Inspection on 02/10/07 for Bonaer

This inspection was carried out on 2nd October 2007.

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

Bonaer 26/09/06

Bonaer 13/01/06

Bonaer 09/06/05

Bonaer 09/12/04

Bonaer 17/06/04

Bonaer 24/02/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Bonaer 17 Station Hill Hayle TR27 4NG Lead Inspector Diana Penrose Key Unannounced Inspection 2nd October 2007 09:30 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 Bonaer DS0000043280.V345259.R01.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. Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bonaer Address 17 Station Hill Hayle TR27 4NG 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) 01736 752090 01736 759681 bonaercarehome@tiscali.co.uk Anthony Joseph Metalle Sarah Jayne Metalle Position Vacant Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (33), Physical disability (7), Terminally ill over of places 65 years of age (5) Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th September 2006 Brief Description of the Service: Bonaer is situated next to Hayle railway station, which is very close to the local amenities. It is a big adapted house with an extension and a large conservatory. There is limited car parking space in the grounds but there is additional free parking nearby, on the roadside. The home provides residential and nursing care for up to thirty-one elderly people. The registration allows for seven people with a physical disability and the home also provides palliative care. Accommodation is on two floors with a shaft lift provided. There are hand washbasins in all bedrooms and there are adequate toilet and bathing facilities. Meals are prepared in the kitchen on the ground floor and served in the three lounges or individual bedrooms if preferred. There is no dedicated dining room in the home but dining tables and chairs are provided in the lounges. Present residents seem to prefer to have a table in front of their armchair. To the front of the home there is a veranda and a garden with a large fishpond and seating that is accessible to residents. There is also a garden at the back of the home, which has been made accessible with a raised bed and greenhouse for residents’ use. The Registered Providers have owned the home since May 2003 and are still in the process of upgrading and refurbishing. They are very involved in the running of the home; Mrs Metalle is the Manager but also works as part of the nursing team. Qualified Nurses and Care Assistants provide care within a relaxed and friendly atmosphere. Information about the home is available in the form of a residents’ guide, which can be supplied to enquirers on request. A copy of most recent inspection report is available in the home. Fees range from £345 to £515 per week; this information was supplied to the Commission during this inspection. Additional charges are made in respect of private healthcare provision, hairdressing and personal items such as newspapers, confectionary and toiletries. Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An inspector visited Bonaer Nursing Home on the 02 October 2007 and spent eight and a half hours at the home. This was a key inspection and an unannounced visit. The purpose of the inspection was to ensure that the needs of the people using the service are properly met, in accordance with good care practices and the laws regulating care homes. The focus was on ensuring that placements in the home result in good outcomes for people. All of the key standards were inspected. On the day of inspection 30 people were living in the home, 1 of these was receiving respite care. The methods used to undertake the inspection were to meet with a number of residents, relatives, staff and the registered providers to gain their views on the services offered by Bonaer Nursing Home. Records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. The completed CSCI Annual Quality Assurance Assessment has also been considered as evidence to support this inspection. Residents and relatives expressed satisfaction with the care and services provided at the home. The one requirement notified at the last inspection has been met. Overall the home is providing a good quality of care to the residents placed there. What the service does well: The home provides a warm, clean, safe environment for residents, staff and visitors. The registered providers continue to upgrade the décor and furnishings in the home and improve the grounds so they are attractive, safe and accessible for residents. Care provided is to a high standard and residents are only admitted following an assessment to ensure the home can meet their needs. Residents have an individual detailed care plan and relevant risk assessments are undertaken to assure resident’s safety. Care needs are reviewed each month to ensure the care plans are up to date. Residents said their healthcare needs are met and they have access to their doctor, optician, dentist or other professional when required. All those spoken with were very happy living in the home. They said the staff are kind and caring and they are treated as individuals. Visitors said the home looks after the residents very well. They said the registered providers are approachable and resolve any problems quickly Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 6 There is a suitable system in place for medications and the home has appropriate equipment for pressure relief and moving and handling. Activities take place in the home and outings are enjoyed. There are a number of photos of outings and activities on display in the home. A trip to Paradise Park and a summer fete were topics spoken about by residents, staff and visitors. There is a resident’s committee who discuss ideas and improvements. Friends and family are welcome in the home and residents can go out with them according to their wishes and ability. There are suitable systems for dealing with complaints and abuse. Staff and residents said they could approach