Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Bellsgrove Bellsgrove 250 Cobham Road Fetcham Surrey KT22 9JF 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: Jane Jewell
Date: 1 4 0 1 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 30 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 30 Information about the care home
Name of care home: Address: Bellsgrove 250 Cobham Road Bellsgrove Fetcham Surrey KT22 9JF 01372379596 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): bellsgrove@hotmail.com Mr Somasundaram Logathas,Mrs Shyamala Logathas Name of registered manager (if applicable) Mr James Iswurdut Sobun Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 14 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Dementia - DE Mental Disorder, excluding learning disability or dementia - MD Date of last inspection 14 14 0 Over 65 0 0 14 care home 14 Care Homes for Older People Page 4 of 30 Brief description of the care home Bellsgrove was first opened as a care home in 1982. The current owners purchased the property in 2001. It is a family run care home registered to accommodate up to fourteen older people including residents who have dementia. The home is a large detached converted domestic property situated in the village of Fetcham, with a range of local shops nearby. The home is presented across two floors, with a passenger providing level access to the first floor. Residents accommodation consists of fourteen single bedrooms with half providing en-suite facilities. Communal space consists of a combined lounge dinning room and conservatory. There is a rear garden, which has a patio and seating areas. The front is in the main paved to provided off road parking 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 information contained in this report has been comprised from an unannounced inspection undertaken over six hours and information gathered about the home before and after the inspection. This is the second Key unannounced inspection of the home within twelve months. The inspection was facilitated by Mr James Sobun (registered manager) and in part by Mr Somasundaram Logathas (registered provider). The focus of the inspection was to assess the progress made towards addressing the areas of shortfall noted at the previous inspection and to look at the experiences of life at the home for people living there. The inspection consisted of a tour of the premises, Care Homes for Older People
Page 6 of 30 examination of the homes documentation and discussion with residents and staff and two relatives. Feedback surveys were sent to the home in advance of the inspection, three were returned from residents, three from relatives, and four from a health care professional. The feedback and comments from these surveys were used to inform the inspection process and are included in this report. Small groups of residents were observed for signs of well-being/ill-being (terminology used for observing behaviour for people with dementia) and these observations are also included in this report. There were eleven residents residing at the home at the time of the inspection. What the care home does well: Residents continue to live in a clean and homely environment, which is decorated and maintained to a good standard. The home provides a gentle and relaxed lifestyle for residents who in the main have low to medium assessed level of needs including residents who have dementia. Residents comments about their lives at the home included very happy here could not be looked after better if we were in our own home A sample of comments made by relatives about their experiences at the home included recommended by the Alzheimers society as a very caring home and My mother has been very content in the home since she moved there . She is always cheerful when I visit and I feel this must reflect the positive attitude and calm caring of the staff. I am very impressed by the way they run the home. also they are very open and inclusive about everything. Staff commented best bit about the home is we care about the residents, it is a happy kind home best thing is how we have improved in caring for people with dementia as our understanding has improved. There is an effective complaints system with evidence that relatives feel that their views are listened to and acted upon. A relative said If I had any problems I would not hesitate to speak to Mr and Mrs Logatheas they are always responsive and helpful. Residents receive prompt health care intervention from a range of health care professional with health care professionals commenting excellent patient care good liaison with family excellent working relationship with GP excellent service excellent care seek medical advice appropriately. A relative commented the proprietor or general manager has no hesitation in calling GP or ambulance service for medical advice action whatever is required. Residents lives are enriched by the provision of some organised activities. A resident said We can do lots of things here if you want I really like card making. Relatives commented My mother is regularly involved in activities in the home and trips out Mr loaghtas holds events during the year at which family members friend can attend eg xmas party summer BBQ occasional drinks fireworks nibbles evenings and summer outingsand My mother enjoys pottering about in the garden and she is encouraged to do. Sometimes a member of staff takes her out for a walk. Personal support is offered in ways, which promotes and protect residents privacy and dignity. Residents are helped to exercise some choice and control over their lives with flexible routines being an integral part of daily practice at the home. Links with families and friends are valued and supported by the home A variety of meals is provided with those residents who need supporting assisted in a sensitive and dignified manner. Comments made about the food included good here given plenty of choice I believe my mother eats well and the menu is written up each day looks satisfactory and lunch was very nice I always have enough to eat. Staff make a positive contribution in residents lives as they benefit from a stable, trained and enthusiastic staff team that know them and who are employed in sufficient Care Homes for Older People Page 8 of 30 numbers as is necessary to meet their needs. A resident said The staff are all really nice. A relative commented all the staff at Bellsgrove are gently and caring people . They are very kind to my mother and sensitive to her needs and moods. They will often put their arms around her and give her a hug if she is felling a bit low. One staff member always does the cross word with her when he is on duty. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Older People Page 9 of 30 240 7535. Care Homes for Older People Page 10 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 11 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. Prospective residents and their representatives are provided with information in a form that is appropriate to them to allow them to make an informed choice with minor adjustments needed to this information to ensure that it fully reflects the full range of services being provided. The way in which prospective residents are assessed ensures that the home admits only those residents whos needs can be met by living at the home. The home is able to identify and meet the assessed needs of the residents. Evidence: There is a range of information about the home and the services it provides, this includes a statement of purpose and service user guide which are given to prospective residents, representatives and other interested parties. In line with the previous
Care Homes for Older People Page 12 of 30 Evidence: requirement this literature has been reviewed and updated to reflect the range of services and facilities offered by the home. A minor addition is needed to this literature to include the details regarding the provision of day care being offered at the home. The manager agreed to update this promptly. The manager reported that residents are provided with a written contract of terms and conditions of residency with the home. This can be used with residents and their families to make explicit the placement arrangements and clarify mutual expectations around rights and responsibilities. In line with the amendments to the care home regulations in 2006 the manager agreed to ensure that residents terms and conditions of residency now include a description of the services offered, the arrangements for charging and paying of additional services and a statement whether any of the above conditions are different where a service users care is being funded by another party other than the service user. A new format for the assessment of prospective residents has been introduced this provides comprehensive information about their needs in order for the manager to make an informed decision whether their assessed needs could be safely met at the home. Advice is sought during the assessment process from health care professionals and others who know and understand the needs of the prospective resident. The needs assessment then forms the basis of their care plan. This helps ensure that staff are aware of the recorded needs of new residents prior to them moving into the home. In line with the previous requirement that all assessments are undertaken by a suitable qualified person the manager confirmed that it is only themselves that now undertake assessments. There continues to be a wide range of needs being accommodated at the home this includes residents who are currently receiving nursing input from district nurses, residents who have mild and complex dementia including challenging behaviour. Through observation of the daily practices, interactions between residents and staff, tour of the environment and examination of care plans it was concluded that the home is able to demonstrate that it is able to meet most needs of the residents. Residents continue to benefit from the relaxed and gentle lifestyle provided at the home. The inspector noted many signs of wellbeing in residents who were not able to verbally share their experiences of the home, this included positive body posture, smiling, initiating conversation and physical contact with staff. Residents comments about their lives at the home included Very happy here and Could not be looked after better if we were in our own home. A sample of comments made by relatives about their experiences at the home included recommended by the Alzheimers society as a very caring home My mother has been very content in the home since she moved there . She is always cheerful when I visit and I feel this must reflect the positive attitude and
Care Homes for Older People Page 13 of 30 Evidence: calm caring of the staff. I am very impressed by the way they run the home. also they are very open and inclusive about everything. Staff commented best bit about the home is we care about the residents, it is a happy kind home and best thing is how we have improved in caring for people with dementia as our understanding has improved. Residents representatives consulted with spoke of being provided with the opportunity to visit the home with their relative in advance to assess the quality, facilities and suitability of the home. The first four weeks of occupancy is looked upon as trail occupancy, a relative feedback that The trial Period was also important in deciding whether the right choice had been made seeing the home in action, by comparison we feel that Bellsgrove is the best place she could be. Intermediate care is not offered at the home therefore this standard is not assessed. Care Homes for Older People Page 14 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. The care planning process enables residents assessed needs to be identified and appropriate guidance for staff provided with the manager aware of the further work needed to ensure that care plans are more person centred. Generally medication is managed satisfactorily however safe practices need to be consistently undertaken in the managers absence in order to ensure residents safety. Residents receive prompt health care intervention from a range of health care professional. Personal support is offered in ways, which promotes and protect residents privacy and dignity. Evidence: Four plans of care were looked at in detail, these comprised of several documents including basic information, daily notes and a plan of care. Some work has been initiated to create more person centred care planning, which is a good practice model in the care of people who have dementia. Care plans generally contained the
