Inspection on 26/01/09 for Codnor Park Residential Home

This inspection was carried out on 26th January 2009.

CSCI found this care home to be providing an Excellent service.

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

Codnor Park Residential Home 05/02/07

Codnor Park Residential Home 21/06/06

Codnor Park Residential Home 05/12/05

Codnor Park Residential Home 01/06/05

Codnor Park Residential Home 02/11/04

Codnor Park Residential Home 11/05/04

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Codnor Park Residential Home 88 Glasshouse Hill Codnor Ripley Derbyshire DE5 9QT     The quality rating for this care home is:   three star excellent 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: Susan Richards     Date: 2 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. that people have said are important to them: They reflect the things 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 33 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 33 Information about the care home Name of care home: Address: Codnor Park Residential Home 88 Glasshouse Hill Codnor Ripley Derbyshire DE5 9QT (01773)741111 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Gerald Poxton,Mrs Sandra R Poxton,Mrs Ann Theresa Poxton,Dr Michael G Poxton,Ashmere Care Group,M Name of registered manager (if applicable) Linda Bexton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Forty as the number of residential places in the category Elderly Persons to include Five People with Physical Disabilities over the age of 55. Plus Four (4) Day Care Places Date of last inspection Brief description of the care home Codnor Park is a purpose built care home registered to provide personal care for up to forty people, male and female. Five of the forty places can be used to accommodated people with physical disabilities aged fifty five and above. Care Homes for Older People Page 4 of 33 care home 40 Over 65 35 0 0 5 Brief description of the care home It is located in the village of Codnor, close to local amenities and on a main bus route, near to the market town of Ripley and within easy reach of the M1 motorway and Nottingham. Accommodation is over two floors, having thirty eight single and one double room and with all but two bedrooms having a wheelchair accessible en suite facility. There is level access to attractive well kept gardens with seating for people and also to a car park. There are also a number of environmental aids and adaptations to assist people who may have mobility problems, including a shaft lift, emergency call system, corridor hand rails, grab rails in wcs and hoists. There is a choice of lounge and dining rooms, including a library room and suitably located and accessible, communal bathing and toilet facilities. People are provided with personal care and support from a team of care and hotel services staff, led by the registered manager and with good external management support. Further information about the home and its services can be obtained directly from the home at the telephone number and address at the top of this report, or by email: derbys@ashmere.co.uk or alternatively by visiting the homes website: www.ashmere.co.uk Care Homes for Older People Page 5 of 33 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: three star excellent 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: For the purposes of this inspection we have taken account of all the information we hold about this service. This includes our annual quality assurance assessment questionnaire, AQAA, which we ask the home to complete on an annual basis in order to provide us with key information about the service. We also received survey returns from five service users and four staff. We received a number of comments from people who use the service. Here are some examples of these, The manager visited me in hospital before I came here and talked with me at length about my likes and dislikes and hopes for living at the home. And all the Care Homes for Older People Page 6 of 33 admninistration was very efficient. The care and support I receive is very good, I am happy here. I have had so much attention since I came last year. They have helped me get new spectables, a new set of teeth that fit properly and I have my feet attended to regularly by the visiting chiropodist. I enjoy the activities in the home and my family are made welcome. My family came from away recently and we had a big family get together here. They let us use one of the smaller lounges which was nice and private and with a buffett tea organised by the home, it was a lovely day. At this inspection there were twenty five people accommodated. We used case tracking in our methodology, where we looked more closely at the care and services that three people receive. We did this by talking with them, observation of staff interactions with them, looking at their written care plans and associated health and personal care records and by looking at their private and communal accommodation. We spoke with staff about the arrangements for their recruitment, induction, training, deployment and supervision and we examined related records. We also spoke with the manager, who has managed the home from our last key inspection, about the arrangements for the management and administration of the home and we examined associated records. All of the above was undertaken with consideration to any diversity in need for people who live at the home. At the time of our visit all people accommodated are of British white backgrounds and of Christian religion. The range of fees charged per week are are as follows. 