Inspection on 22/10/08 for Brookholme Croft Nursing Home

This inspection was carried out on 22nd October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brookholme Croft Nursing Home 09/08/07

Brookholme Croft Nursing Home 21/06/06

Brookholme Croft Nursing Home 06/02/06

Brookholme Croft Nursing Home 25/01/05

Brookholme Croft Nursing Home 30/06/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Brookholme Croft Nursing Home Woodstock Drive Off Challands Way Hasland Chesterfield Derbyshire S41 0EU     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: Brian Marks     Date: 2 2 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Brookholme Croft Nursing Home Off Challands Way Woodstock Drive Hasland Chesterfield Derbyshire S41 0EU 01246230006 Telephone number: Fax number: Email address: Provider web address: brookholmecroft@yahoo.co.uk Name of registered provider(s): Name of registered manager (if applicable) Angela Alice McInnes Type of registration: Number of places registered: Dr A P M Matthews,Mrs A Matthews care home 45 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: the registered person may provide the following categories of service only: Care Home with Nursing - Code N 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 - Code OP The maximum number of service users who can be accommodated is 45 Date of last inspection Brief description of the care home Brookholme Croft is a purpose built care home, which opened in 1996. The home provides nursing and personal care and support for up to 45 older persons. It is situated at the head of a residential close and is located in the village of Hasland, within close proximity of Chesterfield town centre. There is wheelchair access throughout the home, which is suitably adapted and equipped to assist those with Care Homes for Older People Page 4 of 30 Over 65 45 0 Brief description of the care home physical disabilities/mobility problems and with an emergency call system in all private and communal areas. There is level access to a well-kept garden to the rear of the building, with car parking spaces to the front of the home. Single room accommodation is provided for all residents, nine of which have en-suite toilet and wash hand basin facilities. There is an option for those who choose to share a room, as there are two sets of rooms which link via interconnecting doors. These doors are kept locked when the rooms are used as single accommodation. There is a choice of bathrooms, showers and toilets, which are suitably located and equipped and a choice of lounge and dining rooms on each floor. The registered manager is a registered general nurse, who is supported by a team of nursing, care and hotel services staff, including a part time activities co-ordinator and a physiotherapist The homes stated aims are to provide a friendly, safe and pleasant environment, together with high standards of care and support, delivered by a dedicated and professional staff team, who will promote individual rights to privacy, dignity and choice. A copy of the most recent inspection report is openly displayed in the entrance to the home and nursing office located there. Information detailing the range of fees and what they cover are included in the homes service guide/brochure. 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: This was a Key unannounced inspection that took place at the home over two days and through interviews carried out by our Expert by Experience, a lay person who has been recruited by the Commission because they have had direct experience of receiving care services. Additionally, time was spent in preparation for the visit, looking at key documents such as previous inspection reports, records held by us, the written Annual Quality Assurance Assessment document (AQAA), which was returned before the inspection, and surveys that had been previously sent out to the agency, its staff and the people living at the home. All of the above material assisted with the preparation of a structured plan for the inspection. Eight resident and five staff surveys were returned before the inspection and the Care Homes for Older People Page 6 of 30 information supplied in this way was analysed and the outcomes included in the inspection process and reflected in this written report. At the home, apart from examining documents, files and records, time was spent speaking to the manager, who was in charge of the home during the visit, and twelve of the staff working on the day shifts. The care records of four people who live at the home were examined in detail and these were interviewed by our Expert personally along with four others. The relatives of three more, who were at the home on the day of the inspection, were also spoken to. No other inspection visits have been made to the home since the last Key unannounced inspection on 9 August 2007 and the assessment was made against the key National Minimum Standards (NMS) identified at the beginning of each section of this report, as well as other Standards that were felt to be most relevant. What the care home does well: 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 Care Homes for Older People Page 8 of 30 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 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 10 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. People do not come to live at the home without the care they need being properly identified, but extending this activity into more details about their social world and the risks facing them would provide a more complete picture. Evidence: In the AQAA we were told that the care needs of people coming to the home are assessed by the manager before a decision is made for them to move in and this includes an NHS nursing assessment and assessment