Inspection on 06/01/09 for Chatsworth Lodge Nursing Home

This inspection was carried out on 6th January 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Chatsworth Lodge Nursing Home 410 Chatsworth Road Chesterfield Derbyshire S40 3BQ     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: Rose Moffatt     Date: 0 6 0 1 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. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 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 29 Information about the care home Name of care home: Address: Chatsworth Lodge Nursing Home 410 Chatsworth Road Chesterfield Derbyshire S40 3BQ 01246556655 01246231306 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Karen Busby Type of registration: Number of places registered: Leyton Healthcare (No 3) Limited care home 40 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 users who can be accommodated is 40 The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: - Either Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP, maximum number of places, 40 Date of last inspection Brief description of the care home Chatsworth Lodge provides nursing and personal care for up to 40 older people. It is located to the southwest of Chesterfield town centre within a busy residential area with good access to a variety of local amenities. The home is modern and purpose built. Accommodation is on three floors accessed by a lift or stairs. There is an accessible garden to the back of the home and a car park at the front. Leyton Healthcare took over as providers of Chatsworth Lodge in August 2008. They have started a programme of refurbishment of the home. The fees at the home currently range from Care Homes for Older People Page 4 of 29 Over 65 40 0 Brief description of the care home £362.52 - £540.02 per week, depending on individually assessed needs. This information was provided by the manager on 6th January 2009. Information about the home, including CSCI inspection reports, is available in the main entrance area of the home or from the manager. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. The focus of our inspection is on outcomes for people who live in the home and their views on the service provided. The inspection process looks at the providers ability to meet regulatory requirements and national minimum standards. Our inspections also focus on aspects of the service that need further development. We looked at all the information we have received, or asked for. This included: the annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people Care Homes for Older People Page 6 of 29 using the service. It also has some numerical information about the service; surveys returned to us by people using the service and from other people with an interest in the service; information we have about how the service has managed any complaints; what the service has told us about things that have happened - these are called notifications and are a legal requirement; the previous key inspection and the results of any other visits we have made to the service in the last 12 months; relevant information from other organisations; and what other people have told us about the service. We carried out an unannounced inspection visit that took place over 7 hours on 6th January 2009. This was the first inspection of the home since the new providers took over in August 2008. The inspection visit focused on assessing all the key standards. We sent out 10 surveys to people living in the home and received 6 completed responses. We sent out 10 surveys to the relatives or representatives of people living in the home and received 7 completed responses. We sent out 10 surveys to staff employed at the home and received 2 completed responses. There were 37 people accommodated in the home on the day of the inspection visit. People who live in the home, visitors and staff were spoken with during the visit. The manager was available and helpful throughout the inspection visit. Some people were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. Case tracking was used during the inspection visit to look at the quality of care received by people living in the home. 4 people were selected and the quality of the care they received was assessed by speaking to them and / or their relatives, observation, reading their records, and talking to staff. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking 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 8 of 29 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 9 of 29 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. There was sufficient information made available about the home and a satisfactory assessment process so that people were confident their needs could be met. Evidence: We received six completed surveys from people in the home. All six said they had received enough information about the home so they could decide if it was the right place for them. People spoken with confirmed they had received information about the home to help them make a decision. People told us, I came for a visit and liked Chatsworth Lodge immediately, and, we visited other homes but chose Chatsworth Lodge and are pleased we did. One person had come to the home for respite care and then decided to stay permanently. Relatives spoken with had visited the home before the person came to live there. Care Homes for Older People Page 10 of 29 Evidence: The Statement of Purpose and Service User Guide were available in the main entrance area of the home. Both documents had been updated since the new providers had taken over the home in 2008. The manager said it was planned to put a copy of the Service User Guide in each persons room. Five of the people who returned our surveys said they always received the care and support they needed, one person said they usually did. People we spoke with said their needs were usually met at the home. Four of the relatives