Inspection on 29/09/08 for Ashton Court Care Home

This inspection was carried out on 29th September 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.

Other inspections for this house

Ashton Court Care Home 12/10/06

Extracts from inspection reports are licensed from CQC, this page was updated on 04/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashton Court Care Home 56 Three Tuns Road Eastwood Nottingham NG16 3EJ     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: Linda Hirst     Date: 2 9 0 9 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 30 Information about the care home Name of care home: Address: Ashton Court Care Home 56 Three Tuns Road Eastwood Nottingham NG16 3EJ 01773712017 F/P01773712017 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Hearn Care Homes Limited Type of registration: Number of places registered: care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Restriction of PD beds to 3 Within the total number of beds a maximum of 3 beds only may be used for the category of PD of 50 years or above. Date of last inspection Brief description of the care home Ashton Court is a purpose built which provides care for up to thirty five older people. Up to three of these places can be used for people who have a physical disability and who are aged 50 or over. The service does not provide nursing care. The home is situated just outside of the centre of Eastwood which is a busy town with shops, places of worship, places to eat and access to local transport facilities. The home has a wide range of communal areas, there are four lounges (one of which is in the conservatory), a quiet area on the first floor and three dining rooms. People living at the service are able to choose where they sit and who they sit with. The bedrooms (five of which are en suite) are on both the ground and first floor and there is a vertical lift for people Care Homes for Older People Page 4 of 30 Over 65 35 0 0 3 Brief description of the care home who may have problems with their mobility. There are pleasant enclosed gardens with decking at the front of the building and car parking facilities are also at the front of the home. The latest report on the service is available in reception and the statement of purpose is sent to all enquirers, a copy of the service user guide is given to every person living in the home. The fees at the service range from £294 to £360 per week. This fee does not include hairdressing, chiropody, newspapers and transport or escorts to Hospital Care Homes for Older People Page 5 of 30 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: The Quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people who live at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. We have introduced a new way of working with owners and acting managers. We ask them to fill in a questionnaire about how well their service provides for the needs of the Care Homes for Older People Page 6 of 30 people who live there and how they can and intend to improve their service. We received this back from the acting manager in good time, the form was well completed and it helped us to plan our visit and to decide what areas to look at. We also reviewed all of the information we have received about the home since we last visited and we considered this in planning the visit and deciding what areas to look at. The main method of inspection we use is called case tracking which involves us choosing three people who live at the service and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. One person who lives at the service does not have English as their first language and we case tracked the person to make sure that their equality and diversity needs are met. Unfortunately we were unable to communicate effectively with the person concerned on the day. The staff team come from a variety of backgrounds and experiences, but unfortunately no one speaks the preferred language of the person identified. We spoke with four members of staff, four people who live at the service and two relatives to form an opinion about the quality of the service being provided to people living at the home. We read documents as part of this visit and medication was inspected to form an opinion about the health and safety of people who live at the service. What the care home does well: What has improved since the last inspection? The staff have done a lot of training since we last visited the home and it is clear from our discussions with staff that they understand and are committed to meeting the needs of people living at the home in the most positive and enabling way. The servicing of the boiler has been done by a suitably qualified engineer so that people can be sure the heating system is safe and effective. The care planning system has been significantly improved and there is a clear format that all plans now follow, this makes it easier for staff to find out what help and support people need. The Medication Administration Record sheets of people living at the service are fully completed and well recorded. It was clear when people have taken their medication and when they have not been given it the reason is recorded and their health can be reported on and monitored. The range and frequency of activities has improved a lot since our last visit to the home, and people are encouraged to pursue interests that they already have providing meaningful occupation. Care Homes for Older People Page 8 of 30 People have choices for every meal and other alternatives to the menu are available to make sure people have what they would like to eat. Each person who lives at the service has a copy of the complaints procedure in their room, there are also residents meetings and people get the chance to raise concerns and express their views at these meetings. The service now has a new acting manager who has begun the process to become registered with us. This will mean that there is an accountable person in charge of the home. There have been improvements to the physical environment at the home, rooms have been redecorated, new carpets laid, and a new call alarm system installed. 