Inspection on 26/11/08 for Badgers Holt

This inspection was carried out on 26th November 2008.

CSCI found this care home to be providing an Excellent 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

Badgers Holt 06/12/06

Badgers Holt 19/01/06

Badgers Holt 01/08/05

Badgers Holt 31/01/05

Badgers Holt 20/09/04

Badgers Holt 15/12/03

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Badgers Holt Butts Ash Lane Hythe Southampton Hampshire SO45 3QY     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: Janette Everitt     Date: 2 6 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 © (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 31 Information about the care home Name of care home: Address: Badgers Holt Butts Ash Lane Hythe Southampton Hampshire SO45 3QY 02380849310 F/P02380849310 badgersadmin@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Gina Rayner Type of registration: Number of places registered: Mrs Teresa Rayner care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Badgers Holt is a home offering personal care and accommodation to 25 older people, some of whom may have dementia. The home is located in an area known as the Waterside, on the outskirts of a village, which in turn is on the outskirts of the New Forest. Both areas offer attractive scenery, being a mixture of beach, sea and forest. The city of Southampton is accessible by car and public transport. The home was opened in 1986 and consists of a two-storey building although most of the bedrooms are on the ground floor. There are 21 single bedrooms and two shared rooms. Communal accommodation includes three sitting rooms, and a dining room. There is a large garden which is accessible to service users. The fees are £485 highest and £415 lowest. Care Homes for Older People Page 4 of 31 Over 65 25 25 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: The site visit to Badger Holt, which was unannounced, took place over a one-day period on the 26th November 2008 and was attended by one inspector. The deputy manager and proprietor assisted the inspector throughout the visit. The visit to the home formed part of the process of the inspection of the service to measure the service against the key national minimum standards. The manager had returned the Annual Quality Assurance Assessment (AQAA) to the CSCI for the current year and an Annual Service Review had been completed in November 2007. The focus of this visit to the home was to support the information stated in the AQAA and other information received by the CSCI since the last fieldwork visit, which was a key inspection, made to the home in December 2006. Care Homes for Older People Page 6 of 31 Documents and records were examined and staff working practises were observed where this was possible without being intrusive. The inspector spoke to a number of the residents, staff and visiting relatives in order to obtain their perceptions of the service the home provides. Those spoken to were very happy and complimentary about the care and services that are provided. Surveys had been distributed to service users, visiting professionals and staff. Nine service user survey, fifteen staff surveys and four visiting professional surveys were returned to the CSCI. The outcome of the surveys indicated that there was a very high level of satisfaction with the service and that residents, staff and other stakeholders in the home were pleased with the care and the environment the home provides. There were 23 residents accommodated in the home at the time of this visit, most of whom could communicate effectively to give their views.There were no residents from an ethnic minority group. What the care home does well: What has improved since the last inspection? What they could do better: There are no requirements or recommendations made from this report. 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. Service users are given information and their needs assessed before a decision is made for them to move into the home. Intermediate care is not available in this service. Evidence: A pre admission assessment is undertaken by the manager or deputy, prior to a decision about the potential service user being admitted to the home. A sample of these assessment records were seen by us on service users files. The assessment tool seen covered all aspects of a persons needs and the assessments captured a good level of detailed information about the persons care needs. A service user spoken with confirmed that she had had an assessment at home by the manager before going to the home to live. Care Homes for Older People Page 11 of 31 Evidence: A more detailed assessment is undertaken once the person has been admitted to the home. The care plan is then formulated from these assessments together with other information gained from care managers, if they are involved. A service user told us that a great deal of care was given to their assessment of needs. Service users receive a welcome pack in their rooms. This gives them all the information they need about the home and also gives information about how to deal with any complaints they may have. In the past twleve months the home had now produced this information in an easy read format. The home offers a free day of care for potential service users and anyone who wishes to experience what the home is like, and gives them some idea of what standards to expect when going to live in a care home. Service users and relatives told us in surveys received by CSCI that they received all the necessary information about the home, were able to visit the home and read the recent inspection report, before making a decision to move in. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and healthcare needs of residents are met. Policy and procedures are in place to manage the residents medication safely and effectively, whilst promoting residents autonomy and independence. The home promotes staff working practice to ensure that residents privacy and dignity is respected. Evidence: A sample of three care plans was examined by us. These contained detailed information about all aspects of the persons care needs and would guide staff on how to meet the persons health, personal and social care needs. The Annual Quality Assurance Assessment (AQAA) stated that the care plans are reviewed monthly with service users and this includes nutritional screening and mental capacity sceening. This is undertaken by a staff member trained to do this. Care Homes for Older People Page 13 of 31 Evidence: Care plans contained risk assessments regarding the possibility of falls, moving and handling, nutrition and tissue viability. The care plans gave specific details about the level of help service users needed with areas of their care that risks had been identified. Plans are reviewed on a regular monthly basis with relatives and service users confirming their involvement in this process, together with that of the key worker. The home has a number of visiting medical professionals. GPs visit regularly, a psychiatrist, the community psychiatric nurse team and the district nurses if requested. All visits made by professionals are recorded separately in the care plans with recorded outcomes of the visits. Health professionals returned surveys to the CSCI with positive comments about the home saying: The home is always proactive in contacting the appropriate people for advice and review. We have regular contact with the home and have established an excellent communications and action plans are alway executed. Most staff have an individual approach to residents. The care staff are experienced and competent. A very caring environment I send the training doctors there for a half day to see how it should be done. A service users told us that medical support is available day and night when requested. There was evidence in the records that service users receive appropriate services from opticians, chiropodist, dentists and dental technicians. The home has a policy and procedure for dealing with medication, which enables service users to exercise choice over whether they wish to deal with their own medication. At the time of this visit there was one resident who was choosing to selfmedicate some of their medications and this was planned within a risk assessment framework, which was recorded and evidenced in the medication recording sheets (MAR) folder. A locked cupboard had also been supplied within the persons room and the deputy manager audited the medication weekly. The deputy manager reported that there was one service user who was receiving medication covertly. The documentation was in place to support this practice. There was evidence that the GP and pharmacist had been consulted and this had been discussed with relatives of the service user, who it was deemed, lacked the capacity around making decisions on medication. The drugs trolley and cupboard, including the separate controlled drugs cabinet, was secure at the time of the inspection. Records relating to the administration of prescribed medication were examined and were in order and up to date. These records are audited by a designated staff member Care Homes for Older People Page 14 of 31 Evidence: every day and this was observed to take place at the time of this visit. A check was made on the controlled medication register and balance with the amount tallying with the record held. Staff responsible for dealing with medication have been trained. This commences during the induction period and further in-house training is given on policies and procedures and more in-depth training is provided by the local college in the form of a work book. The home is then visited by the college for them to assess the carers competency in practice. Staff were observed to be providing assistance to service users in a calm and dignified manner, and knocked on doors, and awaited a response, before entering. Screening is available and used in double rooms. Service users wishes regarding the way in which they are addressed by staff are recorded in their care plan and respected by staff. 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. Service users religious and recreational interests are provided for. Service users are able to maintain contact with family and friends and visitors are welcome to the home at any time. Service users are supported to exercise choice and control over their lives and are provided with wholesome and nutritous meals that are well presented. Evidence: The home has a full activities programme, which is displayed on the notice board. The programme demonstrated a wide variety of activities to suit everyone, which take place every afternoon and evening. The deputy told us that the programme does cater for those with a dementia illness and activities are specific to their needs. Extra staff are employed to organise and support the activities every day. Care plans clearly detail each service users social history and what their particular interests are. Records of what the service users participate in and their level of participation is recorded in care plans. Service users themselves confirmed, that they enjoyed activities such as bingo, arts and crafts and quizzes. The home aims to have an activity every weekday, this includes exercise to music, arts and crafts, quizzes and reminiscence therapy. The home has arranged for a local college to provide an art Care Homes for Older People Page 16 of 31 Evidence: class every Friday and it was clear that this was much enjoyed by service users, who were proud to display their paintings around the home and in their bedrooms. The residents have the opportunity to voice their wishes at the residents meetings as to what activities they would like to take place and are actively involved in choosing what activities do take place daily. Surveys returned to CSCI by service users were very positive about the activities programme and one saying suggestions are always listened to and arranged and staff give their time to help residents that like evening pastimes. Service user are encouraged to participate in the homes life and are able to help with laying tables and simple tasks. At the time of this visit the residents were involved in an art class around the dining table, which was a very social occasion with service users chatting to each other. One relative commenting on the survey returned to CSCI that there is a pleasant family attitude