Inspection on 14/01/09 for Cherryfield House

This inspection was carried out on 14th 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

Cherryfield House 16/01/07

Cherryfield House 24/01/06

Cherryfield House 13/09/05

Cherryfield House 15/11/04

Cherryfield House 22/06/04

Cherryfield House 10/12/03

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 20/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cherryfield House Petersburg Road Edgeley Stockport Cheshire SK3 9QZ     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: Helen Dempster     Date: 1 4 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 30 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 30 Information about the care home Name of care home: Address: Cherryfield House Petersburg Road Edgeley Stockport Cheshire SK3 9QZ 0161-4741787 NOFAX Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Cherryfield Homes Limited care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC 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 Dementia - Code DE The maximum number of service users who can be accommodated is: 29 Date of last inspection Brief description of the care home Cherryfield House is owned by Cherryfield Homes Limited. The home is a two storey detached property set within the community of Edgeley. The care home is close to the town centre of Stockport, situated in a residential area and is within walking distance of a local park. Cherryfield House offers 21 single rooms, of which 18 have en-suite facilities, and four double rooms. The home is equipped with a passenger lift. People who use the service have access to a large lounge and dining room on the ground floor and a lounge and dining room on the first floor. There is a small garden for use during fine weather and a roof garden on the first floor provides service users with additional Care Homes for Older People Page 4 of 30 Over 65 0 29 29 0 Brief description of the care home outdoor seating. Cherryfield House is registered to accommodate service users over the age of 65 who may or may not have mental health frailty. the service is in the process of extending the range of service to include nursing care for older people. Fees for accommodation and care at the home range from 380 pounds up to 500 pounds per week. Additional charges are made for hairdressing and chiropody services, newspapers and personal toiletries. People who are considering using the service can obtain information from the Service User Guide, which is a booklet which tells people all about the home and what they can expect from the service. Alternatively, the manager is happy to provide any information by telephone, or in person. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection included a site visit. The manager and staff at the home did not know that the visit was going to take place. In January 2008, an Annual Service Review (ASR) was done, as part of the lead up to this inspection. This involved the manager filling in an annual quality assurance assessment (AQAA), and people who use the service and staff filling in surveys to tell us their views of the home. We then considered this information, and all the other information we had received about the service, so that we could decide when we needed to visit the home to do a key inspection. The outcomes for people who used the service at that time were good. This reassured us that people at the home continued to be happy with the way they were supported at the home and that they continued to Care Homes for Older People Page 6 of 30 receive a good service and this helped us to plan the timing of this inspection. Prior to this inspection, we sent surveys out again to people who use the service and staff so they could tell us what they thought about the service. Five of the staff and five people who use the service returned their surveys. Comments from these surveys are included in the report. We asked the manager of the service to complete an AQAA again. This form gave the manager the opportunity to tell us what they feel they do well, what they needed to do better and what had changed since the last key inspection and ASR. This helps us to determine if the management of the service see the service they provide in the same way that we see it. The form was well completed and the manager was able to tell us what plans there were to develop the service. All of the key inspection standards were assessed at the site visit and information was taken from various sources. This included observing care practices, talking with people who use the service, their relatives, the manager, a senior manager and other members of the staff team. Three people were looked at in detail to learn about their experience of the service from when they first used it to the present-day. A selection of records were looked at, including medication records, training records and care records. What the care home does well: What has improved since the last inspection? The way that people were supported to take their medication had improved. The manager and staff had worked hard to make sure that they met recommendations made about medication at the last inspection. Although there were still some more improvements they could make, the manager was constantly making spot checks to make sure that all was well. The way that the service records and meets peoples nutritional needs and any special diets was very good. Since the last inspection, the menu had been improved to provide choices at every meal. This included a full English cooked breakfast every day, spending more money on food and having more home-made dishes and avoiding convenience food. These improvements were pleasing to the people who use the Care Homes for Older People Page 8 of 30 service and all five people who filled in surveys either always, or usually, liked the meals at the home. One person said that the meals were marvellous. The environment of the home had improved a lot since the last inspection, as the home was being refurbished. This included replacing all the carpets, all the internal doors, all the beds, all the soft furnishings and tiling bathrooms. The service had recruited a full-time administrator to do some of the paperwork, so that the manager could spend more time with people who use the service and staff. 