324.00 to 456.00 pounds per week. Fees are dependant on peoples individually assessed needs and may include contributions from local authorities for those eligible for assistance with funding. Day care is fifty pounds per day. A bathing service is charged at ten pounds for non residents who wish to access this facility from the local community. What the care home does well: What has improved since the last inspection? What they could do better: This is a service which strives to continually improve and to ensure it keeps up to date with changes in practise and guidance concerned with the care of older persons. There are good systems in place for continuous self monitoring by way of an established quality assurance system. This means that the home knows what they do well, improvements they need to make and with clear plans that are regularly reviewed to determine these. At this inspection we have made only a small number of recommendations and with no requirements. Care Homes for Older People Page 8 of 33 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 33 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 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are very well informed, supported and consulted with throughout the admission process and their needs are effectively accounted for. Evidence: At our last key inspection of this service we judged that limitations in the recording of peoples needs may result in these not being met. We made a requirement about this, which is met at this inspection. In our annual quality assurance questionnaire completed by the home, they told us they ensure that peoples needs are fully assessed. And that they receive the information they need and have opportunities to visit the home before choosing to move there. They also told us about some improvements they have made over the last twelve Care Homes for Older People Page 11 of 33 Evidence: months and improvements they aim to make over the coming months. These include providing transport for people to and from the home when making enquiries or for day care and enabling greater access to service information for people via their company website. Also in ensuring that peoples individual mental capacity is routinely and formally considered within the assessment process and with the aim of sourcing appropriate independant advocacy where circumstances deem this to be necessary. At this inspection we found that all people accommodated were British white and of Christian based religion. People told us that they received the information they needed about the home when choosing to live there and that their needs are usually met. One person told us, The manager visited me in hospital before I came here and talked with me at length about my likes and dislikes and hopes for living at the home and all the administration was very efficient. We saw that key service information is provided in peoples own rooms and is also displayed in the reception area of the home. There is also a company brochure, which is given to people on initial enquiry. This provides useful information to assist people, including how to access independant financial advice about fees and also an impartial Care Home Comparison Questionnaire. The latter guides people as to what to look for when choosing a home and gives a scoring and comparison tool that people can use to help them shortlist their choices from homes they may have looked at. This guide also tells people that the homes service information can be provided in alternative formats as may be necessary and on request. People that we case tracked told us they were able to visit the home and choose their own room. That they were made welcome, with all their questions answered and able to bring in their own personal furnishings and possessions. They also told us that their needs are usually well met. Individual needs assessment records that we looked at were recorded in a person centred manner, were holistic and accounted for peoples personal safety and risk. The manager was in the process of introducing an additional record into each persons file to account for their actual capacity to consent and make key decisions about their lives. This showed us that the home keeps up to date with changes in legislation and practise. Care Homes for Older People Page 12 of 33 Evidence: Care Homes for Older People Page 13 of 33 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 care needs are well accounted for and met and their rights to dignity and privacy and to be treated with respect are upheld. Evidence: At our last key inspection of this service we judged that the content of care plans, where they were in place, was generally good and descriptive of peoples care needs. We made a requirement then that there must be regular auditing of care plans so as to ensure they account for all peoples assessed needs. This is met at this inspection. In our annual quality assurance questionnaire completed by the home they told us that peoples needs are effectively accounted for within their written care plans, which are regularly reviewed and formulated as per their risk assessed needs. They also said that they ensure peoples health care needs are met. That they are provided with the equipment they may need and are treated with respect and their rights to dignity and privacy upheld. Care Homes for Older People Page 14 of 33 Evidence: They told us about some improvements they have made, which we found were mostly achieved by this inspection visit. These related to improved systems for monitoring aspects of peoples physical health and in seeking to maintain and improve peoples access to specific healthcare professionals. This tells us that the home is able to identify improvements and seeks to act on these in peoples best interests. Information that we hold about the service shows us that the home always informs us of any significant incidents or events that occur concerning peoples individual health and welfare, including action taken by them to maintain these. At this inspection people told us that they always or usually receive the