who returned our surveys said the persons needs were always met at the home, two said they usually were, one did not respond to the question. Relatives spoken with said the persons needs were generally well met - they had sometimes raised issues with staff about the persons care and said the issues were usually addressed. We looked at the care records of four people in the home. Each had an assessment carried out by the home and also assessments by social services and / or hospital staff. Each person had a care plan produced from the assessment information. The person or their representative had signed to confirm they had been involved in planning their care. Two staff returned our surveys and both said they had up to date information about the needs of people in the home and training to help them to meet those needs. Staff spoken with also confirmed this. Some, but not all, staff had received training about the care of people with dementia. There was information available to staff about the needs of people with specific conditions, such as Parkinsons disease, Multiple Sclerosis, and Alzheimers disease. The AQAA said that people who are considering coming to live in the home are offered a trial day. Also, that the home carries out an assessment and gathers as much information as possible to ensure the persons needs can be met. Care Homes for Older People Page 11 of 29 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. There was a consistent, purposeful approach to care planning and delivery, and people were generally satisfied with the care and support they received. Medication was generally well managed although there were some areas where the systems in place were not fully robust to ensure people were protected. Evidence: Five of the six people who returned our surveys said they always received the care and support - including medical support - they needed, one person said they usually did. One person said I am looked after very well. Four of the relatives who returned our surveys said the home always gave the care to the person as expected and agreed, three relatives said the home usually did. One relative said the persons needs are many and various and the care home is able to answer them in many different ways. Another relative said the home was good at generally caring for people making them comfortable and at ease. Care Homes for Older People Page 12 of 29 Evidence: We looked at the care records for four people in the home. Each person had a care plan that covered all of their assessed needs and had been reviewed every month. The care plans generally had good details of the action needed by staff to ensure the persons needs were met. Two care plans did not have sufficient detail about the care the person needed to ensure they did not develop pressure sores. All of the care plans lacked details of the persons individual preferences and of how their privacy and dignity should be maintained. There were appropriate risk assessments in place for each person and the risk assessments had been reviewed monthly. There were assessments of the persons dependency, risk of developing pressure sores, nutritional needs, moving and handling needs, and continence needs. All these assessments had been reviewed monthly. People told us they were able to see their own GPs when they needed to. They also had access to the District Nurses, chiropodist, dentist and optician. People were appropriately referred for specialist advice and help, for example, one person who had swallowing problems was referred to the Speech and Language therapist. A relative said they were particularly impressed with the standard of nursing care the person had received. The six people who returned our surveys said the staff listened to them and acted on what they said. People we spoke to said the staff treated them with respect and ensured their privacy and dignity. People said, everyone is kind and helpful, and that the staff were always friendly, very kind and caring. A relative said they had never heard staff make any inappropriate comments to people. Staff spoken with were able to give examples of how they would ensure privacy and dignity for people in the home. We observed that staff were courteous and friendly when talking with people. We observed that staff knocked on bedroom doors before entering. Medication was stored in a cupboard behind the reception area on the ground floor and in the first floor clinical room. The manager said it was planned to change the use of the ground floor staff room so that all medication could be stored together. Medication was administered by the registered nurses and senior care assistants. The senior care assistants had received appropriate training in the safe-handling and administration of medication. All the people in the home had been assessed to see if they were able to manage their own medication. One person was able to manage some of their medication and had secure storage in their room. The medication administration records (MARs) seen all had a protocol in place for Care Homes for Older People Page 13 of 29 Evidence: medicines prescribed as required. The MARs kept with the medication trolleys were fully completed. If people were prescribed topical creams / ointments, these were kept in the persons bedroom with a MAR for staff to sign when the cream had been applied. None of these MARs seen were fully completed to show the cream had been applied or had been omitted. There were regular audits of the MARs to ensure they were correctly completed, but it was not clear that the MARs in peoples rooms were included in the audits. There were records of the receipt and disposal of medication. The records of medication disposed of were signed by one member of staff - current good practice is for two members of staff to check and sign the record. The ordering system for medication did not include the prescriptions being checked by the home