the manager if they had a problem. The registered providers say they practice person centred care at Bonaer and try to make the daily routines as flexible as possible. Residents said they can choose what they do each day, the daily routines are flexible and there are choices on the menu. Nutritious home cooking is provided and residents said “the food is good”, “we have very good food and it is what we like”, “There is plenty to eat”. Drinks and snacks are on offer all day long. Sufficient numbers and skill mix of staff are on duty to ensure that resident’s needs are met. Residents said, “there seem to be enough staff”, “There is always someone here”, “They are very kind and patient”. Staff were observed to interact well with residents in a very kind, relaxed manner. Care practices observed were appropriate and safe. The registered providers are committed to providing appropriate training for staff and 83 of care staff are NVQ qualified. Quality assurance surveys take place annually and there are staff and residents meetings regularly. An informative newsletter is circulated to staff and residents bi-monthly. What has improved since the last inspection? The registered providers have complied with the requirement notified at the last inspection and all staff now attend statutory training according to legislation. The home has employed a new maintenance person who has been doing a great deal of work in and around the home. The grounds have been tidied and a new wall built to one side of the home. Plants such as roses have been planted on top of the wall. The flowerbed around the pond at the front of the home has been re-planted with colourful flowers. A greenhouse has been erected at the back of the home and residents have grown salad vegetables over the summer months. A wheelchair lift has been installed upstairs where a steep ramp used to be. Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 7 The home has new pets for the residents; they now have a cat, a rabbit, guinea pigs and fish. One lady has a budgerigar. New purchases include a few electric beds, dynamic mattresses, chair cushions and bed tables. Two members of staff have been delegated responsibility for the organisation of staff training. Two nurses have received training on the Liverpool Care Pathway and the home is undertaking the Gold Standard Framework for palliative care. 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. The summary of this inspection report can be made available in other formats on request. Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 8 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 Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (6 is N/A) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are only admitted to the home following an assessment of their needs to ensure the home can provide suitable care. EVIDENCE: Evidence was provided in the form of records, talking with the people using the service, staff and registered providers. The home has a specific form for recording the initial assessment. The manager said that she or one of the nurses visits prospective residents prior to admission. Completed forms were inspected and recording was comprehensive. Information from Adult Social Care and hospital staff was seen as well. An individual plan of care is compiled from the assessments. Bonaer DS0000043280.V345259.R01.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. 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 using available evidence including a visit to this service. Individual care plans are generated for each resident that inform and direct the staff in the care provision. The people using the service have access to health care services as necessary to ensure their assessed needs are met. There are systems and policies in place for dealing with resident’s medicines that assure residents safety; some additional safeguards have been introduced to ensure a safer system. Systems are in place to ensure that residents are respected and their privacy is upheld at all times. EVIDENCE: Evidence was provided in the form of documentation, records, talking with the people using the service, relatives, staff and registered providers. Each person using the service has a detailed written care plan. Plans inspected were reviewed monthly and any necessary changes made. Risk assessments include Waterlow scoring, nutrition, moving and handling, falls, Barthel, wounds and capability. There are also risk assessments for the use of bed rails and transportation by wheelchair. The care plans are compiled with and signed by the resident or their representative whenever possible. One relative has Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 11 written comments and questions on the care plan for his wife. The manager said she has discussed these with him. Daily records are maintained and the care staff keep records of personal care provision. Residents spoken with said their health needs are met and they have access to their doctor, optician, dentist or other professional when required. Care practice was observed to be appropriate during the inspection and carried out in a calm, efficient manner. Pressure relieving equipment is supplied and a mattress audit takes place every 6 months. Hospital style beds are provided where needed. There is appropriate equipment in the home for moving and handling and staff receive regular training in house. Several of the nurses specialise in specific subjects and link with external agencies to remain up to date, for example, tissue viability, continence and palliative care. The manager said that links with healthcare professionals is good. One of the nurses explained the medicine system. A monitored dosage system is used in the home. No residents administer their own medicines at present. The records for receipt, administration and disposal are satisfactory. There is a suitable medicines policy in place for staff to follow, there is a copy of ‘The Royal Pharmaceutical Guidelines for the