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Inspection on 04/04/07 for Cathedral View Residential Home

Also see our care home review for Cathedral View Residential Home for more information

This inspection was carried out on 4th April 2007.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service provides a well maintained home set in very tidy grounds. It is clean, warm and comfortable and there are no offensive odours. There are good measures in place for the prevention of infection. Residents are only admitted following an assessment to ensure the home can meet their needs. Prospective residents and their family are invited to visit the home prior to any decisions being made to live there. Some relatives said the registered manager was very good to them when their dad first moved in. Resident`s said their healthcare needs are met and specialist healthcare professionals visit the home when required. Appropriate equipment is provided for pressure relief and moving and handling purposes. There is a suitable system for medications. There are several risk assessments undertaken to enhance the resident`s care. All residents spoken with said the care is very good and they are happy living in the home. They said they are treated with respect and dignity and their privacy is upheld at all times. They also said their individual preferences are respected and they can choose what they do each day. There is an open visiting policy. Visitors said they are always made welcome and can visit when they like.Social activities take place each day and are organised by a co-ordinator. There are posters to inform residents of what`s on and when; records of attendance are kept. Time is spent on one to one sessions when staff and residents get to know each other. Life histories are on file to help staff interact with residents. There is a nutritious menu and residents said the food is good. Fresh fruit and vegetables are included. All residents spoken with said they enjoy the food and it is of a very good standard. There have been no complaints but there is a system in place that ensures complaints are dealt with promptly and records are kept. There is a suitable policy for the prevention of abuse and staff receive appropriate training. There is a robust recruitment policy and procedure. There are suitable staffing levels with a skill mix that meets resident`s needs. Residents said the staff are very kind, caring and cheerful. One said, "I am settling in here and know there is someone around if I need them". The Registered Manager is a qualified mental nurse and a competent manager. Staff and residents spoke highly of her and her management skills. They said she is approachable and works as part of the team. The management endeavour to ensure that working practices are safe. Relevant service checks take place as required and are up to date.

What has improved since the last inspection?

The stocks of pharmacy have reduced but staff have to keep working on this. The dying and death policy has been expanded and now meets the standard. The large windows in the front of the home and a bay window have been replaced. The whole home has been decorated since the last inspection. Carpets have been replaced along with furnishings as required.

What the care home could do better:

Care plans should be compiled with the resident or their representative and signed if possible. Although there is a lot of information and very good risk assessments in the residents files the actual care plans need to be more detailed and in line with standard 3.3 rather than problem based. They need to fully inform and direct the staff in the care to be provided. There must be a risk assessment for residents requiring cotsides and consent must be sought from the resident, relatives, community nurse, GP and so on, as appropriate.There is a medicines policy in place, it needs to be reviewed and updated, and this was discussed with the registered manager. Any hand written instructions on the MAR charts must be witnessed and signed by two members of staff. The manager said she would ensure that basic medicines training is formally included in the induction programme. At present it is done informally and not recorded.