Care Homes for Older People Page 15 of 30 Evidence: information to support staff to meet the needs of residents. However there remains a need for the development of personal histories, which can aid understanding of the current needs of a person who has dementia. The manager and provider were aware of this and agreed to ensure that these were completed promptly. Staff were clear on the needs of residents but were aware of the need for them to become more fully involved in the development and review of care plans once the new care plans have been further developed. Changes in residents needs and preferences were promptly identified through the regular review of care plans. The home maintains a daily record for each resident on events and occurrences. The standard of recording was noted to be good with a clear account of actions and events that had occurred written in a respectful and sensitive language. In line with previous requirement individual risk assessments are in place, which covered core and specialist areas of risks and records the actions to manage any identified risks. Any risks faced by a resident that the inspector noted during the course of inspection had been recorded within an individual assessment. Records of medical intervention showed that the home continues to work closely with health care professionals including GPs, specialist nurses, chiropodists, opticians and dentists to ensure residents receive a good range of health care intervention. A sample of comments made by health care professionals included excellent patient care good liaison with family excellent working relationship with GP excellent service andexcellent care seek medical advice appropriately. Residents and relatives continue to confirm that when they have asked for medical input then this has been sought promptly by the home. A relative commented the proprietor or general manager has no hesitation in calling GP or ambulance service for medical advice action whatever is required. The system for the administration of medication is generally well managed with arrangements in place to ensure residents medication needs are met safely. It was previously recommended that hand written Medication Administration Record charts should be signed and dated by the person recording and in order to fully eliminate the associated risk when copying prescribed instructions onto medication administration records they should also be checked and countersigned for accuracy by a second member of staff. This had not been completed in all cases and examples were noted whereby a record of medicines received into the home had also not been completed. It was while the manager had been on leave that these shortfalls occurred. The manager agreed to ensure a closer monitoring of medication practices in their absence and to ensure that all staff are fully aware of the homes medication practices. It was
Care Homes for Older People Page 16 of 30 Evidence: previously recommended that following advice from the Commissions Pharmacy inspector that schedule three controlled drugs are recorded in a controlled drugs register in order to provide a clear audit trail of this medication. This had not yet been undertaken and has now been made a requirement. Observation in the home confirmed that resident)))))))s privacy and dignity is largely respected, staff knock on doors and speak to residents in a courteous manner. Personal care information displayed in the kitchen was not in keeping with promoting residents privacy and staff removed this immediately. Residents were dressed appropriately, in accordance with preserving their dignity and the prevailing weather. Care Homes for Older People Page 17 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. Social activities and meals are well managed providing daily variation and interest for people living in the home. Residents are helped to exercise choice and control over their lives with flexible routines being an integral part of daily practice at the home. Links with families and friends are valued and supported by the home. Evidence: There is evidence that residents continue to be treated as individuals with residents able to exercise their personal choice with regard to meal times, going to bed, rising and bathing. During the inspection residents were observed to move around the home choosing which room to be in and what level of company they wanted to enjoy. For a few people living at the home, exercising their choice was difficult due to the level of dementia. The staff were seen to use their acquired knowledge of a person to help them make choices with regard to food, beverages and how personal care was to be undertaken. An activities co-ordinator visits the home three days a week to undertake a variety of
