Inspection on 10/11/08 for Ashling House

This inspection was carried out on 10th November 2008.

CSCI found this care home to be providing an Excellent 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

Ashling House 20/02/07

Ashling House 14/10/05

Ashling House 26/04/05

Ashling House 10/12/04

Ashling House 01/09/04

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 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashling House 119 Elmhurst Drive Hornchurch Essex RM11 1NZ     The quality rating for this care home is:   three star excellent 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: Harbinder Ghir     Date: 1 7 1 1 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: Ashling House 119 Elmhurst Drive Hornchurch Essex RM11 1NZ 01708443709 Telephone number: Fax number: Email address: Provider web address: ashlinghouse@aol.com Name of registered provider(s): Name of registered manager (if applicable) Ms Beverley Holmes Type of registration: Number of places registered: Ms Beverley Holmes care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: One (1) place for a service user with dementia can be accommodated. Date of last inspection Brief description of the care home Ashling House is a privately owned care home for 14 older people. It is in a pleasant residential area in Hornchurch, about half a mile away from shops and public transport links of the town centre. First opened as a care home in 1981, Beverley Holmes became the owner in March 2001, and also the manager in day-to-day charge. She takes great pride in providing high quality facilities, including thorough attention to cleanliness. Considerable improvements to the building have been carried out over the past two years. This has included a new wood-panelled dining room, creating new single bedrooms, and giving the garden a major make-over. The lounge is a large conservatory. Fees are between £420 and £500 per week. Care Homes for Older People Page 4 of 31 Over 65 1 14 0 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: three star excellent 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 was an unannounced inspection undertaken by Regulation Inspector Harbinder Ghir. The inspection took place on the 10th November 2008 and returned on the 17th November 2008 to provide feedback to the management of the home. During the inspection the inspector was able to talk to the residents residing at the home, staff and relatives who were visiting . The London Borough of Havering who is the host authority for the service was contacted, inviting their comments on the service they are commissioning. They did not provide any feedback to be included in this report. As part of the inspection the inspector toured the home, read records of people who Care Homes for Older People Page 6 of 31 use the service and examined documents in relation to the management of the home. The Commission for Social Care Inspection received a completed Annual Quality Assurance Assessment prior to the inspection. The inspector would like to thank everyone involved in the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: 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 8 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 9 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. At this inspection we looked at standards 3, 4, 5, 6. The service completes comprehensive pre-admission assessments, to ensure they can fully meet the needs of prospective residents. Trial visits are offered to all prospective residents, to ensure residents have information on the services and facilities provided at the home. People who use the service know that the home they enter will meet their needs. The service does not provide intermediate care. Evidence: The service has a comprehensive pre-admission policy and procedure in place and Care Homes for Older People Page 10 of 31 Evidence: admissions would not be made to the home until a full needs assessment has been undertaken. The service had obtained care management assessments from placing authorities where required and information on the homes assessments and care plans was consistent with the information provided by the funding authority. Two pre-admission assessments were closely examined and assessments comprehensively covered the personal, health care and social care needs of residents. Assessments were personalised and also included information on the life history of the individual and their likes and dislikes. Assessments clearly focused on achieving positive outcomes for people and this included ensuring that the services provided at the home met the diversity needs of the individual. For example residents religion was identified on their pre-admission assessment and information on whether they practiced or not and how the service would meet spritual needs. It was evident from speaking to residents during the inspection and examining the assessments that significant time and effort is spent planning to make admissions to the home personal and well managed. That residents and their families are treated as individuals and with dignity and with respect given for the life-changing decisions they need to make. There was a high value within the home on responding to individual needs for information, reassurance and support. Residents and relatives spoken to during the inspection commented very positively about the care provided at the home. It was evident from their comments that new prospective residents would be able to visit the home as many times as they like before making a decision whether they would like to move in or not. Relatives and family would also be invited to visit the home. One resident said I have lived here for about a year and I am very happy here, the carers are very kind. I came to visit the home before I moved in, and this was the one I liked. I feel very well cared for, it is very nice to live here. I came to the visit the home twice, once for lunch and another time to meet other residents. I would like thank people for what they do for me here, overall I feel very satisfied informed another resident. A relative visiting the home stated I came to look at the home after seeing a few and we thought