Inspection on 12/03/09 for Caburn House

This inspection was carried out on 12th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Caburn House 10/03/10

Caburn House 17/03/08

Caburn House 02/05/07

Caburn House 25/04/06

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Caburn House 15 Caburn Road Hove East Sussex BN3 6EF     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: Jennie Williams     Date: 1 2 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Caburn House 15 Caburn Road Hove East Sussex BN3 6EF 01273771945 01273526795 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Vigcare (Caburn) Limited Name of registered manager (if applicable) Mrs Barbara Warren Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 28. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the hoem are within the following categories: Old age, not falling within any other category - (OP) Date of last inspection Brief description of the care home Caburn House is a care home providing personal care for twenty-eight (28) older persons. The home is located in a residential area of Hove. The home provides four intermediate care places. Residents who require nursing input receive this from the district nurses. The Registered Providers own several care homes throughout the South of England, predominantly older people services. There are local amenities within walking distance of the home and there is nearby links to public transport. No parking is available at the home; however paid parking is Care Homes for Older People Page 4 of 31 care home 28 Over 65 28 0 Brief description of the care home available on the adjacent streets. The residents accommodation is located over three floors. There are five double occupancy rooms that are not provided with en suite facilities. All other rooms are for single occupancy, of which four are provided with en suite facilities (toilet and hand basin). All rooms are used for single occupancy, unless people have chosen to share. There is a passenger shaft lift that services the first floor and stair lifts are available to assist residents to access other floors within the home. There are communal toilets and assisted bathing facilities located throughout the home to meet the needs of the residents. Residents have access to a paved courtyard area. Weekly fees range from 314 to 450 pounds per week. There are additional fees; hairdressing, chiropody, newspapers/magazines, dry cleaning and personal toiletries (at cost). A full list of additional fees is provided in the Service Users Guide. This information was provided to the CSCI on the 12March 2009. Prospective residents find out about the home through social services referrals, word of mouth and from themselves/relatives living in the area. Care Homes for Older People Page 5 of 31 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 peterchart Environment Staffing Management and administration Poor Adequate Good Excellent How we did our inspection: It should be noted that following CSCI consultation, it was identified that service users prefer to be called people who use services. It was confirmed that the home uses the term residents. For the purpose of this report, people who use the service will be referred to as residents. This unannounced site visit took place on the 12 March 2009 for eight hours. Evidence obtained at this site visit, previous information regarding this service and information that the CSCI have received since the last inspection forms this key inspection report. An annual quality assurance assessment (AQAA) was sent to us by the service, completed by the home on the 08 September 2008. The AQAA is a selfassessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. The last key inspection was undertaken on the 17 March 2008. Care Homes for Older People Page 6 of 31 Eleven residents in the dining room at lunchtime were met and advised to let the Inspector know if they wished to speak after lunch. Individual conversations were had with six residents, of either gender. One resident did not wish to speak with the Inspector and this was respected. Two care plans were viewed and specific areas of care looked at in a further seven care plans. Three staff and the Registered Manager were spoken with throughout the site visit, along with a visiting health professional. Four staff files were inspected, along with some training records. Medication procedures were viewed and the procedures and records for handling residents finances were inspected. A tour of the environment was undertaken and some individual rooms were viewed. The quality assurance system, complaint records and quality monitoring checks in place were viewed/discussed. There were twenty-one residents residing at the home on the day of the site visit. What the care home does well: What has improved since the last inspection? What they could do better: The home needs to ensure that written confirmation is given to prospective residents, confirming that having regard to their assessment, the care home is suitable for the purpose of meeting their needs in respect of their health and welfare. Written confirmation needs to be obtained that the controlled drugs cabinet complies Care Homes for Older People Page 8 of 31 and is installed correctly. This is to ensure compliance with current legislation. Action needs to be taken to ensure that all staff be kept up to date with all mandatory training, to ensure staff and residents are safeguarded and best practices are followed. The Registered Manager has confirmed immediately following the site visit, that a training matrix has been implemented to assist in easy monitoring of expired training certificates. Any minor shortfalls noted at the site visit, of which no requirement or recommendation has been made have been highlighted throughout the report of which the Registered Manager confirmed she will address or has already been identified in the AQAA as their plans for improvement in the next 12 months. The AQAA received from the home evidences that the home is working to improve the quality of the service provided at Caburn House. It provides the CSCI with information on areas that have been improved in the last twelve months and what their plans for improvement are within the next twelve months. Whilst three requirements have been made from this inspection, the Registered Manager has previously demonstrated her commitment to ensuring compliance and improving outcomes for residents. The AQAA identifies that they are committed to making further improvements and ensures the views of residents are included in future plans. When residents were asked what changes they would make in regards to living at the home, no one could identify any areas they would want changed. Staff identified the change they would like is to receive more pay, this is not within CSCIs remit. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 31 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 31 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. The home has information available for prospective residents/representatives on the facilities and services provided to make an informed decision if their needs can be met at the home. The pre admission process ensures that only residents whose needs can be met at the home are admitted. Evidence: The home has a Statement of Purpose and Service Users Guide that is available at the home and provides prospective residents/representatives with information about the services and facilities provided at the home. These documents advise that they are available in other formats on request. Residents residing at the home are quite independent and require limited assistance from the staff. Care Homes for Older People Page 11 of 31 Evidence: The Registered Manager confirmed that she or the deputy manager undertakes an assessment on all self-funding prospective residents to ensure that their needs can be met with the services and facilities provided at the home. Additional information is obtained from social services and other health professionals wherever possible. For residents who are referred through social services, the home uses information from other professionals on which to base their decision. If there is insufficient information available, the home will not admit anyone until they are satisfied the needs can be met. It is in the homes best interest to ensure that they undertake a comprehensive assessment themselves to ensure the needs and expectations of the prospective resident can be met. Wherever possible, it was confirmed that the assessments take place at Caburn House so that people have an opportunity to meet staff and other residents. There was a pre admission assessment observed to be in place for two newly admitted resident. Prospective residents/representatives are encouraged to visit the home prior to admission. Of the residents that were asked, all confirmed that they or a representative visited the home prior to moving in. The Registered Manager confirmed that there is no resident at the home from any minor ethnic community, social/cultural or religious groups with any specific needs or preferences. A resident stated the church comes to me. Staff spoken with confirmed that they felt all residents were appropriately placed at the home and confirmed that appropriate action is taken if someones needs can no longer be met at the home. There was evidence of this at the site visit. There are four rooms allocated to provide intermediate care. Any specialist equipment is identified and provided by the various external agencies involved in providing the intermediate care support. This includes district nurses, occupational therapist and physiotherapists etc. Two intermediate care residents confirmed that they had no choice in being admitted to Caburn House. People sign up for intermediate care and health professionals decide which service the person is appropriate for. The Registered Manager confirmed that she was of the understanding that prospective residents are provided with information about their service. She will address this with the intermediate care team. The home needs to ensure they confirm in writing to all prospective residents that following an assessment the home is able to meet their needs. Care Homes for Older People Page 12 of 31 Care Homes for Older People Page 13 of 31 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. Residents needs are being met with the information provided in the care plans on the assessed needs of individuals. Residents are safeguarded by the medication procedures in place. Evidence: Care plans overall provided information to staff on how to meet the assessed needs of individuals. Where someone is admitted for respite care, there was limited information in place for staff. The home uses social services care plans for the needs of residents. It is in the homes best interest to ensure they carry out their own detailed assessment. Specific areas of care viewed identified that there were guidelines in place for staff. A monthly review is done, with the residents involvement and any changes identified are then reflected in the main care plan. It was discussed with the Registered Manager that care plans should be a working document and any changes identified should be reflected immediately in the care plan and not to wait until the monthly review. The Care Homes for Older People Page 14 of 31 Evidence: Registered Manager demonstrated a willingness and assurance that this would be implemented. Some minor shortfalls noted at the site visit were addressed immediately by the Registered Manager or confirmed that they would be amended. Staff confirmed that monthly reviews are done or earlier if the needs of an individual changes. Of the residents that were asked, all confirmed that they have viewed their care plans and staff discuss care with them. The Registered Manager confirmed that there had been no changes made to the risk assessment format and these are also reviewed monthly or earlier if the needs change, along with care plans. Records are maintained of any multidisciplinary visits and any specialist equipment required is accessed. It was confirmed that there continues to be good communication within the service with the intermediate care team, ensuring needs are met and continuity of care provided. The AQAA identifies