Inspection on 05/06/06 for Cams Ridge Nursing & Residential Care Home

This inspection was carried out on 5th June 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cams Ridge Nursing & Residential... 15/10/09

Cams Ridge Nursing & Residential... 19/10/07

Cams Ridge Nursing & Residential... 28/10/05

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Winton House

Newbeech House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Cams Ridge Nursing & Residential Care Home 7 Charlemont Drive Cams Hill Fareham Hants PO16 8RT Lead Inspector Tim Inkson Unannounced Inspection 5th June 2006 09:00 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 Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.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. Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cams Ridge Nursing & Residential Care Home Address 7 Charlemont Drive Cams Hill Fareham Hants PO16 8RT 020 7929 3444 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) Ashbourne (Eton) Limited To be confirmed Care Home 51 Category(ies) of Old age, not falling within any other category registration, with number (51), Physical disability (10), Physical disability of places over 65 years of age (37), Terminally ill over 65 years of age (37) Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users must be at least 50 years of age. Date of last inspection 28th October 2005 Brief Description of the Service: Cams Ridge is a care home with nursing for service users over the age of 65 years. The Home is also registered to take terminally ill service users and persons with physical disability. The home has been recently extended to provide accommodation for 51 service users. The Home is situated in a quiet residential area near to local amenities. Potential residents are given a brochure and a “Service Users Guide” that provide information about the services and facilities provided by the home. The guide includes a copy of the last report of inspections of the service by the Commission for Social Care Inspection. At the time of the fieldwork visit to the home on 5th June 2006, the home’s fees ranged from £400 to £734 per week. The fees did not include the cost of hairdressing; newspapers; chiropody and dry cleaning. Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This fieldwork visit was unannounced and took place on 5th June 2006, starting at 08:45 and finishing at 18:10 hours. The process included viewing the accommodation including bedrooms, communal/shared areas and the home’s kitchen and laundry. Documents and records were examined and staff working practices was observed where this was possible without being intrusive. Residents, visitors and staff were spoken to in order to obtain their perceptions of the service that the home provided. At the time of the inspection the home was accommodating 48 residents and of these 8 were male and 40 were female and their ages ranged from 53 to 99 years. There was no resident from a minority ethnic group. The home’s registered manager was present throughout the visit and was available to provide assistance and information when required. Other information that influenced this report included information that the Commission for Social Care inspection had received since the last fieldwork visit made to the home on 28th October 2005, such as statutory monthly reports made to the home for the owner and notices received about incidents that had occurred. Also a pre-inspection questionnaire that was returned by the home before this fieldwork visit took place. What the service does well: Detailed records were in place that gave nursing and care staff information that enabled them to provide the help that residents needed. Residents felt safe and secure and happy that staff could look after them properly and treated them with respect. The home promoted the right of residents to make choices for themselves and exercise personal autonomy as far as was reasonably possible, including dealing with their own finances and participation in the civic process. Management systems and procedures in the home worked well including, dealing with complaints, quality monitoring, and health and safety. Staff were recruited properly in a way that should ensure that residents safety and welfare is promoted. There was a strong commitment to staff training and development to ensure that staff were able to fulfil their roles and responsibilities and meet residents needs. Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were procedures in place to ensure that the home identified the assistance and support that potential residents needed before they moved into the home EVIDENCE: The home’s Service Users Guide stated the following: “Prior to admission the Home carries out a detailed assessment often in conjunction with other health and/or care professionals, to ensure that the staff are able to meet your care needs and that any appropriate equipment is in place…………….We avoid unplanned admissions where possible”. The records of 5 residents were examined including those concerned with identifying the help and care that people needed. There was evidence from these documents that the admissions to the home of the individuals concerned had all been planned. Discussion with residents and visitors to the home also Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 9 indicated that information about the needs of potential residents was obtained before individuals moved into the home. • “ I remember them coming to see me at the hospital”. • “They came to see Mum