Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 20/10/08 for Dingle Meadow Care Centre

Also see our care home review for Dingle Meadow Care Centre for more information

This inspection was carried out on 20th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

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

The dementia unit in the home provides people with a bright and colourful environment with a number of areas where people are able to pick up items and use independantly. Alot of thought by staff members had gone into the hallways of this unit where an indoor garden area with windchimes and flowers with many other objects to stimulate individuals with dementia. Also there is a wall mural where collectively people have placed their own paintings/drawings which are removable and peoples doors are brightly painted with a letterbox and door knockers so that people can recognise their rooms with as much ease as possible. People appeared to be supported well to maintain their personal hygiene wearing clothing and jewellery that reflected their age, gender, cultural background and the time of year. Throughout our visit we observed a range of activities for people to participate in if they chose to and some of these were done on a `one to one` basis which reflected peoples personal preferences and thereby enhancing peoples quality of life. For example, one person was supported to dust as this is what they enjoy doing and another individual was assisted by a local artist in making a vase as they were interested in the arts. Visits were observed throughout the day and were seen to be made welcome. Visitors commented that, `Staff are always friendly and make you feel welcomed`. `You are asked if you want a drink as soon as you arrive`.

What has improved since the last inspection?

50% of staff have now acheived their National Vocational Qualification (NVQ) Level 2 which meets the minimum standards so that people can feel confident that their needs will be met by staff who have gained the appropriate knowledge and skills. The home encourages people to complete satisfaction questionniares about the service they receive in the home and the findings are collated into a report which is displayed in the main reception area of the home together with the last minutes of the residents meetings. This shows that the home are listening to people and acting on the feedback that is received so that improvements can be acknowleged to enhance peoples lives.

What the care home could do better:

The home must be able to demonstrate staff are competant to support individuals at mealtimes on the residential unit. This must include assisting and supporting individuals at mealtimes so that people are not left struggliing to eat their meals and this must be reflected in peoples care plans for staff to follow. Mealtimes should be unhurried and people given time to eat their main meals before their desserts are brought to the table so that individuals health and wellbeing is not compromised and mealtimes are an enjoyable experience for all.Care planning must be completed with individuals, families or appropriate external agencies. This will ensure that people are involved in this process so that they have the opportunity for their preferences and choices to be heard and acted upon appropriately. The administration of prescribed creams and ointments must have the opening date of the item placed on them together with a description of where the prescribed medication needs to be applied so that people are not placed at risk and staff are provided with the appropriate guidelines to follow. A number of requirements and good practice recommendations were also made (as detailed on the back of this report). These include, manager should register with CSCI, review statement of purpose and service user guide, monitorinig food intake and repairs to an individuals ensuite bathroom.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Dingle Meadow Care Centre Goldencrest Drive Oldbury West Midlands B69 2DR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sally Seel     Date: 2 0 1 0 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 30 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 30 Information about the care home Name of care home: Address: Dingle Meadow Care Centre Goldencrest Drive Oldbury West Midlands B69 2DR 01215529355 01215442442 dinglemeadow@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr James John Parkes Type of registration: Number of places registered: Southern Cross Care Homes No 2 Ltd care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Age: Dementia (DE) age 55 and above. The maximum number of service users who can be accommodated is: 46 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 46 Dementia (DE) 20 Date of last inspection Brief description of the care home Dingle Meadow Care Centre is a purpose built care establishment which is situated in a residential area within easy access to Oldbury town centre. It is close to public transport routes to local areas, Birmingham, Dudley and Wolverhampton and within easy access of the M5/M6 motorway network. There is a car park at the front and rear Care Homes for Older People Page 4 of 30 Over 65 0 46 20 0 Brief description of the care home of the premises. The garden is situated at the rear of the property. There is level access to the front and entrance is via a keypad system. Service users accommodation is en-suite and on three floors that are accessed via passenger lift or stairs. There are forty-one single and two double rooms. Communal space consists of two lounge/dining areas on the ground floor. There are a number of bathrooms with assisted bathing facilities and toilets situated through the premises. Balmoral unit has provision for 20 service users who have dementia, it has recently been extended and now has two communal lounges and two separate dining areas. All of the bedrooms are en-suite and located within the unit. The home provides activities for service users and has an open visiting policy. There are different charges at Dingle Meadow for residency, at present the home charge #418 per week with social services. Those service users who fund their own care can expect to pay between #485 and #565. These fees do not include extras such as chiropody, newspapers and hairdressing services. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of our inspections is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and on aspects of service provisions that need further development. One inspector undertook this fieldwork visit to the home, over nine hours and the manager assisted us throughout. The operations manager was also present for some of the day. The home did not know that we were visiting on that day. There were fortytwo people living in the home with one person being in hospital on the day of our visit. Also a new person was in the process of moving into the home. Care Homes for Older People Page 6 of 30 Information was gathered from speaking to and observing people who lived at the home. Three people were case tracked and this involves discovering their experiences of living in the home by meeting or observing individuals, looking at medication and care records and reviewing areas of the home relevant to these people, in order to focus upon outcomes. A further two care records were partly reviewed. Case tracking helps us to understand the experiences of people who use the service. Staff files, training records and health and safety files were also reviewed. It was not possible to hold meaningful conversations with all individuals due to their differing levels of dementia. However, five people who live in the home and three relatives were spoken to. Prior to the inspection the registered manager had completed an Annual Quality Assurance Assessment (AQAA) and returned it to us. This gave us some information about the home, staff and people who live there, improvements and plans for further improvements, which was taken into consideration. Regulation 37 reports about accidents and incidents in the home were reviewed in the planning of this visit. What the care home does well: What has improved since the last inspection? What they could do better: The home must be able to demonstrate staff are competant to support individuals at mealtimes on the residential unit. This must include assisting and supporting individuals at mealtimes so that people are not left struggliing to eat their meals and this must be reflected in peoples care plans for staff to follow. Mealtimes should be unhurried and people given time to eat their main meals before their desserts are brought to the table so that individuals health and wellbeing is not compromised and mealtimes are an enjoyable experience for all. Care Homes for Older People Page 8 of 30 Care planning must be completed with individuals, families or appropriate external agencies. This will ensure that people are involved in this process so that they have the opportunity for their preferences and choices to be heard and acted upon appropriately. The administration of prescribed creams and ointments must have the opening date of the item placed on them together with a description of where the prescribed medication needs to be applied so that people are not placed at risk and staff are provided with the appropriate guidelines to follow. A number of requirements and good practice recommendations were also made (as detailed on the back of this report). These include, manager should register with CSCI, review statement of purpose and service user guide, monitorinig food intake and repairs to an individuals ensuite bathroom. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals, their families and relevant others are supplied with sufficient written details about the home for them to make an informed decision about living there. Some of this information provided now requires updating and making accessible in easy read formats. There is some evidence that the home completes pre-admission assessments so that the home can demonstrate that it can meet peoples identified needs at the time of admission. Evidence: The home has produced a service user guide and statement of purpose but these now require reviewing and up dating to reflect the new management of the home. This will ensure that correct information is supplied prior to individuals moving into the home. The manager is now considering producing the service user guide and statement of purpose in a variety of formats. For example, words and pictures so that whatever a persons reading abilities and/or visual impairments are they will be able to access this Care Homes for Older People Page 11 of 30 Evidence: information. This will ensure that people will be able to make decisions about whether they would like to live at the home. The manager and members of staff confirmed that these documents are given to people when they are considering moving into the home. There was evidence in one care record that was sampled that this was the case and staff confirmed that the service user guide and statement of purpose are accessible to people in their rooms. One person confirmed that they had all the information that they required before making their mind up about moving into the home. Prior to moving into the home this person was able to look around the home which supported the information supplied in the homes, Annual Quality Assurance Assessment (AQAA) which states, Prior to admission the service users are offered to come and spend the day or a few hours at the home. If they are unable to the offer is extended to a relative or important others. One person said, I like it very much, it is like an hotel as you get waited on. Another person told us, I am very satisfied as the staff are always helpful. The home completes pre-admission assessments of peoples needs before they move into the home and there was evidence on two of the care records that were sampled that this was the case. This should ensure that the home are able to meet individuals needs when moving into the home. The home does not provide an intermediate care service. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally peoples needs are being identified and arrangements made to promote their health and wellbeing. Further work is needed so that individuals are involved in care planning ensuring their individual needs are met and preferences are promoted. Staff practices in respect of safe administration of medications need to be improved in respect of creams and ointments to ensure that these types of prescribed medications are administered safely. Evidence: We looked at the care records of three people in detail and partially looked at a further two care records within a case tracking process. This enables us to examine assessments and plans of care which inform care staff what a person is able to do independantly together with what assistance is required from staff in order for the person to maintain their needs. All care records seen contained an assessment of need, in some cases there were two, one from the social worker and one completed by the home manager. Needs identified Care Homes for Older People Page 13 of 30 Evidence: in these assessments had been transferred into individual care plans. Some care plans seen were found to contain some good details for staff to follow together with any risk to the individual highlighted. For example, one care plan gave staff details about the type of equipment to use to prevent any injuries occuring when moving this person. Risk assessments were in place for the identification of falls, moving and handling, nutrition and skin soreness. There were some shortfalls in care planning and this was mainly due to people and/or family members not being included in the writing and development of their own care plans so that preferences and choices are upheld. The manager is aware of this and is currently looking to improve peoples care plans and how these are written. Social profiles recorded gave staff details about peoples past lives, likes, dislikes and interests need to be further developed in greater detail with individuals and/or family members. This will assist staff to have meaningful conversations with people about the things important to them. There was evidence of people receiving visits from external healthcare professionals including general practitioners, district nurses and opticians. On the day of our visit we observed district nurses visiting the home and they were welcomed by staff who seemed to have good relationships with them. The management of medication was reviewed. Practices within the home are generally good with robust systems in place for the ordering, receipt and administration of medicines. Only senior staff are allowed to administer medication and only once they have completed Safe Handling of Medicines training. The medications that were audited were correct. There are some shortfalls in the administration of creams and/or ointments. When staff open this type of medication a date needs to be recorded on it together with a description of where the prescribed medication needs to be applied. This will ensure that people are protected at all times by knowledgeable staff. The management of controlled medication was robust with recording of two signatures in the register and this type of medication being stored separately in a secure wall cabinet that is locked. Peole told us that, Staff are lovely and if a doctor is needed they will get him for us. People appeared to be well supported by staff to choose clothing appropriate for the time of year which reflected individual cultural, gender and personal preferences. The home is part of the dignity in care challenge which promotes an awareness around respecting and assisting people to express their own needs and wants. To promote this challenge the home has a identified a staff member to be the homes champion and this information is prominently displayed on the notice board by the signing in and out book for visitors to the home. Care Homes for Older People Page 14 of 30 Evidence: In the main staff were observed to assist people in a sensitive manner, we observed staff encouraging people to join in the activities and people appeared relaxed within their surroundings. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally people are able to choose the activities that they participate in which promotes their individuality and independance but these need to be recorded robustly thereby promoting individuals choices. People are offered a choice of meals to meet their dietary needs and preferences. Mealtimes are not a pleasant experience for all people with staff showing little consideration for the needs of individuals. Evidence: The home has a dedicated activities coordinator who is employed to work four days per week, Monday to Thursday, to support people with their interests. We were told, I enjoy reading books but if I wanted to I could play bingo or watch the television. Another person said, staff throw the ball to us in turn. People were showing a fondness for the homes two cats by stroking them and calling their names. We observed the activities coordinator interacting with people in the dementia unit in the morning where one person was assisted with some dusting as this was an activity that they enjoyed. In the afternoon we observed people in one of the residential lounges singing to the music being played and individuals were also playing a musical instrument of their preference. On the walls of the dementia unit there is