that nutritional screening is carried out on everyone admitted to their service and take action to meet the needs of people at risk of malnutrition. There was limited information in the daily notes. It was discuss with the Registered Manager that these should be expanded. The Registered Manager confirmed that staff would write more details if there are any changes. Daily records are a good source of evidence to show that care is being provided, as detailed in the care plan. Daily records when well written, help ensure a consistent approach and good quality of care for residents. It is in the homes interests to be able to show what they have done, along with providing the evidence on which to base the monthly review and to record that they are following the assessment of needs. A letter was sent to the CSCI from a relative of a resident who resided at the home complimenting the home and staff regarding the care shown. Some comments received from residents were; very nice being here, receive marvellous support, look after me well and really happy here. It was confirmed that there are policies and procedures in place for all aspects of dealing with medicines. Medication Administration Records (MAR) charts and blister packs viewed identified that accurate records are being maintained of medicines administered within the home. Residents are provided with a choice to self administer, if they wish and a risk assessment identifies it is safe for them to do so. There were accurate records being maintained of controlled drugs. The home needs to Care Homes for Older People Page 15 of 31 Evidence: obtain written confirmation that the controlled drugs (CD) cabinet complies and is installed in compliance with current legislation. It was confirmed that the supplying pharmacist undertakes regular audits at the home and the home has there own monitoring systems in place. Staff were observed to have a good professional rapport with residents and were heard calling them by their preferred term. Residents spoken with felt that their privacy and dignity are respected and stated that staff knock on their room doors prior to entering. A comment received was they always listen to you. There is a list of residents names and room numbers by the front door identifying if an individual requires assistance in the event the home needs to be evacuated. Since the last inspection, the Registered Manager confirmed that she has discussed this with all residents and they are happy for this information to be kept in a public area. Care Homes for Older People Page 16 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents lifestyle within the home is their own choice and residents are provided with sufficient stimulation to fulfil their interests and needs. Residents choice and preferences are catered for with meals. Evidence: Residents spoken with confirmed that their lifestyle within the service is generally to their own choice. A resident confirmed that they choose when to wash, to have a bath or shower, choose their own clothes and when they wish to go to bed or rise in the morning. Staff confirmed that there is a bathing rota in place, however this is flexible and residents choose when they wish to bathe. Staff initiate activities in the afternoons. It was confirmed that residents are asked daily what they wish to do for the day. Outside entertainers also visit the home. Some examples of activities provided at the home are: monthly art class and weekly exercises. One resident confirmed that there were indoor games provided throughout the winter period and staff were available to assist them if they wished to go out for a walk. The Registered Manager confirmed that outings will commence to be arranged again now the weather is improving. Care Homes for Older People Page 17 of 31 Evidence: Residents confirmed that there are enough activities provided at the home if they choose to get involved. One confirmed that they dont do much, however this is the individuals choice not be involved. There are no visiting restrictions at the home and people are able to receive visitors in private. There was evidence of this seen at the site visit. A resident stated that their family come to visit and that they are also able to go out and visit them outside of the home environment. Residents meetings are held every three months, where a variety of issues are discussed and residents are able to express their views or ideas about different aspects within the service. There is a four-week rolling menu at the service and this is changed according to the seasons. Residents are provided with choice. Residents were overall positive about the provision of food at the home and comments received were: very good, the sweet trolley is good, and alright. Since the last inspection, the home has implemented a sweet trolley that is taken around after the main lunch meal, so residents are able to view and choose their dessert from the trolley. There is a menu board in the dining room that advises residents what food is on offer for the day. Care Homes for Older People Page 18 of 31 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. Complaints are dealt with appropriately, reassuring those involved that they are being listened to and that action will be taken, if necessary. Safeguarding Adults procedures ensure residents are safeguarded. Evidence: There is a complaints procedure available at the home and a copy of this is also included in the homes Statement of Purpose and Service Users Guide. Residents spoken with confirmed that they knew who to speak to if they were unhappy about anything within the home and would feel comfortable to raise any complaints. A resident stated no complaints. The AQAA identified that there had been six complaints made in the last 12 months. There were no records available pertaining to these at the site visit. It was ascertained that this figure is incorrect. From the day of the site visit, there had been three complaints raised with the service in the last 12 months. One complaint was forwarded to the home from social services and one referred to the providers to investigate from the CSCI. The response we received