before she moved here”. One of the records examined of an individual who had moved into the home under care management arrangements also included a copy of an assessment of that persons needs completed by staff working for the relevant local authority. The home does not provide intermediate care Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had systems in place to ensure; the personal and healthcare needs of residents were met and medication was managed safely and effectively. Staff working practice generally ensured that residents’ privacy and dignity was promoted EVIDENCE: The home’s Service Users Guide stated the following: “Staff will draw up a care profile with your involvement, which will detail how all your care needs and lifestyle choices will be met. We encourage you to include your views and to agree to sign the plan wherever possible. Your family/friends may also be involved…..This care profile will be kept under review and revised … on a monthly basis….” A sample of care plans of 5 residents was examined. All the plans were comprehensive and based on the assessments of the needs of the individuals concerned (see page 9 above). Assessments also included a range of potential risks to residents e.g. pressure sores; falls; nutrition; etc. The plans set out Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 11 clearly the action staff had to take to meet the needs of those residents and where relevant what equipment was required to promote their independence or ensure their comfort e.g. Zimmer frame, pressure relieving aid. Staff were able to describe the contents of the plans and residents comments about the abilities of staff included: • “I am happy that the staff know what they are doing when they help me – they preserve my modesty and dignity when they help me”. • “They call the doctor if I am not well and we have a chiropodist come in” • “I am not very good with walking so I have someone come in and help me on my feet. They help me with showering. The staff are very nice, very obliging if I want anything - they come quickly if I ring the bell”. • “I have been here about 4 years – they help me in and out of bed and wash and bath me. They are very good, they would do anything for me but I am very independent. I feel quite safe when they help me they would not let me fall”. Residents and relatives spoken to confirmed that the care set out in plans was provided and where plans referred to the use of equipment or how a specific need was to be met this was observed to be available, provided or in place e.g. pressure relieving aid; Zimmer frame; hoist; plate guard; soft diet/pureed meal; etc. Records indicated that care plans were reviewed at least monthly and that daily notes referred to the actions taken by staff to provide the needs set out in those plans. Not all the plans examined had been signed by either the resident or a relative to indicate that they had been involved in its preparation/development. There was some discussion with the registered manager and also the home’s clinical manager about the focus in plans of care on health and personal care omitting social and psychological needs. This was despite reference to relationships and leisure interests in the information obtained about individuals before they moved into the home. Both the managers said that they would ensure that these would be included in future. Records examined also indicated that a range of healthcare professionals visited the home and that arrangements were made for treatment for service users when it was necessary. Residents said that they saw and received treatment from among others, chiropodists and opticians and when required arrangements to attend outpatient clinics were made by the home. There was evidence that specialist support was provided to the home when required e.g. physiotherapist and speech and language therapist. The home used a range of nationally recognised health care assessment ”tools” (see above reference to risk of pressure sores, etc). There was documentary evidence that when an individual had a wound/pressure sore that specific plans were implemented to manage the wound and monitor progress with healing. Individuals’ health was monitored routinely and regularly e.g. blood pressure and weight. Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 12 The home had written policies and procedures concerned with the management and administration of medication. A range of reference material about medication was readily available including a copy of the British National Formulary (BNF). Medication was kept in locked and secured medicine trolleys, cupboards and where required in a medical refrigerators. Controlled drugs were stored securely and in appropriate metal locked cabinets. Medicines were dispensed from their original containers and the only staff responsible for the management and administration of medication were registered nurses. The home’s manager said that the system at Cams Ridge was changing to the use of “blister packs” prepared by a pharmacist for the management and administration of medication. A new contract had been agreed with a national pharmacy chain and they were due to provided training in the new system for registered nurses on 13th June 2006. Records were kept of the ordering, receipt, administration and the disposal of medicines and these were accurate and up to date. The home complied with procedure introduced in 2005 concerned with the disposal of unwanted drugs and medicines that reflected changes in the National Health Service