CARE HOMES FOR OLDER PEOPLE Cathedral View Residential Home Kenwyn Church Road Truro Cornwall TR1 3DR Lead Inspector Diana Penrose KeyUnannounced Inspection 4th April 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cathedral View Residential Home DS0000046330.V335419.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. Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cathedral View Residential Home Address Kenwyn Church Road Truro Cornwall TR1 3DR 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) 01872 240974 Cathedral View Limited Mrs Lynde Gilbert Care Home 34 Category(ies) of Dementia - over 65 years of age (15), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (15), Old age, not falling within any other category (34) Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Residents to include up to 19 adults of old age (OP) Residents to include up to 15 adults aged over 65 with dementia (DE{E}) Residents to include up to 15 adults aged over 65 with a mental illness (MD{E}) Total number of residents not to exceed a maximum of 34 Date of last inspection 10th November 2005 Brief Description of the Service: Cathedral View Limited owns two registered care homes, Cathedral View Residential Home and Cathedral View Nursing Home. Both homes are located on the same site, close to the centre of Truro with good transport links into the town and surrounding areas. Cathedral View Residential Home is registered to accommodate 34 elderly residents requiring personal care; some may be suffering with a degree of mental disorder or dementia. All facilities are accessible to residents including those who have limited mobility or need specialist equipment such as wheelchairs. There are extensive accessible gardens and there is sufficient parking outside the home for staff and visitors. The home provides single bedrooms for the majority of residents although two rooms are registered for shared accommodation. Bedrooms are situated on three floors and there is a shaft lift to all floors. There are stair lifts but these are not to all floors. There are two lounges, a large dining room and a conservatory for resident’s use. Meals are prepared and cooked in the nursing home and transported to the Residential Home. Suitably qualified and experienced staff provide care in a relaxed and friendly atmosphere. Suitable activities take place each day organised by an activities co-ordinator. Information about the home is available in the form of a statement of purpose, residents’ guide, and colour brochure, which can be supplied to enquirers on request. A copy of the most recent inspection report is available in the home. Fees range from £400 to £675 per week; this information was supplied to the Commission on the day of inspection. Additional charges are made in respect of Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 5 private healthcare provision, hairdressing and personal items such as newspapers, confectionary and toiletries. Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. An inspector visited Cathedral View residential Home on the 04 April 2007 and spent seven and three quarter hours at the home. This was a key inspection and an unannounced visit. The purpose of the inspection was to ensure that residents’ needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus was on ensuring that residents’ placements in the home result in good outcomes for them. On the day of inspection 32 residents were living in the home, two of these were receiving respite care. One person attends for day care. The methods used to undertake the inspection were to meet with a number of residents, relatives, staff and the registered manager to gain their views on the services offered by the Home. Records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. There were no requirements set following the last inspection or this inspection. Residents and relatives expressed satisfaction with the care and services provided at the home. Overall the home is providing a very good service and a high standard of care to the residents placed there. What the service does well: The service provides a well maintained home set in very tidy grounds. It is clean, warm and comfortable and there are no offensive odours. There are good measures in place for the prevention of infection. Residents are only admitted following an assessment to ensure the home can meet their needs. Prospective residents and their family are invited to visit the home prior to any decisions being made to live there. Some relatives said the registered manager was very good to them when their dad first moved in. Resident’s said their healthcare needs are met and specialist healthcare professionals visit the home when required. Appropriate equipment is provided for pressure relief and moving and handling purposes. There is a suitable system for medications. There are several risk assessments undertaken to enhance the resident’s care. All residents spoken with said the care is very good and they are happy living in the home. They said they are treated with respect and dignity and their privacy is upheld at all times. They also said their individual preferences are respected and they can choose what they do each day. There is an open visiting policy. Visitors said they are always made welcome and can visit when they like. Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 7 Social activities take place each day and are organised by a co-ordinator. There are posters to inform residents of what’s on and when; records of attendance are kept. Time is spent on one to one sessions when staff and residents get to know each other. Life histories are on file to help staff interact with residents. There is a nutritious menu and residents said the food is good. Fresh fruit and vegetables are included. All residents spoken with said they enjoy the food and it is of a very good standard. There have been no complaints but there is a system in place that ensures complaints are dealt with promptly and records are kept. There is a suitable policy for the prevention of abuse and staff receive appropriate training. There is a robust recruitment policy and procedure. There are suitable staffing levels with a skill mix that meets resident’s needs. Residents said the staff are very kind, caring and cheerful. One said, “I am settling