before being dispensed by the pharmacist, in line with current good practice. The AQAA said the home had improved by allocating named staff to each person in the home to ensure their care plans were kept up to date. The home also had a new format for care plans in place which the manager described as a vast improvement on the previous format. The home planned to improve further by including more information in the care plans, particularly about specific conditions, such as Parkinsons disease or dementia. Care Homes for Older People Page 14 of 29 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. People were offered a range of appropriate activities, a varied menu, and flexible routines so that the lifestyle in the home met their needs, expectations and preferences. Evidence: Two people who returned our surveys said there were always activities arranged by the home that they could take part in, one person said there usually were, and three people said there sometimes were. One person said I am always included and told what is happening that day even if I choose not to do the activity. A relative said, My mothers desire to join in with activities is limited. However, she appreciates live singing acts and pantomime etc. which are provided by the home. There were two activities staff employed at the home who organised a range of activities for people in the home. There was a weekly coffee morning held in the conservatory lounge and a monthly church service. There were regular games of bingo, baking and arts and crafts sessions. There was a visiting entertainer every month and a theatre company visited four times a year. Trips out had been provided in the summer and also for Christmas shopping. One person said they regularly went out Care Homes for Older People Page 15 of 29 Evidence: to a local supermarket cafe with staff. One of the activities staff had received training to enable them to do armchair exercises with people and said they planned to start the sessions soon. The home had recently refurbished the hairdressing room to provide a bright, contemporary, welcoming salon for people to use. A small lounge next to the hairdressing salon had been refurbished for use as a quiet room / therapy room. People waiting for the hairdresser could have a manicure or foot spa in this room. There was a weekly newsletter produced by the home that gave details of future activities and events as well as items of interest to people in the home and their relatives. There were regular meetings for people in the home and their relatives where they could make suggestions for activities and events, and could comment on activities and meals provided. People told us they could get up and go to bed when they wanted to. We observed that one person who had got up later was still able to have the cooked breakfast they wanted. We observed that people were able to go back to their bedrooms when they wanted to. People were encouraged to bring in any items from home to personalise their bedrooms. The bedrooms seen had items of the persons own furniture, ornaments, photographs etc. People were offered a key for their bedroom doors, though the manager said few people chose to have a key. Four people who returned our surveys said they always liked the meals at the home, two said they usually did, one person said they sometimes did. One person said, The standard of cooking is high and there is a good variety of dishes. A relative said, The food seems very good. People we spoke with were generally pleased with the meals provided, though one person said its not like I had at home, but they try, and another person said the menu could be a bit limited for my tastes. The menu was displayed on a large whiteboard in the main dining area with the choices available for lunch and tea. The dining area was bright and spacious. The meal served at lunchtime on the day of the inspection visit looked appetising and people said they had enjoyed it. The AQAA said the home now has an activities committee who devote their own time to planning fund-raising events to provide more entertainment for people in the home. The home planned to improve by having more trips out for people. The AQAA said the Care Homes for Older People Page 16 of 29 Evidence: home would like to have their own transport to enable people to go out more often. Care Homes for Older People Page 17 of 29 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. There were satisfactory systems in place so that people were protected and their complaints listened to and appropriate action taken. Evidence: All six of the people who returned our surveys said they knew how to make a complaint and who to speak to if they were unhappy. Six of the relatives who returned our surveys said they knew how to make a complaint, and that the home had responded appropriately to concerns raised. (One relative did not respond to these questions on the survey). One relative said,The staff always go to a great deal of trouble to alleviate any concerns I may have and problems are almost always sorted out immediately. People spoken with said they knew how to make a complaint. Relatives spoken with said they knew how to make a complaint and had been satisfied with the homes response to concerns raised. One relative said that although action had been taken to address their concerns, the action was not always consistently followed by staff. The complaints procedure was included in the Statement of Purpose and Service User Guide and was also provided in each bedroom. Records were kept of formal complaints with details of the action taken and the outcome. The manager said that less formal complaints were dealt with as they arose and the action taken was usually Care Homes for Older People Page 18 of 29 Evidence: included in the persons daily records. One complaint about the home had been received by CSCI in October 2008. The complaint was referred to the provider