contract for community pharmacists and ensured compliance with legislation about the disposal of waste. Good practice noted during the fieldwork concerned with the management of medication included: • Recording the temperature of the refrigerator used for storing some medication • Dating of containers of certain medications when they were opened because of limited shelf lives i.e. eye-drops and magnesium hydroxide. • Permission obtained from residents’ doctors’ for the use when required of homely remedies • Sample copies of the signatures of the Registered General Nurses that dispensed medication. • Assessments of competence of night care assistants to witness the dispensing of Controlled Drugs. • Some sedative medication was treated as if it was Controlled Drug The home strongly promoted independence and the clinical manager said that those residents assessed as being able and wished to were encouraged to keep, and take their own medication. At the time of the fieldwork visit however no resident was managing their own medication. The home’s Service Users Guide included information about its philosophy of care including among other things the promotion of service privacy and dignity. All residents were accommodated in singe rooms and they said they appreciated the privacy that these afforded, particularly some of those that had the benefit of en-suite WCs. Those spoken to also said staff usually knocked before entering their rooms and this practice was observed during the inspection visit. Residents described the staff as generally respectful and polite. Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 13 Residents were consulted and could decide which staff members they wanted to help them with their personal care. The staff group was balanced to enable choice of male, female and age related preferences. Comments about these matters included the following: - • • • • “I only have women looking after me, they have some male staff but they ask me if I would mind a man and I say that I would so they send a woman”. “Some staff are polite others aren’t – sometimes they knock before they come into my room” “I think that there are enough staff. They are polite and friendly” “ They are very polite, they always knock on my door”. Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home organised a range of social activities and enabled service users to exercise choice about all aspects of their daily life. Service users were able to maintain links with relatives and representatives. The dietary needs of service users were well catered for with a balanced and varied selection of food available that met service users tastes and choices. EVIDENCE: At the last fieldwork visit to the home on 28th October 2005, it was noted that although activities were organised for residents they were somewhat limited. Since then a new activities organiser had been employed and staff, residents and visitors spoke highly of the improved range of organised and regular activities in which residents could participate. These included quizzes, music and movement, craft sessions, outings and celebrations of special occasions e.g. St George’s day. Many service users chose to pursue their own individual interests and some were too frail to participate. The activities organiser arranged one to one sessions for the latter. On the day of this fieldwork visit the organiser had taken a resident out shopping in the morning and in the afternoon arranged a quiz. The programme of organised activities for each month was circulated to residents and was also prominently displayed in the entrance hall to the home. Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 15 The home’s Service Users Guide included a commitment to promoting freedom of choice for people living in Cams Ridge and also details about how the home could assist individuals with their spiritual needs. Residents also confirmed that they could exercise choice in all aspects of life in the home. One individual said, “I choose to stay in my room all the time, but sometimes I go downstairs in the afternoon they come and ask me if I want to go down for lunch but I don’t”. Another said, “You can eat in your room if you want but I go down to the dining room to get a bit of a change .I get up when I want, if they come too early you tell them and they come back later …….. I prefer my own company because a lot of people can’t talk. There is a communion service once a month”. The home had a notice on display in the entrance hall that stating that visitors were welcome at any time. Both residents and visitors that were spoken to during the fieldwork confirmed this. • “I have a few visitors and they can come when it suits them”. The home’s Service Users Guide stated that all residents had the right to see their own personal records it also said: “All written information that relates to individual care needs shall be deemed confidential and will not be made available to any unauthorised person without the service user’s proper consent”. It was noted that Information about residents was kept securely. The home’s registered manager said that residents were encouraged to personalise their bedroom accommodation and could bring items of furniture into the home with them. Several residents spoken indicated that some furniture in their rooms belonged to them. One resident said that having her own “bits and pieces made it feel like home”. There were pamphlets/leaflets in the entrance of the home with details about organisations that offered to provide advice, information