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 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given information, and have their needs assessed before moving into the home, so they know that their needs can be met. Evidence: Wherever possible, people who use the service receive information prior to their admission to allow them choice. This was evident from information received in surveys filled in by five of these people. Four of these five people said that they had received enough information about the home before they moved in so they could decide if it was the right place for them. The exception to this was the occasions when people were admitted for short-term periods of care as an emergency admission from the community, as was the case for the fifth person who had filled in a survey. When emergency admissions did occur, it was seen that the staff rely on the Social Services Assessment intially, and begin their own assessment of the persons needs and progress when they are admitted. This information is then used to form the care plan. Care Homes for Older People Page 11 of 30 Evidence: One persons relative said that this person initially came into the home for a short stay and that the assessment of this person was done in their own home by the staff before the admission. This person said that their relative made their own decision to stay following the short-term stay at the home. All five staff who completed a survey said that the ways in which information about people is passed between staff always, or usually, worked well. One member of staff said, Staff discuss between them any problems which people may have, by discussing this we can draw up solutions which can help for future problems which may arise. Another member of staff said, We ensure that all people receive correct care assessed for. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs were met in the way they preferred and with respect for their privacy and dignity. Evidence: At the time of the visit to the home, the manager and staff were writing new care plans for all the people who use the service, alongside the existing care plans. The manager and a senior manager explained that the organisation wanted them to record each persons needs on a new care plan form, which prompted and encouraged staff to record more detailed imformation. When looking at the new care plans for three of the people, it was seen that the form was designed to provide more detailed information, which included details of a persons physical and mental health, mobility, aids and adaptations needed, weight, medication details, range of risks including the risk of falls, allergies, culture and religion. The care plans then gave staff instructions on how to meet each persons needs in the way that the individual wanted. In the AQAA, the manager stated that Care Homes for Older People Page 13 of 30 Evidence: people undergo regular health and social care reviews. This was found to be the case in the care plans seen. It was obvious that the manager and staff were at an early stage of getting used to the new forms. A senior manager agreed that the manager and staff did need more intensive training to enable them to fill in the new care plans well. It was also obvious that the manager and staff were skilled in recording peoples needs as there were lots of examples of good practice in the existing care plans and some aspects of the new care plans. This included very detailed information about peoples nutritional needs, the way that the skin of frail people should be cared for, and a wide range of risks, including the risk of falls. The manager and staff concluded that the confusion as to where to put information was affecting the care plan detail and that they needed time to get used to the new forms. The process of introducing these new care plans was not affecting the way that peoples needs were met. People and their relatives who spoke about their care, were all pleased with the way their needs were met. One persons relative said that the manager, relatives communicates well with relatives, and added that they and their relative were involved in the care plan and any treatment planned, which they appreciated. This persons relative concluded that the staff, tell us everything. People who filled in a survey were also happy with the care they received. All five people said that they always received the care and support they needed, that the staff always listen and act on what they say, that the staff are always or usually available when they need them and that they always receive the medical support they need. Medication policies and procedures were in place and staff were about to have more training in the administration of medication. Medication is administered by the manager, deputy manager and three senior carers. There were lots of examples of good practices which ensured that medication was given safely. Examples included completing a weekly medication count and monthly audit. Random spot checks were also made by the manager on the way that staff give people their medication and any things they needed to learn were recorded and discussed with them. The manager and staff had also worked hard to make sure that they met some recommendations made about medication at the last inspection. Only one person managed their own medication and this person said that they were satisfied with this arrangement and that staff checked that all was well regularly. This person was seen to have a lockable cupboard to store their medicaton. Although the way that medication was managed was