to investigate. The complaint was promptly dealt with and a response was sent to the person making the complaint. The two staff who returned our surveys and staff we spoke with all knew what to do if anyone raised concerns about the home. Most of the staff spoken with were aware of the procedures to follow if abuse was suspected or alleged. Nearly all of the staff had received training about safeguarding vulnerable adults. The homes policy for safeguarding vulnerable adults did not include details of the local multi-agency procedures to be followed. The home had a copy of the local multiagency procedures. The AQAA said no complaints had been received by the home, (the complaint referred to above was received after the AQAA had been completed). The homes policies about complaints and safeguarding vulnerable adults had been updated when the new providers took over. The manager and the registered nurses at the home had already attended training about the Mental Capacity Act 2005, and it was planned for senior care assistants to attend this training in 2009. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was clean, suitably equipped and generally well maintained so that people lived in a safe, pleasant environment that met their needs and preferences. Evidence: The home was modern and purpose built with accommodation on three floors. There was an accessible garden with level paths and seating areas. The smoking area for staff and visitors was situated in the garden. The manager said that currently two people in the home smoked in their own bedrooms, (following risk assessments), but eventually the home would be totally smoke-free. Several areas of the home had recently been redecorated and refurbished, including the dining room, the first floor lounge, the hairdressing salon, the therapy room/quiet lounge, and the new shower room. The decor in some of the bathrooms, corridors and stairs looked tired and worn. The lounges were comfortably furnished, including recliner chairs for people to use. The large ground floor lounge had been divided into three areas using groups of chairs. Although this made the lounge more homely, it did not allow always easy access for wheelchairs and hoists, particularly when there were visitors with extra chairs. This main lounge and the adjacent dining area were busy and quite noisy on the day of the Care Homes for Older People Page 20 of 29 Evidence: inspection visit. There were two televisions in this lounge and although they were both on the same channel the sound was not in sync and so it was difficult to follow the programme. The manager and activities staff said people enjoyed using the therapy room/quiet lounge as a change from the main lounge. The manager said they were encouraging people and their relatives to use the first floor lounge to allow them more space and privacy in a quieter environment. The manager said the conservatory lounge was used more in warmer weather and was also used for the weekly coffee mornings. The bathrooms were suitably equipped with adapted baths and a new accessible shower. The manager said people liked the new shower and it was planned to have a shower room on each floor. The bathrooms had been made more homely and welcoming by the use of curtains, blinds, pictures and ornaments. People told us they were pleased with their bedrooms and were glad they could bring in items of furniture from home. The manager said that shared rooms were only used for two people when they chose to do this. No people in the home were sharing a room at the time of the inspection. The six people who returned our surveys all said the home was always clean and fresh. People we spoke with and visitors told us the home was usually clean and free from offensive odours. The home appeared clean on the day of the inspection visit. There were some slight odours noticed around a few of the bedrooms. The home was equipped with suitable laundry and sluice equipment. Most of the staff had received training about infection control. Staff spoken with were aware of good practice in infection control. The AQAA gave details of the areas of the home already refurbished. The AQAA said that redecoration and refurbishment was planned for other areas, including some of the bathrooms, the stairs and corridors, and the reception area. Care Homes for Older People Page 21 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were satisfactory recruitment practices, good induction and training for staff, and sufficient staff available so that peoples individual needs were met. Evidence: Four of the people who returned our surveys said staff were always available when needed, one person said staff usually were and one person said they sometimes were. One person said, They do their best but there are not enough staff available particularly at weekends. People we spoke with said staff were always available when needed. Two relatives we spoke with said people sometimes had to wait for help to go to the toilet. Staff who returned our surveys and the staff we spoke with all said there were usually enough staff available to meet peoples needs. The staff rotas showed that there were usually six care assistants in the morning, five in the afternoon and three at night, plus a registered nurse on each shift. The rotas showed that these staffing levels had been maintained, even when staff were off sick. The care staff were supported by domestic, laundry and kitchen staff. We received positive comments about the staff from people in the home and their relatives. They said, the staff create a pleasant atmosphere by their welcoming Care Homes for Older People Page 22 of 29 Evidence: friendliness, From management, through nursing staff to the carers and domestic staff - all do their best to help the residents, and, Everybody is kind and helpful I have only praise for all of them. We looked at the records for three members of staff. One new member