this one was very good and most suited to my mothers needs. We are quite pleased with the way mums been looked after. I had heard allot of good stories from other people about this home. The cleanliness in this home is unbelievable, we have had no problems. Care Homes for Older People Page 11 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. At this inspection we looked at standards 7, 8, 9, 10, 11. Residents health and personal care needs are set out in individual care plans. Care plans are detailed, to ensure the needs of residents can be met effectively. There are clear medication policies and procedures to follow. However, there are some inconsistencies in the management of medication, which may result in unsafe practices. All residents can be assured that, at the time of their death, staff would treat them and their family with care, sensitivity and respect. Evidence: Three care plans were closely examined. Each care plan contained a large photo card of the resident, details of their next of kin and emergency contacts. Information covered the comfort and safety of residents, their communication needs, their Care Homes for Older People Page 12 of 31 Evidence: nutritional needs, personal care, mobility and their hobbies and leisure. Care plans were very comprehensive and gave attention to particular attention to how each individual resident would like their needs met. For example for one individual their care plan stated X likes to wear her nails long, X prefers to wear slacks and jumpers, and enjoys to have a bath. The times residents like to get up and go to bed were also identified in their care plans and their communication needs and how staff must meet those. For one resident their care plan stated that their favourite colour was pink. The individual was observed to be wearing a pink jumper on the day of the inspection and informed that it was their favourite colour. It was evident that residents receive effective personal and health care support using person centered approaches with support based upon the rights of dignity, equality, fairness and respect. The documentation/ health records relating to pressure care areas; management of diabetes, falls were examined. The records for these were found to be detailed and were adequately maintained. There was evidence that care plans were being reviewed at least two to three monthly or as when required and risk assessments were updated accordingly. For one resident whos mobility had decreased and now required the assistance of two carers; their care plan and risk assessments had been updated to reflect the changes in need. Evidence was seen of reviews taking place with care managers and also involving the resident and their representatives. Risk assessments are routinely undertaken for all residents around nutrition, manual handling, continence, falls and pressure care areas and are reviewed on a regular basis. Monthly weight checks were in place where necessary and fluid intake charts were also in place where there were concerns regarding nutritional intake. One resident who had recently been poorly with identified poor fluid intake was regularly prompted by staff during the inspection to keep drinking and had plenty of drinks left with in easy reach of them. There were also fluid monitoring charts in place which staff kept up to date. Records indicated other health professionals such as the district nurses, optical, dental and chiropody services saw residents. A General Practitioner was also seen to be visiting during the day. A relative spoken to informed that the home is very quick to contact the GP if there are any concerns. They informed When mums been unwell they are very quick to contact the GP and they keep me informed. They have been most helpful, when mum has been in and out of hospital. A resident further informed I have seen the doctor a few times since coming to the home. They call the doctor, if needed, they dont hesitate and Beverly (registered manager) always takes an interest in us. Daily case recording notes were examined which are linked to the care plan and focus on the specific needs of residents rather than recording information in a general manner. Each resident has a personalised case recording sheet which focuses on Care Homes for Older People Page 13 of 31 Evidence: particular areas of concern, for example their challenging behaviour, their diet or the risks they are posed to, which is used to monitor their care needs or their behaviour on a on-going basis. The accident and incident book was reviewed. Accidents were recorded in full, and the registered manager informed that residents received follow up checks to ensure there were no further health-associated risks and this instructions would be recored in staff communication book. However, it is recommended that when follow up checks take place that the outcomes of these checks are also recored to ensure that there is documented evidence to ensure that are no further risks posed to that individual. All care plans viewed contained information on the end of life wishes of residents and the contact details of relatives and representatives where appropriate. All staff receive in house training and practical advise and have continuous support and opportunities to discuss any areas of anxiety and concern. There are policies and procedures for the handling and recording of medicines. Policies and protocols were seen in relation to convert medication administration, medication administration errors and the protocol to follow, medication leaving the home and guidelines for staff to follow when handling Cytoxic medications. All medication is stored in a locked cupboard with a handy-pull out shelf in the lounge area. The deputy manager was observed administering medication at lunch time. She made sure the individual had a fresh drink of water and signed the medication administration record before she observed the individual taking the medication. The deputy manager and staff must sign the record after observing the individual taking their medication to ensure it has been administered. An audit was undertaken of the management of medicine within the home and a random sample of Medication