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Inspection on 04/02/09 for Bannatyne Lodge Care Home

Also see our care home review for Bannatyne Lodge Care Home for more information

This inspection was carried out on 4th February 2009.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bannatyne Lodge Care Home Manor Way Peterlee Durham SR8 5SB     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: Elaine Charlton     Date: 0 4 0 2 2 0 0 9 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. that people have said are important to them: They reflect the things 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 34 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 34 Information about the care home Name of care home: Address: Bannatyne Lodge Care Home Manor Way Peterlee Durham SR8 5SB 01915869511 01915871741 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Tamaris Healthcare (England) Ltd care home 50 Number of places (if applicable): Under 65 Over 65 50 0 old age, not falling within any other category physical disability Additional conditions: 0 8 Named Individual: The home may accommodate a named individual as set out in a letter to the registered person dated 22 September 2005 which establishes the basis on which the individual`s needs will be met by the home. Where necessary the home`s Statement of Purpose shall reflect any changes in service provision required for this arrangement. This condition may not apply to anyone else, other than the named individual, who falls outside the registered category. Physical disability up to a maximum of 8 persons with a physical disability, (aged 55 and over) may be accommodated commensurate with the home`s Statement of Purpose. Date of last inspection Brief description of the care home Bannatyne Lodge is a care home with nursing for older people. It has some beds registered for people who are physically disabled over the age of 55 years. It has 50 single bedrooms, each equipped with an en suite toilet and wash hand basin. Older people with or without nursing needs may be admitted, depending upon their assessed needs. The home is well situated close to the centre of town. It is accessible by people Care Homes for Older People Page 4 of 34 Brief description of the care home with mobility problems and there are pleasant garden and patio areas for residents to enjoy. The home is well equipped and there are a number of attractive lounges throughout the building. Fees at the time of inspection were £417 residential £437.50 nursing and £474 private. Care Homes for Older People Page 5 of 34 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: An unannounced visit was made on the 4 February 2009. A total of six hours were spent in the service. The manager was present throughout the inspection. Before the visit we looked at Information we have received since the last visit on the 25 and 29 January 2007. The Annual Quality Assurance Assessment (AQAA) that gives CSCI evidence to support what the service says it does well, and gives them an opportunity to say what they feel they could do better and what their future plans are. How the service has dealt with any complaints and concerns since our last visit. The providers view of how well they care for people, and the views of people who use the service, their relatives, staff and Care Homes for Older People Page 6 of 34 other professionals who visit the service. Sent out Have your Say questionnaires for residents, relatives and healthcare professionals to complete. We have also reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. During the visit we Talked with people who use the service, staff and the manager. Looked at information about the people who use the service and how well their needs are met, other records which must be kept, and checked that staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around the building/parts of the building to make sure it was clean, safe and comfortable and checked what improvements had been made since our last visit. We told the manager what we found. What the care home does well: What has improved since the last inspection? New brochures have been produced to give information to people who might want to live in the home. A quality rating card has been introduced and is part of the information that tells people the homes star rating, what this means and how it is achieved. Care Homes for Older People Page 8 of 34 A new consent form has been put in place to record each persons agreement to having their photograph taken as part of the homes records and to say who information about them may be shared with. The complaints procedure is now available on CD so that people who might have a problem with the written word can listen to what they need to do if they have a concern or want to make a complaint. Areas of the home have been upgraded and redecorated and part of the garden has been decked providing a comfortable and pleasant seating area for residents. Staff and members of the local Fire Brigade joined together to produce a 2009 calendar that was sold to raise money for the residents fund and a local cancer charity. 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 34 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 34 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 are given enough information to help them decide whether they want to move into the home and their care and support needs are properly assessed so everyone is sure that they can be met. Evidence: Five people who live in the home sent back our Have your Say questionnaires. They all said they got enough information to help them decide whether to move into the home or not. The homes service user guide has been updated and new brochures have been produced. There is a brochure for people living in the home and one that is sent out when people make enquiries about moving into the home. The enquiry brochure inlcudes a leaflet about funding arrangements and respite care. Care Homes for Older People Page 11 of 34 Evidence: The organisation has also introduced a bookmark type card that is included in the homes brochure detailing the quality rating it has received from CSCI, there is also an explanation of what this means and how the system works. This is a very nice addition. We saw copies of healthcare professionals assessments