identified that concerns raised were investigated and found to be unsubstantiated. Another complaint was raised directly with the service and action was taken to resolve this. Care Homes for Older People Page 19 of 31 Evidence: Records were not able to be viewed at the home in relation to complaints. The Registered Manager has confirmed in writing following the site visit that she was unable to locate documentation relating to concerns raised and has obtained additional copies from their head office. A complaints book is kept providing a quick summary of complaints raised. A staff member confirmed that they knew what action to take should someone wish to raise a complaint. There has been one Safeguarding Adults investigation in the last 12 months, which was unsubstantiated. The home is co-operative with the investigation authority. The home was able to demonstrate other action they have taken in order to ensure residents within the home are safeguarded from abuse. Staff confirmed that they are provided with Safeguarding Adults training and are familiar with the procedures to follow in the event of an allegation being made. The Registered Manager and deputy manager are booked to attend Safeguarding Adults training with the local authority designed for managers. Staff confirmed that Safeguarding Adults training included whistle blowing procedures and they would feel comfortable to whistle blow within the home. Information booklets have been given to all staff that provides information regarding Deprivation of Liberties. There is information at the home in relation the Mental Capacity Act and the Registered Manager has attended a half-day training session and is providing in house training for staff in relation to this. Care Homes for Older People Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a clean and homely environment and work is continuing to ensure residents are provided with comfortable indoor and outdoor communal facilities. Evidence: Residents spoken with confirmed that they are happy with the environment and their individual rooms. Rooms visited were seen to be personalised to reflect the individuals choice and character. The Registered Manager provided updated information on work that had been done to environment since completion of their AQAA. Examples of improvements made in the last 12 months are: new commodes have been purchased to replace old ones, new garden furniture has been purchased, some rooms and communal areas have been redecorated and a new bath seat hoist has been purchased. There was work in progress in a bathroom on the day of the site visit. Appropriate action has been taken by the home to ensure there is minimal impact on the residents whilst work is being undertaken. Staff spoke positively about the improvements made within the home. On tour of the environment, it was noted that improvements have been made and are Care Homes for Older People Page 21 of 31 Evidence: continuing to be done. There are no sluice facilities at the home and the Registered Manager confirmed that very limited commodes are in use. These are sterilised daily and the Registered Manager had previously confirmed that environmental health representatives were happy with the procedures in place. The home was observed to be clean on the day of the site visit and offensive odours were restricted to the one area. The home is trying to address this. It was observed that bins in communal areas were not provided with lids. This was discussed with the Registered Manager. Written confirmation was received following the site visit that pedal bins for the bathrooms have been ordered. This will assist in promoting infection control. The AQAA identifies that their plans for improvement in the next 12 months is to continue with the programme of refurbishment as and when bedrooms become vacant, ensuring residents are involved in this process. Care Homes for Older People Page 22 of 31 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. Residents needs are being met with the number of staff on duty and are generally safeguarded by the recruitment procedures in place. Ensuring staff are up to date with mandatory training will better safeguard staff and residents. Evidence: Residents spoken with were complimentary about the staff working at the home and confirmed that they felt there were enough on duty and there was always someone around to offer assistance if they needed. Staff also confirmed that they felt there were sufficient numbers of staff on duty. There are suitable numbers of ancillary staff employed at the home. The AQAA identifies that there is nine permanent care workers at the home, of which five have National Vocation Qualification (NVQ) level 2 or above. It was confirmed that there is a pay incentive for those staff who undertake these studies. Four staff files were viewed. References are obtained, Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks are undertaken and application forms are completed. Ensuring application forms are fully completed will assist in addressing shortfalls i.e. employment history and reasons for leaving. Shortfalls and other areas for improvement were discussed with the Registered Manager. Information Care Homes for Older People Page 23 of 31 Evidence: on file at the service identified that a visa/permit had expired for a staff member. Written confirmation was received following the site visit confirming that documentation is now in place. The Registered Manager confirmed that any new staff commencing employment on just a POVA First check is supervised and works supernumery. It was confirmed that staff are kept up to date with mandatory training, however on viewing training records, some training was out of date. This must be addressed to ensure staff and residents are safeguarded. It was recommended that the Registered Manager implement a training matrix so she can clearly identify when training is required to be updated for individuals. Written confirmation was sent following the site visit that she has now developed a training matrix. It was confirmed that all new staff undertake the Common Induction Standards as set by Skills for Care. Care Homes for Older