Inspection on 16/10/06 for Blackwood House

This inspection was carried out on 16th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Blackwood House 17/10/05

Blackwood House 09/06/05

Blackwood House 17/11/04

Blackwood House 24/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Blackwood House Roskear Camborne Cornwall TR14 8BA Lead Inspector Richard Coates Key Unannounced Inspection 16th October 2006 09:15 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Blackwood House Address Roskear Camborne Cornwall TR14 8BA Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01209 713498 01209 613495 Cornwall Care Limited Mrs Beverly Wills Care Home 44 Category(ies) of Dementia - over 65 years of age (24), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (24), Old age, not falling within any other category (20) Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Service users to include up to 20 adults of old age (OP) Service users to include up to 24 adults aged over 65 with dementia (DE[E]) Service users to include up to 24 adults aged over 65 with a mental illness (MD[E]) Service users not to exceed a maximum of 44 Date of last inspection 17th October 2005 Brief Description of the Service: Blackwood House is one of eighteen care homes owned by Cornwall Care Ltd. The home is situated in grounds off the main road into Camborne at Roskear. It is registered to provide accommodation and personal care to forty-four older people. The first floor provides a self-contained unit for twenty-four service users who have dementia or mental ill health. The ground floor provides accommodation and care for twenty service users in the category of older persons. All service users have their own room with access to nearby toilets. There are lounges with dining areas in each unit. Residents can use small kitchen areas with staff support. The home is accessible to residents. There is a large garden accessible to residents. Community health care professionals visit the home when needed and for planned visits. The home also provides a day centre and day care for up to twenty service users. Admissions are planned and emergency admissions are avoided whenever possible. Weekly fees were given at August 2006 as from £293.25 up to £436.00. Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a planned unannounced key inspection. The purpose of the inspection was to follow up the provider’s compliance with the requirements and recommendations set in the last inspection report dated 17 October 2005, and to focus on the key national minimum standards as identified by the commission. The inspector was on the premises during two days. The methods used were discussion with the manager, staff, residents, and their relatives, inspection of records and documents, observation of the daily life of the home and inspection of the premises. This included case tracking of four residents selected using the criteria of their age, disability, and gender. The Registered Manager completed a pre-inspection questionnaire and provided supplementary material. The inspector is grateful to the providers, staff and residents for their assistance in completing the inspection. What the service does well: Blackwood House provides a safe and comfortable home for older people. Service users and their representatives reported that Blackwood House provides good quality care and accommodation. Comments made by residents included ‘They are very good here’ and ‘Wonderful…very attentive’. Residents and their representatives felt that that their health needs were well monitored and appropriate assistance sought when required. The managers obtain detailed assessment information from Health and Cornwall Department of Adult Social Care before each resident’s admission and carry out a needs assessment. Residents felt that they were well supported to follow their preferred daily routine. Most residents reported that there were sufficient activities and enough to do. Residents felt their visitors were welcomed to the home. Residents, relatives and staff said that they were confident that they could approach the registered manager with any concerns and issues. Residents expressed satisfaction with the quality and quantities of the meals provided. The home is well maintained, tidily decorated and generally clean and hygienic. The staff team has a number of staff who have worked at the home for some years. Staff and residents know each other well and this promotes consistent care delivery. Residents made positive comments about the staff’s kindness, skills and attitudes. Staff stated that the informal and formal supervision supported them to do their jobs well. Cornwall Care has a well-established training programme for staff. The company supports staff in their training and development so that residents and their representatives can have confidence in Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 6 a well trained and supervised staff team. Staff were satisfied with the training they receive and with the support from the management team. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, Blackwood does not provide intermediate care (Standard 6) Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The needs of service users are assessed so that they can be assured that the home can provide adequate care. EVIDENCE: The Statement of Purpose has been revised to reflect changes in the management of the home. Managers visit prospective residents and complete a needs assessment. Cornwall Care Ltd has a standard format for assessment and care planning. When completed in sufficient detail, this record covers the assessment issues specified in the standard and the diverse needs of prospective residents. All the residents’ records case tracked contained needs assessments completed by the home’s staff. The records contained copies of social work and professional assessments, and summaries of joint assessments from Health and Cornwall Department of Adult Social Care. Some of the home’s assessments did not state who was present at the assessment. This would provide evidence that the prospective resident and their family, or Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 9 representatives, were involved in the assessment to ensure that their diverse needs were recorded. Relatives felt that the home involved them in the resident’s care arrangements. A recently admitted resident said that her admission had gone smoothly. She knew the home through having attended for day care, and staff provided sensitive support to help her settle in as a resident. Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Written care plans direct and inform staff about the residents’ health and personal care needs. The healthcare needs of residents are monitored and addressed so that their needs are met. The arrangements for the management of medicines on the whole protect service users. EVIDENCE: All the residents case tracked had written care plans. Cornwall Care Ltd has a standard single format for assessment and care planning. The care plans were dated and signed, with regular dated reviews. The care plans directed and informed care staff on meeting the health and personal care needs of residents. Residents’ preferred social activities and interests are included in the Personal Routine and Preferences record and in the written Occupational Profile and Plan. There were good examples of individual care planning. Staff use the full assessment and care planning record as the working care plan document, rather than a summary care profile. Each resident has a key worker who is involved in the review process with assistant managers. The Personal Routines and Preferences records detail residents’ lifestyle Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 11 preferences and choices, their dietary preferences and needs, and their religious beliefs. All residents case tracked had a moving and handling assessment. These assessments had been reviewed recently. Falls risk assessments were included as a part of the moving and handling assessment. Where a resident is at risk of falling, there should be a separate and detailed risk assessment to direct staff in reducing the risk and safeguarding the resident. Daily records detailed the care delivered, visitors, health care matters and activities. However, the records lacked regular daily entries. Consequently, these records may not reflect all the activities and events in the home. Staff keep separate records in respect of bathing, and other specific individual care needs. The contents of residents’ records meet regulatory requirements. Residents are registered with local GP practices. Residents and their representatives felt that their health care needs were monitored and attention obtained when needed. Each resident’s medical contacts and appointments are recorded. The Registered Manager reported that no residents currently have pressure areas, but three residents are monitored specifically for tissue viability and have suitable pressure relieving equipment from the Community Nurses. Medicines are stored in a locked trolley and a locked cupboard in a treatment room. The controlled drug cabinet is within the main cupboard. The cupboard and the controlled drug cabinet are not steel medicine cabinets to the industry standard. The cupboard and trolley were tidy and well organised. There is a small medicines refrigerator and the temperature is checked daily. The monitored dosage system is in use. Residents sign an agreement to the administration of medicines. Cornwall Care has a corporate policy and procedure on the handling of medicines which includes guidance on the use of homely remedies. Identified staff, who have completed training, have responsibility for the administration of medicines. The administration records were generally well maintained. However, a second member of staff should check and countersign hand written medication records, drawn up, for example, when residents are admitted for respite. There is a controlled drug register and each administration is signed and witnessed. A record of medicines returned to the pharmacist is kept as a duplicate book. The pharmacist last visited on 6 October 2006. Residents made positive comments on the skills and caring qualities of staff. They felt very well cared for and reported that staff delivered care sensitively and respected their privacy and dignity. Residents made statements like, “They are very good here” and “Wonderful”. Residents felt safe when, for example, staff were transferring them and providing personal care in the assisted baths. The Registered Manager said that the staff work very hard at Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 12 respecting residents’ privacy and dignity. Examples of staff providing skilled and sensitive care were observed during the inspection. Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents are supported in a lifestyle which accords as far as possible with their own expectations and preferences. A range of activities takes place and the Registered Manager is reviewing this to ensure it reflects residents’ preferences and expectations. The diet provided is varied and nutritious with attention to individual preferences. EVIDENCE: Residents felt that they had control over their daily lives and routines. One resident was pleased that she could continue to make her own bed each day. Residents can join in with the activities in the day centre, although residents may not always be made aware of planned activities. Some residents felt that there was enough to do; other residents felt that there were fewer activities than previously. The Registered Manager is currently reviewing the mix of activities provided. There is a notice board displaying information and events. The residents’ occupational plans and preference records provide information about residents’ social and activity interests. Staff and residents were engaged in one to one and small group activities during the inspection. Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 14 Residents and visitors reported that they found the visiting arrangements open and flexible. They felt that visitors were made welcome and they were offered a drink. Residents choose where they meet their guests. One visitor reported that when her relative had been unwell, the staff had supported her to stay with her for long periods and had provided her with meals and drinks. The Registered Manager reported that she is not appointee for any residents for their benefits. A minority of residents manage their own finances. Other residents’ finances are managed with informal assistance from relatives or through Power of Attorney arrangements. Residents can bring in possessions and furniture at admission by agreement with the provider. A number of bedrooms inspected had been personalised to a high degree. Cornwall Care has introduced the ‘appetite for life’ initiative for residents to receive a varied and appealing diet in a relaxed atmosphere. Residents were very positive about the quality of food provided, reporting that the meals were very good with appetising choices and sufficient portions. Breakfast is served flexibly according to individual preferences and residents were very happy with the choices available. There is a three-week rotating menu for lunch with seasonal variations. There are two main choices each day for lunch. Tea is a choice of savouries and cakes. The cook discusses the menu choices with residents. The inspector joined residents for lunch. The main choices were shepherds pie or sausages and onion rings, both with fresh vegetables. The pudding was bread and butter pudding and custard or fruit cocktail. The food was appetising and well presented. Residents were relaxed and unrushed with staff providing appropriate support. Residents enjoyed a glass of wine or a non-alcoholic drink with their meal. One resident in the dining room was assisted sensitively to eat her meal. Hot and cold drinks are served between meals. Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home has a satisfactory complaints procedure that would ensure that complaints are listened to and acted upon. There are arrangements to protect service users from abuse. EVIDENCE: Cornwall Care Ltd has a corporate complaints procedure. Blackwood House has received no formal complaints since the last inspection. There is a record for complaints and compliments containing a number of expressions of appreciation and thanks. Residents and representatives had confidence that they could approach the managers with their concerns and these would be addressed. One resident said, “If there is something we do not like, they see into it”. Cornwall Care Ltd has a corporate adult protection policy and procedure. The policy and procedure have been recently revised to comply with the local MultiAgency Adult Protection Guidelines. Staff receive training in adult protection following their induction and as part of their NVQ level 2. Cornwall Care should review the staff’s need for refresher training in safeguarding vulnerable adults. The Registered Manager stated that she has nominated an assistant manager initially for the Cornwall multi-agency alerter’s training. The home had a copy of the Cornwall Multi-Agency Adult Protection Guidance. Staff were aware of Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 16 their responsibilities to report concerns about the protection of vulnerable adults. Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home is accessible, well maintained and safe. The premises are clean and hygienic providing a pleasant environment and reducing risks to residents. EVIDENCE: Blackwood House is situated in a residential area of Camborne in grounds set back from the main road into the town. The car park is close to the main entrance which is accessible for wheelchair users. The home is on two floors with a shaft lift. The first floor Kerensa unit provides accommodation for people with dementia. The ground floor Lowenva unit accommodates people whose principal reason for admission is their age. Cornwall Care Ltd continues to maintain and refurbish the home’s décor and furnishings. The communal rooms and residents’ rooms inspected were pleasantly decorated and furnished. Residents and their representatives commented that the home is kept clean, fresh and well presented. The quality of furniture in communal areas is generally good. The carpet in the first floor corridor, which shows Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 18 signs of wear, is planned for replacement soon. The use of communal rooms in Kerensa has been changed recently to provide two separate rooms which both have sitting and dining areas for smaller groups. This has provided a more pleasant environment for residents compared to the previous single dining room for 24 persons, but has implications for staffing levels. There is an accessible garden directly adjoining the home. Staff reported that repairs and maintenance tasks were generally carried