Inspection on 04/03/09 for Dudley Court Rest Home

This inspection was carried out on 4th March 2009.

CSCI found this care home to be providing an Good 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

Dudley Court Rest Home 01/03/08

Dudley Court Rest Home 21/09/07

Dudley Court Rest Home 31/01/07

Dudley Court Rest Home 05/06/06

Dudley Court Rest Home 01/11/05

Dudley Court Rest Home 08/06/05

Dudley Court Rest Home 17/12/04

Dudley Court Rest Home 12/05/04

Dudley Court Rest Home 18/02/04

Dudley Court Rest Home 30/10/03

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Dudley Court Rest Home 16 Dudley Park Road Acocks Green Birmingham West Midlands B27 6QR     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: Sarah Bennett     Date: 0 4 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Dudley Court Rest Home 16 Dudley Park Road Acocks Green Birmingham West Midlands B27 6QR 01217063087 01217063087 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Paresh Parmar Name of registered manager (if applicable) Mrs Jill Lynette Durrant Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 22 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) 22 Date of last inspection Brief description of the care home Dudley Court is a three storey residential service for twenty two older adults. The home is situated near to a busy shopping centre in Acocks Green that can be accessed by local bus links to Birmingham and Solihull. Acocks Green Railway Station is within walking distance. It is also close to a variety of local churches of various denominations and the local library. There is a driveway with some space available for off road parking to the front of the premises. The ground floor consists of two lounges, a dining Care Homes for Older People Page 4 of 31 care home 22 Over 65 22 0 Brief description of the care home area and a conservatory providing a choice of areas to sit. There are twelve single bedrooms, two of which have en suite facilities on the ground floor. The first floor consists of seven single bedrooms and there are three bedrooms on the second floor. The remaining rooms have a wash hand basin and all areas have a call bell. There is a separate laundry area on the second floor. There are four bathrooms with assisted baths including one that has a hoist. There are four toilets. A passenger lift gives people access to all floors. There is a pleasant garden to the rear of the property that has ramped access for people who use wheelchairs plus seating for when the weather permits. Wheelchair access is also available to the front of the home. There is information about the services and facilities available in each bedroom. The fees are available on enquiry, these do not include, toiletries, newspapers, chiropody or hairdressing. Care Homes for Older People Page 5 of 31 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 quality rating for this home is two stars. This means that the people living there experience good quality outcomes. This was the homes key inspection for the year 2008 to 2009. They did not know we were going to visit. The inspection lasted for one day. The focus of our inspections is on the outcomes for people who live in the home and their views of the service provided. We look at how the home meets the Regulations, the minimum standards of practice and what they need to do to make the service better. The last inspection was in March 2008. The manager completed the Annual Quality Assurance Assessment (AQAA) about the Care Homes for Older People Page 6 of 31 home and how they think the home is running. They sent this to us before our visit. We looked at some parts of the building. We looked at records about four of the people living there and three staff. We looked at health and safety records. We talked to the people living there, the staff on duty and the manager. Some people were unable to communicate their views verbally so we also observed what was going on during the day. We sent out our Have your say surveys before the inspection. This was completed and returned to us by three people who live there, four relatives, three visiting professionals and two staff. Their comments are included in this report. An expert by experience visited as part of the inspection. This is a person who has experience of using services. They talked to the people living there and gave their views about the home. Their views are included in this report where they are referred to as the ex by ex. Four people who live there were case tracked. This means we look at their experiences of living in the care home by meeting or observing them, talking about their care with staff and looking at their records. Tracking peoples care helps us understand the experience of people who use the service. What the care home does well: What has improved since the last inspection? What they could do better: People should have the information they need so they know how to contact us if they need to. A wider range of activities should be provided including trips out of the home to improve the quality of life of the people living there. Care Homes for Older People Page 8 of 31 Staff should ensure that peoples personal possessions are kept safe and it is clear what belongs to each individual. The people who live there should have a healthy diet that meets their dietary needs to ensure their well being. Rooms should be redecorated where needed so that the home is comfortable for people to live in. All areas of the home should be kept clean so it is pleasant for people to live in. All staff should be kept updated with the changing needs of the people living there and with best practice. Reports of the owners monthly visits should show they are auditing how the home is meeting the standards and regulations. 