines and sign on the medicine administration record (MAR) to confirm they have done this (see recommendations). The staff signature list was up to date. The storage of non-schedule medicines was generally satisfactory. The manager confirmed that the shift leader holds the keys to the medicine cabinets. Internal and external medications were being stored separately. The temperature of the drugs refrigerator was being checked and recorded daily. At the time of the inspection, only one medicine was being stored in this fridge. Controlled drugs (CD) were being stored in a metal cabinet screwed to a solid wall. The manager was advised that the CD cabinet needs fixing with rawl or rag bolts rather than with screws, to comply with 2007 legislation. The home must also make sure the cabinet is made of metal of a specific gauge and that it has a specified double locking mechanism (see requirements). The MARs for three residents were selected for inspection. Two were satisfactory, showing clear records that all medications had been given as prescribed. The third was inconsistent, and it became evident errors had occurred with regard to the residents medication (see requirements). A CD medication that is to be given once each week had not been signed as given the previous week. The manager was advised that blocking out the relevant days on the MAR might help to avoid errors in giving medications that are prescribed once each week (see recommendations). It was also evident that a laxative medication prescribed for this resident had not been given. Further checking showed the same laxative medication had not been given to another resident either. The manager undertook to investigate these important matters immediately and take any necessary action. Homely remedies had been reviewed and signed by the homes GP in May 2008. The Care Homes for Older People Page 14 of 31 Evidence: administration of any homely remedies had been recorded in a specific book and on the back of the persons MAR. Medicines needing disposal had been recorded in a returns book and counter-signed by the supplying pharmacist before they had been returned to the pharmacy. The home has policies and procedures for the administration of medicines and provides medication training for its staff. The manager said that the supplying pharmacist provides a half-day training programme for care staff, that covers ordering and receiving of medications, controlled drugs, administration routes, drug errors, and contraindications and adverse reactions. There is a test at the end of the training programme to check peoples understanding of the content and certificates are issued. The manager said she also does in-house training with staff, such as observing them to make sure they are competent to administer medicines. The manager said the homes policy is that staff are only allowed to give medicines after they have completed the half-day training programme and been assessed by her as being competent. Some relatives said one of the main reasons they had chosen the home for their mother was they had noticed residents appeared happy and were treated with dignity, for example, residents were asked for permission for the relatives to look at any bedrooms. A resident who was being visited by a relative told the inspector, I like it here, its very nice, good company, very clean and comfortable. Im very happy with my room. Both she and her relative said they were very pleased with the standards of care. Our expert by experience was told by a resident, I am very happy in this home. The food is good, the staff are caring, they look after us quite well. We have no complaints. I feel as if I am at home. Care Homes for Older People Page 15 of 31 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. The home makes sure that people living there can choose to take part in various planned activities. Contact with families and friends is encouraged and supported. Residents are offered a choice of food from a menu, which is varied and provides them with a balanced and nutritious diet. Evidence: Many of the residents were in the lounge when we arrived to carry out the inspection. However, one resident told our expert she preferred to stay in her room and read. Newspapers were available to those residents who wanted them. Our expert by experience met with the homes activities coordinator. She comes in three times a week and encourages residents to take part in various activities. She said that the natures of the activities provided were driven by the wishes of the residents. They like quizzes and other related activities, which kept their minds active. Bromley Library provides a service to the home, bringing books once a month. During our unannounced visit, different activities were being provided for residents. In the morning, the activities coordinator led sessions in gentle exercise and in reminiscence. In the afternoon, a person came in to the home to play keyboards and Care Homes for Older People Page 16 of 31 Evidence: sing songs that the residents knew and liked. Care documentation examined during the inspection included records of activities undertaken by each resident. A relative commented that the manager and her staff look after her mother very well, by encouraging her to join in and socialise but also respecting her wishes on the occasions when she prefers her own company in her room. The relative stated the activities programme is very good, I see varied things on offer from a sing-song with keyboard to reminiscence sessions with the activities coordinator. A relative who stated the home always supports people to live the life they choose commented that, the persons wishes always seem to come first. Residents can choose when they get up in the morning and when they go to bed. Residents told our expert that they were never compelled by the home to retire to their room at a set hour. Care documentation had recorded peoples preferences in relation to different aspects of their lifestyles. People had been encouraged to bring personal possessions and mementos from home, to personalise their own bedrooms. Discussions with residents confirmed they are supported to keep in touch with their families and friends as they choose. The inspector met with a relative who visits the home regularly, who said he was always made welcome in the home. Our expert by experience was pleased to see there is the facility of a quiet room that can be used by residents to meet their relatives and friends and talk with them in private. Our expert and the inspector visited the kitchen, which is situated next to the dining room. The kitchen was clean and all equipment was working well. Food stocks were good and foods needing chilled or frozen storage were being stored appropriately, with fridge and freezer temperatures monitored. The homes cook was new in post and keen to provide a good service to residents. The menu was based on a four-week cycle and was varied with choice available. Our expert by experience spent time with residents during lunch when it appeared that they were enjoying their meal. A resident told him The food here is very good. It appeared that residents knew each other quite well and were talking amongst themselves whilst eating, very much like