Inspection on 08/12/07 for Choice Care Home

This inspection was carried out on 8th December 2007.

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

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

Other inspections for this house

Choice Care Home 27/09/06

Choice Care Home 04/10/05

Choice Care Home 16/06/05

Choice Care Home 22/02/05

Choice Care Home 25/05/04

Choice Care Home 15/01/04

Choice Care Home 16/07/03

Choice Care Home 06/08/02

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

CARE HOMES FOR OLDER PEOPLE Choice Care Home Cary Avenue Babbacombe Torquay Devon TQ1 3QT Lead Inspector Douglas Endean Key Unannounced Inspection 09:50 8th December 2007 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 Choice Care Home DS0000018337.V342816.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. Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Choice Care Home Address Choice Cary Avenue Babbacombe Torquay Devon TQ1 3QT 01803 403026 01803 403026 Choice-carehome@hotmail.co.uk www.choicecarehome.co.uk Rosepost Healthcare Ltd 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) Mrs Lorraine Cunningham Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (24), of places Physical disability over 65 years of age (24) Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th September 2006 Brief Description of the Service: Choice Care Home is situated on the level to the small shopping areas of Babbacombe and St Marychurch, about 2 miles from the centre of Torquay. Close by is also Babbacombe Downs which has magnificent views out to sea. The home is a large detached property with ample parking at the front and level access into the home. There is an attractive enclosed garden area at the rear of the home that has seating for use in good weather. There are 18 single rooms and 3 double rooms spread over three levels, those above ground floor being accessible by stair lifts. All but one single, the respite room, and one double, have en-suite facilities that vary from a toilet to full domestic bathing facilities. Every room has a wash hand basin either in the ensuite or in the room itself. The home is registered to provide personal care to a maximum of 24 older people who may have a physical disability or suffer from dementia. The home is laid out over 3 levels, ground, mezzanine and first floor. In terms of communal space, the home has a large lounge, 2 conservatories, and a dining room. Fees commence at £340 per week. Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place on the 8th December 2007 beginning at 09:50 hours and lasted approximately 4.5 hours. Initially we (the Commission for Social Care Inspection) spent time in discussion with the Registered Manager and looked at the records that showed how care was delivered, and the business of the home managed. We looked at the records of 3 people who live in the home, 3 staff files and several samples of records, policies and procedures to establish the needs of the people in the home and how the home has prepared itself to meet them. In addition to the above process we spoke to 2 staff members, and 3 people who live in the home the Commission for Social Care Inspection had sent survey forms to the home when the Annual Quality Assurance Assessment was sent. We received 3 completed staff survey forms, 1 from a person living at the home, and 7 from relatives. The Annual Quality Assurance Assessment form that was returned by the Registered Manager had been completed to a high standard. We made a full tour of the home looking in bedrooms, and meeting more people who live in the home. We also discussed the main meal that people had just completed in the dining room, looked at the kitchen, laundry and other facilities such as the bathrooms. What the service does well: The home is very well presented being clean, uncluttered, and well decorated in an attractive and homely way with comfortable furniture and nice fixtures and fittings. It also is adapted so that people who have a disability can use the home in relative safety. The records that show how care is planned and then received were very good as were the general records about staff, and the business management of the home i.e. maintenance records, building risk assessments, etc. The people in the home looked happy and comfortable. Those who had higher care needs had their care planned well. They had suitable equipment that was monitored for its appropriate use in supporting the care package such as pressure relief mattresses. The way the home has approached staff training, from induction onwards was also excellent and the staff we met were more than satisfied with the training they had received and the work environment. Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 1, 2 & 3. Standard 6 does not apply. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information available to anyone considering admission to the home is well written and comprehensive. The home has gathered suitable amounts of information about everyone that is referred to them, before agreeing to their admission. EVIDENCE: The home has their statement of purpose on display in the front entrance of the home with the signing in book. It has been updated since the last inspection and now holds current information about the home and its management. It also has all the information required of it by the regulations including having a copy of the complaints procedure. There were the contact Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 9 details of advocacy services at the back of the information folder including Age Concern. The Registered Manager provided the website address for home so that people can gain information about the service from the Internet, www.choicecarehome.co.uk. The file also has a copy of the last inspection report and many letters of thanks from families and friends of people who have lived in the home. The contract was read and we saw that it included information about the fee that is charged and what is included in the charge and what is not included. It states that the first 4 weeks are considered to be a trial period followed by what the normal period of notice is to be after that. We saw completed contracts in a sample group of files that were chosen at random. The Registered Manager or Registered Provider are normally the people who will carry out the pre-admission