of peoples needs included in their files. We looked at the assessment for the person most recently admitted to the home. Four Seasons Health Care has its own assessment document that is known as the DART (Dependency Assessment Rating Tool), this is now being replaced by the CHAP (Care and Health Assessment Profile). The assessment we saw had been fully completed and signed. It included very sensitively and respectfully written information about the person, their needs, wishes and background. There are also pre-admission and admission checklists for staff to use to make sure everything has been completed. For the assessment we looked at the pre-admission checks had been carried out and recorded, but not those listed for admission and the form had not been signed by the person moving into the home. A range of other professionally recognised assessment documents are used to record a persons skin integrity, moving and handling needs, mobility, nutritional status and any continence issues. These are all supported by risk assessments and care plans. A new form has been introduced that records a residents understanding of confidentiality, who information can be shared with and their agreement to having photographs taken for their personal and medication records. The home does not provide intermediate care. When asked what the home did well a relative said our family are very happy that Mum has been made so welcome and comfortable. I cannot speak highly enough about the attitude of all the staff at all times. It is a very big step to give up ones home. Care Homes for Older People Page 12 of 34 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. People who live in the home have their health and personal care needs met and are protected through policies, procedures and staff training in the safe handling of medication. Evidence: Four people who sent back questionnaires said they always got the care and support they needed and the other person said they usually did. They all said that staff always listened to and acted on what they said. One person said, all staff are always helpful. A relative, on behalf of their parent said, my mother had a fall whilst in the home and had to be hospitalised, she couldnt wait to get back home - Bannatyne Lodge. People also felt that staff were always or usually available when they needed them and that they could always get medical support when they needed it. Care Homes for Older People Page 13 of 34 Evidence: A relative said my mother had a virus over Christmas. She was extremely well looked after and the nurse did not hesitate to call the GP when there was no improvement. We looked at three more service user plans. These all contained a range of care plans appropriate to the persons level of need. They were well written in a person centred way and had been evaluated. The manager carries out care plan evaluation checks and these are recorded on a checklist at the front of each file. Any failings or omissions that she identifies are written in red. This is good practice. We saw evidence of people being able to see a wide range of healthcare professionals. As well as GPs and community nurses, these included consultants, community matron, physiotherapist, optician, dentist and chiropodist. Two healthcare professionals also sent back our Have your Say questionnaires. They said that the home always seeks advice and acts upon it. They also said we have observed records detailing calls to doctors, specialist nurses etc. Two people we saw as we walked around the home said they were not feeling well but that staff had made arrangements for their GP to visit. They were re-assured by this. One ladies DART assessment had been updated and replaced with the CHAP. It had been well completed giving staff a lot of information and included information about the persons ability to consent, their rights and choices. We saw peoples preferred choice to a bath or shower, and whether they wanted a male or female carer to assist them, being recorded. One note in a care plan said staff to communicate in a manner that is supportive and respectful and includes the resident in decisions. We were told that there are 10 people using profile beds in the home, one gentleman we spoke to said his was very comfortable. The home is well equipped and people are able to bath, shower or use an assisted bath as they wish or their needs dictate. People were seen using a range of equpiment to aid their mobility including wheelchairs, walking sticks, rolators and zimmer frames. Some people who need to use a wheelchair to get around can propel themself and are encouraged to do so. We carried out a random check of medication for those people whose records we saw, Care Homes for Older People Page 14 of 34 Evidence: those medicines that should be refrigerated and those that are controlled. The treatment room is located on the ground floor, is kept locked, is spacious, clean and tidy. Medication for both floors are kept in separate trolleys and are dispensed by the nurse on duty or a senior member of staff who has complete safe handling of medication training. The home is operating the red tabard system when medication is being given out. This lets people know not to disturb the person to reduce the risk of errors. During the morning medication round the nurse dispensing medicines was not wearing the tabard. Refrigerator temperatures in the treatment room are checked and recorded daily and all medicines that we saw in the refrigerator had been dated when opened and were labeled with the residents name and proper dispensing instructions. Plastic spoons and pots are used when dispensing liquid medicines. We saw evidence of people having their medication provided in a liquid form to make it easier for them to take. Controlled drugs are kept separately and securely within the treatment room. The controlled drugs register was seen to be properly and fully completed with all entries dated and signed by two people. We checked the stock of medication against the register and this was found to be correct. Where possible medication is dispensed using the blister pack system and is delivered to the home on a four weekly cycle. There were no errors or omissions on the medication administration records (MAR) for any of the people we checked. During the random check of