evidence of a Care Homes for Older People Page 16 of 30 Evidence: picture where people are able to place their own preferred smaller pictures, such as hands and flowers. We were told that people move the pictures around as they wish. When the activities coordinator is not at work then staff told us that they join in activities with people. We observed a local artist assisting a person who particularly likes art in making a vase with mosaic tiles. Staff told us that this artist comes in regularly to assist this person in continuing with their interest. A hairdresser visits the home weekly and people can choose to have their hair attended to. One person said, I have my hair done every week. A church service is held monthly for people who wish to take part so that people can maintain their religoius beliefs. There is an open visiting policy, which means people can see their visitors as they choose and maintain relationships that are important to them. Information supplied in the homes Annual Assurance Quality Assesment (AQAA) states, We welcome visitors and encourage service users to maintain contacts with the wider community. This was reflected in our observations as visitors were seen throughout the day and one visitor said Staff are lovely and welcoming when you visit, its like a family here. The home has a three week rotating menu. People have a choice of three types of breakfast either cereal, toast with marmalade, bacon sandwich or scrambled eggs. At lunchtime there is a choice of two hot meals and at teatime that is a choice of a hot snack or sandwiches. Fresh fruit is offered throughout the day with choices of drinks. The home is able to cater for special diets for reasons of cultural or medical needs. We spoke with the cook who was knowledgeable about individuals preferences and food choice for people with diabetes. The tables are nicely presented with cutlery, napkins and a copy of the menu. Information supplied by the home in its Assurance Quality Assessment, (AQAA), states, We treat service users with respect and dignity and staff receive training in this during their induction. We observed people having lunch in one of the residential lounges and found that this statement is not reflected in practice. For example, staff were not always on hand in this lounge area whilst people were eating their lunch in case support was required. One person was slowly trying to eat their lunch but this became a difficult task for them and food was being dropped as the person was trying to reach their mouth. Care staff were not seen asking this person if they were managing or offering support in a discreet and respectful manner. This persons hot dessert was brought to the table and placed by the side of their lunch which they were still eating. The person sitting close by thought at one point that this dessert was theirs but then their dessert also appeared. This dessert was left on the table to go cold whilst the person was eating their lunch. We shared our concerns with the manager who also observd this practice and could offer no explanation as to why this was happening but assured us that this practice does not normally happen at meal Care Homes for Older People Page 17 of 30 Evidence: times. People told us: We see the menu everyday and staff also always ask us what we want. The food is not too bad here. Our visitors can join us for meals if they wish. Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home and their families are confident that their views will be listened to and complaints dealt with effectively. The arrangements in respect of adult protection are robust and protect people from harm. Evidence: The complaints procedure is displayed in the home and is included in the service user guide so that people know how to make a complaint if they need to. The home have not received any complaints in the last twelve months. One person commented, If I had a complaint I would tell a carer but I am very satisfied. The home has an adult protection policy together with copies of the multi-agency guidelines so that staff are able to refer to these in the event of an allegation of abuse. Staff had received training in adult protection procedures so that they should know what to do in the event of an incident or allegeation being made, to ensure people are safe. Information supplied in the homes Annual Assurance Quality Assessment (AQAA) states, Staff are trained in abuse awareness and have a good knowledge and understanding of adult protection issues. In the main staff spoken with demonstrated that they possess adequate knowledge to take action when abuse is suspected. Care Homes for Older People Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally people are provided with a homely, clean and comfortable living environment in which to live where their privacy is maintained. An individuals ensuite bathroom needs some repair work so that the first floor environment has no unpleasant odours and the persons room is well maintained for them to use. Aids and adaptations provided meet the needs of individuals. Evidence: A partial tour of the home was undertaken, we looked at communal areas, some bedrooms and ensuite bathrooms. The atmosphere was calm, relaxed and friendly. The residential unit of the home is situated on the ground floor where there are two lounges with dining areas. These are pleasantly decorated making them a comfortable and pleasing environment for people to live in. Hallways are wide and people were seen to moving around the home as they chose to. There are a number of smaller seating areas throughout the home where people can choose to sit on their own or with visitors. Chairs have been arranged to promote social interaction as far as possible. The dementia unit of the home is on the first floor and a passenger lift makes this easy accessible for individuals and visitors. There