when they gather around the table to do activities . Service users go out on outings in the mini bus in the better weather and also go out into the community with their relatives. The home has a visiting library who visits at intervals to change books. The books were observed to be on display in a hallway for residents to choose from. Service users religous needs are met. The deputy manager told us that some service users attend the local church and that there was a church service in the home on a regular monthly basis, this being provided in turn by Methodist, Catholic and Church of England ministers respectively. The AQAA states that in the previous twelve months the home has endeavoured to organise transport for those residents wishing to attend their choice of where they worship. The visitors book evidenced that the home has many regular visitors. Those spoken to at the time of this visit said that they were pleased with the services offered to their relatives. One relative saying I thoroughly recommend Badgers Holt. My family and I are very happy with the care mum receives. Service users were observed during this visit to be entertaining their visitors either in the communal areas of the home, of which there are three lounge areas, or in privacy of their bedrooms. Service users are able to move freely around the building and were seen to be making use of all communal areas as well as their bedrooms. The home has a twenty eight day menu plan. Choices are available at every mealtime. Care Homes for Older People Page 17 of 31 Evidence: Menus at the home were varied and it was noted that in addition to the 28 day menu there were also full 7 day menus for soft diets, vegetarians and diabetics. The newly trained chef is about to attend training to provide menus for those with special dietary needs. Service users spoken to confirmed that the food was good and that individual choices were available should either of the alternatives offered at lunch, not be liked. Service users are encouraged to take meals communally in the dining room but may use their own rooms if they wish. A small number of which did choose to stay in their room at the time of this visit. The lunch time meal was observed and the dining room was attended by most of the service users who made it a social occasion and reported that the meal was very good. The meal was observed to be wholesome and well presented. Three different menus were served that day to service users who were choosing to have an alternative meal to the main menu. The home has a snack bar available to service users 24 hours a day to which they can help themselves to chocolate bars and fruit. The manager explained that the home was moving towards a more hotel type service whereby service users could expect to have what they wanted when they liked. The provider explained that the home displays some foods to make the choice visual for those who have less mental capacity to choose. The home has a mini-bar in the evening and sherry is available should residents choose to participate before their supper or during the evening. Nutritional risk assessments are undertaken on all service users and weights are recorded monthly. It was observed that a care plan was in place to manage an identified nutritional risk for one service user. The kitchen was visited and the chef spoken with. The kitchen was clean and well organised with appropriate records being maintained of the cleaning and auditing of equipment. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a suitable complaints procedure, which service users are aware of and feel able to use. Service users are protected through an adult protection policy and procedure known to and understood by staff. Evidence: The home has a complaints policy and procedure, a copy of which was included in the information pack available to potential service users and is produced in large print. The procedure is also displayed in the dining room. Service users all appeared to have a good degree of confidence that any issues raised would be dealt with. The deputy manager told us in the AQAA that the home has had no complaints to deal with in the previous 12 months. Staff spoken with said that they would report to a more senior person any complaints made to them by service users. The surveys returned to CSCI from service users indicated that they would know who to go to if they wished to make a complaint but comments said they have no complaints and one commenting they had an easy co-operative relationship with management and staff who were always available. The home also has a policy and procedure relating to adult protection, this is included in the welcome pack in service users rooms. Staff have been trained in Safeguarding Care Homes for Older People Page 19 of 31 Evidence: and the Whistle Blowing procedure as part of their induction programme and on-gong training programme and would know how to deal with any reports or suspicions of abuse. The training files evidence that staff have undertaken training. Staff spoken with and all fifteen staff surveys returned to CSCI said that they would report anything they needed to the deputy or proprietor and were knowledgeable in the procedures to take. 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. Service users live in a safe and well maintained environment and have access to comfortable indoor and outdoor facilities. The home is clean, pleasant and hygienic. Evidence: The communal areas of the home consists of three lounge areas and a large dining area. These areas have been redecorated in the past twelve months with new furniture purchased. The decor and fixtures and fittings are of a high standard and the rooms are very pleasant relaxing rooms in which to sit. Service users told us that they had the opportunity of help choosing the fabrics and colours of the communal areas which they are very happy with and they enjoy sitting in the lounges. The AQAA states that the home has a continual programme of redecoration and refurbishment. The schedule was seen and recorded dates of when furniture and redecoration took place. The building is very well maintained with the opportunity taken when a room is vacated for any new service