of staff did not have a Criminal Records Bureau (CRB) disclosure in place and so was working under supervision at all times. This person had a POVA First check in place, received before they started to work in the home. This person had all the other required documents and information in place, except for a photograph. The two other records had all the required documents and information in place. Three of the relatives who returned our surveys said the care staff always had the right skills and experience to look after people properly, four said staff usually had. New staff followed an induction programme that met the Skills For Care standards. Staff training records showed that the required training was up to date for nearly all the staff. Some staff had received training about the care of people with dementia. Over 60 of care staff had already achieved a National Vocational Qualification (NVQ) at Level 2 or above. The senior care assistants had achieved or were working towards NVQ Level 3. Staff we spoke with said they were encouraged and supported to take part in training. They were knowledgeable about the care needs of people in the home. We observed that staff used correct techniques for moving and handling people. The AQAA said there was very little staff turnover at the home. The home had recently employed a clinical lead nurse to work alongside the manager. The AQAA said the home aims to have a good skill mix of staff on duty to ensure peoples needs were met. The home planned to improve by ensuring staff continue to have the training they need. Care Homes for Older People Page 23 of 29 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 was well managed and there were satisfactory systems in place so that the health, safety and welfare of people was promoted and protected. Evidence: The manager was in post before the new providers took over the home. The manager was suitably experienced to run the home. She was working towards NVQ Level 4 in management and hoped to complete this by February 2009. The manager was supported by a clinical lead nurse to provide help and expertise with all clinical and care matters in the home. The manager did not have any administrative help and said it would be useful to delegate some administrative tasks so that she could use her time more effectively. People told us The manager is helpful, and, The manager is totally dedicated to providing the most comfortable, safe and happy home...always willing to go the extra mile. Her attitude is reflected in her staff. A member of staff said, The manager is Care Homes for Older People Page 24 of 29 Evidence: very supportive and bends over backwards to ensure that full support is given to all staff, service users and relatives. Staff told us they could go to the manager with any concerns and were confident she would take appropriate action. The AQAA was completed by the manager. The AQAA contained clear, relevant information supported by a range of evidence. The data section of the AQAA was fully completed. The quality assurance system at the home included questionnaires given out every three months to people in the home and / or their relatives, and staff. The results were analysed by the manager and action taken to address any issues raised. The manager said she planned to put the results of the questionnaires into the next newsletter for people in the home and their relatives to see. There were regular audits of care plans, staff files and medication to ensure compliance with regulations and standards. There were monthly meetings for people in the home and their relatives to comment on the service provided and to make suggestions for improvements. Personal money of people in the home was securely kept. The records we looked at had details of each transaction with receipts and the signatures of two members of staff. The AQAA showed that maintenance of systems and equipment was up to date. We looked at a sample of records - accident records, fire safety equipment and systems checks, and passenger lift maintenance records - and found they were all satisfactory and up to date. Staff had received relevant training about health and safety, such as training about fire safety, food hygiene, manual handling and infection control. Care Homes for Older People Page 25 of 29 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 26 of 29 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 9 13 The medication administration records must be fully completed for all medication administered by staff, including topical medicines. This will help to ensure that people are given medication as prescribed. 31/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Care plans should include more details of the persons individual preferences and should remind staff how privacy and dignity are to be maintained. This would help to ensure a more person centred approach to care planning and delivery. The medication procedures should be improved by ensuring all prescriptions are checked by an appropriately trained member of staff before being sent to the pharmacy, and two members of staff should check and sign all medication disposed of. This will help to protect people in the home. The homes safeguarding vulnerable adults policy should include details of the local multi-agency procedures to 2 9 3 18 Care Homes for Older People Page 27 of 29 ensure that staff are aware of the correct procedures to follow if abuse is suspected or alleged. This will help to protect people in the home. 4 30 All staff at the home should have training about the needs of people with dementia. This will help to ensure that peoples needs are well met and also ensure that staff are up to date with current good practice. Care Homes for Older People Page 28 of 29 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. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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