Administration Records (MAR) charts were examined. The medication file included the identification signatures of staff with permission to administer medication. Each resident medication file included a photo card, and identified any allergies. However the following issues were highlighted and discussed with the management of the home. Medication administration records (MAR Chart) were not completed in full. Two entries were missing. There were hand written entries on the Mar chart, which were not clearly signed and dated. Staff must clearly sign and date in the medication details box when making a handwritten entry, to ensure accountability of those making the entries. Medication was secondary dispensed into dosette boxes by staff for residents when leaving the home to stay with family or friends. If the home fills medicine containers or compliance devises they will require contacting their pharmacist for advise before Care Homes for Older People Page 14 of 31 Evidence: transferring medication as the transfer of some medicines from the manufacturers packaging is contraindicated. It will be stated as a requirement that medication practices are reviewed to ensure the safety of residents. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. At this inspection we looked at standards 12, 13, 14, 15. There is a varied programme of activities available within the home, to meet the social needs of residents. There is a wide choice of meals in the home, to ensure they meet the needs and choices of all residents. Visiting times are flexible and people are made to feel welcome in the home, so that residents are able to maintain contact with their family and friends as they wish. Evidence: The home employs an activities co-ordnitor who is responsible for organising indoor activities and entertainment within the home and staff also help organise activities. On the day of the inspection residents were seen to be playing bingo with staff which they all seemed to be enjoying. Posters of forthcoming entertainment were also displayed around the home, with a trip being organised to the local theater for residents. Activities are also arranged with the services sister home Arron Manor where residents Care Homes for Older People Page 16 of 31 Evidence: are given the opportunity to socialise and participate in activities together. One relative informed that they have been invited to garden parties at the home which they have thoroughly enjoyed and informed that there is always something residents can join in with. Activities and social events are discussed with residents and relatives at monthly meetings and views are further seeked through quality assurance surveys. Residents did have varying forms of social entertainment throughout the home, with a library of books available in the dining area, a CD player and a large T.V in the lounge. Residents were also seen to be doing different things during the afternoon of the inspection, as some were in the lounge listening to music, whilst others were reading, and some had resided to their rooms. One resident informed We all go to the other home, and have had Halloween parties there and also have clothes sales here, there is plenty to do, if you want to do it. There is a four weekly menu, which is also provided in large print which is given to residents to make their meal choice, which included a variety of fresh fruits and vegetables and a choice of two meals at lunchtime and snacks throughout the day. On speaking to the chef, she was able to demonstrate her knowledge of those residents requiring special diets, for example diabetic and pureed diets. Residents and relatives spoken to spoke very highly of the meals provided at the home. The inspector joined residents for lunch and the menu for the day was braised beef with vegetables and new potatoes, cheese salad or vegetae le lattie with vegetables and new potatoes, there was also a sandwich selection available. Dessert was bread and butter pudding with custard or fresh fruit, or yogurt, cheese crackers or ice-cream. Lunch was observed being served which looked and smelt appetising. There were condiments placed on each table and attention was given to dressing the tables with table clothes and table decorations. Residents were offered a choice of drinks. Very positive comments were received about the lunch being served, which included Its nice, The meat is very soft, its very tasty, Very nice, Very tasty. Other comments from residents spoken to about the choice of meals on offer included I think there is enough choice, I am diabetic and they cater for me. Another resident said There is enough choice of food here. There are set meal times at the home, and all residents are encouraged to eat in the dining room which is accepted by residents who commented that this suits them and in turn appreciate the cleanliness of the home. Residents were also asked about routines and about tims of going to bed and getting up. Comments included I can go to bed anytime and get up when I want, but I do like to get up early. Another resident informed We can stay up late and watch T.V if we wanted to. Visiting times were flexible and visitors could visit at any time convenient to residents. Relatives, family and friends were seen to visit residents throughout the time of the inspection and were made to feel welcomed by the staff at the home. Care Homes for Older People Page 17 of 31 Care Homes for Older People Page 18 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. At this inspection we looked at standards 16 and 18. People who use the service can be assured their views are listened to and acted on. All complaints are recorded, including concerns to ensure any dissatisfaction is acted upon regardless of source. All staff have received up to date training in safeguarding adults, which ensures the protection of residents. Evidence: The ethos of the home is that it welcomes complaints and suggestions about the service, uses them positively and learns from them. Residents and relatives spoken to informed that they were satisfied with the service, felt safe and well supported and well cared for. The complaints procedure is clear and easy to follow and was displayed in