in here and know there is someone around if I need them”. The Registered Manager is a qualified mental nurse and a competent manager. Staff and residents spoke highly of her and her management skills. They said she is approachable and works as part of the team. The management endeavour to ensure that working practices are safe. Relevant service checks take place as required and are up to date. What has improved since the last inspection? What they could do better: Care plans should be compiled with the resident or their representative and signed if possible. Although there is a lot of information and very good risk assessments in the residents files the actual care plans need to be more detailed and in line with standard 3.3 rather than problem based. They need to fully inform and direct the staff in the care to be provided. There must be a risk assessment for residents requiring cotsides and consent must be sought from the resident, relatives, community nurse, GP and so on, as appropriate. Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 8 There is a medicines policy in place, it needs to be reviewed and updated, and this was discussed with the registered manager. Any hand written instructions on the MAR charts must be witnessed and signed by two members of staff. The manager said she would ensure that basic medicines training is formally included in the induction programme. At present it is done informally and not recorded. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 9 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 Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. 6 is N/A Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitable information is given to prospective residents enabling them to make an informed choice as to where to live. Residents are only admitted to the home following an assessment of their needs to ensure the home can provide suitable care. EVIDENCE: Evidence was provided in the form of documentation, records, observation, case tracking, talking with residents, relatives, staff and registered manager. The home has a suitable statement of purpose and resident’s guide. There is also a colour brochure with photographs of the home and grounds. The documents form a welcome pack for new residents. A copy of the home’s contract is issued with this to prospective residents. Signed contracts were seen in resident’s files. Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 11 The registered manager said that prospective residents and their relatives are encouraged to visit the home before deciding it is the right one. The registered manager or the matron from the nursing home visits prospective residents to undertake an assessment of needs. This is recorded on specific forms, which were seen and completed appropriately. Information from social workers or hospital nurses is included where appropriate. The home does not provide intermediate care. Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual care plans are generated for each resident that are problem based; they all need to be reviewed and updated to ensure they fully inform and direct staff in the care provision. Residents have access to health care services as necessary to ensure their assessed needs are met. There are systems and policies in place for dealing with resident’s medicines that assure residents safety; the policy needs to be reviewed to ensure every aspect of medication is included. The homes policies and culture ensures that residents are respected and their privacy is upheld at all times. EVIDENCE: Evidence was provided in the form of documentation, records, observation, case tracking, talking with residents, relatives, staff and registered manager. The registered manager said that each resident has a written care plan. They need to be compiled with the resident or their representative and signed if Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 13 possible. Care plans inspected are sparse and problem based. They are not compiled from the assessment requirements in standard 3.3. They need to be expanded to fully inform and direct staff. This was discussed with the registered manager who said she would work on the care plans gradually and involve the care staff. There is a lot of information in the resident’s files including life histories, records of health professional’s visits and relevant risk assessments. The care staff have a summary of the individuals care needs as an easy reference sheet. Bath and bowel sheets are maintained and daily records are informative. The care plans and risk assessments are reviewed monthly. There must be a risk assessment for residents requiring cotsides and consent must be sought from the resident, relatives, community nurse, GP and so on, as appropriate. This was discussed with the registered manager and details given as to where to obtain guidance. She stated that all cot sides in use have bumpers fitted. Residents spoken with said their health needs are met very well and they have access to their GP or other health professionals when required. The registered manager said that links with specialist healthcare professionals is very good. A GP and a community nurse visited during the inspection and several telephone calls were made to GP surgeries. There is appropriate moving and handling and pressure relieving equipment provided. Care practice was observed to be appropriate during the inspection and carried out in a calm, efficient manner. Residents said their personal care is carried out as they wish it to be. There is a medicines policy in place, it needs to be reviewed and updated, and this was discussed with the registered manager. There is a monitored dosage system in place for the administration of medication. No residents are selfadministering at the moment. Records are kept of all medicines entering and leaving the home. The medicine charts are clear and there were no gaps observed in the administration records. Any hand written instructions on the MAR charts must be witnessed and signed by two members of staff. Medicines were administered in a professional manner at lunchtime. There is a homely remedies policy and a list approved and signed by a doctor from each surgery. There are relevant reference books and patient information leaflets are available for staff or residents to refer to. All care staff that administer medicines have received appropriate medicines training, the manager said she would also ensure that basic medicines training is formally included in the induction programme. Staff were observed to uphold resident’s privacy during the inspection and knocked on doors before entering. Residents said they are treated with respect and their privacy is respected. Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 14 Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides activities daily and staff spend time with residents, aiming to offer a lifestyle that meets their needs. Links with family and friends are excellent and allow residents the opportunity to socialise. Residents are helped to maintain control over their lives and staff respect their individual preferences and choice. Dietary needs of residents are well catered for with a varied selection of food that aims to meet their taste and preference. EVIDENCE: Evidence was provided in the form of documentation, records, observation, talking with residents, relatives, staff (including activities co-ordinator) and registered manager. There are activities provided on a daily basis, these are organised by an activities co-ordinator. She holds committee meetings with some of the residents every 2-3 months and posters are displayed to advertise what is happening and when. Activities include Holy Communion, music recitals, entertainment, art and craft, keep fit, sewing and reminiscence workshops are Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 16 being organised. Some residents went out on a mini bus trip during the inspection. There is an art file full of pictures painted by the residents. There is a record of visitors to the home and there were several visitors in the home during the inspection. Residents said they could receive visitors in private and at any time. Visitors spoken with said they are always made welcome in the home and can call in when they like. Residents said they choose when they get up and go to bed within reason. They said they choose what clothes to wear and how they spend their day. They said they choose whether to stay in their room or go to the lounge. All residents were suitably dressed in clean clothes. Residents’ rooms were personalised with their own belongings and furniture. Some residents control their own money. Staff said residents choose what they do each day and there is no time limit for breakfast, other meals are more structured to time. Some residents who cannot manage to use the stairs have been restricted to their floor recently as the lift is out of order the registered manager was hoping that the repairs would be completed by the end of the week. There is a six week set menu but everyone spoken with said there is are alternatives for those who do not wish to have the set meal. This was evidenced in the record keeping. Nutritional needs are assessed and the registered manager said that special diets are catered for. Everyone spoken with said the food is very good. Fresh vegetables and fruit are included. Snacks and drinks are available between meals; water or juice is provided for all residents. The meals are cooked in the kitchen in the nursing home (not inspected on this occasion) and transported to the residential home. There is a kitchen facility in the home for the provision of drinks and snacks. Meals are served in the dining room but residents can eat in a lounge or their bedroom if they prefer. The lunchtime meal was observed to be unhurried and appropriate assistance was given. The registered manager said the cook has undertaken Intermediate Food Hygiene training and other kitchen staff basic Food Hygiene training. Cathedral View Residential Home DS0000046330.V335419.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure that ensures complaints are listened to and acted upon. Arrangements are in place for the protection of residents safeguarding them from harm or abuse. EVIDENCE: Evidence was provided in the form of documentation, talking with residents, staff and registered manager. There is a suitable complaints policy available in the home and issued to residents. Residents and visitors said they could approach the staff or manager if there was a problem. There are a great deal of thank you letters and cards that are kept in a file. On the day of the inspection residents were enjoying a thank you cake provided by a relative. The registered manager and several staff have attended the local ‘No Secrets’ course provided by the department for adult social care. In house training also takes place regularly. Staff said the training is very useful. There is a copy of the local inter-agency procedures in the home and the home has a suitable policy. There has been one abuse issue at the home, which was dealt with appropriately. Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 18 Cathedral View Residential Home DS0000046330.V335419.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home and grounds are well maintained providing a safe environment for residents, staff and visitors. The home is comfortable, clean and free from offensive odours making it a pleasant place for residents to live in. EVIDENCE: Evidence was provided in the form of a tour of the building, talking with residents, staff and registered manager. The property is well maintained and appears to be safe. It is comfortable, warm, homely and clean with no offensive odours. Furnishings and decorations are to a good standard, the registered manager said that new carpet has been fitted downstairs and other carpet and blinds are awaited. The whole home has recently been decorated. The registered manager said that the three bay windows on the front facade have been replaced, in keeping with the limits and Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 20 constraints of the Listed Buildings Regulations. There is an on going maintenance programme is in place. On the day of the inspection the lift was awaiting repair and had been out of order for two and a half weeks, which was frustrating for residents. It was hoped that it would be fixed by 06/04/07. There are stair lifts but not to each level. The property has pleasant tidy gardens, which residents can utilise. There is a conservatory attached to the dining room. The laundry facilities are adequate with two washers and one large drier. Protective clothing is supplied for staff and they were seen wearing aprons and gloves. Hand washing facilities for staff are suitable and alcohol hand cleansing gel is provided. There are relevant policies in place for infection control. Cathedral View Residential Home DS0000046330.V335419.