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 9 of 30 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 30 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. People who want to live at the service have their needs fully assessed to ensure their needs are met at the service. The information people are given could mislead them about the nature of the service being provided at the home. Evidence: The acting manager told us in her Annual Quality Assurance Assessment that a copy of the Statement of Purpose and Service user guide is provided to each person. We looked at the statement of purpose which says that a service is provided to, those who are confused, have memory loss and mental health problems. The service is not registered to provide a service to people with these needs when they are admitted to the home, and this wording could be misleading to members of the public. The acting manager told us she is very clear about the category of registration and would not admit a person to the service who has been diagnosed as having Dementia or a mental Care Homes for Older People Page 11 of 30 Evidence: health problem. The service is considering applying to become registered to provide a service for people with Dementia. Until this happens the statement of purpose should give very clear information about who a service can be provided to on admission. People we spoke with did not make any comments on the information received about the service, although one person told us, I dont think I had a choice, the circumstances of their admission were not clear. The acting manager told us in her Annual Quality Assurance Assessment that visits to the service are arranged and people are involved in assessments from the start. She states that they have worked hard to promote peoples independence. We looked at the care plan for the last person to be admitted to the service and found that there is a copy of the assessment from the social worker on each file. There is also a comprehensive, clear and detailed initial assessment document written by the acting manager. This includes a brief life history and the acting manager told us these are being rewritten to include more detail at the moment. She showed us an example of a more in depth social history which contained good, person centred detail. One person told us, I come into the home a few times a year to give my family a break. It is the best place I have ever been in. Another person commented to us, I havent lived here long, I have been to other homes and here is about the best one you can get. Staff we spoke with told us, when we have handovers we are told if anyone new is coming in. We are told verbally and asked to read the care plan, the social workers assessments are in there. When people first come in I think they need reassurance, its a big thing for them. Whatever they want, you make sure they are alright. Intermediate care is not provided at the service and this standard is not applicable. Care Homes for Older People Page 12 of 30 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 have their personal and healthcare needs properly assessed and met at the service. Care is provided in a way shows respect for the privacy and dignity of the people living at the service. Evidence: The acting manager told us in her Annual Quality Assurance Assessment that the service provides clear and accurate records detailing the care offered to people, that care plans are comprehensive and user friendly. Life histories are undertaken and social needs are assessed. We looked at the care plans and found them to be well written, comprehensive and up to date. We saw evidence that care plans are reviewed monthly or more often if needed and that people who live at the service or their relatives are involved in these reviews where necessary. We found that one persons equality and diversity needs could be more comprehensively addressed, and the acting manager and staff discussed some of the difficulties they have encountered, which have not necessarily Care Homes for Older People Page 13 of 30 Evidence: been of their making. However, the acting manager agreed that they need to be more proactive in terms of accessing appropriate resources to meet the social and emotional needs of the person. That said, it is clear from our interviews with staff that they are tuned in to this persons needs and assess and provide for their care needs well. People we spoke with told us, the staff give you the help you need but they let you do the things you can. We observed staff promoting peoples independence and a member of staff told us, I think it is good for people to keep their independence as it would be so easy to lose that. We found peoples health care needs are properly assessed in terms of their nutrition, skin care, mobility and falls. We found clear evidence that people are accessing specialist services in the Hospital, and they see the optician and chiropody services regularly in the community. There are good records maintained of visits by the Doctor and District Nurse. We found that one person has bed rails in place to maintain their safety and their use has been authorised by the Doctor, rather than internally, this is good practice. Staff told us that three people have pressure relieving mattresses and cushions as a preventative measure, but that no-one has a current pressure sore. Three people have Physiotherapy input, and staff told us, we do their exercises with them. I think we are really good at getting people referred on for treatment. If we need anything the (acting) manager is on the ball like that. Another said, I think that the care plans are good at identifying what the need is and how to meet it. If we find the care plan needs changing we report that to the acting manager. People living at the service told us, If I need to see my Doctor the staff get her. I am healthy and well. We spoke to the relatives of a person who is living at the home and they told us, (our relative) has been in Hospital having problems with (their) legs and with walking, this is the best we have seen (the person) for a long time. They have worked wonders. The acting manager told