Administration of Medicines in Care Homes’ and suitable reference books available to staff. Patient information leaflets are kept in a file on the medicines trolley. Storage of medicines is safe and secure. Liquid medicine, in bottles prescribed for an individual, for example, Lactulose was being shared between several residents at the time of the inspection. The manager has said that this issue has since been resolved and the medicine is only administered to the person it is prescribed for on the label. A new medicines trolley has helped to enable this. Medicines are disposed of through a waste disposal company and since this inspection the process has changed and is satisfactory. A GP has agreed a list of homely remedies. Some care staff have received training in medicines during the NVQ level 3 training and some have done the safe handling of medicines course. Basic medicines training is included in the induction programme. Residents’ privacy was upheld during the inspection. Residents said they are treated with respect and their privacy is upheld at all times. Shared rooms are provided with appropriate screens. Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 12 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. 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 using available evidence including a visit to this service. The home provides a range of activities and aims to offer a lifestyle that meets individual residents needs. Links with family, friends and the community are good and allow residents the opportunity to socialise. Residents are helped to maintain control over their lives and staff respect their individual preferences and choice. Dietary needs of residents are well catered for with a varied selection of food available that aims to meet their taste and preference. EVIDENCE: Evidence was provided in the form of documentation, AQAA, records, observation, talking with the people using the service, staff and registered providers. The registered providers said they have strong links with the local community and they liaise with transport agencies to take residents out. They are hoping to provide their own means of transport very soon, which will be suitable for those in wheelchairs. Several people talked about a visit to Paradise Park and what a lovely time they had there. One resident goes to a day centre each week. There is a resident’s committee who discuss ideas and improvements. Activities and entertainment are on offer in the home and posters are Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 13 displayed. There are a number of photos of outings and activities on display in the home. Activities include singers, entertainers, bingo, art, games, gardening, massage and nail painting. Holy Communion also takes place. Residents have grown salad vegetables in the greenhouse in the rear garden this summer and are encouraged to participate with cooking if they wish. The annual summer fete appears to have been very popular and residents spoke of their involvement. Two people knit squares to make blankets, which they sell; they said they have plenty to do. One of the carers runs a small shop in the home. There is a library upstairs for residents and provides a quiet room for meeting with visitors and so on. The care staff are responsible for activities at the moment and individual resident records are maintained. There is a record of visitors to the home and there were visitors in the home during the inspection. Residents said they could receive visitors in private and at any time. Visitors spoken with said they are always made welcome in the home and can call whenever they like. Residents said there are suitable telephone arrangements in the home and they can have their own private line if they wish. The registered providers say they practice person centred care at Bonaer and try to make the daily routines as flexible as possible. Residents said they choose when they get up and go to bed within reason. They said they choose what clothes to wear and how they spend their day. Some said there is not a lot to do and they just sit in the lounge all day. There are choices on the menu and residents were observed to have a selection of meals at lunchtime. Residents’ rooms are personalised with their own belongings and furniture. One person has her budgerigar with her and the home has other pets such as a cat, a rabbit and guinea pigs. Each resident has a nutritional needs assessment. Individual likes and dislikes, preferred time for meals, preferred place to eat, and any special requirements are recorded. There is a varied menu that spans four weeks; the winter menu starts soon. Residents and relatives said the food is good and it was enjoyed at lunchtime. Homemade pasties and stew were on the menu on the day of the inspection. Fresh fruit and vegetables are served and the cook said that all cakes are homemade. Meals are served in the lounges or individual bedrooms and appropriate assistance was observed. The dining tables do not tend to be used apart from on special occasions; the manager said this is the choice of the residents. Plenty of fluids were observed to be available for residents in all areas with different sized beakers, straws and feeders for residents use. Staff were seen to offer drinks regularly. Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 14 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. 