care and support they need, including medical support. And that staff listen and act on what they say. Treat them with respect and ensure their dignity and privacy. One person told us that the care and support they receive is very good and went on to say, I have had so much attention since I came last year. They have helped me get new glasses, a new set of teeth, which fit properly now and I have my feet attended to regularly by the visiting chiropodist. Another told us that the arrangements to support people to access to outside health care professionals is well organised. All people we case tracked told us they have the equipment they need to assist them with their mobility, which they said helps them to maintain their independence. One person told us that they used to have bed rails before their admission to the home, but said that they felt safe with the environmental arrangements in their room, including their bed position and a sensor type floor mat. The manager advised that the home has difficulties in obtaining inputs from relevant outside healthcare professionals for the purposes of risk assessments for the use of bedrails and that the home operate a policy of non use of these. We saw that peoples written care plans were in accordance with their risk assessed needs, with regularly recorded reviews and that these are audited on a monthly basis by the manager. We also saw areas where people had signed their agreement regarding some decisions they had made about their care, which they told us about during our discussions with them. However, these were not always consistent and we saw for one person case tracked, where a key decision and instruction recorded was made by their relative. It was not clear whether the person we case tracked was aware of this or had been consulted about this decision. Also care plans relating to specified arrangements for the management and handling of Care Homes for Older People Page 15 of 33 Evidence: peoples finances were not signed as agreed by them. However, we could see from speaking with the manager about these that work is being undertaken to develop more clear and consistent consideration of peoples capacity to make decisions and to consent to their care arrangements in accordance with the principles of the Mental Capacity Act 2005. This shows us that the home seeks to keep up to date with changes in practise and knows what it needs to do to address these issues. Of the people we case tracked, two people had chosen for the home to retain and handle their medicines on their behalf. One person had chosen to retain and manage their own medicine. Risk assessment and consent records were in place in respect of the latter, in accordance with the homes medicines policy. Although we found that the standard of recording could be improved in respect of clearly identifying what, if any potential risks there may be as a result of this and also by ensuring that the person completing this, signed so. We also saw that a written entry for medicines instructions made onto a medicines admnistration record sheet was not signed by the staff member writing this nor countersigned and dated by a witnessing staff member. However, we could see from looking at other medicines administration record sheets that this was an isolated occurrence. The medicines policy did not include any procedures for staff to follow in the event of any written instruction from a GP. Although staff spoken with were conversant with good practise in this event. In all other respects the arrangements for the ordering, receipt, storage, administration and disposal of medicines was found to be satisfactory and in accordance with the homes medicines policy and procedures and also recognised guidance concerned with the management and handling of medicines in care homes. We observed a staff member responsible for medicines, administering these to people, in a sensitive manner and in accordance with good practise guidance. And we saw from speaking to staff and examining training records that all staff responsible for the handling and management of peoples medicines are suitably trained to do so. Care Homes for Older People Page 16 of 33 Evidence: Care Homes for Older People Page 17 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Routines of daily living and activities are flexible and varied and suit peoples expectations and lifestyle preferences. People are provided with nutritious food, in pleasant surroundings, which usually accords with their preferences and assessed needs. Evidence: At our last key inspection we judged that the service provided by the home was respectful of peoples abilities and offered them choices in their everyday lives. In our annual quality assurance questionnaire completed by the home, they told us that they encourage people to take part in social activities in the home and strive to promote their preferred daily living choices and lifestyle expectations. That they also support people to maintain contact with their families and friends and encourage them to exercise their rights to control their lives, including their finances. They told us that they had improved by increasing their links with the local community and access for people to specific organisations and groups there. By promoting greater Care Homes for Older People Page 18 of 33 Evidence: involvement of peoples families and friends in events held at the home and by increasing their fund raising capacity for the the residents fund. They told us about improvements they aim to make over the coming months, in further developing opportunities for people to engage in social, leisure and recreational activities and with focus on staff training to better engage people who may be confused or have memory difficulties. At this inspection people told us there are usually activities they can join as they choose, with