other MAR sheets we saw that entries that had been handwritten onto the MAR had not been signed by the person making the entry or countersigned by another member of staff to say the entry was correct. We saw the privacy and dignity of residents being promoted through care planning, whilst entering peoples bedrooms and during the provision of care and support. As we walked around the home one lady said you get nothing but loving care here, it is always a pleasure to see the manager. A lady we spoke to in her bedroom showed us pictures of herself when she was admitted to the home, very unwell and very thin. She said it was only the care and support she had received in the home that had helped her to get better and to put weight on. She also said she liked to do as much as she could herself, including making her bed. Care Homes for Older People Page 15 of 34 Evidence: Heathcare professionals said, when visiting the home I have witnessed privacy and dignity being met, I have always witnessed the individuals dignity and privacy being respected, family and residents have informed me that their health needs are being met, and family and residents have informed me that they are encouraged to live as they choose. Care Homes for Older People Page 16 of 34 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. People who live in the home can be as independent as they want. They are able to join in activities and social events inside and outside the home as they choose. Evidence: People living in the home felt there were always or usually activities taking place that they could join in and one person said the activities co-ordinator works very hard to make sure we are entertained. There is a dedicated activities organiser who works 30 hours a week. She told us that she tries to carry out one to one activities with residents each morning with more inclusive, group activities in the afternoons. People were seen having their nails done, and they could have a hand massage if they wanted. The hairdresser was also in the home, as she is every Wednesday. She came to speak to the manager to check whether a lady who was not too well could have a perm or whether she should wait until the next visit. People were seen carrying out activies or following hobbies of their choice. These Care Homes for Older People Page 17 of 34 Evidence: include knitting, crochet, word puzzles and reading the daily papers. One gentleman had had his picture in the local newspaper reporting on the art work he does. He said he enjoys this. We saw evidence of lots of events having taken place including a Halloween party, VE day party, open day following the homes refurbishment, a Macmillan Biggest Coffee Morning that Bob Johnson, the weather man, attended, a Christmas Fayre and visits to the theatre. There had been a trip to Billingham Forum to see Goldilocks, one lady had been to see the Strictly Come Dancing show and several residents had attended the Mayors New Year Party at Shotton Hall. We were told this is an annual event and staff try to make sure that different people get to go each year although some people do not like to go out to this type of event. Staff and members of the local Fire Brigade posed for a 2009 calendar that was sold to raise money that was split between the residents fund and a cancer charity set up by one of the homes popular entertainers. The calendar was professionally produced and sold out. Some residents bought copies to give as Christmas presents, others had one up on their bedroom wall. The calendar has been, and still is, a talking point. We were told that there is a different entertainer booked every month. One person who recently left the home to live back in the community with his wife is continuing to attend these events. Staff are making sure he knows what the entertainment is and that he and his wife can get there safely. One resident told us how they found love when they moved into the home. The couple exchanged friendship rings at a small ceremony with prayers that the home arranged to mark the event. The lady told us that she also goes down to the kitchen each evening to get them both a small glass of brandy which they enjoy. We met a relative of the couple who said they kept each other company. People can go out and about in the local community with or without the assistance of staff. Two people went out, alone, during the inspection. One lady to her hairdressers and a gentleman to the shops. One person has joined the local leisure centre Get Active group and this has helped to increase their confidence. The same person showed us their pets. A beautiful tropical fish tank and four caged birds. Care Homes for Older People Page 18 of 34 Evidence: A lounge on the first floor has just been re-decorated. It is an L shaped room and one area has been furnished in the past and the other in the present. Four people said they always or usually enjoyed the food. One person said good food. A relative said It is not always possible to please everyone, but there is usually an alternative choice. When we arrived to carry out the inspection we saw that the dining room was nicely set up with linen table cloths and flowers. People were still having breakfast at almost 10:00 am. Lunch on the day of the inspection was bacon and leek roll or a grilled pork steak mashed potatoes or chips and two vegetables. Pudding was a choice between fruit crumble and custard or ice cream or yogurt. We saw examples of how cook prepares moulded food for people who need a soft diet. There are also photographs of moulded meal examples for residents and families to see. This is a good idea. The choice at teatime was souffle and grilled tomatoes or bacon with beetroot and mash. Pudding was jelly squares or sorbet. Throughout the day we saw that people who live in the home can easily get a drink, jugs of water or juice are put in their bedrooms, and chilled juice is available in the dining room. Quite a few people have also chosen to have mini or small refrigerators in their bedrooms where they keep their own supplies of drinks and snacks. Cook also told us about the tuck shop basket that goes around each evening. It contains cereals, crisps, fruit, and teacakes. Staff use a prepared tick list to record what residents have wanted/taken. This gives staff an idea of what people want and