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 using available evidence including a visit to this service. The home has a satisfactory complaints procedure that ensures complaints are listened to and acted upon. Arrangements are in place for the protection of residents safeguarding them from harm or abuse. EVIDENCE: Evidence was provided in the form of documentation, records, and observation, talking with the people using the service, staff and registered providers. The home has a satisfactory complaints policy and procedure. There have been no complaints to the home or the Commission since the last inspection. The manager said that one relative had one or two issues regarding a resident settling in but they have been sorted and records were seen. Thank you letters and cards are kept in the home. The home has an adult protection policy and a copy of the alerters flowchart. In house training takes place, the manager has a training video. Some staff have attended the local “No Secrets” training provided by Adult Social Care. The registered providers are arranging training in respect of the mental capacity act. They have a code of practice book and a training package for in house training as well. There is a secure facility for the storage of money in the home. Residents said there are no barriers to raising concerns with the management. Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 15 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. 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 using available evidence including a visit to this service. The home and grounds are well maintained providing a safe environment for residents, staff and visitors. The home is clean and every effort is made to eliminate unpleasant odours making it a pleasant place for residents to live in. EVIDENCE: Evidence was provided in the form of a tour of the building, observation, AQAA, talking with the people using the service, staff, maintenance man and registered providers. The home is warm, homely and clean with no offensive odours. A significant amount of work has been achieved at the home over the past year. Further decorating has taken place since the last inspection and more carpets have been replaced including those in the corridors. The upstairs corridor walls have been painted as a seaside scene. Some residents have chosen the décor for their rooms. A wheelchair lift has been installed upstairs. Residents said they Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 16 are happy with their rooms and the facilities provided. A new maintenance man has been employed and he explained the maintenance system and plans for improvements. Doors to resident’s rooms now have magnetic catches fitted that are integrated into the fire system. New electric beds and bed tables have been purchased. There are plans to purchase new crockery and to refurbish the main lounge. The grounds have been tidied and re-planted with colourful flowers. The wall has been re-built with plants growing on the top. The back garden has a new flowerbed with sunflowers planted by the residents. A greenhouse has been erected and the residents are growing salad vegetables. All laundry is dealt with in house and residents said they are happy with the service. There are adequate sluices with washer disinfectors. Hand-washing facilities are appropriate and staff were observed wearing protective clothing. The manager and some staff are going to attend an infection control course. There is a copy of the infection control guidelines for care homes in the home. Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 17 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. 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 using available evidence including a visit to this service. Staffing levels meet the needs of residents and staff morale is good. Residents are in safe hands and they benefit from the 83 of care staff trained to at least NVQ level 2 in care. Recruitment procedures need to be more robust to offer protection to the residents. The home provides appropriate training for staff to help them be more competent in their roles. EVIDENCE: Evidence was provided in the form of records, talking with the people using the service, staff, visitors and registered manager. The registered providers said there are sufficient staff employed to meet the resident’s needs. There appeared to be enough on duty during the inspection. There is a nurse on duty at all times, sometimes two, and on average six care staff in the mornings, three during the afternoon, four in the evenings and two at night. The nurses and the manager were observed assisting care staff in their work. Residents and relatives said there seem to be enough staff in the home and staff did not appear to be rushing around. The figures provided in the AQAA document by the manager show that 83 of care staff have an NVQ either at level 2 or 3 and that three other staff are undertaking training. Copies of NVQ certificates are kept on file. Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 18 Four personnel files were inspected; some of the records required by legislation were missing. One had no photograph and two had no induction evidence, the manager said she would check that all files held the correct records. CRB and POVA checks are undertaken. However there was no evidence to show that the registered providers had received a satisfactory POVA check for three staff prior to them starting work in the home. An immediate requirement was notified to the registered providers stating that staff in contact with service users must have a satisfactory POVA check prior to commencing work in the home. There was evidence that staff are supervised prior to an enhanced CRB check being received. Nursing registrations are checked with the NMC. One employee had changed jobs within the home but there was no evidence of this on file. The registered providers must confirm in writing any changes to an employees terms or conditions of employment. This was discussed and the manager agreed to do this. An induction pack was seen and some signed records were in the files. The manager said that training needs are identified at interview, appraisal, supervision and during meetings. She said she has updated the training plan and two members of staff are assisting with the implementation of training. One said she is really enjoying the extra responsibility and has been allocated time to develop her new role. Individual training records are maintained for staff. Staff have received recent training on the Liverpool Care Pathway and are undertaking the Gold Standard Framework for palliative care. The manager and another member of staff are attending equality and diversity training in November 2007. There is information on courses available to staff and posters are displayed. Staff said there are opportunities to attend external courses if they wish and in house training takes place regularly. The manager said that staff are encouraged to share the knowledge gained on courses with the rest of the team. Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager is a person of good character and fit to run the home. The home is run in the best interest of the residents and they benefit from the Quality Assurance systems in place. The system in the home for dealing with residents’ money needs to be more robust to ensure that residents’ financial interests are safeguarded. Appropriate training and safety checks are undertaken to ensure the health safety and welfare of residents and staff; extra vigilance in respect of fire alarm checks will ensure further protection. EVIDENCE: Evidence was provided in the form of documentation, records, talking with the people using the service, staff and registered providers. Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 20 The registered providers are competent and experienced to run the home; they work hard to comply with legal requirements. The manager is a registered general nurse and has achieved the Registered Managers’ Award; she has five years experience in the care homes sector. She said she keeps herself up to date on current issues by reading relevant magazines and using the internet. She attends courses when she can and keeps up to date with statutory training in house. Staff, residents and visitors said the registered providers run the home very well. Comments include: “Sarah is the mainstay of the home”, “If it wasn’t good here I wouldn’t stay”, Sarah is lovely, so kind and caring”, “Sarah and Tony are approachable, we have sorted a few problems out”. Staff said they are supported in their roles, there are regular staff meetings and formal supervision takes place. A quality assurance survey is undertaken annually with the residents and their relatives; the results have been positive. The manager is considering a staff survey. Staff meetings take place regularly and a resident’s committee meets monthly. Minutes are maintained for all meetings. A newsletter is circulated bimonthly and contains a lot of information. Some audits take place, for example accidents, mattresses and an informal medicines audit. There is also an annual maintenance programme. The manager said she intends to use the Commission for Social Care Inspection’s Annual Quality Assurance Assessment document to assist with her quality assurance programme. There is a system in place for the handling of resident’s money. There is a safekeeping policy with a form for residents to sign as agreeing to the policy. One resident deals with his own money and relatives deal with most of the other resident’s money. Mr Metalle is responsible for dealing with the monies for residents and he is appointee for one person, her money is kept in a separate account. Cash is held individually in the safe and money checked was correct according to the records. Three peoples records were inspected. Records are maintained for transactions and receipts are kept. Double signatures are on the records and they are not always the same staff members. One receipt for newspapers appeared to be missing and receipts are not provided for the sale of cards made by a member of staff. There must be receipts for all purchases and services. There is confusion in respect of money received for residents as some personal money is received along with fees but there is no statement as to how much is intended for each. The registered provider said that some money is given directly to residents, from the money received, without being recorded. The records must be accurate to provide a detailed audit trail. The registered provider said that one resident is saving for a chair and he has money in the resident’s fund account. Records are kept but this money should not be in the fund account, the resident must have his own account. Records of power of attorney are maintained. The registered providers endeavour to ensure that working practices are safe and staff confirmed this. There are health and safety policies, procedures and risk assessments for the home. There is a fire risk assessment and fire safety Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 21 procedures and checks are in place. The last fire alarm test was recorded as done in August 2006; Mr Metalle said this would be attended to urgently. Relevant service checks and maintenance of equipment takes place. PAT testing was not dated; the registered provider said this was 2007 but will be done in house in future. The environmental health officer’s report was good and catering staff have undertaken appropriate food hygiene training. Fire training attendance has improved and records are kept. Accident reporting complies with data protection and there is an audit system in place. The home does not have many accidents. Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 22 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 23 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 OP35 Regulation 20 Sch 4 (9) • Requirement The records in respect of residents’ personal money, receipt and expenditure, must be accurate to provide a detailed audit trail. Money for individual residents should not be held in the residents’ fund account; residents must have their own bank accounts. Timescale for action 30/01/08 • RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 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 © 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 Bonaer DS0000043280.V345259.R01.S.doc Version 5.2 Page 25 - 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. 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