out promptly. The day care unit has now been provided with its own toilet and bathroom, so that service users coming for day care have facilities close by and no longer have to share the facilities of the care home. The toilet is spacious and accessible. The bathroom has an assisted bath and required only the taps to be fitted, at the time of the inspection, to be complete and operational. Work to box in hot water pipes in residents’ bedrooms to reduce risks is progressing. This work meets the outstanding requirements of the last inspection report. The name of each resident is clearly printed on a plate on his or her bedroom door. Residents reported that their rooms were comfortable and pleasant. There is one double room, which would only be occupied by two people wishing to share. Bedrooms have been provided with multi-socket extension power cables fitted to the walls to provide residents with sufficient electrical sockets. This arrangement detracts from the general appearance of the rooms. The provider should consider a programme to install proper additional electrical sockets. Bedrooms were generally clean, but there was undisturbed dust on higher surfaces, for example the tops of wardrobes, the wall lights and pictures. The sluice rooms where the door was marked ‘Keep Locked Shut’ were not secured to protect residents when left unattended. The laundry complies with the standard. The washing machines and tumbler driers are industrial standard. Clothes and linen for laundry is transported through the home in sealed red bags or covered containers. Residents and their representatives were satisfied with the laundry service. Residents’ clothes appeared well cared for. The bathing and toileting facilities in the home comply with the standard, with assisted baths on both floors. Doors to bathrooms and toilets are a distinctive blue to assist residents in finding their way. Toilet and bathroom doors have signs and suitable locks. There is a level entry shower on the ground floor. Hot water was supplied at a safe temperature. Toilets are suitably close to communal areas. All the bathrooms and toilets inspected were tiled on the lower half of the wall, pleasantly decorated and clean and hygienic. Facilities for staff hand washing, with hand wash and paper towels, were situated throughout the home. Staff reported that there were good supplies of gloves and aprons. Equipment and adaptations were in place to assist with mobility and transfers. Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The staffing and training arrangements generally ensure that the needs of residents are met, but the staffing levels during the afternoon on the first floor need to be reviewed. Recruitment procedures support and safeguard the residents. EVIDENCE: Residents commented that they felt staffing levels were sufficient. Visitors observed that staff could be under pressure when there were absences from sickness. The registered manager stated that staffing levels have improved since the last inspection. Staff also felt that staffing levels had improved. They said that they would like staffing levels that allowed them to spend more time with residents outside the home. There is a core group of staff who have worked here for some years and provide consistency. Seven or eight care staff, with usually three general assistants and an assistant manager, are on duty across the two units during the morning. Staffing reduces to four or five care staff during the mid-afternoon, with general assistants and an assistant manager. This means that currently there are two care staff on duty in the Kerensa Unit for two hours in the afternoon. This does not appear adequate for the layout of the unit or to meet the needs of twenty-four residents, a number of whom require two staff to assist them with personal care. The number of care staff increases later in the afternoon, again with an assistant manager and ancillary staff. There is a cook each day. At night there are 2 Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 20 waking staff and an on-call manager. Residents were positive about the skills, kindness and caring qualities of the staff team. Over 80 staff have completed their NVQ in care at level 2. The Cornwall Care Ltd training structure ensures that all new staff are registered promptly for their NVQ training. Posts are advertised through the Job Centre and local press. Cornwall Care Ltd has standard corporate recruitment procedures including equal opportunities. The records for two recently recruited members of staff showed that the required employment checks had been properly completed. Staff records for established staff contained the required documents and information. Staff receive a statement of terms and conditions of employment. Cornwall Care Ltd provides a structured corporate training programme for staff which covers induction, NVQ and other required training. Staff and the employer sign up to a Contract for Training and Development. Records documented the progress of recently appointed staff through their inductions. Training records showed that staff had completed training in moving and handling, first aid, dementia care and health and safety. Staff were satisfied with the training they received to do their jobs. Cornwall Care Ltd should review the use of the Personal Profile staff record. These were on file but not completed or up to date; the staff member’s training history was generally recorded on other documents. Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home has an experienced and qualified registered manager who has a clear understanding of her responsibilities. The health and safety of residents and staff are promoted and protected. EVIDENCE: The registered manager Mrs Beverly Wills exceeds the experience requirement in caring for older persons and has completed her NVQ 4 care management qualification. She is currently working on a further diploma in management. There are clear lines of accountability from the manager through the three assistant managers, who each have specific areas of responsibility. Staff were positive about the support and supervision that they received from the managers. Residents had confidence in the Registered Manager and felt that she would listen to and address any concerns that they might have. Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 22 Cornwall Care Ltd has corporate policies for the safekeeping of small amounts of residents’ money. A record for each resident details payments in and out, and a running balance, with receipts for all expenditures. Each resident’s balance is not held as an individual amount of cash as this would amount to a large sum for the home to hold. There is a specific bank account with a float available for daily transactions. A cash book details all payments in and out of the cash float. The administrator has systems in place for checking and reconciling the cash held, the bank account balance, and the residents’ individual recorded balances. The Registered Manager countersigns transactions. Cornwall Care Ltd has previously sought the views of residents and their representatives, and other stakeholders through questionnaires. The manager stated that the annual quality assurance survey this year is being carried out by an external organisation. The surveys have been distributed to residents and completed and returned to the external organisation for analysis. There has been a good response. The Registered Manager has held two residents meetings since coming to the home. She reported that one was well attended and one was not well attended. The records showed that staff receive regular formal supervision. Each assistant manager is responsible for supervising a number of staff. Staff receive annual appraisals. Staff reported that informal and formal supervision supported them to do their jobs well and they had confidence in the management. They stated that they received helpful guidance and information when they approached managers with concerns and queries. Staff felt that they worked well together to provide a good standard of care to residents. They valued the staff team being a friendly group that resolved issues. Cornwall Care Ltd has comprehensive policies for health and safety. The preinspection questionnaire detailed required maintenance and safety records. A sample were checked against the original records and found to be accurate. Staff have attended relevant health and safety training. Staff reported that Cornwall Care Ltd promotes safe working and manages health and safety well. One of the assistant managers takes the lead on health and safety in the home. The accident record for residents was inspected. This does not record a high level of incidents. The environmental health officer last visited on 13 April 2006 to inspect food hygiene arrangements. The report is mostly satisfactory, but makes a recommendation about improvements to the less easily cleaned painted and untiled areas of walls in the kitchen. This work has not been undertaken yet. The records showed regular tests of the fire alarm system and the emergency lighting. There is a written fire plan. The home’s fire risk assessment has been completed. There are records of fire safety training with question and Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 23 answer sessions for staff. The fire alarm was triggered during the inspection. Staff followed the fire procedure and assembled by the fire control panel while two staff went to the indicated zone to identify the site and cause of the fire. This alarm had been caused by an over sensitive detector responding to a toaster and there was no need to begin evacuating the affected area. The fire service attended. Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP27 Regulation 18(1)(a) Requirement The registered person must ensure that at all times suitably qualified, competent and experienced persons are working at the home in such numbers as are appropriate for the health and welfare of service users. (The registered person must review the staffing levels on the Kerensa unit during the afternoon.) Timescale for action 30/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP3 OP7 Good Practice Recommendations Service users’ care needs assessment records should record who was present at the assessment and where it took place. Service user records should have a regular daily entry including such matters as their well being, changes in care needs, visitors, activities and any significant DS0000008909.V304639.R02.S.doc Version 5.2 Page 26 Blackwood House 3 4 5 6 OP7 OP9 OP18 OP19 occurrences. Service users who are at risk of falling should have a separate detailed risk assessment. A second member of staff should check and countersign hand written medication records. The registered person should review the staff’s need for refresher training in safeguarding vulnerable adults. The registered person should plan for the replacement of the current fitted extension power cables in service users’ rooms with properly installed power sockets. Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 27 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Blackwood House DS0000008909.V304639.R02.S.doc Version 5.2 Page 28 - 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. 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