daily acivities and regular entertainments organised. People told us about their preferred daily routines and about some of the activities they enjoy. Examples given, ranged from quizzes, sing alongs, knitting, bingo, card making, music and movement, film days, coffee mornings, manicures, board games, outings with families and friends for meals and to the theatre, engagement in a local art group and also via the local Rotary Club. Two people told us that church services are held at the home on a twice monthly basis, including one for Holy Communion. Recent trips out included to the local garden centre and out for Christmas lunch and two boat trips were booked for coming warmer months. We saw during the course of our visit people engaged in a variety of ways, including a group quiz, soft ball throwing, music and individual hand nail manicures. People chose which lounge to spend time in and when and whether to go to their own rooms. One person told us that she likes to spend time knitting during the afternoon and another said they like to go to their own room then. We saw that many friends and relatives visited during the course of our visit and one person we case tracked told us they were planning to visit their friends for a meal over the coming weekend. Information about activities and entertainments are displayed on the residents noticeboard along with information about how to contact advocacy and the location of the residents phone. This information is also included in the homes service guide provided in each persons own room. We also saw that there is a separate well stocked library room and that art works by people living at the home via the local art group were displayed in the home. These had formerly been displayed at the local community hospital. People told us that they enjoy the dedicated hair dressing salon facility in the home and being able to choose from spending time in the busy main lounge, to having quiet time in their own rooms, where they have their own TVs or in quieter lounge areas in the home. Peoples individual needs assessment and care planning records detailed their stated preferred activities and daily living routines and also contained records of their engagement in activities. Care Homes for Older People Page 19 of 33 Evidence: Everyone said that they families and friend are made very welcome and one person told us about their recent family get together in the home, where food and drinks and privacy was offered in a separate lounge area. People also told us that seasonal events are celebrated, are well organised and enjoyable. And some told us that they enjoy the homes pet cat and regular visits from a dog via a staff member. This tells us that people are free to choose how they spend their time and can join structured and individual activities offered both within and outside the home. That they have opportunities for individual, group and also self directed activities within and outside the home. That their friends and families are made welcome and they are supported to maintain their contacts with them. People also told us that they usually enjoy the meals at the home, although some felt that tea time menus could be improved, commenting on repetitive offerings of sandwiches and that their preference for soup would be to have this offered at lunch time. However, we saw from minutes of recent resident meetings and feedback gained there about peoples satisfaction with meals, that menus had been revised to account for these and were to be introduced. We saw that at lunch time people chose where to eat and menus offered an alternative to each course. Tables were attractively set with table linen, were well equipped and with posies of flowers on each table. Menus were not provided on each table, however we were advised that revised menus were awaiting lamination and would be provided there. Staff assisted people who required this, in a sensitive and calm manner. Care Homes for Older People Page 20 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples concerns and complaints are taken seriously and acted upon and they are protected from harm and abuse. Evidence: At our last key inspection of this service we judged that whilst policies and procedures were in place to promote peoples protection from harm and abuse and that staff appeared conversant with these, that the lack of formal training had the potential to adversely affect peoples safety. We made a requirement then that all staff receive formal training in respect of multi agency safeguarding procedures. This is met at this inspection. In our annual quality assurance questionnaire completed by the home, they told us that they take all complaints seroiusly and efffectively deal with any they receive. They told us they have improved by ensuring that all staff have undertaken safeguarding adults procedures training and are provided with key related written guidance to follow, including equal opportunities and staff whistle blowing procedures. They also told us about some further improvements they aim to make in relation to the ongoing measurement of staff performance and knowledge in this area, which is referred to under the Management section of this report. Care Homes for Older People Page 21 of 33 Evidence: Statistical information provide in the AQAA tells us that they have received two complaints since over the last twelve months, which were both responded to within twenty eight days and upheld. Records that we saw about these at this inspection tells us that these were relatively minor in nature. That satisfactory action is taken by the home in their respect and which are recorded as resolved to the satisfaction of the complainants. At this inspection visit people told us that they know who to speak with if unhappy and how to complain. They also told us that they are provided with written