of mental capacity and decision making. We were told that people are encouraged to visit and meet staff, judge the homes facilities and see the homes envIronment. This includes the option to have a meal and meet other residents, so that they can make an informed decsion about moving in. We were also told that everybody is given a contract of residence and this is discussed fully so that everybody is clear about their rights and responsibilities. Care Homes for Older People Page 11 of 30 Evidence: We looked at the care records of four people who are living at the home, including somebody who had moved in about two weeks before the inspection and somebody who had lived there for two years. Within these records, there are clear assessments of the physical care needs of the person concerned including, in one, details of complex health and medical issues. The information had been obtained from the person concerned, from their family, or from outside professionals such as physiotherapist or occupational therapist, and the person concerned had signed to indicate their involvement. However the amount of information about the psychological and social worlds of the people concerned is variable and in most of the files looked at is very brief. This does not fully support the stated intention to provide person centred care for everybody living at the home. All of the care records looked at contain assessments of the general and specific areas of risk that are relevant to the individuals concerned, such as safe moving and handling, skin breakdown and pressure sores, falls and nutrition. Some but not all of these directly linked to an action plan that described the detail of how staff were to work safely and consistently and maintain the persons welfare whilst living at the home. The home does not provide intermediate care so Standard 6 does not apply. Care Homes for Older People Page 12 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 people living at the home have care and risk assessment records that generally promote safety and consistency, and staff work in ways that respect individuality, privacy and dignity. Evidence: In the AQAA we were told how everybody has a person centred care plan which is regularly updated to reflect changing needs, and identified the range of professionals that staff at the home routinely work with. We were also told that staff respect everybodys privacy, noting that some people prefer to spend all their time in their own rooms, and that staff are also reminded to respect peoples dignity and the fact thay they are working in their home environment. The care records that we looked at contain clear descriptions of the areas where people need help or where they experience risk, as well as the areas in which they are independent, and the care and nursing activities to be carried out by staff are identified. As referred to above, the descriptions of social interests and life background Care Homes for Older People Page 13 of 30 Evidence: are generally brief. The links between activities identified in the care plans and the assessments of need and risk previously carried out are clear but, as noted above, some of the risk assesment documents do not describe the required actions by staff in full detail. The various elements of the care records looked at held documented evidence that they had been reviewed and evaluated at regular intervals. The care records that we looked at confirmed that contact with external healthcare services is routinely made, particularly the local doctors and district nurses, as well as a number of specialist healthcare services, such as the diabetes clinic and mobility specialists. Additionally in the written records and the direct comments from people, it was evidenced that the staff at the home work hard to care in sensitive and dignified ways, and to keep people as independent as possible: I love to watch snooker, golf and the dancing on TV and I choose to go to bed around 9 most nights. I enjoy my early morning cup of tea around 6:30. I have a hearing aid but know how to get supplies of new batteries for myself. Whilst most people are happy with the standards of personal care given to them we did notice a bedroom door left open during a session of personal care and staff giving feeding assistance, in the dining room, whilst standing up and not giving their full attention to the person in question. Examination of the arrangements for the receipt, storage and administration of medicines indicated that these are generally satisfactory and that, apart from 2 specific days, all entries in the written records had been made properly. Medication is stored securely and the home uses a Monitored Dosage System for administration. However, there was one instance where a nurse had handwritten an adminstration instruction when the 28 day cycle had finished and had not had this countersigned by another responsible member of staff. The dose of medicine used that day had been removed from the medicines cassette from a location that did not correspond to the day in question, which could lead to unsafe practice and the use of unprescribed medicines. There are a number of people living at the home who are using controlled drugs and examination of the separate written record indicated that these are managed satisfactorily. There are a number of medicines for occasional use (PRN) and specific instructions for their administration were included in the records. Care Homes for Older People Page 14 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at the home enjoy lifestyles and routines that suit them but have limited opportunity to take part in organised leisure and social activities. This remains a feature of the home that needs development. Evidence: In the AQAA we were told about the