Care Homes for Older People Page 18 of 30 Evidence: organised activities. A resident said We can do lots of things here if you want I really like card making. Staff spoke of going for short walks with residents to local shops and organised outings during warmer weather. Relatives commented My mother is regularly involved in activities in the home and trips out. Mr loaghtas holds events during the year at which family members friend can attend eg xmas party summer BBQ occasional drinks fireworks nibbles evenings and summer outings and my mother enjoys pottering about in the garden and she is encouraged to do. Sometimes a member of staff takes her out for a walk. Visitors continue to comment upon how welcomed they are made to feel during their stay, this included being offered beverages or meals, staff being friendly and approachable and how they were able to visit at any reasonable time. There is a high ratio of male carers and the home remains sensitive to the gender preferences of female residents when male staff are undertaking personal care, and no issues were highlighted to the inspector or noted on care plans of any gender preferences. Good practices were noted in the use of individual agreements on the use of pressure mats that alert staff to a residents movement during the night. These agreements provide individual information on how they are to be used to promote independence. The meal served at inspection was presented well with the majority of residents eating their meals in a pleasantly set and decorated dinning room. Meal times were an important social occasions at the home which residents clearly enjoyed talking with one another. Residents spoke of being given an alternative meal if they did not like what was on the menu. Residents who needed support to eat were assisted discreetly and sensitively with some good practices noted in the way in which staff were gentle encouraging and orientating residents to eat. A sample of comments made about the food included good here given plenty of choice I believe my mother eats well and the menu is written up each day looks satisfactory and lunch was very nice I always have enough to eat. Care Homes for Older People Page 19 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. A complaints procedure and appropriate adult protection policies and staff training helps to protects the rights and interests of residents Evidence: There is a written accessible complaints procedure in place for residents, their representative and staff to follow should they be unhappy with any aspects of the service. All residents and relatives consulted with said that they were aware of how to raise any concerns and felt comfortable to do so. A relative said If I had any problems I would not hesitate to speak to Mr and Mrs Logatheas they are always responsive and helpful. The manager reported that no formal complaints have been raised with the home in the last twelve months. The home has written policies covering safeguarding adults and whistle blowing. These make clear the vulnerability of people in residential care, and the duty of staff to report any concerns they may have to a responsible authority for investigation. Staff have received formal training in safeguarding adults and prevention of abuse and the staff consulted with showed an understanding of their roles and responsibilities under safeguarding adults guidelines. The Manager confirmed that they have applied to attend updated training in safeguarding adults. Care Homes for Older People Page 20 of 30 Care Homes for Older People Page 21 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. Residents continue to live in a clean and homely environment, which is decorated and maintained to a good standard. Evidence: The premises consist of a large converted domestic property situated in a busy village location, with local shops and amenities within walking distance. Much effort is made to create and maintain a homely environment. At inspection building works were underway to create additional staff accommodation and office space. The provider has identified the need to replace many carpets in bedrooms and confirmed that this was to be completed along with communal areas in the near future. Communal space consists of a lounge dinning room and large conservatory. There is a rear secure garden, which is accessible either by a ramp or steps. There is patio area with seats and a large outbuilding used as storage. A significant loose paving slab posed a potential trip hazard and the manager agreed to address this with the provider before the patio is used again in warmer weather. Residents bedrooms were observed to have been individualised to reflect their individual lifestyle and preferences with many of the residents saying that they were able to bring small items of furniture and personal belongings with them.
Care Homes for Older People Page 22 of 30 Evidence: There is sufficient number of toilets and bathrooms located around the home, including half of the bedrooms providing to have ensuite facilities. There was a range of individual aids and adaptations to assist residents mobility and independence, including raised toilet seats, assisted bath, walking aids, hoists, height adjustable beds, shaft lift and grab rails. The home was previously required to manage more effectively offensive odours. At inspection all areas were noted to be clean with more robust procedures put into place to manage odours, which included the employment of a cleaner seven days a week. Relatives said there was sometimes a smell of urine but that is never evident now my mothers room is always clean and tidy whatever time I visit and I feel that the staff make every effort to keep the home smelling fresh. The inspector noted a slight unpleasant odour in some seating which the provider agreed to look into immediately. The inspection was undertaken on a cold winters day with all residents confirming that the home was always kept at a comfortable Care Homes for Older People Page 23 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. Staff make a positive contribution in residents lives as they benefit from a stable, trained and enthusiastic staff team that know them and who are employed in sufficient numbers as is necessary to meet their needs. People who use the service are protected by the homes robust recruitment policy and procedures. Evidence: Residents, staff and relatives consulted with all felt that there was sufficient number of staff on duty as is necessary to meet residents needs in a timely manner. In line with previous requirement the manager confirmed that the duty rota now reflected the hours worked and evidenced that sufficient numbers of staff are on duty as is necessary to meet the needs of residents. Since the previous inspection additional staff have been employed