Inspection on 03/12/08 for Digby Manor

This inspection was carried out on 3rd December 2008.

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

Digby Manor 18/12/06

Digby Manor 03/03/06

Digby Manor 31/08/05

Digby Manor 15/02/05

Digby Manor 10/08/04

Digby Manor 03/03/04

Digby Manor 16/12/03

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Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

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Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Digby Manor 908 Chester Road Erdington Birmingham West Midlands B24 0BN     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: Gerard Hammond     Date: 0 4 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Digby Manor 908 Chester Road Erdington Birmingham West Midlands B24 0BN 01213732333 01213821719 janet.alrubaie@shonali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Janet Al-Rubaie Type of registration: Number of places registered: Mr Jafar Safar Al-Rubaie,Mrs Janet Al-Rubaie care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Digby Manor is registered to provide accommodation, care and support for up to 26 people. It is located on the main Chester Road, in the Erdington district of Birmingham. Public transport links to the area are good: some car parking is available at the front of the property. Two substantial detached houses were linked and converted to provide the accommodation. Most of the rooms are single, with a few twin or double rooms: some also have en-suite facilities. There are ample bathing and toilet facilities on both floors of the home to meet the residents needs. A full passenger lift enables access to all parts of the building for people with mobility support needs. The home is also appropriately equipped with aids and adaptations. Communal areas include a recently extended main lounge and dining area, another small lounge and a conservatory. These provide residents with a number of options to choose from, as well as their own Care Homes for Older People Page 4 of 29 0 Over 65 26 Brief description of the care home rooms. There is a large landscaped garden to the rear of the property. This offers people a most attractive outdoor space that is also accessible to those with decreased mobility. Regular activities are organised for people wishing to take part, and residents visitors are made welcome. The home should be contacted directly for current information about fees and charges. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: This is the homes key inspection for the current year 2008-9. We gathered information from a number of places to inform the judgements made in this report. The Manager completed an Annual Quality Assurance Assessment (AQAA) and sent it back to us.This is a self assessment that focuses on the outcomes for people who use the service and provides us with some numerical information about it. We made two visits to the home and spoke with residents, the Manager and Assistant Manager and other members of the staff team. Records including previous inspection reports, policies and procedures, personal files of people using the service, care plans, staff files and other documents were also looked at. Direct observation of care and support, and residents feedback to questionnaires about service quality provided further evidence for judgements made. Thanks are due to the residents, the management team and staff for their co-operation Care Homes for Older People Page 6 of 29 and support throughout the inspection process. What the care home does well: What has improved since the last inspection? There were no outstanding requirements from the time of the last inspection. Work has continued to maintain and upgrade facilities around the home, for the benefit of the residents. Care planning and management continue to be of a high standard. Plans are kept Care Homes for Older People Page 8 of 29 under regular review and the involvement of other professionals is sought as required, in order to ensure that people get the care that they need. Changes are being introduced to the way in which staff are supervised, so that they get the support they need. The Managers continue to look for ways of improving consultation with people using the service, so that it can be developed for their benefit. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the information they need to help them decide if the service is right for them. Their needs are fully assessed so that their care can be properly planned for. People are able to try out the service for themselves before deciding whether or not to move in. Evidence: The home has a Statement of Purpose and a Service Users Guide in place as required. These documents are currentlyunder review, to ensure that they contain the most up to date information about the service. Sampling of residents personal files showed that each person had a written contract. This included terms and conditions of residence and outlined the responsibilities of all parties concerned. Care Homes for Older People Page 11 of 29 Evidence: As shown in previous inspection reports, there is a well-established pre-admission and assessment process. People have the opportunity to come and visit the home, so that they can see for themselves what it is like. This was observed directly during the inspection. Placements are offered on a months trial initially, so that people can make sure that they are happy with the service before making longer term commitments. Sampling of records provided clear evidence of thorough assessments of peoples needs, to help make informed judgements about the suitability of any placement, and ensure that future support can be planned for and met. Assessments were comprehensive, and records showed that these are kept under regular review, together with individual care plans. The home does not provide intermediate care, so Standard 6 is not applicable. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good planning and regular review of care helps to ensure that people get the support they need to stay healthy and well. Management of medication is effective so that people get their medicines when they should, and in the right amounts. People are well looked after. Staff support them in ways that they like, so that peoples privacy and dignity are properly respected. Evidence: Sampling of residents personal files showed that individual care plans are in place, as required. Plans are detailed and provide staff with clear guidance about how each person likes to be supported. They include risk assessments and management strategies to keep people safe from identified hazards such as falls. They describe individuals preferred routines for personal care and daily living. Plans are kept under regular review: evidence of this is contained in the written care summaries that are updated every month. Records provide evidence of support given to manage and meet healthcare needs. These include referral to appropriate healthcare professionals as and when required. The Manager advised that they get good support from GPs and local Care Homes for Older People Page 13 of 29 Evidence: health services. In particular she acknowledged the help and support given by the District Nurses with regard to promoting good pressure area care and tissue viability, to minimise the risks of pressure sores developing. Care plans and other records provide further evidence of the support given to promote and manage good oral health, chiropody, nutrition, psychological, physical and spiritual wellbeing. Previous inspection reports show that the home has a an appropriate policy and a good record for managing and administering peoples medication effectively and safely. This continues to be the case. The Medication Administration Record (MAR) was examined. This had been completed appropriately, and medicines given as shown. Individuals records included a photograph of each person, specimen signatures of staff authorised to give medicines and protocols for PRN (as required) medication. Temperature checks had been carried out each day on the medication fridge, to ensure it is working properly and that medicines stored in it remain effective. There is separate secure storage for controlled drugs and a complete record of all occasions when these are administered. An audit was carried out on stocks held: this tallied with the record, as required. A senior member of care staff was able to describe clearly the procedures for receipt of medication, handling and administration, and to demonstrate her understanding of her responsibilities. Full stock audits are carried out when medication is delivered, and also at random intervals by senior staff. The medication storage cupboard was kept clean and tidy, and secured appropriately. Direct observation of residents showed that they were well dressed and had clearly received what support they needed with their personal care. Interactions between staff and residents were warm and friendly: support was given with discretion, consideration and respect. Both were clearly at ease in each others company. Feedback received as part of the homes quality assurance and monitoring activity also confirms that people feel that their rights to privacy and dignity are well respected. On the day of the inspection visit one resident commented, the staff are lovely, they couldnt treat me better if I was one of their own. Previous reports have shown that palliative care has been dealt with professionally and with sensitivity and skill. The Assistant Manager has taken a lead with the development of advanced care planning in the home. This is in recognition of the changes taking place in general practice, and of the care needs of elderly people now being admitted into residential care. This initiative is to be commended. Advanced care planning involves close liaison with local doctors and other health professionals involved in end of life / palliative care. This is so that arrangements can be made for people to get the support they need to stay in the home, avoiding admission to hospital, if this is their wish and in their best interest. This means that they can continue to be looked after in familiar surroundings by staff they know well. Senior Care Homes for Older People Page 14 of 29 Evidence: care staff are scheduled to do additional training in palliative care in the near future. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to make choices so they can do the things they value and keep in touch with the people who are important to them. They have a balanced and nutritious diet, so that they can eat healthily and enjoy their food. Evidence: Particular efforts are made to provide residents with a lifestyle that suits their needs and preferences, and offers them opportunities to do things they value. The assessment process ensures that every effort is made to find out things that are of particular significance or importance to each individual. At the time of the inspection, preparations were underway to get ready for Christmas.A programme of activities was posted on wall in the main lounge. These included singalong sessions, Christmas videos, songs of worship to be led by members of the local Baptist Church, a musical Christmas show,coffee and mince pies event, and a Christmas quiz. Outside of the festive season a programme of regular activities is also available including bingo, board games, skittles, darts, quizzes, hairdressing, films and progressive mobility (exercise sessions). Staff say that motivating people to get involved in activities presents particular challenges. The home recently organised a trip Care Homes for Older People Page 16 of 29 Evidence: to a local theatre to see a production of Singing In the Rain, as musical entertainment is very popular with the residents. The experience highlighted some of the difficulties inherent in engaging and supporting people who may become disoriented or confused in unfamiliar surroundings. It is to the homes credit that the team continues to look for different ways to stimulate and involve residents in a range of different opportunities and experiences. A new large flat screen television has been installed in the main lounge so that residents viewing experiences can be enhanced. It was good to see that this is being used selectively and not just left on during the day. Books and magazines, and a collection of films, DVDs and music are available for people to use as they wish. One of the residents said she enjoyed knitting, another that she liked the exercise class, and the church hymn singing. Another person said that she had helped choose the decorations for the Christmas tree and had made some Christmas cards. The home operates an open door policy for residents visitors. Sampling of peoples records provided evidence of regular contact with families, friends and loved ones. On the day of the inspection visit there was a steady stream of visitors coming and going. Staff made particular efforts to make people welcome and provided them with refreshments. The lunchtime meal was observed. The food was well presented and served, and taken in the relaxed atmosphere of the dining room. People were not rushed and supported as necessary. The home operates a 4-week rolling menu, drawn up in consultation with the residents and also based on staff knowledge of peoples likes and dislikes. Alternatives are always available. Records show plenty of variety and choice, and positive comments were received from residents interviewed. It was positive to note that information and training materials were available in the home relating to the Mental Capacity Act. This shows that the service continues to work at keeping up to date with current legislation and policy initiatives, and recognises the significance of ensuring that people get the support they need to make important decisions about their lives. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that any concerns will be listened to, taken seriously and acted upon. Action is taken to ensure that peoples rights are protected and they get the support they need to stay safe. Evidence: The home has an appropriate complaints policy and procedure in place. Their response to the Annual Quality Assurance Assessment shows that they have not received any complaints since the time of the last inspection. We have not received any complaints in respect of this service either. The management team is very proactive and positive about encouraging residents and their families to express their views about the quality of the service provided. This is shown through internal quality assurance and monitoring activity in the shape of satisfaction surveys / questionnaires. It was also noted that complaints / comments leaflets were available in communal areas of the home. Managers express concern that these do not get used and are keen to explore other ways of promoting feedback from residents. Conversations with residents showed that they know they are able to complain, and can speak to staff or managers if they wish. The home has a collection of cards, letters etc. from relatives complimenting the service on the quality and standard of care provided. The Annual Quality Assurance Assessment (AQAA) shows there is a safeguarding policy in place and that this has been reviewed recently. A training package has been Care Homes for Older People Page 18 of 29 Evidence: purchased recently to refresh and enhance staff development in this area. Staff interviewed were able to demonstrate their understanding of the different forms abuse can take, knowledge of potential indicators and the need for vigilance at all times. They also showed that they understand their responsibilities to report immediately any concerns in this area. Sampling of staff records provided evidence that checks with the Criminal Records Bureau (CRB) had been made before people commenced employment at the home. Residents finances are managed outside of the home (by family members, appointees etc.). The home looks after small amounts of money where this is requested. Proper records are in place of all transactions, backed with receipts so that individuals money is appropriately protected and accounted for. These examples of good practice show that the home takes positive action to promote the protection of residents from harm or abuse. As reported above, the home is also taking action to ensure that staff have an understanding of their duties and responsibilities under the Mental Capacity Act. This is so that residents get the support they need to ensure the protection of their legal rights. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents enjoy the benefit of a home that is well maintained, comfortable, safe and clean. Evidence: A tour of the home was completed in the company of the manager. Communal spaces include the recently extended main lounge area. The extension provides residents with an airy, bright room with access to and excellent views of the attractive landscaped rear garden. There is also a conservatory at the front of the building. Most residents tend to congregate in these areas during the day. There is another lounge available on the other side of the home, but the Manager reported that this did not get used much. She said that people did not tend to use their rooms during the day preferring to be in the main dining / lounge area most of the time. Residents spoken to said that this was what they liked to do. Shared spaces are comfortably furnished, and well decorated and maintained. A new flat screen digital TV has recently been purchased, and installed in the main lounge. A passenger lift gives access to all floors. There are ample bathrooms and toilets available throughout the building to meet residents needs. Some of the rooms have en-suite facilities, and the Manager is currently considering options to increase the number of rooms that have these. People have the equipment they need to support their mobility including grab rails, hoists, raised toilets, walking frames and wheelchairs. The Annual Quality Assurance Assessment shows that Care Homes for Older People Page 20 of 29 Evidence: pressure sensitive mats that can be linked to the staff call system have recently been purchased so as to enhance levels of safety and security for residents that need it. There is a rolling programme of renewal and maintenance for the home, and the Manager continues upgrading and developing the facilities and quality of the home environment. The recent lounge extension and past work on the extensively landscaped garden are testament to this. Bedrooms are generally well maintained and decorated, and people have their own ornaments, pictures, photographs and personal effects to make their private spaces personal and individual. There is also a continuous cycle of redecoration of residents rooms, or as the need arises. Staff work hard to keep the home clean and tidy: good standards of hygiene are maintained throughout. The staff team includes cooks and people with designated responsibility for laundry and housekeeping. These arrangements help to support effective infection control measures. The home was seen to be clean and fresh throughout. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are well trained and qualified so that they have the knowledge and skills they need to do their jobs well. Enough staff are employed to make sure that residents get the care and support they need throughout the day. Low turnover of staff means that residents enjoy the benefit of being looked after by familiar people. Important checks are done before staff begin work at the home. This is to make sure they are suitable for their jobs, so that people in their care are protected. Evidence: An examination of the staff duty rota showed that four care staff are available on each shift, one of whom is a senior. These are supported by two housekeeping staff, a cook and a person doing the laundry. The Manager and Assistant Manager are also on duty throughout the day. As reported previously, the staff complement is good, with care staff able to focus on supporting residents. Low staff turnover at the home further promotes continuity of peoples care. Feedback from residents about the staff who look after them is very positive. As reported above, direct observations reinforce the perception of good working relationships. Conversations with staff showed that they have a good knowledge and understanding of the people in their care. Care Homes for Older People Page 22 of 29 Evidence: The Annual Quality Assurance Assessment shows 90 of staff are qualified to NVQ 2 or above. Continued investments have been made in providing ongoing training opportunities for the staff team. This