information about how to complain in the service guide provided in their own rooms. One person showed us this and we saw that it was provided in large print to assist them given their sight difficulties. The procedure gave comprehensive, easy to follow step by step guidance as to how to complain and who to and included contact details of other relevant agencies, such as advocacy services, the Comission and relevant local authorities. We saw that this procedure is also displayed in the home. People told us that they are regulary consulted with, including by way of meetings and directly from the manager and said that any issues they raise are always dealt with, without having to complain. Staff spoken with were conversant with the homes policies and procedures for handling complaints, recognising abuse and responding to any suspicion or witnessing of the abuse of any person. They said they had undertaken training in respect of safeguarding procedures since our last key inspection in 2006 and that this is provided on a rolling programme. We also saw certificates of this training in their personal files. Care Homes for Older People Page 22 of 33 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 benefit from the homes environment, which is well maintained, clean and safe and which suits their needs. Evidence: At our last key inspection we judged that for the most part the home was clean and well maintained, although general housekeeping was not always to a good standard in some areas, which may place people at risk of infection. We made a requirement to ensure adequate standards of cleanliness, which is met at this inspection. In our annual quality assurance questionnaire completed by the home, they told us that the home is safe, well maintained, comfortable and hygienic. With ongoing redecoration and maintenance and with recorded environmental risk assessments, including for peoples own rooms that are regularly reviewed. They also told us about how they have improved standards of cleanlinss and how they intend to maintain these, together with further improvements they aim to make relating to their programme of redecoration, repair and renewal of the home. At this inspection people told us that the home is always fresh ad clean and one person told us that standards of housekeeping are very good. Another person said Care Homes for Older People Page 23 of 33 Evidence: they enjoy sitting in the well kept gardens in the warmer weather and the views from the quiet lounge onto those gardens. We saw from looking at the private and communal areas accessed by people we case tracked, that the home was safe, fresh, clean, free from hazards, well maintained, furnished and decorated to a good standard, well lit, ventilated, warm, comfortable and suitably equipped. People told us that they were satisfied with their rooms, which were personalised as they chose, many having accessible en suite facility. Although one persons room provided a very old commode in need of replacement and we saw that some waste bins in communal bathrooms and toilets were not fully occlusive. We could also see from speaking with people and from our own observations that people appreciated the range of lounge space provided. These provide people with opportunities to socialise with others, to spend quieter time, including a separate library room provision and afford privacy with family and friends. We also saw that records of maintenance are kept, along with a planned programme for the repair, upgrading and renewal of the home. Care Homes for Older People Page 24 of 33 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. People may be confident that their needs will be met from staff that is effectively recruited, inducted, trained and deployed. Evidence: At our last key inpsection we judged that staff were well spoken of by service users, who were confident that staff were accessible and able to meet their needs. We made two requirements then about staff recruitment and training records, which are met at this inspection. In our annual quality assurance questionnaire completed by the home, they told us they ensure appropriate staff deployment arrangements necessary to meet peoples needs and to ensure cleanliness of the home. That they achieve a good staff retention records, with staff that is effectively recruited, trained and competent and well supported in their role They gave us some statistical information that we asked for relating to staff employed and told us about some areas of improvement they aim to make over the coming months. The latter relate to ongoing staff training, development and front of house matters. And statistical information they gave us included details as to staff Care Homes for Older People Page 25 of 33 Evidence: achievements in National Vocational Qualifications in care. With thirteen out of nineteen staff having achieved at least NVQ level 2 or above and with three working towards. The information they gave us indicates that they seek to continually develop their staff team. At this inspection, people told us that staff is usually available when they need them and that they listen and act on what they say. All indicated that they enjoy good relationships with staff who they say treat them with respect, are patient and who promote their rights to dignity, privacy and choice. During our inspection visit we observed staff to be courteous and respectful in their approaches with people. Staff spoken with described effective arrangements for their recruitment, induction, training and deployment and related records that we examined reflected this. There is an operational training plan in place and discussions with the manager and staff told us that continual staff learning and development is a high organisational priority and that they aim to keep up to date with changes in practise and national