activities that had taken place recently for people living at the home, including involvement with the local Village Gala during the summer. We were told how contact with family and friends is encouraged and flexible visiting arrangements are in place. Routines in the home were described as being flexible and decided by individual residents and we were told how dietary requirements are catered for and that there is an alternative choice available at each meal. An activities coordinator is in post and she has the responsibility for encouraging activities and structuring leisure time. However she was on maternity leave during the inspection and no structured activities took place on the day of our visit. The notice board in the entrance hall indicated a list of forthcoming events at the home; these were limited to five during October, November and December. Our Expert by Experience spent the day at the home and talked informally to people who are living Care Homes for Older People Page 15 of 30 Evidence: there, to family members and to some of the managers and staff. The people spoken to confirmed that they are generally happy with life at the home and they are able to do very much what they like. They develop their own routines, including spending their time in the communal areas or in their rooms; the former is the choice of the majority although quite a number chose the latter. As well as receiving written feedback we spoke individually to people around the home and they told us about their lives: I would be lost without my newspaper and being able to read it every day. However, we did not see any evidence of large print newspapers and talking books. I have my own daily routine and its my choice to spend most of my time in my room. I can speak Spanish and practice with a Mexican member of staff. You wont find a better home anywhere - brilliant. I have my own telephone and speak daily to my family. I never see anybody - I would be happier at home. I always have a member of staff with me when I have to go to hospital. I am very happy here and I feel welcome. In the written feedback, received before the inspection, people told us that activities are arranged usually or sometimes, although one person said that life is alright but we could have more activities for the residents to keep us all motivated. A number of relatives were seen at the home during the visit and we were told that family visits are encouraged and welcomed. I first visited the home without prior appointment and the staff on duty showed me around - they were ever so obliging. My mother has only recently moved here but we liked the atmosphere of the home, its layout and that staff seem friendly and supportive. Overall our Expert by Experience concluded that It seems that, whilst there is on paper a commitment to the holistic care for residents, the reality doesnt quite match up to that aspiration in terms of quality and meaningful activities for residents. This home could indeed be more like a first class hotel by working to address these issues. A brief visit was made to the kitchen and the cook described current arrangements. Good standards in the catering service have continued, and a 5-week menu is being followed. The menu indicates a choice at the main meals of the day and a hot option regularly available for breakfast and at teatime. People were generally very positive in their feedback about the standard of food at the home with several mentioning good quality and quantity: the food is very good - brilliant what they cook - they do it lovely. Arrangements for purchase, storage and stock control are satisfactory. The cook routinely deals with people who have special dietary needs, and at the time of the inspection these included diabetic and softened. Regarding the latter the cook said: each food item is fork-softened or liquidised and served separately, indicating a sensitive approach to individual needs. Care Homes for Older People Page 16 of 30 Care Homes for Older People Page 17 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. The home responds to complaints made by residents and their representatives according to a written procedure, and aims to protect them from harm. Evidence: In the AQAA we were told that the complaints procedure is displayed and how complaints will be listened to, taken seriously and acted on. A copy is given to everybody as part of the Service User Guide. The AQAA indicated that there had been four complaints since the last inspection and this was borne out by our examination of the record book. All complaints had been dealt with appropriately and responded to in writing. In the feedback that we received before the inspection, everybody said that they knew about getting their problems resolved and were confident that they would be listened to. Informal issues are regularly raised at the planned meetings between the homes staff and the people living at the home and their relatives. The minutes of these meetings showed a positive attitude from all concerned and encouragement of people to become more involved with the running of the home. The AQAA told us how there are systems in place to protect people living at the home and how all staff have received training in their responsibilities to recognise and alert others to suspected abuse. We were also told how the home now has an in-house trainer to keep this subject at a high profile within the staff group. Staff records indicate that all staff have received training in the need to safeguard the vulnerable Care Homes for Older People Page 18 of 30 Evidence: people living at the home and that this subject had also been addressed for new staff within their induction programme. All the staff spoken to were able to describe their understanding of this subject and were