and guidance that could be helpful to residents and their families. Residents were generally complimentary about the food provided and some indicated that the quality had improved recently. All residents spoken to confirmed that they had 3 meals a day and could have snacks and drinks at other times. The menus and records of food provided indicated that there was a wide range of meals provided and that the food was nutritious. In addition special diets and individual preferences and needs were catered for e.g. soft diets; salt free; and diabetic. Fresh ingredients were used and the preparation of meals and the ready availability of fluids and fresh fruit was noted. The main meal on the day of the inspection was attractively presented. Residents could choose where to eat and a number preferred to eat in their rooms. The main meal of the day was observed and staff were seen sensitively assisting individuals unable to feed themselves and the occasion was unhurried and relaxed. Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 16 Comments about the food provide from residents and relatives included the following: • “The food is OK it has got better recently” • “I come here a lot and what I have seen of the food it is very good, the cook will discuss things with you. • “The food is not always good because they don’t drain the vegetables. We do get more than enough. You can have breakfast whenever you want, we have lunch, supper and a late drink and biscuits. You can eat in your room if you want but I go down to the dining room to get a bit of a change” • “You are told the day before what the menu is and if there is something you don’t like you can have something else”. • “The food is alright, in fact it is very nice. We have 3 meals and drinks and biscuits and things. They bring the menu around and we can choose what we want”. Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a clear and satisfactory complaints procedure and residents’ were confident about raising concerns with the home’s management. Robust procedures were in place to protect service users from the risk of abuse. EVIDENCE: The home’s complaints procedure was prominently displayed in the entrance to the building. All residents had a copy of the home’s Service Users Guide, which also included details of the procedure that stated that all complaints would be acknowledged and responded to within 28 days. All residents and visitors spoken to were confident about raining any concerns that they might have with the registered manager. One resident said: • “If I was unhappy or had a complaint I would speak to David (the registered manager) he would see to it immediately. He was most helpful when I had a problem and sorted it out”. There had been 2 complaints made to the home since the last inspection and both had been resolved satisfactorily. There had been no complaints about the home made to the Commission for Social Care Inspection during this period. Following the receipt of one of these complaints the home’s registered manager had made a referral to the local authority in accordance with their adult protection guidelines/procedures. There were written procedures concerned with adult protection and ensuring that the risk of service users suffering harm was as far as reasonably possible Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 18 identified and/or prevented. Staff said that training in the subject of adult protection/abuse was provided and an examination of staff training records confirmed this. Staff spoken to were able to demonstrate an awareness of the different types of abuse and the action they would take if they suspected or knew that it had occurred. Where subsequent to an assessment it was considered necessary for a resident’s safety to use bed rails written permission/consent was obtained. Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s environment is safe and well maintained. There was an infection control policy and procedures in place and staff practice ensured that as far was is reasonably possible residents were protected from the risk of infection. EVIDENCE: The exterior and interior of the premises, its décor, furnishings, fittings and equipment were in good repair. The registered manager said that the organisation that owned the home had an estates division/department that organised and arranged major maintenance, repair and redecoration of the home. He said that he had a budget for minor repairs and replacement of some items of equipment and furniture. He also expressed some pleasure that the relatively new owners of the home unlike the previous owners appeared to be “investing” in the home and he had some capital expenditure in his budget and was purchasing some new bed sets, divan beds and a “profile bed” (specialist nursing bed). Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 20 Residents spoken to expressed contentment with both their accommodation and the shared or communal rooms that they could use. The local fire and rescue service had not visited the home during the time that the registered manager had been in post (some 9 months). He said that the organisation/company that owned the home had a designated fire safety officer who had visited the home on 26th January 2006. There was a detailed fire risk assessment in place for the home that had been completed on 17th March 2006 by a fire safety consultant and subsequently a number of matters identified in the assessment had been addressed e.g. installation of smoke detectors in roof spaces. The local environmental health officer had visited the home on 24th March 2006 and identified some matters concerned with food hygiene practice that the home had subsequently rectified i.e. implemented a food stock control system. There were comprehensive procedures in place and one of home’s staff had specific delegated responsibility for the management of infection control. Procedures referred to among other things effective hand cleaning and the use of protective clothing. The latter was readily available and one member of care staff said: • “They are very hot on the use of gloves and aprons here, you will get picked up instantly if you don’t use them when you should”. There were sluice disinfectors available on both floors of the home. The home’s laundry was appropriately sited and equipped and effective procedures were in place for the management of soiled laundry items. • “When dealing with dirty bed linen we put it into red bags to go to the laundry and the bags go straight in the washing machine”. There were no offensive odours apparent at the time of the fieldwork visit and residents and visitors to the home said that the building was kept clean and odour free. Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was an appropriate and satisfactory level and mix of staff that ensured the needs of residents were met. The home had clear staff recruitment, training and development procedures that ensured that service users were protected and supported. EVIDENCE: The total number of staff employed to work in the home at the time of the fieldwork visit was 61, this included 11 registered nurses and 29 health care assistants and of the latter 15 had obtained a qualification equivalent to a National Vocational Qualification level 2 in care (i.e. 52 ). The registered manager said that another 5 heath care assistants were pursuing the qualification. Staff and residents said that the staffing levels in the home were sufficient and service users also expressed confidence in the abilities and competence of the staff to meet their needs. Comments from residents and relatives about the sufficiency and competence of staff included the following: • “ I am happy that the staff know what they are doing when they help me” • “I think that there are enough staff. They are polite and friendly”. • “I think that there are enough staff here” Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 22 • “I can’t complain. The carers do a good job”. (Relative) Comments from staff about the level and numbers of staff on duty at any time included the following: • “Staffing levels are good at the moment. We all have our off days when someone is off sick we pull together – we work as a team”. • “Sometimes we are short because of sickness or holiday. We cover shifts then but when everyone is in there are enough staff”. The registered manager said that on day a week the clinical manager was supernumerary to enable her to deal with administration matters and staff training and supervision. He also said, ““We have a full quota of staff we rarely have to use agency staff”. The care staff rota setting out the minimum number and skill mix deployed in the home was as follows: AM 2 8 PM 2 5 Night 1 4 Registered nurses Health care assistants Apart from registered nurses and care assistants the home employed other staff and these comprised. Administrator Activities organiser Kitchen assistant Cooks Cleaners Laundry assistants Housekeeper Maintenance persons Gardener Records were examined of 4 staff and of those 2 had been employed to work in the home since the last fieldwork visit to the establishment on 28th October 2005. All statutorily required information and checks had been obtained and conducted before they had started work in the home. The home had a training room equipped with TV and video player, magazines, training videos and there were charts on the wall about practice issues e.g. wound care. Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 23 It was noted that outside the ground floor nurses station lists of courses/training events and their dates were on display and staff were required to attend the following: • Control of substances hazardous to health (CoSHH) • Basic Food Hygiene • Manual Handling • Fire Safety • Medication management for trained staff There was a matrix document with details of health and safety training topics/subjects and dates that staff attended, enabling easy identification of those individuals who needed to update or refresh their training in those subjects that included adult protection. There was evidence of staff attending training in matters that were relevant to the care and support provided by the home e.g. palliative care; pressure care; infection control. All staff spoken to were enthusiastic about the opportunities to undertake training and enhance their skills and knowledge. They said that the there were regular training afternoon sessions held in the home. Comments from staff about their training included: • “I got NVQ 2 about 2 years ago. I did a first aid course about a week ago at St Mary’s hospital. We do fire safety training with the handyman. We watched a video and answered questions about abuse about 3 months ago. We use the training room. We did bereavement last year. We have food hygiene and CoSHH”. • “I have NVQ level 3 in care and OCN level 2 in infection control. Recently I have done the mandatory training and I have also done palliative care, incontinence and pressure sore prevention and I am starting a dementia awareness course at Highbury College. The manager