the home. Timescales within which a complaint would be investigated were stated on the complaints procedure and included the contact details for the Commission for Social Care Inspection. A complaints logbook is kept by the home, which was viewed. There were two recent complaints logged, the service investigated the concerns highlighted satisfactorily. The Commission for Social Care Inspection has not been informed of any Care Homes for Older People Page 19 of 31 Evidence: complaints. The home also holds regular residents meetings and records seen demonstrated that all concerns raised by residents were listened to. All staff attend POVA training and adult protection is comprehensively covered in the induction programme. The service has comprehensive safeguarding adults procedures and protocols in place. The service has obtained safeguarding adult protection procedures devised by The London Borough of Havering. Staff also completed a health and safety checklist at night to ensure the emergency call bells were in easy reach of each resident at night to ensure their safety and to ensure residents were comfortable and safe. Equipment such as bed rails, recliner chars and wheelchair belts were only used when absolutely necessary, with the home promoting independence and choice as much as possible. Care Homes for Older People Page 20 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. At this inspection we looked at standards 19, 20, 21, 22, 23, 24, 25, 26. Residents live in a comfortable environment and decor is of an excellent standard and provides a homely and pleasant living environment enhancing residents comfort, but further environmental safety checks would minimise risks presented to residents. Evidence: The manager of the home who is also the proprietor has ensured that the physical environment of the home provides for the individual requirements of resident and they appreciate the hotel grade facilities that have been provided. The living environment is appropriate for the lifestyle and needs of the residents and is homely, clean, and comfortable, and very well maintained. The home has maintained very high standards of hygiene and safety and has gone an extra mile to provide an environment that fully meets the needs of all residents. It also has a wide range of up to date specialist equipment and adaptations to meet the individual needs of people who use the service. The home can accommodate fourteen residents and has one double shared room which currently occupied by a married couple. All rooms were viewed as part of the inspection which all have en-suite facilities, which were very comfortable with high Care Homes for Older People Page 21 of 31 Evidence: quality fixtures and furnishings and were also personalised by residents with personal family photos and furniture. All rooms were lockable and could be overridden by staff in an emergency. There is a choice of communal areas residents can use, which include the conservatory lounge, dining room and a very well maintained rear garden, which is equipped with high quality garden furnishings. During the tour of the premises, it was identified that bathrooms stored residents personal toiletries communally and were not labelled in regards to whom they belonged. The cupboard underneath the sink in the laundry was not locked which stored household cleaning products and sharp utensils. The main kitchen is situated on the ground floor, which was inspected. The kitchen was clean and was equipped with suitable cooking appliances and kitchen equipment. There was a wide range of fruit and vegetables and meats with food being correctly labelled with the date of opening. Fridge, freezer and food temperatures were however not taken consistently with some entries missing. All parts of the home to which residents have access to must be so far reasonably practicable made free from hazards to their safety and unnecessary risks to residents are identified and so far as possible eliminated, this will be stated as a requirement. Care Homes for Older People Page 22 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. At this inspection we looked standards 27, 28, 29, 30. Recruitment practices ensure residents are in safe hands at all times. Comprehensive staff training is provided to all care staff, to ensure they are equipped with the skills and are competent to do their jobs. There is good skill mix of staff to meet the needs of residents. Evidence: Three staff files were closely examined, two which were of recently recruited members of staff. Staff files included satisfactory identity checks, contracts of terms and conditions, which were signed by the employees. All three members of staff employed by the service had undergone POVA and Criminal Bureau checks. However, on viewing two application forms it was identified that previous employment start and end dates had not been recorded on the application forms. For one member of staff only one reference had been obtained. The registered manager of the home informed that they were in process of receiving that reference and that she had received a verbal reference from the referee. It is recommended that the application form is reviewed to ensure applicants record their start and end dates or previous employment, which will Care Homes for Older People Page 23 of 31 Evidence: ensure that any gaps in employment are easily identified and that verbal references if seeked and their verification are appropriately recorded in staff files. The home has a good staff complement. There are eight permanent members of staff and agency staff are used to cover sickness and annual leave. There are two members of staff on duty during the day, with an overlap of a third member of staff coming on duty to cover busier peak times. At night there is one waking and one sleep in member of staff. Staff were observed to be caring and supported residents in a person centered way. Very positive comments were received from residents and relatives regarding the staff team. One resident said The carers here are very caring, they listen and do the best they can for you. A relative informed When I come here, I always see enough members of staff on, who are very