sharing a family meal. The staff took good care to ensure that the residents were properly fed. Drinks were provided at lunchtime, and the presentation of the food was attractive. Care Homes for Older People Page 17 of 31 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 an appropriate complaints procedure. The recording of information about each complaint received has improved. The home makes sure its residents are kept safe and protected from abuse. Evidence: The home has a complaints procedure, which is made available in its service user guide. The commission has not received any complaints about Ashglade since our previous inspection. The home had met our previous requirement to keep records of all complaints made, including details of any investigation and action taken. The complaints file was seen and appropriate records were in place. Since our last inspection, three entries had been made, including a complaint about being put to bed too early, and about a radiator not working in one of the bedrooms. These issues had been resolved. Staff members spoken with or who supplied written comments confirmed they knew what to do if a resident or one of their representatives has concerns about the home. Relatives who spoke with the inspector or who provided written comments confirmed they knew how to make a complaint if they needed to. One said, I would always go to the manager in the first instance, though I have had no reason to complain thus far. Written comments included, the manager and her staff are always willing to listen to Care Homes for Older People Page 18 of 31 Evidence: any queries or questions we have and help us solve any niggles quickly. The home has policies and procedures for safeguarding adults and for whistle blowing. The local authority interagency adult protection guidelines were available in the home. Relevant training had been provided to staff, who are given access to local authority training and to electronic training materials. Guidance for staff about preventing abuse and about whistle blowing was on display in the staff changing area in the basement. Staff showed basic understanding of their responsibilities in relation to protecting residents. Care Homes for Older People Page 19 of 31 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, 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. 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 homes environment is fit for its stated purpose. The home is clean, tidy and generally well maintained, though both of its bathrooms require attention. Evidence: Our expert by experience toured the premises with the inspector and the rooms seen showed that the home was clean and tidy. There were no unpleasant odours and no evidence of dust on the furniture. The home had obtained grant money, which it had used to fit new carpeting. The cleaner on duty spoke about her cleaning routine and said she tries to make sure the home is as clean as possible for the residents. She said she has enough time to do her job effectively. She understood about basic infection control practices and about the need to store cleaning fluids safely. The laundry room was well equipped, with machines using a dosed system, and our expert found that systems are in place to ensure that the right clothes are returned to their owners. Our expert thought the call alarms throughout the home were easy to operate. We tested one in a bedroom and staff were quick to respond. The bedrooms inspected were well decorated, equipped and furnished. Four bedrooms were assessed against the standards and found to be satisfactory. The temperature in the rooms we saw was comfortable. A radiator cover in room 9 needed attention, which the manager stated had already been identified and was about to be repaired. Care Homes for Older People Page 20 of 31 Evidence: Most of the residents had personal items in their rooms. One bedroom was being converted to add en-suite facilities. This conversion was almost finished and someone was already waiting to move in. The bathrooms were clean but the bath on the upper floor was not in working order as a repair had not been completed. The toilet in this bathroom could be used but because the bath was not in use, there was only one bath available to the residents (see requirements). The hot water was at a safe temperature and our expert saw there are notices warning residents to be careful if they find the water too hot. The ground floor bathroom had a bath panel needing repair and this is commented on under standard 38. Care Homes for Older People Page 21 of 31 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. There are enough staff to meet the needs of the people living in the home. Staff members listen to residents and try to meet their choices and preferences. Recruitment practices are satisfactory though more evidence of close supervision is needed for any staff starting work before CRB checks are returned. Staff are supported to complete training that is relevant to their work with the residents. Evidence: On the day, staff levels and mix were sufficient to meet residents needs. The manager said there had been significant issues about care staffing arrangements since the summer, with three members of staff leaving. This had meant the use of some temporary staff but the provider had been recruiting and the manager said the home was now fully staffed. The staff changes had meant time had been needed for the new team to settle in. The home had enough cleaning staff and a newly appointed cook. There was an all female staff group, caring for the residents who at the time of this inspection were all female. The manager said the home had not had any enquiries from prospective male residents or applications from males for staff posts. Comments from residents and relatives were that staffing levels were generally good. Some people said that occasionally there might be a short wait for attention or to find someone to ask them about something but this would usually be because staff were Care Homes for Older People Page 22 of 31 Evidence: giving care to another resident. A relative commented about a staff shortage in the summer causing some difficulties but stated this had been resolved now. Staff members spoken with or who supplied written comments stated they thought there were enough staff to meet residents needs. They confirmed there had been a period earlier this year when some care staff had left and temporary staff had been needed, but said that new staff had been recruited and the new team was now working well. Comments we received from staff included, if you have any problems all you have to do is ask, my manager is very understanding. Staff said the training available to them is good. They are supported to obtain NVQ in care, as well as to complete mandatory health and safety training. A staff member undertaking induction commented that the programme covered everything needed to know to do the job when she started, and that she could always ask more experienced staff for advice and support. The manager meets with her regularly to give support and discuss how she is working. A relative commented that,the staff I have got to know are very good with the residents, they are very kindly towards them