aware of their responsibilities. The policies and procedures in place are in line with the statutory procedures on safeguarding adults, and the records indicate two situations that have been investigated under these in the past year. These were in relation to one person who had fallen from their bed and another whose medications had been missed. The conclusion reached in both situations was that no fault was to be found in relation to the homes systems and no action has been taken. Care Homes for Older People Page 19 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. The home is purpose built and has been satisfactorily maintained so that people can enjoy an environment suited to their needs. Evidence: In the AQAA we were told that there is a maintenance schedule in place for the home which is organised by the manager and home engineer, and also about the improvements that have been made to the homes environment following an increase in registered numbers. We were also told how standards of hygiene and safety are being managed through policy guidelines and further staff training. From a brief tour and visits to some of the bedrooms we saw how things had been changed using upstairs rooms that were not being used or were large enough to be split up. This has resulted in the five extra places indicated by the homes new registration and also two new shower rooms that are popular with both residents and staff for their convenience, safety and ease of use. We also noted that bedrooms have good levels of personalisation to suit individual residents and which create a sense of personal space, and the manager indicated how they are routinely redecorated after they become vacant. We also noted that a separate room had been created for hairdressing and noted a good range of equipment in different parts of the building available for staff to help people with mobility difficulties. Overall this tour of the Care Homes for Older People Page 20 of 30 Evidence: bulding demonstrated that the standard of decoration of the home is satisfactory. Comments from people living at the home and relatives were positive about the standards of comfort and cleanliness offered: I have my own room which is very comfortable. The home is always clean. Garden areas are well maintained and seating is available, although they didnt contain other amenities that might interest people living at the home such as bird feeders. At the last visits by the Environmental Health and Fire Officers a number of recommendations were made and these have been carried out or are in hand for completion, and include the fitting of new self closures for all bedroom doors to improve fire safety. On the day of the inspection the home was clean, tidy and free from odours and everybody spoken to was very complimentary about the service provided by the laundry. A visit to the latter indicated well organised facilities and all residents observed in the home were seen wearing clean and well-presented clothing. Care Homes for Older People Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has adequate numbers of staff to carry out the physical care needs of the people living at the home, but the home is sometimes stretched and challenged to provide a genuinely person centred approach to care. Staff have received training necessary to do their jobs properly and in a more professional way. Evidence: In the AQAA we were told how the home has a robust recruitment process which ensures that the best interests of the people living at the home are being served and also how all grades of staff are encouraged to attend training and achieve qualifications. Since the last inspection the home has created two new senior carer posts to improve the staffing structure of the home, and we were also told that in October 2007 the home achieved a positive assessment in their Investors in People review for the third time. This is a national award that is concerned with how staff are trained, supported and managed. Placements for student nurses have continued as well as work experience for students from local schools and colleges. During the inspection we interviewed most of the staff on duty and those recently appointed described their induction training which they followed just after they started working at the home. Records indicated that this follows the national Skills for Care programme and includes all the basic health and safety subjects, as well instruction Care Homes for Older People Page 22 of 30 Evidence: about how they must look after the safety of all people living at the home and report any suspicions of abuse they may have. The records of two recently appointed staff supported that their recruitment had been carried out properly with the right checks being made. Examination of the duty roster and discussion with staff indicated levels of nursing and care staff on duty unchanged from the last inspection. Although, in the written feedback we received, most people said that there is usually enough staff, people we spoke to were more concerned that the care staff are so busy and they work hard to please everybody, that the home could do with a lot more staff and that more staff are needed to care for the many frail people in the home. Whilst many people felt that they are satisfied with what they do for me, the opinion that, particularly at mealtimes and during busy mornings, more staff are needed was repeated to us. One lady who is in bed most of the time described how she does not receive her preferred bed bath until as late as 11.30 some mornings. The staff spoken to did not generally feel that their workload was routinely excessive but that they are steadily busy and work is focussed and prioritised through good teamwork. However others said that the basic care needs are covered but