assessment, which takes place at their present place of abode such as home or hospital. They use a format that has been produced by the home. It is a document that obtains information about an individual’s physical and mental health status including continence, sight, mobility, and history of falls, dietary requirements and likes and dislikes, mental health state, and any medication that the person may be on. It also gathers information about their ability to manage personal care and any current family involvement. The person that is to use the service, and their relatives or advocates, are all asked to contribute to the assessment. The completed assessments we saw were signed and dated by the assessors. We read the files of 3 people who live in the home and found that the preadmission assessments had been completed fully on each of them. The home also has other information from health care professionals, external to the home, which helped them make their decision to accept the admission. Once all the information is gathered the home completes a formal dependency rating that forms the basis for every assessment that is carried out in the future. The Registered Manager will carry out a further assessment in hospital on anyone who has been hospitalised and is due for discharge to return into the care of the home. Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 7, 8, 9 & 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The process used in planning care is thorough and recordings are excellent. The staff treat the people who live in the home as individuals, and with dignity and respect. EVIDENCE: We looked at 3 files belonging to people who live in the home. The structure of each file was excellent and described as “person centred approach”. The files began with the personal details of the person followed by a story of their personal history that has been gathered from several sources during the period of the admission. It included such things as photographs of family where they had been made available, likes and dislikes in childhood and adulthood, and things they remember. The name by which someone prefers to be addressed is recorded along with good events in their life that they would be happy to Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 11 recall. We saw one comment written in a file that showed that the approach was indeed centred on the individual “Can be embarrassed if asked to visit the bathroom in front of others. Important to make the right approach to maintain privacy and dignity”. The care plans were written in a very clear format along side evidence. They include input from the person they are about and their advocate, the key worker, the Registered Manager and healthcare professionals where they have been involved. The files each had a problems index making navigation to an issue easy. They were initially formed using the information gained in the preadmission assessment and subsequent risk assessments i.e. falls. Each issue that had been identified was fully risk assessed. The risk assessments had additional information such as one about volatile behaviour that had a section, “When do you walk away”. Falls risk assessments had the assessment, reviews and a falls record. This in turn informed the dependency score. The plan of care then followed this risk assessment. This process flowed through each set of files providing a trail from problem through to action and then monthly review. The actual plans are written using a software program that this home, and others in the group, has purchased that is a complete home management package. We saw in the files that where a health care professional had visited an individual, or provided information such as a part of their history, it was also clearly recorded in the persons file. The daily record would begin the process and the Registered Manager also has completed records of General Practitioner, District Nurse and Community Psychiatric Nurse visits. The staff also have a total of 3 handovers a day that keep the staff informed about the current status of everyone being cared for at the home. The home uses a monitored dose system for medication. The supplying pharmacy makes up packs of medication that are to be given out at different times of the days. The packs have colour coding to help the person administrating medication know what time of the day the drug is to be given. There were clear records made of what had come into the home, what had been administered and what had been returned to the pharmacy. The administration sheets had photographic identification for safety as many of the people who live in the home do suffer from dementia. The medication was stored in locked cupboards within a locked room. Staff who manage medication have had formal training by a major pharmaceutical company that was verified during the inspection. The training included a questionnaire that tested the individual’s knowledge at the end of the training. Staff are then shadowed by a competent person until they too are competent. On just a few occasions staff had not filled in the box on the administration sheet when a drug had not been given and we have recommended that this be done. Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 12 The home does allow self-administration of medication but again this is only after discussion and risk assessment has taken place. Suitable storage is then provided and the staff will monitor the situation. During the inspection we notes that people were treated with dignity and respect. They wore their own cloths, and received personal care in the privacy of their own rooms or in locked bathrooms. Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 13 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): The homes performance was assessed against Standards 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The activities that are provided are suitable for the people who live in the home and have a therapeutic and entertainment value. The meals are nutritious, well presented, and enjoyed by the people who live in the home. EVIDENCE: From the first point of meeting an individual who is to be admitted to the home the staff are obtaining information about them so that they know them as individuals who have history. They gather the everyday information such as the food they like and don’t like but add to this by having a history complied over time that records the good moments in their life that they would like to be reminded of. Knowledge of what they liked to do when a child through to adulthood is compiled as the information is made available. The information is used when having day-to-day contact with the individuals, in conversation and when planning meals and activities. Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 14 The home employ a Occupational Therapist one day a week who does have one-to-one sessions with people who need that level of contact. She also works with groups doing crafts and a game she has designed called musical bingo among other things. We saw a record of the activities people are engaged in when reading a sample of people’s files. The people who live in the home also take part in activities that the staff take part in such as cards, bingo and walks to the shops. In planning activities the staff consider any problems that individual may have such as memory problems, sight, hearing and mobility problems. The home has a mini bus that they share with the sister home that has wheel chair access and is used for trips out in good weather. The Registered Manager has held residents meetings and pursued topics. She has asked them what they wanted to do for Christmas with the result being a planed event that was displayed on the notice board outside of the Registered Manager office. The Annual Quality Assurance Assessment, a document required by the Commission for Social Care Inspection that allows the home to assess their own performance, and also tell us about plans they have, was received before this inspection. The Registered Manager has written that the library has a “reminiscence box scheme” and that the people in the home, “were fortunate enough to be the first ones to make use of the service”. She said that this activity appealed to those particularly with a sensory impairment as it had thing that people could touch and smell. They intend to use the service again and explore other ideas to improve the variety of activities that they offer. Independence is also encouraged in the way people decorate their rooms. During the tour of the home we saw that each room was personalised to the liking of the person who lived in it. Visiting is open so that people can come to the home at any reasonable time. In the Commission for Social Care Inspection survey of relatives and friends we received very positive comments about the home and the welcome people receive. One person wrote,” As soon as you enter the home you are welcomed by a member of staff who are always friendly. Coffee and biscuits are set up just after my arrival, which is much appreciated. The whole place has a nice feeling about it”. Another said,” The staff are friendly and cheerful. The home looks and smells nice. The food looks appetising.” One person did comment that they the staff interact with the people who live in the home well. “They play records and CD’s relating to peoples requests, memories of days gone by. They encourage them to pursue hobbies and interests. They have an excellent Occupational Therapist every Friday afternoon.” Finally another person did comment that if funds were unlimited they would like the home to provide more in house entertainment, craft sessions and something to stimulate the mind. The home does not manage the financial affairs of any of the people who live there. The home does not hold any money on behalf of the people who live Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 15 there either. Items will be bought for them by the home as they are needed or requested and the home will invoice the person responsible for managing their affairs. We saw evidence of this system with receipts for such things as hairdressing and papers awaiting collection by visitors for payment. The Registered Manager has a nutritional assessment on each person who lives in the home. Everyone is weighed monthly and we saw evidence of that. If there is nutrition issue because of ill health or swallowing problems the home have specialist assessments carried out and nutritional supplements provide in conjunction with the General Practitioner. Their knowledge of the individual likes and dislikes the kitchen assist in the production of meals that people will eat. The home has also used various Internet sites to help them in the production of a nutritious diet. We talked to 3 people immediately after dinner who said that they had enjoyed their dinner, although 2 could not immediately remember what they had eaten until prompted by others. An inspection of the kitchen, and discussion with the cook for the day showed that it is a well organised facility, care staff do not enter the cooking area, and the records are in line with the, “Safer Food, Better Business” practises. There were very good stocks of dry foods and vegetables in the storeroom. Meats and vegetables are purchased fresh from local butchers and green grocers. Meals are taken either in the dining room or one a tray in the person’s own bedroom. Where there is an issue over fluid intake we noted that the home do record a persons fluid intake and output. Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 16 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): The homes performance was assessed against Standards 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure and process of investigation, is good. The home has good recruitment and vulnerable adults training so that staff are aware of what signs to look for and how to report their observations. EVIDENCE: The home has a complaints procedure that complies with the Regulations in that it does include information about how to contact the Commission for Social Care Inspection if a person is not satisfied with how the home has addressed a complaint. It also has a time scale for responding to the complaint. The procedure is displayed in the front entrance of the home in the Statement of Purpose. In addition to the procedure the home has a complaints form. This invites a complainant to provide information about their complaint and then has space for the Registered Manager to make their own records of the action taken and outcome with space for the complainant’s signature when the issue is resolved. The Commission for Social Care Inspection has not dealt with any complaints since the time of the last