which goes a long way to keeping people cheerful and feeling safely looked after. Our expert found that the staff on duty were cheerful and caring. He reported that watching the carers ensuring that the residents were comfortable was a good sign that they enjoyed their work. One carer who spoke with our expert had been working at the home for some years and was quite happy to continue to work there. Our expert said it was a pleasant surprise to be met by a smiling carer at the front door, and then be offered a cup of coffee. Our expert thought that an attitude of this nature gave an indication of the attitude of staff in general. Our previous requirement about recruitment information had been met. We had required the home to always obtain a full employment history before an applicant begins work at Ashglade, together with a satisfactory written explanation of any gaps in their previous employment. The staff files sampled for inspection were generally satisfactory, though there was one issue needing attention. A staff member had been allowed to start work after a POVA First check but before the CRB had been returned. The inspector was told this staff member was sometimes working alone. The manager said the staff member was working within a supervisory environment. However, it was not evident that the home had appointed a qualified and experienced member of staff to supervise the newly appointed person and made sure that as far as is possible this staff member is on duty at the same time as the new worker (see requirements). The manager agreed to make sure there is close supervision and stated she would Care Homes for Older People Page 23 of 31 Evidence: keep the new worker supernumerary to the rota until the CRB is received. Care Homes for Older People Page 24 of 31 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 manager has the skills and experience needed to run the home effectively. The provider aims to ensure the home is run for the benefit of its residents. The home promotes the health and safety of its residents, staff and visitors. Two health and safety matters need attention. Evidence: From observation, feedback and discussions, the home is being managed well. Our expert by experience reported that, from all the evidence that he saw, it seemed to him that the home was well run and the welfare of the residents was paramount. The homes registered manager, Denise Gill, has been in post since October 2005. Her previous experience and qualifications are relevant to managing a care home for older people. She is a registered nurse and has completed the Registered Managers Award. The manager has access to administrative support, which is important as it enables her to spend more time on activities such as monitoring residents care and supervising staff. A relative stated the homes manager always lets the family know Care Homes for Older People Page 25 of 31 Evidence: about any important matters affecting their mother, for example, if she is feeling poorly or needs something to be brought in. The CSCI registration certificate and a valid certificate of liability insurance were displayed prominently in the hallway of the home. The companys nursing director makes monthly visits to the home during which the quality of services is monitored. Copies of written reports of these visits have been retained and were made available for inspection. The home had carried out a quality assurance survey at the end of 2007, and the report of the findings was available for inspection. The manager stated the home does not provide any assistance to residents with managing their money and does not store any residents money. Residents either manage their finances or do so with help from their families or other representatives. When petty expenditure is needed, for example on an outing or for hairdressing, the home will pay this and invoice the resident or their representative. As recommended at our last inspection, each resident has a lockable storage space in their bedroom where they can keep valuable items. A sample of health and safety documentation was selected for inspection. These were up to date and within the appropriate timeframes, with the exception of a current gas safety certificate. This was brought to the managers attention so she could take the necessary action (see requirements). Our previous requirement to consult with the fire officer in relation to an appropriate lock for one of the bedrooms had been met. As mentioned in the Environment section of this report, the downstairs bathroom had a cracked bath panel. This was potentially hazardous to residents and needed repair (see requirements). The manager said the need for this repair had been identified already and had been recorded at a providers monitoring visit. The local councils environmental health department had carried out a food hygiene inspection in October 2008. The home had achieved a very good rating. Recommendations had been made for improvement, which the manager confirmed had been addressed though the replacement of work surfaces remained to be completed. Care Homes for Older People Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 27 of 31 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 Requirement 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 Requirement Timescale for action 1 9 13 The registered person must ensure that medicine administration is always carried out safely and according to procedures. This is so that residents always get the right medication at the right time. 09/01/2009 2 9 13 The registered person must ensure the homes cabinet for storing controlled drugs meets current legislation. This will help to ensure controlled drugs are stored safely. 31/03/2009 3 21 23 The registered person must ensure repairs to the upper floor bathroom are completed. This is important so there is a fully working bathroom on the upper floor. Most residents do not have ensuite facilities so have to use the ground floor bath. 09/01/2009 Care Homes for Older People Page 28 of 31 4 29 19 The registered person must 09/01/2009 ensure that any staff member who starts work after a POVA First check works only under supervision until a satisfactory CRB disclosure is received. This includes appointing a qualified and experienced staff member to supervise the new worker and as far as is possible ensuring this staff member is on duty at the same time as the new worker. This is important as it helps ensure residents are protected. 5 38 13 The registered person must ensure the cracked bath panel in the ground floor bathroom is repaired or replaced. The crack is a potential hazard for residents using the bath. The registered person must ensure the home has a gas safety certificate that is up to date. This is important for the safety of people living or working in the home and for visitors. 09/01/2009 6 38 13 31/01/2009 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 Care Homes for Older People Page 29 of 31 1 9 The registered person should consider blocking out the dates on MAR charts when once weekly medications are to be given to a resident. Care Homes for Older People Page 30 of 31 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). 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