user to be involved in the choice of decor before moving in. A new fire system has been installed recently and new windows and doors replaced. The tour of the building showed the home to be clean and tidy throughout and there Care Homes for Older People Page 21 of 31 Evidence: were no undue odours. The home has three bathrooms one of which is a shower room, another a wet room and an assisted bathroom. Adequate toilet facilities with aids were available. The inspector visited a number of service users rooms. These were observed to be very clean and had been personalised with individuals personal items and pieces of furniture and favourite chairs which had been accommodated in the rooms. Comments made by service users said that it was nice to bring in my own furniture. All surveys returned from the ten service users commented that the home is very clean and that their rooms are cleaned every day. Staff comments on surveys returned say that the environment is excellent and that the decor and gardens are lovely and well maintained making the home very homely and a nice atmosphere to work in. Most of the bedroom windows look out onto the pleasant well maintained gardens that are at the back of the home. Service users were observed to be freely making use of communal areas, such as the lounge and other communal areas and accessed their bedrooms as they wished. The homes laundry was inspected and was fit for purpose with machines being capable of meeting disinfection standards. Members of staff spoken with were clearly aware of good practice and there were procedures in place to deal with soiled items. Staff were aware of these procedures and confirmed that gloves and aprons were available. A new sluice room has been fitted recently and handwashing facilities are available in all areas. The AQAA states that 18 staff have received infection control training. Necessary aids, such as hoists and handrails were also available around the building. 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. Service users are well supported by a well trained staff team who are deployed in sufficient numbers throughout the day to meet their needs. The home can now demonstrate that recruitment practices are more robust. Evidence: At the time of this visit there were 23 residents being accommodated with 2 being in hospital. The staff rotas were viewed. These demonstrated that three staff are on duty during the day time along with a chef, kitchen assistant, housekeeper, a gardener maintenance man and 2 waking staff at night. The deputy manager is on duty five days a week and the proprietor is in the home most days of the week which includes week-ends on occasions. At the time of this visit a new chef was being trained and therefore there were three staff in the kitchen. From observation throughout the visit there was no indication that there were insufficient staff on duty. Call bells were being responded to quickly and one service user commented you simply ring the bell and they are there. Staff were also observed to be interacting well with the service users and taking their time attending to their needs and were familiar with their daily routines. A number of the service users were quite independent and were able to mobilise around the home and undertake their Care Homes for Older People Page 23 of 31 Evidence: activities of daily living with little support. Staff spoken to told us that there were generally sufficient staff on duty at all times to meet service users needs. The staff surveys returned to CSCI told us that staff consider there are sufficient staff on duty to meet the service users needs and that most staff are willing to do extra duties to maintain staffing levels during staff sickness, annual leave or other absent ism. The home does not use agency staff. The home provides an induction programme for all new staff and is based on the Skills for Care induction standards. Surveys returned from the staff indicate that they have received induction and considered it covered all aspects of the job and the policies and procedures that support the practices in the home. One staff member commented that although there was a lot to take in and lots of reading and courses I was welcomed as a team member. I was asked if I felt confident before I carried out my duties. The training matrix was viewed and demonstrated that the home provides all health and safety mandatory training at appropriate intervals as well as a wide range of training in all aspects of care appertaining to the client group and this includes dementia care. The proprietor told us that she takes into account the staff preferences of how they wish to undertake their training. Some staff prefer to attend college whilst other prefer the training in-house by an outside trainer. The proprietor therefore organises this so as to give them the option of which they would prefer to ensure the training is received. The AQAA states that all training is paid for by the proprietor and this is supported by the comments received from staff surveys that say: We are constantly having training and if we are interested in any course relevant to our work the management are willing to arrange this for us. As a house keeper I am always involved in any training that can improve my understanding of the residents. Staff training is very good at Badgers Holt.We have mandatory training and additional courses and are encouraged to come up with new ideas. All staff indicated on their surveys returned that they are satisfied with the training and consider they are funded and well supported by the management for this. Records of training are maintained in the staff personal files and their training portfolio. The home employs 16 care staff of which 10 have achieved NVQ level 2 and a further 4 at level 3. The deputy manager has achieved NVQ level 4 in Care and is undertaking modules of the registered managers award. This represents 90 of care staff are trained to an NVQ level 2. The home employs a mixed gender of staff and has a mixed gender and sexual Care Homes for Older People Page 24 of 31 Evidence: orientation of service users. Staff are made aware through policy about equality and diversity and the home has endeavoured