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Inspection on 09/10/07 for Cranleigh Paddock Older Persons Resource Centre

Also see our care home review for Cranleigh Paddock Older Persons Resource Centre for more information

This inspection was carried out on 9th October 2007.

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

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

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

What the care home does well

Feedback from residents and their families was very positive about the care they received. They felt staff were respectful and caring. They also thought the home was welcoming and friendly. Comments included: `The home provides a safe, friendly environment. ` ` Staff are approachable and treat residents with respect` `I did not wish to come to a place like this, but after a few days I found the place pleasant and could not think of anything better` The home makes sure it has good information about someone before they move in, so they know what care they will need and are sure they can provide it. Families felt staff worked hard to encourage their relative to remain as independent as possible. Comments included `It gives my mother-in-law independence as well as care. She likes to help and the staff allow her to set tables, clear away etc and this gives her so much joy`. Feedback from some people who live in the home and observations of staff practice confirmed people are enabled to make some choices about their daily routines. The home is well designed to meet the needs of people with dementia. It is on one level with lots of quiet areas where people may sit in comfortable armchairs and settees. People who live in the home are free to spend time where they wish, including a small secure garden.

What has improved since the last inspection?

People who use the service have a care plan, which describes how they like things done. For example, it might describe what help they need to get dressed each morning. As more people living in the home have dementia, it is important that the information is very detailed so that everyone gives the help in the same way. Some care plans now have good descriptions of how to give the help.

What the care home could do better:

Not all the care plans seen gave this detailed information. The registered manager was aware of this and said more work was being planned. A new type of care plan was being tested by another home. If it is felt it is a betterway of recording what people need, it will be used in all the Local Authority homes. Designated time needs to be given to providing activities that meet the needs of people with dementia. The registered manager had already identified this need and there are plans to appoint an activities co-ordinator. This person will, with trained staff, provide a programme of daily activities that people who live in the home like and that provide mental stimulation. The home is now going to provide care only for people who have dementia. Alternative ways of helping them say how they feel about their care will need to be found, as they may not be able to use the ways used now. The registered manager had identified this as an objective in the AQAA.