each morning. The provider was aware of the additional staffing needs when the home increases its occupancy and is in the process of employing additional staff in readiness. There is little staff turnover with All but three staff, including the manager, being family members of the joint providers. Consistent feedback continues to be received on the positive effects of the home being family run and the same staff being on duty all the time and the continuity this provided. Care Homes for Older People Page 24 of 30 Evidence: Staff interactions with residents were positive, residents were observed initiating conversations with staff, showing signs of recognising staff and showed relaxed body posture around staff. Some humour was observed in interactions with staff, which promoted a relaxed atmosphere in the home. All persons consulted with spoke positively about the staff, a resident said The staff are all really nice 27. A relative commented all the staff at Bellsgrove are gently and caring people. They are very kind to my mother and sensitive to her needs and moods. They will often put their arms around her and give her a hug if she is felling a bit low. One staff member always does the cross word with her when he is on duty. The manager confirmed that they have more than 5o of staff having completed a National Vocational Qualification in care. Since the previous inspection there has been much training undertaken by the providers and staff. This has included updating areas of mandatory training needed to work safely with residents and some areas of specialist training including dementia. A plan of further training to be undertaken in the near future has also been developed which shows the commitment of the providers to the continuing development of the staff and the home. A staff member felt that their understanding of dementia had improved following some training and that this resulted in improved care practices. Personal files of staff were inspected, these showed that a robust recruitment process is being followed which includes the use of an application form, interviews, Criminal Records Bureau (CRB) checks and written references prior to employment commencing. Care Homes for Older People Page 25 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. Residents benefit from an experienced manager who provides a clear sense of leadership and direction which enables staff to provide good quality care to residents. Systems are in place for the promotion and protection of health, safety and welfare of residents and staff. Evidence: The registered manager is a registered nurse and was previously the owner manager of the home before it was purchased by the current owners. The registered manager has many years experience in managing services for older people and works part time at the home. They reported that they also work as a trainer in aspects of social care for various colleges. Those consulted spoke positively about the manager and a sample of their comments included nice always very helpful James good manager, experienced encourages us more than ever now to learn.
Care Homes for Older People Page 26 of 30 Evidence: The concerns noted at the last inspection regarding the complex management arrangements with the providers also being directly involved in the day to day management of the home as well as there being a registered manager, has now been addressed through the providers better understanding of their roles and responsibilities and more clearly defined job roles between the provider and manager. Staff commented The biggest change since last inspection is manual handling, more meetings, listen to new ideas and everyone is contributing Management is now much clearer you know where you stand recording more rather than it being word of mouth and Information being passed on more. As part of the homes quality assurance process the manager previously reported that it is their practice to send out annual feedback cards to relatives and residents, however this had not yet been undertaken this year and was planned to be undertaken in the near future. The provider and manager reported that practices changes made in response to previous feedback has included photographs on the wall and the development of the garden. Staff in the main continue to be supervised by the manager working along side them each shift and all staff consulted with felt supported by them to undertake their roles. Care staff also spoke of receiving some formal supervision. Residents are encouraged to retain control of their own finances for as long as they are able to do so and if unable then this responsibility is taken on by a relative or another responsible persons external to the home. The manager stated that they do not manage the personal finances for any current residents. The manager reported that systems were in place to support fire safety, which included regular fire alarms and emergency lighting checks, staff training and maintenance of fire equipment and fire drills. They reported that a fire risk assessment had been undertaken, which recorded the actions necessary to ensure fire safety at the home. The provider reported that they are in the process of meeting the recommendations of a fire safety office to fit expandable fire strips in fire doors. It was reported that there were no recommendations following a recent visit by environmental health. Care Homes for Older People Page 27 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 28 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 1 9 13 That schedule three 25/03/2009 controlled drugs are recorded in a controlled drugs register, which includes the recording of two signatures for each administration, in order to provide a clear audit trail of this medication. To ensure a clear audit trail of all medications and enable accountability. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 29 of 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 © (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. 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!