sometimes the chance to sit and talk to people is cut short. Beyond the induction programme referred to above staff told us that they have received good opportunities for continuing training and records indicated a commitment to getting staff through the National Vocational Qualification (NVQ) with the required target being achieved later this year. The staff spoken to also described attendance on a course aimed to help them care better for people with dementia provided by the Council, and a number spoke movingly about the impact this training had had on them and how they felt they now had a better understanding of this condition. Additionally some have staff attended training about the Mental Capacity Act which will have increasing implications for their work and examination of staff training records indicated good achievements with fire safety and general health and safety training, safe moving and handling, infection control and first aid. As a general comment we noted good standards of morale and enthusiasm expressed during our staff interviews; the commitment of staff to the home and its residents is something the homes management can build on for the future. We were told that all staff work well together and that support is good within the staff team as well as from the nurses and managers. One person rounded off our conversation with the comment that things are working very well here at present, its the best its been for some years. Care Homes for Older People Page 23 of 30 Care Homes for Older People Page 24 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. The home is a well-managed and safe environment in which to live and work. Evidence: The AQAA told us that the manager has some years of experience of running the home and has achieved the recognised managers qualification and is registered with the Commission. Staff spoken to were positive about the way the home is run and how the manager supports them if they have any problems. There have been two meetings this year for staff to express their views on the running of the home and, although the system for planned meetings between manager and individual staff is in place, records indicated the arrangements are not yet occurring regularly enough to meet the National Standard and to ensure staff are properly supported. Generally good administrative and management systems are in place at the home and the manager is supported by a senior colleague who takes responsibility for staff training and deployment. The manager described how she had worked to improve Care Homes for Older People Page 25 of 30 Evidence: things and that during the past year she has tightened up her management style to ensure that staff are supported and monitored to work properly. Systems for auditing how well the home is doing have been continued, with audits of care plans and a resident survey taking place earlier this year. The latter did not produce a very high return although people living at the home and relatives have supported formal meetings with the senior staff and have been able to speak out about any general concerns they have. In October 2007 the home was subject to a reveiw by the Investors in People organisation, which is a national award concerned with staff training and management. The home achieved a positive result for the third time and received positive comments about the quality of its training programme and the open management style of those managing, and the achievement of a culture within which staff are clearly happy to work. The homes owner is a regular visitor at the home and was present during the inspection. The systems in place for looking after residents money were found to be satisfactory at the last inspection and remain unchanged. The AQAA told us about good standards of health and safety activity and regular servicing of equipment and observations made around the building and a sample of fire safety and servicing records indicate that the home was hazard free at the time of the inspection. Care Homes for Older People Page 26 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 27 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 12 16 The social interests and background history of people living at the home must be fully identified and arrangements made for those needs and interests to be met. This will ensure that people continue to enjoy stimulating lives and interests that match their capabilities. 31/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 More information about the social and psychological needs of people living at the home should be obtained at the time they come to live at the home, so that the staff view them as an individuals rather than simply in terms of their physical care needs. The outcomes of the assessment of risks in peoples lives should include clear detailed actions that staff must take in order to minimise those risks, particularly where the use of equipment is indicated to assist with safe manual handling, and where people are identified as having poor skin Page 28 of 30 2 2 Care Homes for Older People integrity. 3 7 Care plans should include clear detailed actions that staff must take in order to minimise those risks that have been identified that seriously affect their lives, particularly where the use of equipment is indicated to assist with safe manual handling, and where people are identified as having poor skin integrity. The homes managers should regularly review levels of staff on duty to ensure that the care and support being given in genuinely person centred. Staff supervision should take place every two months and include career development needs, and philosophy of care in the home. 4 27 5 36 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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