guidance concerned with the care of older people. Care Homes for Older People Page 26 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well managed and run in peoples best interests. Evidence: At our last key inspection we judged that the home was generally well managed and run with systems in place to ensure that peoples health and safety needs were considered. We made one requirement a manager be appointed with application for registration submitted to the Commission. This had been complied with since that inspection, with the then acting manager, who had been in post for one week prior to that inspection approved as registered manager for the home. In our annual quality assurance questionnaire completed by the home, they told us that the home is well managed and run and that peoples health, safety and welfare promoted and protected. That they promote effective communication and support systems for staff and with robust arrangments for the handling and safekeeping of peoples monies. Care Homes for Older People Page 27 of 33 Evidence: They also told us about improvements they are making. These include the further development of their systems for staff supervision and appraisal, their record keeping formats relating to peoples care records and also their methods used to obtain qualatitve feedback from people about their service. They also provided us with some statistical information that we asked for, including for the servicing and maintenance of systems and equipment at the home and the provision of specified policy and procedural guidance for staff, which are satisfactory. At this inspection resident, relatives and staff all said that the home is very well managed and spoke highly of the manager who clearly has a high profile in the home. We saw from speaking with the manager and the records that we examined that she is well supported by the company and ensures her own professional development in order to promote ongoing practise development in the home. She has achieved the Registered Managers Award and received an Award in Excellence from South East Derbyshire District College and has undertaken comprehensive and key training over the last twelve months, including that relating to health and safety in the home, care and employment practises. We spoke with the manager about the quality assurance and monitoring systems, including methods for obtaining peoples views about the services they receive. And we saw from looking at records and from speaking with people who use the service, or who have an interest in it that there is a framework for the continuous review and improvement of the service. This includes regular auditing of all key aspects of the service, with measured monthly action plans, monthly reported monitoring visits conducted from an external manager and regular consultation with service users, including satisfaction surveys and meetings with them. We looked at the work commenced by the manager as indicated in their AQAA return, in terms of improving staff appraisal and supervision systems. Revised systems were in place and ready to roll out to all staff. The system is innovative and inclusive and should promote staff ownership by way of self assessment of key competency skills and knowledge, in conjunction with core management measurement. We looked at the arrangements for the handling and safekeeping of peoples monies and saw that these were robust, with good records and safely stored. Staff that we spoke with described satisfactory arrangements for ensuring safe working practises at the home, including for their training and also provision of equipment. During our inspection of the environment, we saw that the home was Care Homes for Older People Page 28 of 33 Evidence: clean, safe and generally free from observable hazards to peoples safety. Staff were conversant with their role and responsibilities concerned with the recording and reporting of any accidents or untoward occurrences in the home and we saw that there is a suitable record keeping system in place for these. Care Homes for Older People Page 29 of 33 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 30 of 33 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 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 8 The medicines policy should include written procedure for staff to follow in the event of a verbal instruction from a GP in respect of any persons medicines. So as to provide staff with recognised safe guidance to support their practise. The home should seek advice from their local pct with regard to access to outside health care professionals for the purposes of obtaining individual risk assessments for the use of bedrails and recognised policy guidance concerned with their use. In order to ensure best practise to promote peoples safety and best interests. Standards of record keeping should be developed in respect of individual risk assessments where people choose to retain and manage their own medicines. These should always be fully recorded and specify any potential risks that may arise, including control measures to minimise these and should be signed and dated by the person completing them. Hand written instuctions on the medicines administration record should be always signed and dated by the staff member writing these and countersigned by a witnessing staff member. So as to reduce the potential risk of error from transcribing. 2 8 3 9 4 9 Care Homes for Older People Page 31 of 33 5 26 Where necessary commodes, which are old, worn and damaged should be replaced to promote good infection control. Waste bins in communal bathrooms and toilets should always be fully occlusive in order to promote good infection control. 6 26 Care Homes for Older People Page 32 of 33 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). 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