tries to get us to do more training”. • “I keep up to date by subscribing to professional journals. I have not been on any training events for about 12 months because we were without a manager for some time. We are now getting on top of training. I am the link nurse with Countess Mountbatten (local hospice) for palliative care. We are going to implement the Liverpool Care pathway”. • “I have NVQ level 2. I am waiting to do level 3. We have a lot of trainers come in – we do CoSHH, moving and handling, food hygiene, abuse, continence care, palliative care and skin care”. Staff training records indicated that all new health care assistants completed induction training to the required standard as expected by the Training Organisation Personal Social Services (TOPSS). The registered manager was advised that the sector training organisation had changed and was now “Skills for Care”. Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s manager provided effective leadership There were systems and procedures in place for; monitoring and maintaining the quality of the service provided; safeguarding residents financial interests and promoting the safety and welfare of everyone living and working in the home. EVIDENCE: The registered manager had been in post for 9 months. He was a registered nurse and had been qualified for 14 years. He was previously the registered manager of a nursing home registered to accommodate 47 service users. Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 25 He said that he had not done the registered managers award but hoped that his employers will enable him to pursue the qualification. He said that had “made tentative steps to do it” in his last employment. In the last 12 months he said that he had attended training and updates in infection control practice and had also completed a diploma in neuro-linguistic programming. As a result of discussion with the manager and also from observing him in conversation with staff, relatives and residents, he presented as; organised; highly motivated; enthusiastic; concerned; sensitive and empathetic. Comments from staff, residents and relatives about the registered manager were all positive and included the following: • “I have been coming here for nearly 4 years. The manager is very good and fair. He seems to have done quite a lot. If you ask him to do anything he does it, no problem he will get it sorted”. (Relative) • “He has not been here long, he is very good though”. (Resident) • “It was stressful when the last manager left but Dave (the registered manager) is getting us back on track – he is fair – you can go to him with problems”. (Member of staff) • “David (the manager) is excellent. He really does care about residents, staff and the quality of the home. He is fair but does push to get the quality. (Member of staff) The organisation that owned the home had procedures in place for monitoring the quality of the service that it provided that included monthly audits of various aspects such as, the kitchen and the system for managing medication. The registered manager also had to complete a detailed report each month that was validated by his line manager. The home’s registered manager had also organised a consumer satisfaction survey in late 2005 sending out 51 questionnaires to residents and their relatives and published the results. A copy of this was included in the home’s Service Users Guide. The home had a range of written policies and procedures and all staff spoken to said that they were readily available, helpful and influenced the care practices in the home. • “Policies and procedures are useful because they help you know what you are doing”. • “There are files on everything in the office and we were told to sign and date them when we read them. They give you knowledge and understanding about what to do, everything is governed by procedures”. The home looked after small sums of money for some residents that was left with or handed over by relatives or representatives. A sample of records of monies held on behalf of residents was checked and they were accurate and up to date. Records examined indicated that the home’s equipment, plant and systems were checked and serviced or implemented at appropriate intervals i.e. passenger lift and hoists; boilers; fire safety equipment alarms, emergency Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 26 lighting; portable electrical equipment; temperatures of fridges, freezers and cooked food etc. There were contracts in place for the disposal of clinical and household waste. Staff said that they attended regular and compulsory fire and other health and safety training and residents said that the home’s fire alarm system was checked every week. There was a fire risk assessment for the premises and regular risk assessments of the premises were undertaken. Guards covered all radiators in the home and all windows above the ground floor were fitted with restrictors. The home had 2 staff trained as accredited manual handling trainers and there were hoists, and other equipment in the home to promote safe working practices. Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 27 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 28 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. Standard Regulation Requirement Timescale for action 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 Cams Ridge Nursing & Residential Care Home DS0000065930.V296902.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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