nice. Staff training files were closely examined. There is a staff training matrix in place which evidenced that management prioritise training and facilitate staff members to undertake external qualifications beyond basic requirements. The home provides internal Mulberry training programmes, where staff watch a training video and then complete a assessment to test their skills and competencies. There is also external training provided as part of an on-going training plan. Staff training included training in Independent Mental Capacity Advocacy Awareness, Deaf Awareness, Person Centered Care and Assessment Skills, Managing Aggressive and Challenging Behaviour in clients who have dementia, Manual Handling, POVA awareness, Medication Administration. There is also a comprehensive induction programme in place which also implements the Skills for Care guidance. On speaking to members of staff they reported that the home puts a high level of importance on training and reported that they are supported through training to meet the individual needs of people in a person centered way. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. At this inspection we looked at standards 31, 33, 35, 36, 38. Residents benefit from an experienced manager who recognises their needs and adequately manages the home. The systems for service user consultation ensure the home is run in the best interests of residents. The welfare of staff and residents is promoted by the homes policies and procedures. Evidence: The management of the home consists of the registered manager who is also the proprietor of the home and is supported by a deputy manager. The manager has the necessary experience to the run the home. The manager has achieved their Registered Care Homes for Older People Page 25 of 31 Evidence: Managers Qualification and is able to evidence a sound understanding and application of best practice of operational systems, particularly in relation to continuous improvement, customer satisfaction and quality assurance. Equality and diversity, human rights and person centered thinking are given priority by the management of the home, who are able to demonstrate a high level of understanding and best practice. It was evident at this inspection by the way the home is run that the service shows an understanding of peoples needs and the homes aim to provide a personalised service. There are quality assurance systems in place. Completed quality assurance surveys by residents and their representatives were seen which included very positive feedback regarding the care and service provided at the home. Surveys were placed in the entrance of the home, for all visitors to take and complete, it was evident that feedback is welcomed by the management of the home. The registered manager also completed and sent the Commission for Social Care Inspection an Annual Quality Assurance Assessment prior to the inspection. The document did not gave a satisfactory picture of the current situation within the service and was very brief in detail. This was discussed with the registered manager of the home, who assured that future AQAA documents will be completed more comprehensively. Staff supervision is taking place at the home formally and informally. Staff spoken to informed that they are supervised formally every two to three months and supervision is taken very seriously at the home. One member of staff spoken to commented that it is very extensive and it is a big thing for the management. Residents records of finances were viewed and the inspector examined receipts and case tracking sheets in two residents care plan files. All records were recorded appropriately and receipts were adequately maintained. It was noted that the deputy manager of the home was not totally familiar with Regulation 37 and its requirements. This was discussed with her to ensure that where any event in the care home which adversely affects the well-being of safety of resident has been put at risk, the home sends a Regulation 37 notification. There have been no reported incidents at the home since the last inspection. Health and Safety records were inspected. All documentation was in order and appropriately completed. Evidence was seen of water temperatures checks completed at all outlets throughout the home on a monthly basis. Care Homes for Older People Page 26 of 31 Care Homes for Older People Page 27 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 28 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 1 9 13 The Registered Persons must 31/01/2009 ensure that all medication administration charts are consistently completed and that staff sign the charts after observing the administration of medication; staff must clearly sign and date in the medication details box when making a handwritten entry, to ensure accountability of those making the entries. If the home fills medicine containers or compliance devises they will require contacting their pharmacist for advise before transferring medication as the transfer of some medicines from the manufacturers packaging is contraindicated. . 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 19 13 The Registered Persons 31/12/2008 must ensure that all parts of the home to which residents have access to must be so far reasonably practicable made free from hazards to their safety and unnecessary Care Homes for Older People Page 29 of 31 risks to residents are identified and so far as possible eliminated. . 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 8 It is recommended that when follow up checks take place following any accidents, that there outcomes are recored to ensure that there is documented evidence to ensure that are no further risks posed to that individual. It is recommended that the application form is reviewed to ensure applicants record that start and end dates or previous employment and which will ensure that any gaps in employment are easily identified and that verbal references if seeked and their verification are appropriately recorded in staff files. 2 29 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). 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. 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