CARE HOMES FOR OLDER PEOPLE Cranleigh Paddock Older Persons Resource Centre Calpe Avenue Lyndhurst Hampshire SO43 7AT Lead Inspector Mrs Pat Trim Key Unannounced Inspection 9th October 2007 09:00 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 Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.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. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cranleigh Paddock Older Persons Resource Centre Calpe Avenue Lyndhurst Hampshire SO43 7AT Address 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) 023 8028 3602 023 8028 4124 Hampshire County Council Mrs. Sheila May Aplin Care Home 34 Category(ies) of Dementia - over 65 years of age (34), Old age, registration, with number not falling within any other category (34) of places Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st January 2007 Brief Description of the Service: Cranleigh Paddock is a registered care home providing personal care to 34 service users who are older persons or older persons with dementia. Hampshire County Council owns the service. The home is currently in transition as it develops into a specialist dementia service. Accommodation is provided on ground floor level and is divided in four units, each of which accommodate up 8 people in a group living setting. The home is situated in Lyndhurst on the outskirts of Southampton city and close to local amenities and the New Forest. The home has enclosed gardens that are accessible from each unit and to wheelchair users. The current fee given as charged by the home is £446.00 per week. This does not include the cost of hairdressing, chiropody, newspapers and personal toiletries. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence for this report was obtained from a number of different sources. These included: A review of the home’s recent history, including previous inspection reports. The Annual Quality Assurance Assessment (AQAA), which was completed by the home. This is a document that gives information about what the home is doing to make sure it meets the regulations. Seven postal surveys completed by service users and their relatives. A visit to the home by one inspector, that took seven hours. During the visit an inspection of the key standards was carried out. Three residents were case tracked to assess their experience of moving into and living in the home. Time was spent talking with three residents. Significant time was spent with the people who live in this home and observations were made during this inspection. All observations were followed up by discussions with staff and examination of records. There was also an opportunity to speak with the registered manager; service manager, assistant manager, cook and three care staff. Some time was spent discussing the change to providing a specialist dementia service and the impact this was having on current residents and staff. Time was also spent discussing what changes were planned to continue this development. There were no requirements made at the previous inspection and none were made in this report. The registered manager requested the term ‘resident’ be used to describe people who lived in the home and this term has been used throughout this report. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Not all the care plans seen gave this detailed information. The registered manager was aware of this and said more work was being planned. A new type of care plan was being tested by another home. If it is felt it is a better Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 7 way of recording what people need, it will be used in all the Local Authority homes. Designated time needs to be given to providing activities that meet the needs of people with dementia. The registered manager had already identified this need and there are plans to appoint an activities co-ordinator. This person will, with trained staff, provide a programme of daily activities that people who live in the home like and that provide mental stimulation. The home is now going to provide care only for people who have dementia. Alternative ways of helping them say how they feel about their care will need to be found, as they may not be able to use the ways used now. The registered manager had identified this as an objective in the AQAA. 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. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 8 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 Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their families are given sufficient information before moving in to enable them to make a decision about whether they wish to live in the home. Detailed information about the needs of the resident are obtained before they move in. This enables the registered manager to assess whether the home can meet their needs. EVIDENCE: Residents and their families are given an information pack about the home. This gives information about what the home provides and residents’ rights. The information is currently recorded in a way that some residents would not be able to understand the information. Prospective residents are invited to visit the home for a day before they move in for a trial period and information about what is provided is given to them verbally at this time. Their families are given the information pack so they may ask any questions on their relative’s behalf. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 10 Feedback from four residents confirmed they felt they had sufficient information about the home before they moved in. Two relatives also felt the information they were given was good. One resident remembered visiting the home, being introduced to people and shown which unit he would be living on if he decided to move in. All residents have their needs assessed before they are offered a trial placement at the home. The registered manager said she was able to get a copy of the care management assessment. The Annual Quality Assurance Assessment (AQAA) recorded that all residents, whether funded by adult services or self-funding, are referred through the care management process and have their needs assessed by a care manager. The registered manager said an in-house assessment is also completed. Copies of the in-house assessment were seen on three files. This contained detailed information about the help residents would need and what they could do for themselves. For example, the assessment recorded one resident could wash herself but needed prompting so staff would need to put the soap on her flannel and remind her what to do with it. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There has been some improvement in care planning so some residents can be confident they will consistently receive their care in the way they like it. However, some plans need further development if they are to reflect a resident’s individual preferences and support them to maintain their independence. Residents have access to health care services. Staff provide support in a way that maintains residents’ dignity and treats them with respect. Staff receive training and guidance that enables them to manage medication in a way that minimises risk. EVIDENCE: Three care plans were viewed. Two of these were for residents who required a lot of assistance with their personal care. One was easy to follow and contained detailed information about how to offer support whilst enabling the person to do what they could for themselves. For example, when assisting one resident with washing staff were told to run the hot water into the basin, Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 12 put soap on the flannel and remind the resident what to do with it. This guidance linked with the information given in the assessment. Staff were also told to put out her clean clothes and prompt her to put them on. However, the other care plan just recorded the resident could not wash independently and needed help at all times. Also that the resident could not dress and needed staff to make sure her clothes were clean. It was not clear if she could put them on herself or needed staff to assist her. The third plan identified that the resident was independent in all aspects of personal care. The resident confirmed that he did not need assistance from staff, except when getting into and out of the bath. A bathing risk assessment confirmed this was the only assistance required and that the resident could safely be left in the bath, once he had been helped into it. The registered manager said she was aware the care plans needed further development. A new, more detailed care plan format was being trialled by another Local Authority home and a final version would be used by all Local Authority homes providing care for people with dementia. Risk assessments were completed for moving and handling, bathing and nutrition. These were reviewed on a monthly basis. Care plans identified where a risk assessment had been completed so that staff would know they needed to read them before assisting a resident with the task. There was a record to show that care plans were regularly reviewed, but this did not show how the decision ‘no change’ had been reached. However, the files viewed contained a number of assessment tools that were reviewed on a monthly basis. These included a nutritional monitoring form and the risk assessments for moving and handling and bathing. A daily living assessment tool was also completed on a monthly basis to review the level of support needed by each resident. An assistant manager said this was completed to identify what staffing levels were needed each month, but was not used to review the care provided. This was discussed with the registered manager and it was suggested the assessment tools could be used to support the care plan review. One resident, spoken with during the inspection, said he was able to see his doctor when he wished and was visited regularly by the chiropodist and optician. Separate records were kept of visits by health care professionals and showed that residents had access to a wide range of health care support. A district nurse was seen to visit a resident who required support for a shortterm health care need. Feedback from four residents who completed surveys evidenced they were usually able to see their doctor when they wanted. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 13 Feedback from residents both in surveys and during conversations was that staff were very kind and gave them the help they needed. Close and warm relationships were observed between residents and staff. Information given to residents on admission told them about their right to be treated with dignity and respect. The home has a high level of staff that have completed their National Vocational Qualification (NVQ) and core values are included in this course. Staff also have a copy of their Code of Conduct, which tells them about their responsibility to treat residents respectfully at all times. The AQAA recorded that only assistant managers or the night care coordinator handled medication. All these staff had completed training courses to ensure they had the skills and knowledge they needed to manage medication safely. The administration of medication was observed on one unit. The member of staff followed the medication procedure and records were well maintained and up to date. The AQAA recorded that residents could be supported to self medicate if they wanted to and if a risk assessment demonstrated it was safe for them to do so. One resident said he looked after his own medication. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to make choices about how they spend their day. They are offered activities that they enjoy and that provide mental and physical stimulation, but the activities programme needs to be developed to make sure it meet the needs of all people with dementia. There is a good range of meals provided that residents enjoy. EVIDENCE: Residents were supported to make some choices about their daily living. Care plans record some information about the daily routines of individual residents, such as what time they like to get up and go to bed. At 9 a.m. some people were already up and had had breakfast, others were eating and some were still in bed. Residents were seen walking freely around the home. Staff interaction was minimal at this time and mainly comprised asking people if they wanted drinks, but some residents were encouraged to be independent, pouring their own tea and buttering their toast. Other residents spent time watching television or looking at magazines. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 15 Some good interactions between residents and staff were observed. For example, one staff took time to make eye contact with a resident, held her hand to get their attention and spoke to the person about the song they were singing. At lunchtime on one unit, the staff member took the vegetables in dishes to each resident to show them what there was and ask them what they wanted and if they had enough. However, on a second unit residents were asked what vegetables they wanted without being shown them and the meal was served where they could not see it. One resident was distressed she had been given peas and was told she had asked for them. They were removed from her plate. Feedback from resident surveys indicated that they felt there was a good selection of activities provided and that they could choose whether to join in or not. A list of activities is displayed on each unit, although the writing was quite small and some people would not be able to read it. The registered manager said there were plans to develop the activities programme so that it provided a wide range of activities that met the needs of people with dementia. An activities co-ordinator was going to be appointed and specific hours allocated to provide support that would include large and small group activities and one to one time. During the morning one of the care staff provided an exercise class in the forum. She confirmed she had been trained to provide this activity. A large number of residents joined in and others watched and listened to the music. The care staff said she also spent time with smaller groups of people and spent one to one time with those who preferred this. The home has two cats and has regular visits from dogs. Residents were seen making a fuss of both cats and dogs and said they loved having them around. One resident said they were expecting some puppies to arrive shortly and she was really looking forward to seeing them. Feedback from visitors to the home and relatives’ surveys showed they felt they were made very welcome. Comments included ‘we are always offered a cup of tea’ and ‘we can make Mum a drink in the unit kitchen if we want’. All visitors pass the main office before coming in and the door has a security system to prevent anyone walking in. Feedback about the meals provided was very positive. Everyone felt they had a good choice of meals and said they could have their meals on the units or in their rooms. They said they were offered drinks throughout the day and could ring for them during the night. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 16 Residents are asked the day before what main meal they would like from a choice of two. However, it was observed that they often did not remember what they had ordered. They were able to have an alternative if they wanted to when the meal was served. The daily menu is displayed on each unit. Meals were varied and offered a wide range of choice. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All residents have a copy of the complaints procedure, but the home will need to develop different formats and methods to help residents with dementia make their concerns known. A robust policy, procedure and staff training ensure residents are protected from the risk of abuse. EVIDENCE: The AQAA stated that all residents and their relatives are given a copy of the complaints procedure when they come into the home. Feedback from residents completing surveys and those spoken with during the inspection confirmed they knew how to make complaints and were confident their concerns would be listened to. Relatives also said they were able to go to the office to discuss any concerns they had. The complaints procedure is quite simple, but the registered manager said she was aware it might not be clear enough for some of the residents. There were plans to review the procedure to see what other methods might be used to get the information to residents. The AQAA recorded the home had received one complaint since the last inspection. The complaint log showed that this was still being investigated. The complainant had been kept informed of what action was being taken. The commission had received no complaints about the home since the last inspection. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 18 The home had a copy of the Local Authority safeguarding adults’ procedure. The AQAA stated that all staff were required to complete training in safeguarding adults and six staff surveys confirmed they had all attended a course. Two staff spoken with during the inspection said they had attended training and they were able to describe the procedure they needed to follow if they had evidence of possible abuse. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are systems in place to monitor the environment so that it provides a clean, safe and comfortable home that meets the needs of residents. Staff have the training and guidance they need to make sure the risk of infection is minimised. EVIDENCE: The home provides a good environment for people with dementia. The ground level building is divided in 4 units, each of which has a lounge/diner and small kitchen. Residents may walk freely around the home and spend time on the units or in the communal area. Small areas have been furnished with comfortable armchairs and settees so people can sit and chat together if they wish. Dining areas have several small tables and chairs so residents may sit in small intimate groups. There is a small, enclosed garden and patio with tables and chairs that residents can get to from several different parts of the home. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 20 The home has a number of adaptations such as specialist baths, moving and handling aids and a ceiling hoist in one bedroom, that enables them to safely assist residents with mobility problems. The registered manager said work to improve access to two toilets and provide more storage space was due to start shortly. Domestic staff are responsible for all the cleaning in the home. Feedback from residents and relatives demonstrated they were very satisfied with the cleanliness of the home. The home was clean and there were no unpleasant smells. The AQAA stated 27 staff had completed infection control training. Feedback from staff surveys confirmed all six had attended this training. Staff working in the home on the day of the inspection, were able to demonstrate their knowledge of the procedure for disposing of incontinence aids and for handling soiled linen. Staff were seen following the procedure throughout the inspection. The home had a contract for the removal of clinical waste. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have the skills and training they need and are provided in sufficient numbers to meet the needs of residents, but residents will benefit when there is a permanent staff team to meet their needs. EVIDENCE: The registered manager said staffing levels were constantly reviewed as the home continued the transition to a specialist dementia service. Every month an audit tool was completed for each resident to assess whether the current staffing levels were sufficient to meet their needs. The AQAA identified the home had not been able to recruit any new permanent staff for some time as vacant posts were being held in case redeployed staff from other homes wished to take them up. In the interim the registered manager said she had been able to fill vacancies with agency staff and Local Authority home care staff. The same staff were requested every time from the agency so they could get to know the residents and the routines of the home. The hours had also been covered by permanent staff working extra hours and by the assistant managers. This had meant that some of the planned developments, such as the activities programme for dementia care, had been delayed. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 22 The registered manager said she was now able to advertise these posts and would shortly be recruiting new permanent staff. This would mean a period of stability for residents and staff and the opportunity to develop the dementia care service. The recruitment procedure was found to be satisfactory at the last inspection in January 2007 when the records of two new staff were seen. The registered manager said no new staff had been employed since the last inspection, so no employment records were viewed on this occasion. The AQAA stated that the Local Authority recruitment procedure was always followed. Staff who gave feedback both by completing surveys or by speaking with the inspector confirmed they felt they had completed a thorough and fair recruitment process. One staff, who had been working in the home for 18 months, confirmed she had been required to provide two references, complete an application form, attend an interview and have a Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) check before beginning her employment. Staff felt they had a good induction, although some expressed concern that they had to wait to attend a moving and handling course. The assistant manager responsible for booking training said she always put staff forward for the first available course. Until they completed this they were not permitted to work alone with any resident who required assistance with moving and handling. The assistant manager said she had access to the annual training programme and put staff forward for new and refresher courses when required. The registered manager said that as the home had moved towards providing a specialist service for dementia care, all staff were required to complete a 4 day training course in dementia care. Staff confirmed they had attended this, as well as relevant day courses. Staff felt they had access to a wide range of training courses. Some were concerned that the course relating to adult behaviour focussed more on working with people with a learning disability and felt they wanted more guidance on working with challenging behaviour relating to dementia care. The registered manager said staff were able to discuss their learning needs in supervision and annual review and that she was aware this was a concern. The registered manager said two senior staff had attended training about the Mental Capacity Act. They were going to cascade this information to care staff over a period of time, as it was likely to have a major impact in caring for people with dementia. The AQAA recorded that 19/26 staff have achieved their National Vocational Qualification (NVQ) 2. Feedback from staff confirmed they were encouraged and supported to complete this qualification. The member of staff who had Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 23 been working in the home for 18 months had already gained this qualification. Management staff are also supported to continue their professional development to complete NVQ 3 and 4 and other relevant training. Feedback from staff evidenced they receive regular supervision. An assistant manager said she was responsible for providing supervision to a team of care staff and her colleagues supervised other teams. The AQAA stated that supervision was an opportunity for staff to ask questions and to give and be given feedback about their work. It was also used to identify individual learning needs. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and residents have the opportunity to give feedback about the service they receive. However, residents who have dementia may not be able to make use of these opportunities. Systems are in place that protect residents and maintain health and safety. EVIDENCE: The registered manager has the relevant qualification and experience to manage the home. She is supported to run the home on a day-to-day basis by a team of experienced assistant managers and an administration assistant. Feedback from staff evidenced they felt well supported and encouraged to develop their skills. Residents and relatives were seen throughout the day Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 25 asking the registered manager and assistant managers for advice and support and having their concerns addressed. There are clear lines of accountability, with assistant managers each responsible for specific management areas. The registered manager is responsible for overseeing the running of the home and is supervised on a regular basis by her service manager. A visit was taking place at the time of the inspection. Residents or their relatives are able to give feedback at their annual care review. Short stay residents are asked to complete a satisfaction survey to give information about how they found their stay. Residents also have a regular meeting once a month to discuss any issues. As the service continues to develop as specialist dementia service alternative methods of getting residents’ views will need to be found. The registered manager said this is already being considered. A representative of the Local Authority visits the home on a monthly basis and spends time reviewing care, the environment and talking to residents and staff. A written report of this visit is given to the registered manager. The service manager confirmed these take place unannounced. The AQAA stated a quality assurance tool is used to monitor the service and that there is a business and service plan for the home. At the last inspection clear well-maintained records were seen that showed any money held on a resident’s behalf was managed safely. The AQAA stated that the same system was still in use and that stringent safety practices ensured any money was held securely. Relatives confirmed they were satisfied with the arrangements made to look after money left for the resident. Feedback from staff showed they were able to access basic training in all aspects of health and safety, such as first aid, food hygiene and moving and handling. There was information on staff notice boards about health and safety issues and about where staff could find policy guidance. The home has up to date maintenance certificates for all equipment and systems. Fire drills and required fire safety precautions are carried out and recorded. Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Cranleigh Paddock Older Persons Resource Centre DS0000034267.V347467.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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