was confirmed by people who were interviewed during the inspection. New staff have the benefit of an appropriate induction. A matrix of staff training was made available and this was discussed with the management team. It was recommended that the staff training and development plan is drawn up in spreadsheet format.The plan should show (for each member of staff) qualifications gained and training completed (with dates) and include dates when refreshers are due. Doing it in this way will provide an instant overview and an effective monitoring / planning tool for staff training and development needs. Staff confirmed that they had access to a good range of training opportunities. Staff interviewed said managers are open and approachable and they are able to discuss any matters of concern. There is a good teamwork ethos, and this is reinforced by low turnover rates. Examination of staff records provided evidence of robust recruitment and selection practice. Files contained completed applications and employment histories, two written references and checks with the Criminal Records Bureau (CRB). Records also contained job descriptions, contracts terms and conditions, copies of interview notes, receipts for staff handbooks, and training certificates. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience 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 well run: peoples opinions about the quality of the care provided are actively sought. This is so that their views can be used to inform future developments, for the benefit of people using the service. Staff are generally well supervised, so that they get the support they need to do their jobs well. Important checks on equipment around the home get done regularly. Good health and safety practice is a priority, so that people living and working at the home can stay safe and well. Evidence: Digby Manor is a family run business: the Registered Providers, a married couple, are also the owners. The Registered Manager is appropriately qualified and has nineteen years of experience of providing care for older people and running the home. The Assistant Manager is her daughter: she has ten years experience and is also qualified, holding the Registered Managers Award. Conversations with both demonstrated their Care Homes for Older People Page 24 of 29 Evidence: commitment to continuing to provide a quality residential care service for older people. They also showed their awareness of the need to keep up to date with current thinking in social care, and to support their staff team; so that they are enabled to continue learning and developing, for the benefit of the people in their care. They take pride in the low turnover of staff at the home. Staff told us that the managers are open, approachable and flexible and that are able to raise any matters of concern with them. They spoke positively about the good general rapport within the care team, and said that Digby Manor is a good place to work. Residents personal records provide plenty of evidence of good quality care management practice within the home. Peoples support needs are assessed and their care is planned systematically and professionally. The home has a system in place for quality assurance and monitoring. In addition to the monthly reviewing and evaluation of individual care plans, questionnaires are circulated to all residents to seek their views on the quality of the service provided. This process has just been updated and was discussed with the management team during the inspection visits. It was recommended that the questionnaires should be collated and analysed: information gained from this exercise should be reported on, and circulated to all interested parties. The managers spoke positively about their wish to continue developing this aspect of the service, so that they can use the knowledge gained to improve it for the residents benefit. As reported above, residents finances are managed by family members or appointed advocates. The home only holds small amounts of money for individual residents. A proper accounting system is in place for this, with written records of all transactions, duly supported with receipts. Accounts are audited regularly: sampling of records showed that these were complete and in good order. Records show that the staff group meets regularly as required. Good use is made of read and sign sheets to disseminate information. This supports good communication and ensures that staff can be kept up to date with important issues. Staff told us that they feel well supported and have regular formal supervision. Sampling of records shows that recording of formal supervision may be slightly below the recommended standard. However, it should be acknowledged that this has aleady been recognised and action is being taken to address it. Senior care staff will shortly be assuming responsibility for supervising other members of the team. This represents a good opportunity for staff development:consideration is now being given to providing Seniors with the training and support they need to feel confident about taking on this role. Safe working practices were directly observed around the home. Safety records were Care Homes for Older People Page 25 of 29 Evidence: also sampled. A schedule of contracted maintenance is in place, to ensure that important checks and servicing of equipment gets done at the right times. A fire risk assessment for the home is in place. The fire alarm and emergency lighting systems and fire-fighting equipment have all been serviced and tested regularly, with records kept as required.The central heating system, lift, hoists and staff call systems have also been serviced. Portable appliance testing of electrical equipment has been carried out and water storage checked for Legionella and treated to support prevention. A recent report by the local Environmental Health Officer showed that practices within the home ensured generally good food hygiene and safety. An appropriate range of policies and procedures are in place and kept under review. The standard of record keeping in the home is generally very good, with files maintained securely and in good order. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 30 Develop staff training and development plan in a spreadsheet format. Show (for each member of staff) qualifications gained and training completed, including dates. Show when refreshers are due. Doing this will provide an overview of the teams training needs, and provide a tool for efective monitoring. Analyse information from residents questionnaires and publish the findings, circulating to all interested parties. This is so that it can be seen how the views of people using the service are taken into account. 2 33 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) 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. 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