what they have had. Records of individual menu choices are kept for six months. We also saw evidence of the temperature checks that are carried out on food, refrigerators and freezers. We saw well stocked freezers, refrigerators and dry store. Cook is very enthusiastic and was keen to tell us about the choices people can have if they do not want what is on the menu. Care Homes for Older People Page 19 of 34 Evidence: One resident said you wont starve here, cook does a lovely buffet as well. Another resident asked the inspector to look at photographs she had of herself when she moved into the home to show how she had benefitted from the food and care she had received in the home. She said it was down to the loving care she received. Care Homes for Older People Page 20 of 34 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 live in the home are kept safe through policies, procedures and training in safeguarding adults, but some staff still need to complete safeguarding training to bring their practice up to date. Evidence: The company has a clear complaints policy and procedure that includes timescales by which a complainant can expect a response. Information about how people should raise concerns or complaints is also set out in the service user guide and is displayed in the home. To help people who may have difficulty with the written word a new CD has been produced so that people have access to a version they can listen to. This is an excellent initiative. The home has a complaints register and any issues raised are immediately notified to head office. There are no on-going complaints or safeguarding issues. All five people who sent back our questionnaires said they always knew who to speak to if they were unhappy and how to make a complaint. People also said all very supportive, know how to make a complaint but never needed to, quite happy and content. Care Homes for Older People Page 21 of 34 Evidence: A relative said the home manager and nurse are always available and very approachable. The three staff who sent back our questionnaires said that they knew what to do if a resident or their relative raised a concern or wanted to make a complaint. All staff have been issued with a copy of the Four Seasons Safeguarding workbook. They have been given a period of two to three months to work through this and submit it to the manager. People are first introduced to safeguarding policies and procedures during their induction training. Care Homes for Older People Page 22 of 34 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. People live in a home that is warm, comfortable and safe, where they can move around easily and spend time in private or make use of communal areas. Hygiene routines are good and the home is clean. Evidence: We walked around the home and took the chance to speak to both residents and staff as we went. There are two lounges on the ground floor and the dining room. One of the lounges opens out onto an area of the garden that has been updated with decking, benches, seats and a water feature for the enjoyment of the residents. There are two more lounges on the first floor as well as a smoking lounge. One of the lounges on this floor is the Past and Present lounge. We saw 12 bedrooms, each of which had an en-suite toilet and wash hand basin. There are also shared bathroom and shower rooms on both floors and an adapted bathroom on the ground floor. Bedrooms are decorated and furnished as each resident wishes. People are able to Care Homes for Older People Page 23 of 34 Evidence: bring items from their home to personalise their bedrooms. Those we saw were all very different. Some people had also had private telephone lines and SKY TV installed in their rooms. Profiling beds have been purchased for 10 residents to make their life more comfortable and safe. Corridors are very spacious making it easy for people to move around especially those who need to use a wheelchair. There is also ample storage for wheelchairs and hoists. The laundry is on the ground floor, as well as a linen cupboard. Space in the linen cupboard could be better used with the addition of another shelf. There is a sluice room on each floor. All areas were seen to be clean, tidy and odour free. When asked if the home was fresh and clean people said always. One person said always excellent. Care Homes for Older People Page 24 of 34 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 in the home are protected by thorough recruitment and selection procedures that are properly followed. Staff are supported through supervison, appraisal and training to do their job. Evidence: Three members of staff returned our Have your Say questionnaires. They said that they felt their recruitment and selection was properly carried out. All three felt their induction mostly covered what they needed to know and said that they usually got enough information to help them provide the care and support people living in the home needed. Each person felt that they got training that was relevant to their role, helped them to understand peoples needs (including those relating to race, religion, beliefs, equality and diversity and sexuality), and kept them up to date with new ways of working. They all felt that sometimes there were not enough staff on duty and one person said staff sickness is bad. About what the home does well, one person said care is offered to the highest standard. They felt the home could do better by having the correct amount of staff on Care Homes for Older People Page 25 of 34 Evidence: duty and all the equipment people need to hand. Four Seasons Health Care has thorough recruitment and selection procedures in place. We saw the files for three people who were working in the home. The files were selected at random and were for a nurse, a care assistant and a new member of staff. All the staff records were seen to be kept in a standard way. There was evidence of checks being carried out to verify a persons identity, of references being sought and Criminal Records Bureau checks being carried out. The manager carries out checks on the Personal Identification Numbers of nurses to make sure that their registration is current. All staff wear identity badges that show their name and role. We saw well documented notes of disciplinary meetings and follow up actions. All new