us in her Annual Quality Assurance Assessment that there are comprehensive policies in respect of medication and that the people who administer medication are suitably qualified. We looked at the arrangements for medication. We found that medication is stored securely and correctly, though we suggested that temperatures be recorded of the room medicines are stored in to make sure it does not exceed 25 degrees. We found that the Medication Administration Records are well maintained and there is evidence that Doctors sign the Medication Administration Record if they advise any medication Care Homes for Older People Page 14 of 30 Evidence: should be stopped. This is good practice. Handwritten entries would benefit from being countersigned to ensure that what is recorded is correct. Controlled Drugs were checked and the records tally with the tablets remaining on the premises. A random check on boxed medication showed that the records tally with the medication given and the tablets remaining on the premises. The staff we spoke with (who administer medication) confirmed that they have had medication training. They told us, medication is done carefully, we always make sure that people have taken their tablets. If people spit them out, or we find tablets we report it to the (acting) manager, we put them in the medication trolley in a jar for that purpose and we return them to the Pharmacist for disposal. People living at the service told us, the staff look after my tablets for me. I am happy with this, they bring me a drink and wait to make sure I have taken them. The staff we spoke with gave us clear examples of how they promote and maintain peoples privacy and dignity, they said, I treat people as if they were my own family. Occasionally I have seen people behave badly and I have reported it, they dont tend to last very long. You know straight away if someone is suitable. People living at the service told us they are treated with respect, yes the staff are very good. We observed staff supporting people and they were observed to have warm, caring and supportive interactions with people living at the service. Relatives told us they are, absolutely delighted, with the service. Care Homes for Older People Page 15 of 30 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. People who live at the service are encouraged to make choices and these are respected and their independence promoted. Social and recreational activities meet peoples expectations. Evidence: The acting manager told us in her Annual Quality Assurance Assessment that the service prides itself on their extensive activities programme and that all activities are logged. They have also increased the hours of the activities co-ordinator. We found that the care plans contain a recreation sheet which identifies what people like to do with their time and identifies possible activities. We found that recently the service has provided Music to Movement and entertainment from an organist. The acting manager told us that some people like to go out with the activities co-ordinator to local shops or for a walk. The activities co-ordinator also leads the residents meetings and we saw evidence in the records which show that people are consulted about meals, activities and the environment. The service recently ran a Summer Fayre and raised money which the people living at the service have decided should be spent on a pantomime visit. This is being arranged st the moment. Care Homes for Older People Page 16 of 30 Evidence: The activities co-ordinator was not on duty during our visit, but staff told us, the residents like dominoes, doing jigsaws, reading, we have a lady who comes to do Music and Movement and people come and play the organ. We had a Summer Fayre and are arranging a trip to the pantomime. People who live at the service told us, I like doing puzzles but I cant see very well. I play BINGO and dominoes. I enjoy the activities, the woman who does them is very nice. During our visit we saw relatives coming into the home to visit. We spoke to two relatives who told us, we can only praise the service. Its wonderful. People who live at the service told us their relatives visit when they like and they are made welcome by the staff. The staff said, relatives and friends are welcome anytime, I take them a tray of drinks to make them feel welcome. The senior carer on duty liaises with the relatives about their loved ones. The staff we spoke with showed a good understanding of the need to respect peoples privacy and personal relationships. The acting manager told us in her Annual Quality Assurance Assessment that people are given choices in their daily lives and routines. People who live at the service confirmed this and said the staff respect their choices one person told us, I do what I want, I can spend my day as I like. Another told us, I would like to get up later, but I told the staff I like to get up at 07:30 and they have done this ever since. The same person also told us, (the person I sit next to) gets on my nerves sometimes, the person said they would like to sit somewhere else sometimes. We passed these comments on to the acting manager to discuss with staff. Staff told us, I think the service is good at recording likes and preferences. I think the staff are good at delivering choices. It is checked a lot. We saw staff interacting well with people at lunchtime, and although one staff member put an apron on someone without asking, others were observed to respect peoples choices. The staff offered people choices at lunchtime and we saw them being supportive and responsive to need, whilst at the same time promoting independence. The acting manager told us in her Annual Quality Assurance Assessment that the meals are an excellent standard, and they take into account personal preferences. We looked at the menu and found it to be varied and nutritious with alternatives on Care Homes for Older People Page 17 of 30 Evidence: offer for each meal. However, the daily menu was not written up and several of the people we spoke with could not remember what was for lunch. We spoke to the cook on duty and she told us, there are two choices and other alternatives available. We have one person who has Diabetes, and some people who need a soft diet but we blend the food separately. She told us there is a person living at the service who likes culturally appropriate food which family will bring in sometimes. Another person likes a specific bread and butter. She told us, they always have the option of fresh fruit in the afternoon, the staff also ask them what they would like for their meals and they fill in a tick sheet for me so I know how many to cook. There were good stocks of food at the service including fresh fruit and we saw lots of home baked buns and puddings. People who live at the service told us, the food is really good, I enjoy it, and the food is good and there are always choices, but they give me too much to eat. Care Homes for Older People Page 18 of 30 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. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. They are protected from abuse by trained and supportive staff who will protect their rights. Evidence: The acting manager told us in her Annual Quality Assurance Assessment that that all complaints are logged, records kept and complaints are concluded within 28 days. We saw a copy of the complaints procedure in all of the bedrooms we looked at. There have been two complaints since our last visit to the home, one about medication safety and the other about arrangements in an emergency. One was upheld and appropriate action has been taken, the other was not. Both complaints were clearly recorded, with details of the investigations and outcomes. People who live at the service gave different views about whether they would complain, one said, I would complain if I was unhappy, Im sure they would do something about it, the other said, I dont like to complain, Im not that kind of person. I probably wouldnt complain even if I was not happy. The staff we spoke with were clear about what to do if someone complains, they said, I would offer them the chance to speak to the manager. She would definitely respond Care Homes for Older People Page 19 of 30 Evidence: appropriately to complaints. The acting manager told us in her Annual Quality Assurance Assessment that all staff are given safeguarding training. We were able to confirm this by looking at their training certificates and the staff we spoke with confirmed that they have had recent training on this issue. There has been one safeguarding allegation since we last visited the service about the standard of care. This allegation was referred under safeguarding procedures and independently investigated. The allegations were not substantiated. The service has a copy of the current local safeguarding procedures but their own policy is outdated and needs updating in light of the new procedures. The people living at the service all told us they feel safe there, the staff support me when I need it, they are good, very caring, I feel safe. The staff we spoke with showed a clear understanding of what kinds of behaviour are abusive, and of what they should do if they were told about abuse. They told us they would blow the whistle on poor practice, Ive done it before I would do it again. Care Homes for Older People Page 20 of 30 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 service offers a warm, clean, safe and comfortable environment for people to live in. Evidence: The acting manager told us in her Annual Quality Assurance Assessment that the home is safe and well maintained and always meticulously clean and free from odour. Various parts of the service have also been redecorated and new carpets have been laid. There is a new call alarm system in place and they plan to replace all soft furnishings in the coming year. We did a partial tour of the home, including all communal areas, the kitchen, laundry and a sample of bedrooms to make sure the home is clean, comfortable and well maintained. We found the home to be warm, homely, clean and comfortable throughout with imaginative use of communal spaces to create distinct and different seating areas. However we found that some bedroom and bathroom doors had either no approved safety locks or ones which were not working, and this potentially compromises the privacy and dignity of people living at the service. Care Homes for Older People Page 21 of 30 Evidence: People living at the home told us, the home is clean and tidy and I like my room, and my room is nice and clean, it has everything you would need. We spoke with the housekeeper who told us, I am also responsible for making sure maintenance and repairs are reported and done. There is someone on cleaning duty every day, its usually fine but a bit difficult if people are on holiday or off sick. She showed a very good understanding of safe practice in terms of preventing the spread of infectious diseases and told us she has received training this year. We did a partial tour of the accommodation Care Homes for Older People Page 22 of 30 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. People who live at the service are supported by trained and competent staff who have been safely recruited. Evidence: We looked at the staff rota and found that most daytime shifts are covered by a senior carer and three care staff, at night this reduces to two waking staff. The staff we spoke with told us, I think there are enough staff on duty, there are odd times when people ring in sick at short notice, but the manager usually manages to get cover pretty quickly. The people living at the service told us they feel there are enough staff on duty, I dont have to wait long for help. Our observations confirm that there seem to be enough staff to meet the current needs of people living at the service and we noticed that staff were observant and responsive to peoples needs. The acting manager told us in her Annual Quality Assurance Assessment that over 50 of care staff have achieved National Vocational Qualification 2, meaning the home have exceeded the National Minimum Standard in this area. We looked at the staff training records and the staff training matrix and saw that Care Homes for Older People Page 23 