are two lounges on this floor one of which is known as the quiet room where people are able to sit to read or relax. There are Care Homes for Older People Page 20 of 30 Evidence: patio doors in the small lounge area which leads onto a garden area where people are able to walk or sit particularly when the weather is good. Throughout the dementia unit the hallways have been painted with themes to make the home more meaningful to people who may have dementia. There is an indoor garden area which is decorated brightly with flowers, windchimes and various objects which people are able to remove easily if they wish. Peoples bedroom doors are painted with letterboxes and door knockers which individuals can relate to from their own past lives. They is also signage on individuals doors which is good practice and promotes poeples independance. Within this unit there are smaller areas situated along the hallways where people can sit if they choose. Some bedrooms were seen on the second floor area of the home. These were personalised and reflected the individual tastes, gender and cultural preferences. People are encouraged to bring in their own possessions in order to have famaliar items around them to make their rooms as homely as possible. All bedrooms have a call system so that people can be confident that if they need assistance staff will respond in a timely manner. There was an unpleasant odour on the dementia unit on the day we visited and the manager confirmed that this was due to one of the ensuite bathrooms requiring some repair works to its floor area. This should be repaired immediately to ensure that the home is well maintained and a pleasant environment for people who live there. One person told us that they were content with their room and another person commented that their room is a little dusty. The manager confirmed that disposable gloves and aprons are now readily available in the laundry room and this is an improvement from the homes last inspection where these items were not readily available. The enviornmental health officer had undertaken a visit to the home and the home received a silver award. This means that the home should have good hygeine procedures in relation to food handling and this will minimise the risk of any cross contamination. Care Homes for Older People Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In the main people are supported by staff who receive training to ensure that they have the knowledge to meet individuals needs. The recruitment procedure is robust and ensures that people are safeguarded from harm. Evidence: The day we visited there were three care staff on duty for the residential unit and the dementia unit. On each unit there is a senior carer on duty. In addition to the care staff the home employs ktichen, domestic and maintenance staff. This ensures that all aspects of peoples care needs are met whilst living in the home. There is currently a vacancy for administrative support and a deputy manager. The manager confirmed that 50 of staff have now completed their National Vocational Qualification (NVQ) Level 2. This is an improvement from the homes last inspection where this was under the recommended target of 50 . Further staff have now enrolled onto the course and are working towards acheiving this qualification. This should ensure that a knowledgable and skilled workforce can meet peoples needs on an individual basis and collectively. In the main staff were observed to interact well with people living at the home and the atmosphere was generally calm, friendly and relaxed. One person told us, Staff are Care Homes for Older People Page 22 of 30 Evidence: friendly and will listen to your wants. Another person who was referring to the registered manager that has now left the home commented, X always takes times to listen and knows when you are feeling down. We examined four staff records and these were found to contain all of the relevant information including, two written references and CRB checks (Criminal Records Bureau). Records were generally organised well but information was hard to retrieve at times. Staff have been provided with job descriptions and there was some evidence that people receive an induction into the home so that they are aware of their roles and responsibilities. This has improved since the homes last inspection when it was highlighted that staff did not complete a structured induction that meets the Skills for Care standards. Training records and the homes own schedule of training indicated that staff have received training in areas such as, fire safety, food hygeine, moving and handling, COSHH (Control of Substances Hazardous to Health), infection control and adult abuse. Some staff had received training in care planning, pressure care (skin soreness), nutrition and challenging behaviour. This should ensure that staff have received up to date knowledge and skills to care for people living in the home. Care Homes for Older People Page 23 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is newly promoted to this role and requires support at the present time to ensure that the home is run in the best interests of the people who live there. The manager has not completed the process of registration with CSCI. Quality monitoring systems take place to ensure that people living in the home can be confident it is acheiving its aims and objectives. Evidence: The registered manager left their employment at the home on the 15 October 2008 and the deputy manager has now been promoted to the post of manager. The Commission for Social Care and Inpsection, (CSCI), have not been made aware of this but the operational manager who came to the home at the time of our visit told us a letter would be sent. The manager has been deputy manager at the home for two years and they told us that they have National Vocational