staff complete an induction workbook, evidence from this can be used as evidence for their National Vocational Qualification (NVQ) training. Moving and handling, health and safety, emergency first aid, infection prevention and control are all part of the induction course. A nurse or senior member of the staff team act as mentors for people working through their induction. We saw evidence of good staffing levels although some staff felt that this was not always the case. In addition to the manager, nursing and care staff, there is an administrator, activities co-ordinator, chef and two kitchen assistants, two domestic assistants and a maintenance manager on duty. Over 50 of staff have achieved a qualification at a minimum of NVQ level 2. Each member of staff has their own separate training file. This includes a list of training undertaken and a copy of their certificates. A number of staff had recently undertaken a course entitled Dispelling the Myths of the Funeral Profession. This had been carried out by a local undertaker and the feedback had been good. Healthcare professionals said, there is a mixture of care staff some more experienced than others but a good training programme appears to be in place, I am aware training is given. There are care assistants of different grades and experience as well Care Homes for Older People Page 26 of 34 Evidence: as qualified nurses, staff are friendly and welcoming. Its nice not to see them congregating in one place and they seemed to be scattered around the home appropriately. Care Homes for Older People Page 27 of 34 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. People live in a home that is run in an open and inclusive way, where regular checks to keep them safe and well are carried out. They are protected by comprehensive policies and procedures and well kept records. Evidence: The manager is a registered nurse and has completed an NVQ at level 4 and the Registered Managers Award. One resident said it is always a pleasure to see the manager. We were sent a copy of the homes AQAA when we asked for it. This was detailed and told us everything we needed to know. The company has a computerised financial system for budgets, fees and residents monies. We went through the finance systems and records with the administrator. There is an individual file for each resident that includes a copy of terms and Care Homes for Older People Page 28 of 34 Evidence: conditions and a contact sheet that doubles as an audit sheet. We saw extremely good use being made of the contact sheet to record the progress of an application for financial protection for one resident. Quality surveys are sent out from and returned to head office. Surveys are evaluated by head office and the home is provided with a copy of the report. The last survey for Bannatyne Lodge was June 2008, when 54 surveys were sent out and 22 were returned. Feedback included: Are facilities made available for you to talk to your relative in private - 90 said yes. Are you involved in care decisions - 77 of relatives said yes. Are you at ease speaking to staff - 87 said yes. About personal care people felt responsiveness was good - nail cutting and cleanliness was fair - assistance with mobility was good and assistance with mouth hygiene was good. About meals, people said punctuality and service was good, and the variety was good to fair. Laundry and cleanliness people felt was good. Social activities, choice, variety and entertainment value were good to very good and outings were fair. Regular visits are made to the home by the provider and reports of the visits were available in the home. We looked at the accident and health and safety records for the home. The manager completes a risk monitor for head office on a regular basis where all accidents, incidents and events are recorded. People living in the home can be referred to the local Falls Prevention Team if any mobility issues are identified and they will support the person and/or provide equipment if necessary. All maintenance and servicing arrangements were in place and up to date and the records kept by the homes maintenance manager were of an excellent quality. The manager told us that they had had a recent visit from the Fire Officer and told us what actions had been taken in response to his letter. A new fire risk assessment for the home is in place. Care Homes for Older People Page 29 of 34 Evidence: There is a programme of staff supervision and support but this does not meet the minimum level of six one to one meetings a year. Care Homes for Older People Page 30 of 34 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 31 of 34 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 13 Staff must complete their training in safeguarding adults. This will help to keep people who live in the home safe and well. 04/05/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 All assessment documents and checklists should be fully completed, dated and signed by both the assessor and the person moving into the home. This will provide the evidence that all the stages of the pre-admission and admission process have been completed. The person dispensing medication should follow proper procedures and wear the red tabard so that they are not unnecessarily disturbed. This will mean that people are clear medicines are being given out and are kept safe. Handwritten entries on the MAR charts should be signed by the person making the entry and a second member of staff to confirm the entry is correct. This will mean that people living in the home are kept safe. An additional shelf should be provided in the linen Page 32 of 34 2 9 3 9 4 19 Care Homes for Older People cupboard, just above ground level, so that good use can be made of the area between the floor and first shelf to store duvets and pillows. This will promote infection control and good hygiene routines. 5 36 Supervision for staff should be carried out and recorded at a fequency that meets the recommended level of six one to one sessions a year. This will support staff to do their job and help to keep people who live in the home safe and well. Care Homes for Older People Page 33 of 34 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. 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. 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