People Page 24 of 31 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 generally run in the best interest of residents, however further work on monitoring the service will assist in evidencing that the home meets its aims and objectives. The health, safety and welfare of residents and staff are promoted and protected so far as is reasonably practicable. Evidence: The Registered Manager is registered with the CSCI and has the suitable skills and experience to manage the service. She has completed NVQ level 4 in care and has completed the Registered Manager Award course. She confirmed that she keeps herself up to date with current practices by attending training courses and reading relevant literature and the homes head office provides them with information of any changes in guidance or good practices. Staff spoken with confirmed that the Registered Manager is supportive and approachable and there are clear roles and responsibilities within the team. There is a Care Homes for Older People Page 25 of 31 Evidence: deputy manager employed at the service, who is related to the Registered Manager. Staff spoken with confirmed that there are no issues for them with management being related and would feel comfortable to express any issues that may arise. The Registered Manager confirmed that she finds external management supportive and approachable. The registered providers have employed an area manager that provides support to all homes that they own. The Registered Manager confirmed that changes made have been positive. It was confirmed that surveys are given to residents every three months to obtain feedback on how they find the service. Intermediate care residents are given a survey to complete prior to their discharge. Visitor surveys are located in the hallway for people to complete. It was confirmed that the home tries to obtain feedback from other stakeholders. Discussions were had with the Registered Manager that she should actively send out surveys to GPs, care managers and other visiting professionals to obtain their feedback. Whilst staff are able to voice concerns/ideas/opinions at any time and also during the quarterly staff meetings, it was again discussed that staff are provided with an opportunity to provide feedback anonymously. At the last inspection, the Registered Manager was going to implement staff surveys. These have not been implemented to date. The AQAA identifies that this is an area in their plans for improvement in the next 12 months. The Registered Manager confirmed that she now displays results of surveys and residents meeting minutes. The AQAA identifies that one of their plans for improvements in the next 12 months is to make their service user questionnaires available in different formats. There are other monitoring systems within the home to ensure the health and safety of residents, staff and visitors are protected. It was confirmed that weekly checks are undertaken on the fire alarm and hot water outlets etc. Management meetings are regularly held between all Registered Managers at services owned by the same providers, where good practices and ideas are discussed and shared. The Registered Manager confirmed that the registered providers or a representative undertakes monthly visits to the home. Some of these reports were not available at the home for viewing. The Registered Manager confirmed that she is provided with a report following each visit. Action needs to be taken to ensure these are kept securely at the home and are available for inspection. No requirement or recommendation has been made in relation to this as the Registered Manager confirmed that she would address this. The home holds personal allowance for residents, if they wish. Records viewed Care Homes for Older People Page 26 of 31 Evidence: identified that accurate records are maintained of all financial transactions. Receipts are kept of any purchases. As a further safety measure, limited staff have access to this money. It was recommended to the Registered Manager that she gets residents to sign when they are given some/all of their money when they request it, wherever possible. Health and safety records were not viewed. Safety measures have been put in place to address shortfalls noted at the last inspection that posed a risk to the health, safety and welfare of residents. The Registered Manager confirmed that they have provided training for staff in Control of Substances Hazardous to Health (COSHH), ensure all substances are kept locked away when not in use and has implemented a new health and safety folder. The AQAA identifies that there is a fire risk assessment in place and the Registered Manager has completed training in Health and Safety for Managers and any portable appliances in use have been risked assessed. The AQAA also identifies in what they do well is that they have been Contractors Health and Safety Assessment Scheme (CHAS) accredited and received a four star at the last Environmental Health assessment. The AQAA identifies that equipment in use has been tested or serviced as recommended by the manufacturer or other regulatory body and that all relevant policies and procedures are in place. Up to date information was provided on the day of the site visit. Care Homes for Older People Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 31 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 3 14 That written confirmation be 15/04/2009 provided to service users confirming that their needs can be met at the home. To confirm that following an assessment the care home is suitable for the purpose of meeting their needs in respect of their health and welfare. 2 9 13 That confirmation be obtained that the controlled drugs cabinet complies and is installed correctly. This is to ensure compliance with current legislation. That action is taken to ensure all staff are kept up to date with mandatory training. This will assist in ensuring the health and welfare of service users and staff are better safeguarded. 30/06/2009 3 30 18 30/04/2009 Care Homes for Older People Page 29 of 31 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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