good, it was recommended that a risk assessment is done when someone looks after and takes their own medication and that staff only sign a medication record to say that a person has been provided with Care Homes for Older People Page 14 of 30 Evidence: their medication supply, rather than a record which suggests that the staff are administering the medication. It was also recommended that the manager talks to the pharmacist to request that when a person is no longer taking a certain medicine, including different types of painkillers, that the record of this medication is taken off that persons medication record, to avoid any confusion. The manager and a member of staff were seen to support and reassure a distressed person very well. this person was having a short stay at the home whilst their partner was ill. The manager and staff member answered the persons questions about when they were going home honestly and demontrated repect and consideration for the persons feelings. People who use the service did feel that staff respected them. One person said that they chose to stay in their room and that staff, respect privacy and always knock on the door before entering the room. Another person said, The Queen does not get this much respect. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from choices to enable them to exercise day to day control over their lives and enjoy the food of their choice. Their social life would be enhanced by extending the range of activities. Evidence: The manager said that information about peoples daily life and social activity were obtained on admission by recording a social history. Examples seen gave details of family life, past employment, hobbies etc. This information helped the staff to understand what was important to an individual. The manager agreed that while staff were getting used to the new care plans, there were some gaps in information about daily activities and social needs that must be addressed. The service holds a record of activities which included baking, movies, arts and crafts and singing. Of the five people who completed a survey, two people said that there are always activities arranged by the home. The other people said that there were sometimes or never any activities. The manager said that providing social activities was something that the service needed to improve. She explained that she was addressing this by the recruitment of an activities organiser, who was about to start Care Homes for Older People Page 16 of 30 Evidence: working at the home. The manager said that a Roman Catholic Priest visits every week to give people communion and a Church of England Minister visits monthly to provide a service. It was evident that the service aims to support people to follow the religion of their choice. The manager said that she gets information about peoples choices by speaking to people every day, and through meetings with people and questionnaires they have filled in. Records of the outcomes of these meetings and some questionnaires were seen and it was obvious that the manager and staff encourage people to make choices. A good example of a person making choices was described by the manager. The person concerned had told the manager that they wished to fly on a plane for their 100th birthday as they had never done this before. The manager organised this and this person flew on a glider and was on television. Photographs of this happy event were seen. Care plans had lots of details of each persons nutritional plans and assessments and any special diets. Since the last inspection, menus and been completely reviewed to provide a four-week rotating menu with choices at every meal. Some recommendations made at the last inspection about menu choices had also been addressed to improve choices for people. The home provides a full English cooked breakfast every day and all menu choices were recorded on menus kept on the dining tables. The manager said that they had also changed suppliers, increased the food budget, improved the level of home-made dishes and reduced the use of any convenience packets. The improvements in meals were pleasing to the people who use the service as all five people either usually (1) or always (4) liked the meals at the home. One person said that the meals were marvellous. All the relatives of the people who used the service said that they were always made welcome at the home. This is good at it enables people to maintain their family relationships. Care Homes for Older People Page 17 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were confident that the manager and staff would listen to their concerns and staff training in the protection of vulnerable adults ensured that people were safeguarded from abuse. Evidence: The complaints procedure was seen to be in the Service User Guide and was also seen to be displayed on the back of every persons bedroom door. All five people who filled in surveys said that they always knew who to speak to if they were not happy and that they knew how to make a complaint. One person explained that if they had any problems they would contact the manager who was, very approachable. This persons relative said that the manager, communicates well with relatives. All the people spoken to, and their relatives, talked about not hesitating to bring any concerns to the attention of the manager. There was a complaints record and it was seen that the last time the outcome of a complaint was recorded was in July 2007. During the visit to the service, two people made reference to complaining to the manager and said that the manager dealt with their problem immediately to their satisfaction. The manager agreed that she tends to deal with complaints there and then and resolve them and doesnt always record the outcomes. This was evident from the comments of people and relatives, and it was apparent that this was not having any impact on people who use the service. However, Care Homes for Older People Page 18 of 30 Evidence: during a discussion, the manager agreed that it would be better to record these issues so that any patterns in problems could be identified. The Protection Of Vulnerable Adults (POVA) policy was seen to be accessible to the manager and staff. The manager had attended training specifically for managers in the protection of vulnerable adults, which was provided by the local council. On the day of inspection, four staff, including two new staff, were on training about the protection of vulnerable adults. The manager and staff demonstrated an understanding of how to safeguard people from abuse. People spoken to talked about feeling safe at the home. One person talked about feeling secure and added, I feel safe, oh yes. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefited from a warm, clean, safe and well maintained environment that had been significantly improved. Evidence: In the AQAA the manager stated, The feedback we receive from both service users and their families is that the home has a nice feel about it. The environment is, however, tired therefore the home is undergoing refurbishment. During the visit, it was seen that the process of refurbishment was ongoing. Progress already made included replacing all carpets, all internal doors, all the beds, all soft furnishings, replacing lighting with modern fittings, and tiling bathroom areas. This had resulted in a better environment for the people who use the service. All five people who filled in a survey said that the home was always fresh and clean. The manager holds detailed cleaning records for the kitchen and all areas of the home, which staff sign to confirm that cleaning has been done so that the cleanliness of the home can be monitored. Each person has a safe in their room to store valuables. There are four double rooms at the home, three of which have a privacy screen. The manager said that a portable screen is used in the fourth room, but it was not in the room at the time of the visit. The manager agreed that it would be helpful to put a more permanent screen in place Care Homes for Older People Page 20 of 30 Evidence: to preserve privacy at all times. Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from support provided by experienced and committed staff who they trust. Aspects of the recruitment procedure are not always robust enough to protect people and this was recognised by the organisation. Evidence: The way in which staff are recruited at the service was assessed by looking at the files of the three staff who were recruited most recently. Staff files were found to be well organised by using clear indexes. Some of the information on staff files was well recorded and photographs of staff and copies of important documents which identify staff, e.g. their passport, were held. Criminal Record Bureau checks (CRBs) were also being done for all staff. However, when staff started employment after an initial POVA first check, which is an initial check that is done while awaiting the outcome of the CRB check, evidence that this had been done was not always held on the staff file. Some other aspects of the way that staff were recruited also needed to improve. In particular, the service did not always make sure that they took a full employment history, so that they could identify any gaps in the declared employment history and references taken were not always appropriate. This included one file having a reference from an employer that was not named on the employment history, not always obtaining a reference from the most recent employer and several examples of Care Homes for Older People Page 22 of 30 Evidence: references being obtained from friends. The manager was advised of the need to consistently check references and check for gaps in the employment record in order that people are protected. In the AQAA, the manager said, Our staffing levels are kept to an optimum to ensure that our service users receive individual attention. It was observed that when a person pressed their call bell, the staff attended immediately. This person said that the staff always answered call bells very quickly and the five staff who completed surveys said that there was always enough staff to care for people. It was obvious from the comments of people who use the service who filled in surveys and talked about the staff, that people were very happy with the way that staff supported them. One person said that, The staff are wonderful, ever so kind. Another person said, All staff are very helpful and happy at the home. A third person concluded that the staff, treat us really well. The relatives of people who use the service spoken to were also very pleased with the staff. One persons relative said that staff were, quite nice and friendly. Another persons relative said that the staff are superb. Staff at the home do have an induction. Examples of the homes own induction record and the Skills For Care induction record were seen. Staff had an individual training record on their staff file and the manager also provided a copy of the training matrix, which shows the training that all the staff have taken part in. Training courses attended by the staff included infection control, moving and handling, fire training and the protection of adults from abuse. All five staff who filled in a survey about the service said that their induction covered everything they needed to know to do the job when they started very well, that they were well trained and that their manager meets with them to give them support regularly. In the AQAA, the manager said that the plans for improvement in the next 12 months were, Staff recruitment and training are an ongoing process and we will be keeping it monitored. The manager had improved access to training for staff since the last inspection and had also improved the frequency of staff meetings. Both the manager and the senior manager said that they were commited to improving staff recruitment practice to make it consistently safe. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People and their relatives were confident that the manager ran the home in the best interests of people who live there and that their safety and welfare were promoted. Evidence: At the time of the visit, the home was going through the process of changing the type of service they provided to include nursing care, as well as residential care, for people. Because of this, some of the policies and procedures and the care planning process had been amended. As noted earlier, changing the care plan format was providing some challenges for the staff. In the AQAA, the manager stated that the service has a new administrator who works full-time and can attend to some of the paperwork. The manager said that this enabled her to spend more of her time monitoring and assessing care staff and care procedures at the home. Care Homes for Older People Page 24 of 30 Evidence: The manager said the she was in the process of completing the Registered Managers Award. All the comments made about the manager by people who use the service, their relatives, and the staff, were very positive. One persons relative described the time when their relative was admitted to the home. This person said that the manager was, amazing at this difficult time and added that the manager, does try hard and, she knows whats going on with the staff. This relative concluded that the staff look after their relative, they really do. Another persons relative said that the home is, fantastic, and that the manager is excellent. A third persons relative said that coming into the home was, The best thing that ever happened to (their relative). All interactions between the manager and staff and between the manager and people who use the service were seen to be very appropriate and professional. One example was the observation of the manager reassuring a person using the service in an honest, reassuring and respectful way. The manager and deputy manager talked about the arrangements for management and security of money belonging to people use the service. They explained that people pay the fees to the service by direct debit and that the policy of the service is that people manage their own money wherever possible. The manager and deputy manager said that for those people for whom this was not possible, their family supported them to manage their money, or, as was the case for six people, Court Of Protection arrangements were in place. Each person was seen to have a safe in their room. The manager explained that each safe has its own personal code to increase the security arrangements, and so that there were no keys that could be lost. The deputy manager explained that if people needed things buying for them, including toiletries, they or their families gave the manager or deputy manager some money, so that they could make the purchase on the persons behalf. The deputy manager confirmed that the receipt is then given to the person, their relative, or whoever is dealing with their financial arrangements. The manager and deputy manager were very clear that they do not manage peoples money for them and that peoples independence was promoted. The manager used both informal and more formal quality assurance processes. The informal process included talking to people on a daily basis to asked their opinions and holding resident and staff meetings to get peoples views on the way the home was run. The more formal process involved people who use the service and staff completing questionnaires about the way the service is run. Questionnaires had been completed in November 2008 and the manager was in the process of collating this information, so that the views of people influenced the way the service was run. Care Homes for Older People Page 25 of 30 Evidence: Some of the services maintenance records and fire records were seen. Fire safety checks were up-to-date and a fire risk assessment was in place to protect people from the risk of fire. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 19 The manager must make 06/02/2009 sure that a detailed employment history and appropriate references are consistently taken. This is necessary to ensure that people who use the service are supported by staff who are being vetted to ensure the protection of people. 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 It is recommended that the manager and staff are given training in the completion of the new care plans. This is important so that they continue to use their skills to make sure that peoples needs are recorded and met. It is recommended that a risk assessment is done when someone looks after and takes their own medication, and that staff only sign a medication record to say that a person has been provided with their medication supply, rather than a record which suggests that the staff are administering the medication. It is also recommended that the manager talks to the pharmacist to request that when a Page 28 of 30 2 9 Care Homes for Older People person is no longer taking a certain medicine, including different types of painkillers, that the record of this medication is taken off that persons medication record, to avoid any confusion. This is necessary to ensure that people receive their medication safely. 3 12 It is recommended that the range of activities of the home is reviewed and extended to better meet peoples social needs. It is recommended that the outcomes of all complaints are recorded in the complaints record, so that the manager can note any reoccurring problems and can assure people, in writing, that their complaints have been addressed. It is recommended that screening is always available to maintain privacy in double/shared bedrooms. 4 16 5 19 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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. 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