of 30 Evidence: training has been undertaken this year in Basic First Aid, Moving and Handling, Basic Food Hygiene, safeguarding, Health and Safety, Dementia, supporting people with challenging behaviour, Infection Control, Medication, Control of Substances Hazardous to Health and Inductions have started. The staff we spoke with confirmed, all of my statutory training is up to date and I have enjoyed the training on Dementia. The people living at the service told us that the staff are competent, they seem to know what they are doing, the staff are very good. Relatives commented, the staff are phenomenal. The acting manager told us in her Annual Quality Assurance Assessment that there is a a robust recruitment procedure and that all staff have had satisfactory recruitment checks in the past year. We looked at three staff files and found that these contained all of the information and documentation needed to show that staff are suitable to work with vulnerable people. We did notice however, that one persons references were not dated and this would be good practice. It would also be good practice for the reference to indicate in what capacity the person knows the staff member. Staff we spoke with confirmed that they had a Criminal Records Bureau check, completed an application and supplied three references before starting work at the service. Care Homes for Older People Page 24 of 30 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 management and administration of the home is based on openness and respect. There is an effective quality assurance system which makes sure the service is running in the best interests of the people living there. Evidence: The service has an acting manager in post who has started the process of registration. She told us in her Annual Quality Assurance Assessment that she has enrolled on the Registered Managers Award. People who live at the service and their relatives told us, the home is well run. Staff we spoke with said, she is brilliant, great. She is with us, she interacts and is there for us. She is very committed to the residents. If anything needs doing she sorts it, one person needed a larger sling for the hoist, it came the next day. The acting manager told us that Quality Assurance surveys are done and the results Care Homes for Older People Page 25 of 30 Evidence: collated. We looked at these and found that all of the people living at the service have completed a satisfaction questionnaire. Most people were happy with the care, activities and the accommodation. Positive comments included, the staff always listen if you have any problems. People who said the service could be improved, commented, I would like to go out every day, and I would like smaller meals, better dinners, not stews. Staff commented to us, We get told if there are any issues from the questionnaires, we are sent staff questionnaires too. We looked at the arrangements for managing money deposited by people living at the service for safekeeping. We found the balances tally with the records but noticed that the frequency of one purchase seemed excessive and we asked the acting manager to look into this and to make sure there is a receipt for all purchases from the in house shop. She agreed to do this. None of the people living at the service commented about this area, and the staff we interviewed told us they do not have any access to peoples money. We found that the tests on the efficiency of Health and Safety equipment is all up to date and the servicing is done at the required intervals to make sure it is working properly. The staff we spoke with told us, my health and safety is well cared for. Care Homes for Older People Page 26 of 30 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 30 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 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 1 The statement of purpose should be clear about the category the service is registered for. Information which could mislead people should be removed so that people are able to make an informed decision about living at the service. Attempts should be made to investigate possible resources which may enable the identified persons equality and diversity needs to be met more appropriately. Handwritten entries on the Medication Administration Record should be signed as correct by two members of staff as an added check on accuracy. Daily records of the temperature in the medication room should be maintained to make sure that medicines maintain their potency and are effective. Staff should make sure that they check that peoples preferences have not changed to make sure their choices are supported at all times. The daily menu should be written up on the menu board to enable people to make informed choices about what they want to eat. The safeguarding policy for the home needs to be updated to make sure it corresponds with local safeguarding Page 28 of 30 2 7 3 9 4 9 5 14 6 15 7 18 Care Homes for Older People procedures so that staff can take appropriate action if allegations are made. 8 19 All bedrooms, bathrooms and toilets should have a working approved safety lock fitted to preserve the privacy and dignity of people living at the home whilst still offering easy access to staff in an emergency. References should be dated and they should clearly indicate how they know the applicant and in what capacity they are supplying the reference so you can be assured they are suitable to verify the staff members integrity. The acting manager must apply to become registered as soon as possible so there is a person who is responsible for the service. This recommendation is outstanding from the last key inspection. Any expenditure made on behalf of people living at the service must be supported by a receipt to ensure their financial interests are protected. There should be a clear, recorded reason for frequent expenditure 9 29 10 31 11 35 Care Homes for Older People Page 29 of 30 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 © (2008) 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. Care Homes for Older People Page 30 of 30 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!