inspection. The homes recruitment procedure is their first line of protection for the people who live in the home. The section on “Staffing” has reported in more detail Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 17 about this, in brief the procedure is through and provides safeguards through good selection of staff. In addition to this new staff have a good induction into the working practices of providing care and protection of the people who live in the home from any form of abuse. We saw proof that staff have had “Protection of Vulnerable Adults Training”, which is carried out by the home using a training program they have purchased that uses DVD and study notes and questions. This is in addition to the use of the “No Secrets” video and the Alerters Guide. The home have included in their record keeping arrangements body mapping so that any mark that appears on a person who lives in the home can be recorded along with any supporting information. This includes the use of the homes accident record that was clear and thoroughly used, the date time place and witness of any incident being recorded. Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 18 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): The homes performance was assessed against Standards 19, 20, 21, 24, 25 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides an environment that is clean, attractive, homely and fit for purpose as a result of adaptations that have taken place. EVIDENCE: Choice Care Home is situated on the level to the small shopping areas of Babbacombe and St Marychurch, about 2 miles from the centre of Torquay. Close by is also Babbacombe Downs which has magnificent views out to sea. The home is a large detached property with ample parking at the front and level access into the home. There is an attractive enclosed garden area at the rear of the home that has seating for use in good weather. Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 19 There are 18 single rooms and 3 double rooms. All but one single, the respite room, and one double, have en-suite facilities that vary from a toilet to full domestic bathing facilities. Every room has a wash hand basin either in the ensuite or in the room itself. There is a large bathroom on the ground floor that includes a modern disable bathing facility with integral hoist and shower system. Although water temperatures are regulated at source to prevent scalding we saw that the temperature of all baths that are drawn are tested and recorded. Another bathroom is available on the first floor that is more domestic in design but also has a floor mounted hoist to assist people if necessary. The bedrooms were of various sizes but all were attractively decorated and furnished. People had chosen to use some of their own personal items to make their room homely to themselves. All rooms also had a nurse call system and also a television. Many windows had double glazing units and the windows were fitted with restrictors to prevent them opening beyond a safe limit. All the radiators were guarded to prevent burns. On the ground floor there was a very comfortable lounge without a television. This led into the dining room that was nicely laid out with separate tables for small numbers of people. Off the dining room there was a conservatory that also had a television in it and ceiling blinds to make the room more comfortable from heat and glare in the summer months. A second conservatory is available on the side of the building past the office, which is opposite the lounge. The kitchen was also off the dining room. It was made up of 2 areas, food preparation and cooking and washing area. Staff could deal with dirty dishes without walking though the food preparation and cooking area. There is a staircase in the foyer that has a stair lift to the mezzanine floor. Another chair lift is available for the next 5 steps up to the first floor. The whole home was clean, free from clutter or odour. There is a laundry room in the basement that has a washing with a sluicing cycle and a dryer. The facilities are satisfactory and fit for the purpose. There is also a food store in the basement, not sharing the same room as the laundry, which had good stocks of food. We saw that the home has good records of the maintenance that is carried out and was reported on in the Annual Quality Assurance Assessment. Information that was provided was verified by looking at the service records and also the homes Health & Safety assessment report that has been up dated for 2007. Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 20 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): The homes performance was assessed against Standards 27,28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment and training of staff is good. There are sufficient numbers of suitably trained staff on duty at all times. EVIDENCE: The home employs staff in satisfactory numbers to manage the care of the people who live in the home during each day. The rotas showed that there is always a senior carer on duty at all times. The Registered Manager is on duty during office hours and does take part in care duties as was seen during this inspection. The home also has support staff such as catering and domestic who make up the team. The recruitment procedure was looked at and 3 staff files were read. We saw that the procedure had been followed and that the home obtains a completed application form, 2 references, proof of identity and a Criminal Records Bureau and POVA first on all new staff. We saw evidence that staff receive a contract of employment as copies were in the staff files we read. The staff also receive the General Social Care Council information on the Codes of Conduct that Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 21 inform them what is expected of them and also their employer. There is a staff handbook that is available in the office and covers all manner of subjects to do with employment, care and home management for all staff to read. The staff have a through induction that is ongoing until the new staff member has received the first level of training to enable them to carry out their work. The training is initially done under the supervision of an experienced carer in the home. We witnessed a small part of the induction as a new person had begun their work on the day of the inspection. All