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels meet the needs of residents and staff morale is good. Resident’s benefit from the 45 of care staff that are trained or in the process of training to at least NVQ level 2 in care. Recruitment procedures are robust and offer protection to the residents. The home provides training for staff to help them be more competent in their roles. EVIDENCE: Evidence was provided in the form of documentation, records, observation, case tracking, talking with residents, relatives, staff and registered manager. The registered manager said that staffing levels are adjusted according to the resident’s dependency. The normal levels are one officer in charge and six carers in the mornings, one officer and three carers in the afternoons, one officer and four carers in the evenings (until 7pm) then two carers awake and the officer in charge sleeping in overnight. The registered manager is on duty during the week and on call at all times; the matron from the nursing home does some on call duties as well. Staff and residents said they feel there are enough staff and the team works well. Residents said the staff are very kind and care for them well. One resident said the staff are very cheerful and hard working. Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 22 There is a recruitment policy and the home operates an equal opportunities policy. Reference letters have been written in Polish when recruiting from Poland. There are four overseas staff employed, a Polish carer and a Nepalese carer said they are very happy working in the home and are part of the team. The registered manager said that all staff are treated equally. Staff files inspected contained the documents required by legislation, but they lacked interview records. Staff are issued with terms and conditions of employment and an appropriate job description. Relevant employment checks are made. 45 of care staff are qualified to at least NVQ level 2 in care and others are studying for the qualification. Staff receive statutory training as required. There is an induction programme for new staff that complies with the skills for care standards. The induction pack includes the in-house induction checklist and the GSCC code of practice. Care staff are enrolled onto NVQ training following induction if not sooner. Training needs are identified during the interview process for new staff, at annual appraisals and during supervision. The Registered Manager has a training matrix to record training attended, a generous amount of training takes place in the home with packs supplied by a training company. A nurse gives some specialised training and the matron from the nursing home provides moving and handling training. Training attended includes diabetes; cardiac failure, first aid, resuscitation and all staff work through a pack on dementia. Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager is a person of good character and fit to run the home. The home is run in the best interest of the residents and they benefit from the Quality Assurance systems in place. The home handle resident’s money in an appropriate manner and ensures their financial interests are safeguarded. Appropriate training and safety checks are undertaken to ensure the health, safety and welfare of residents, visitors and staff. EVIDENCE: Evidence was provided in the form of documentation, records, observation, case tracking, talking with residents, relatives, staff and registered manager. Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 24 The registered manager is a Registered Mental Nurse with 22 years experience in social care; she is very competent in running the home. She said she attends all statutory training updates and reads the nursing press to keep up to date on current issues relevant to the client group. Recent training includes health and safety and abuse. Staff and residents spoke highly of her and her ability to manage the home. One staff member said she is very supportive and like family to the staff. A resident said there is a good manager here but I have not seen the owners. An annual quality assurance survey takes place with residents, relatives and external stakeholders. Results are compared year on year with an aim to improving the services provided. Residents meetings and staff meetings take place regularly and are minuted. There are notices advertising the next meetings. The owners of the home visit daily and meet with staff and residents. There is a policy for the safekeeping of resident’s money in the welcome pack. There are two residents who deal with their own money and they have a lockable facility in their rooms. One member of staff is appointee for one resident and records are maintained. Money held for residents for toiletries and hairdressing and so on. It is held in a non-interest account and records are kept for all transactions. Receipts are kept for all purchases. There is petty cash for day-to-day requirements. Power of attorney details are recorded. The registered providers endeavour to ensure that working practices are safe. Health and safety and fire risk assessments have been undertaken. Relevant service checks take place as required. Staff receive statutory training regularly and records are kept. The kitchen staff have all received basic food hygiene training and one at intermediate level. Accident reporting complies with data protection and there are very few accidents. Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 25 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 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 2 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 Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 26 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 Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cathedral View Residential Home DS0000046330.V335419.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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