to make changes to promote equality and diversity with regards to individual worship arrangements and transport to outside venues, and signage for those with disabilities. A sample of recruitment files was viewed. These contained all the necessary documentation and Criminal Records Bureau (CRB) and the Protection of Vulnerable Adults (POVA) checks had been sought before staff commenced employment. This was confirmed in a survey returned from staff who stated that both checks had been received before she commenced working. Care Homes for Older People Page 25 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. Currently the home has intrim management arrangements in place and this ensures that the home is run in the best interests of the service users. The home now has a more formalised quality assurance systems in place to measure the level of success against that stated in the Statement of Purpose. Service users financial interests are protected and they control their own money wherever possible. The health and safety of service users and staff are protected. Evidence: The registered manager has been absent from the home for some weeks and the CSCI were informed by the proprietor that the home would be being managed by the deputy manager, who has been working at the home for some years, and the proprietor who is present in the home every day, until such times as a new manager can be appointed. The proprietor informed us that she is actively advertising in a hope of recruiting a manager into this post, but has been unsuccessful to date. Care Homes for Older People Page 26 of 31 Evidence: The deputy manager has been in this role for some years and is very familiar with the management duties and she together with the proprietor are competent to manage the home in the interim. Staff spoken to did not show any lack of confidence with the current management arrangements and are quite used to the deputy and proprietor being in the home as part of the management team. Staff surveys returned told us that they feel well supported by the management team and that they feel they can approach them and they are available at any time to discuss any issues. One comment from staff member said If we have any problems we can always ask to see the deputy manager of the proprietor. The home presents an open and welcoming atmosphere and it was clear through observation that the interaction between service users, staff and visitors that the home is run in the best interests of service users. The home has gained the Investors in People award. The information folder with this award is used by the management as a quality assurance guide. Questionnaires are contained in the back of the information pack in all service users rooms if they wish to complete them. Satisfaction questionnaires were sent to relatives in March 2008 which were analysed when returned. The feed back was very positive. There was one negative comment that was acted upon promptly. Other quality assurance audits that take place are the medication administration records (MAR) sheets, these are checked daily for completion by a designated carer together with the controlled drugs register. These are countersigned by a second carer as evidence of them being completed appropriately. The rooms are checked daily by senior staff for cleanliness and the proprietor regularly tours the building to identify any faults. Staff meetings are held regular intervals in the afternoons and the deputy told us most staff do attend these meetings. Records of these meetings are maintained. Senior staff meet independently to discuss any issues and how to improve the home. The home provides safekeeping for small amounts of cash for some service users but other than this, has no involvement in any service users personal finances. The inspector checked a sample of records of monies held, which balanced accordingly. The staff files evidenced that supervision takes place six times a year and an appraisal yearly. It is at these times that training needs and desires are discussed. The staff tell us that the management always offer full support and guidance when needed at any Care Homes for Older People Page 27 of 31 Evidence: time and encourage staff to undertake training. They also told us in surveys that meetings with the deputy or proprietor can be arrange at any time to discuss any problems that occur outside the home. Another survey told us that the management is always there to listen and give time for you and the residents. A sample of servicing certificates for systems and equipment were viewed and were seen to be current. The fire log demonstrated that the fire alarms and systems are regularly checked at the appropriate intervals. The fire risk assessment was also seen. Fire training is recorded in the fire log and evidenced that staff receive fire training six monthly. The accident records were viewed. These have been completed appropriately. The deputy manager told us that she looks at all accident reports and analysis the records and if she assesses it necessary puts a risk assessment in place and a care plan to manage the risk. One service user was case tracked and there was evidence of a number of accident reports with a risk assessment in place and an action plan to manage the risk. The home has a policy and information for staff on the control and handling of substances hazardours to health. Cleaning chemicals and other items were securely stored in locked cupboards and staff were aware of health and safety issues. The home has a health and safety policy known to staff. Whilst touring the building there were no apparent hazards to service users or staff. Records of all mandatory health and safety staff training were evidenced on the training matrix. These included moving and handling, first aid, food handling and hygiene and infection control. Care Homes for Older People Page 28 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 29 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 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 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 © (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. 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