induction training is recorded in a booklet for each member of the staff, dated and signed by the instructor and the trainee when they are competent at a subject. The training is guided by two professional formats that cover all issues necessary to prepare people for the job they are to do. The Registered Manager is a competent trainer in many subjects including moving and handling. The staff files also record information about the training an individual has had prior to their employment at the home as well as that carried out in the home. Including the Registered Manager who has a National Vocational Qualification at level 4 in care, there are more than 50 of staff with a National Vocational Qualification in care. Those staff who do not have a National Vocational Qualification are working towards the qualification. Much of the training is carried out in the home following various programs. The home has purchased a professional training package that includes DVD’s and information to prepare the trainer. The Registered Manager is the trainer and following the instructions she delivers a subject such as adult protection. The DVD can be stopped at any point for discussion to take place, and at the end of the training the staff complete a questionnaire to verify that they have understood what has been taught. We saw that staff receives training in other subjects such as infection control, Health & Safety, dementia and fire training. The Registered Manager has completed a Fire Managers course. Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 22 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): The homes performance was assessed against Standards 31, 33, 35, 36 & 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed, by a competent person, who uses the resources at hand to meet the needs of the people who live within the safe and comfortable environment. EVIDENCE: The Providers have over 26 years experience in running care homes and nursing homes. They now have 3 homes in the area of Torquay. The Registered Manager has many years experience in the care industry, in different age groups and specialities. She holds the National Vocational Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 23 Qualification at level 4 in care and the Registered Managers Award. She is a very organised person with respect to the way her home is managed and records are kept. We found that the management of the records for the people who live in the home, staff, and the business management were easy to access, clearly written, and well constructed. She was able to find any information that we required for the inspection quickly and easily. It was always through and well presented. She was also able to show that she is a competent trainer using the professional materials she has in the home, and the Internet. She has used the Internet to obtain information about individual subjects to inform herself and the staff about how to meet the individual needs of some people who have very special care needs as a result of their medical condition. She also uses the recourses of the health care community to provide care that the staff in the home cannot, such as the District Nurse and General Practitioner. We saw how she related to staff and the people who live in the home. She was approachable and confident in her duties. She carries out supervision with her staff who first are invited to complete a form that will guide the session. The same form than is used to record what has been discussed and the action that is to follow. At the beginning of each session the staff member is asked to comment on whither the goals set at the last session had been met. We received just 3 completed staff survey forms. One reported that their supervision experience was positive whilst the other felt that it was not saying, “Once supervision has been undertaken nothing further comes of it”, this was not supported by the staff files that were read, or the 2 staff who were interviewed. One person who had recently commenced work at the home said that she had a full induction and also received 9 separate training events in the few months that she had worked at the home including POVA, food hygiene, and first aid. The Provider and Registered Manager have a number of Quality Assurance measures. The home has the Investors in People Award and is working towards fulfilling the requirements of the next review. There are also questionnaires that obtain the views of the people who live in the home, their relatives or advocates, and anyone who might visit the home such as the General Practitioner and District Nurse. We saw examples of the results and how the Registered Manager has carried out an analysis of the results, and reported on the outcomes. The home does not manage the financial affairs of any of the people who live in the home. They do purchase items and services required by individuals, such as chiropody, hairdressing and items of clothing, and then invoice the person or their advocate for the money. We saw evidence of how the home manages this arrangement and that is was satisfactory. During the course of this inspection we saw that the home was very well managed and that they were able to provide evidence of this. The people who Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 24 live in the home were well cared for by staff who had been trained to meet their needs. The home was in good condition and had suitable equipment that was appropriately serviced, records being seen to prove that a competent person had done this. The environment had been risk assessed and risks managed appropriately to make the home safe to live and work in. Choice Care Home DS0000018337.V342816.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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 3 3 3 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 4 X 4 Choice Care Home DS0000018337.V342816.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. 1. Refer to Standard OP9 Good Practice Recommendations Staff should be reminded to fill in all boxes on the medication administration charts even when a drug is omitted, to show why. Choice Care Home DS0000018337.V342816.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Choice Care Home DS0000018337.V342816.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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