Qualification (NVQ) Level 3 but would be applying Care Homes for Older People Page 24 of 30 Evidence: to complete Level 4 in this qualification. The manager said that they also have the Registered Managers Award together with 7302 certificate which means that they have the knowledge to be able to train people. The manager is not registered with CSCI but is now looking to submit an application. The manager is clear about some of the changes they would like to implement in order to ensure that that home is run in the best interests of the people living there but they are requiring some support in their new role. Staff told us, He will be good in his new position and we will all support him. However, it was evident at the time of our visit that some staff are missing the registered manager that has left the home but the new manager is aware of this and staff supervision and meetings will manage peoples feelings at this time of change. Residents and staff meetings are held so that people have the opportunity to voice their concerns and suggestions for improvements. However, these now need to be held on a regular basis so that people can feel confident that staff have up to date information about the home and peoples needs. Operational managers visit the home and complete Regulation 26 visit reports which focus on the quality of the service being offered at the home. The home have a number of audits in place to monitor the service provided. We were showed the results of the managers last monthly audit which reports on a wide range of areas within the home, such as, medication, home presentation, health and safety and care file documentation. The home also sends out customer satisfaction questionnaires and this information is collated into a report. The findings of the last results are displayed in the main reception area of the home. This is an improvement since the homes last inspection when findings were not published for people to see. Prior to the inspection the previous registered manager had completed an Annual Quality Assurance Assessment (AQAA) and returned it to us. This gave us some information about the home, staff and people who live there, improvements and plans for further improvements. Some of this information has been used in various sections of this report. Health and safety and maintenance checks had been undertaken in the home to ensure that the equipment was in safe and full working order. Maintenance checks are completed on the fire system and equipment so that people should be safe in the event of a fire occuring. We discussed in our feedback to the manager that the fire drill that had taken place on the 16 October 2008 had no response time documented and this needs to be noted on all of the fire drills undertaken so that people are protected from harm in the event of an emergency situation. This was discussed with the manager who will ensure this happens in future fire drills. Staff who have participated in fire drills are recorded to ensure that staff are captured throughout the year. Care Homes for Older People Page 25 of 30 Evidence: Accident records were reviewed and the manager completes an audit of these each month in order to monitor any trends so that the home can take action to prevent more occurrences. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 13 The ensuite bathroom must be repaired so that it is a safe and pleasant facility for people to use. This will also result in the in the unpleasant odour disappearing. To maintain a safe and well manitained environment. 15/11/2008 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 1 To review and amend service user guide and statement of purpose so that these accurately reflect the changes within the management structure of the home and comply with the current standards and regulations. This will provide people with accurate information prior to living at the home. Care plans need to be devised with consultation and involvement from individuals and/or representatives so that people are having an opportunity of saying how their health and wellbeing is met. Care plans need to be consistent within each persons care records with information that is easily retreivable for staff 2 7 3 7 Care Homes for Older People Page 28 of 30 to follow so that this can be actioned to meet all aspects of individuals health, personal and social care needs. 4 9 All prescribed creams and ointments need clear indication of when they were opened together with a description of which part of the body these need to be applied so that safe administration and handling of these type of medications with ensure that peole are protected at all times. It is recommended that a robust form of method in relation to recording peoples daily activities is maintained so that appropriate social stimulation is offered to all people. It is recommended that people are offered support whilst eating their meals in a sensitive manner and mealtimes are unhurried with individuals given sufficient time to eat their meals so that peoples health and wellbeing is promoted. It is recommended that a review of the current system for monitoring and recording food intake for individuals is undertaken to ensure their health and wellbeing is maintained. The home must be able to demonstrate that staff have the skills and knowledge required to recognise when individuals require supporting with their meals due to peoples medical conditions fluctuating. This is particularly important for people with Parkinsons Disease. It is recommended that the manager completes the process of registration with the Commission for Social Care and Inspection so that people will be confident that the home is run and managed by a person who is fit to be in charge and able to discharge their responsibilities fully. 5 12 6 15 7 15 8 27 9 31 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!