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 31 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 31 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 about the home so they can make a choice as to whether or not they want to live there. Peoples needs are assessed before they move in so that they know their individual needs can be met. Evidence: The statement of purpose and service users guide included the relevant information so that people had the information they need about the home. It had been updated regularly. This ensures that prospective service users know what the home provides so they can make a choice as to whether or not they want to live there. Each person had a copy of these in their bedroom. The service users guide included our contact details but these were out of date. These should be updated so that people know how to contact us if they need to. People said that before they moved into the home they were able to visit to help them Care Homes for Older People Page 11 of 31 Evidence: make a decision about whether or not they wanted to live there. One relative said, Before she moved in I visited it was my gut feeling that this was the care home for my relative. Records sampled showed and the AQAA stated that before people move into the home an assessment is completed. This finds out what their needs are and assesses whether or not they can be met at the home. Records sampled showed that as well as their needs the assessment also found out their likes and dislikes so that staff knew more about the person. The home does not provide an Intermediate Care Service. Therefore, standard 6 which relates to this was not assessed. Care Homes for Older People Page 12 of 31 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. The health and personal care needs of the people living there are generally well met so ensuring their well being. Evidence: The records of four of the people who live there were looked at. These included an individual care plan that stated how staff are to support the person to meet their needs. Two of the people living there whose records we looked at had been recently admitted to the home so staff were still getting to know them. They had an individual care plan but these did not include all the needs of the individual. In other parts of their records it stated that the person had a specific need but there was not yet a care plan in place for this. These should be developed when the need is identified so that staff always know how to support individuals. Staff spoken to did know how to support individuals to meet all their needs even when there was not a care plan in place. However, it cannot be assumed that all staff will have this information passed on to them. Care Homes for Older People Page 13 of 31 Evidence: One persons care plan had been reviewed every month up until August 2008 to assess whether there were any changes to the persons needs. Where there had been changes the care plan had been updated to reflect this. Since August the persons care plan had not been reviewed. This should be reviewed monthly so that staff continue to support the person to meet their needs. The other care plans sampled had been reviewed monthly. Relatives and friends of the people living there said, I have been impressed with the care and attention my friend receives. My mothers care is excellent and her needs are always met. A health professional who visits the home regularly said, Excellent care plans implemented by competent carers. The manager said that none of the people living there had sore skin. Pressure relieving equipment was provided to help prevent people developing these. Records sampled included a risk assessment as to the risk of the person developing a pressure sore. The risk may change if the person has lost weight. One persons weight records showed that they had lost weight over recent months. Their pressure area assessment stated no weight loss. Staff should ensure that when they are completing assessments that they look at all the information needed so that people are supported and not put at risk. From sampling records and talking to staff it was clear that staff work with health professionals so that individuals health needs can be met. Records showed that staff followed the advice of health professionals to help people to be well. A health professional said, Staff have prevented admission to hospital due to liaison with professionals, communicating, listening and supporting appropriately. Records sampled confirmed this. Records showed that where a persons health had deteriorated health professionals were informed and advice taken to improve the persons well being. It was not clear in some health records sampled what the outcome of a health appointment was or a test such as a blood test. The manager said that action had been taken to ensure the person was well but this was not always recorded with the record about the appointment or test. This should be recorded to ensure that all peoples health needs are followed up and action taken when a person is unwell. Medication is stored in a locked trolley or cabinet so that people are not at risk of taking medication they are not prescribed. Staff were observed giving people their medication one at a time then going back to the trolley to get the next persons medication. This ensures that people get the medication they are prescribed. Staff who give medication receive training in the Safe Handling of Medicines. Care Homes for Older People Page 14 of 31 Evidence: The local pharmacist supplies medication to individuals each week in a pre packed box for each dosage. This helps to reduce the risk of errors so that people get the medication they are prescribed. Where people had refused medication this was recorded on the back of their medication record. Where necessary health professionals had been told about this so that they could give advice as to how to meet the persons health needs. Medication records sampled had been signed by staff appropriately indicating that medication had been given as prescribed. The people living there were well dressed in individual styles of dress that reflected their age, gender and the activities they were doing. Attention had been given to peoples personal care so to ensure individuals self esteem and well being. Staff were observed talking to people in a way that respected them as a person and reassuring people if they were confused or unsure about anything. Relatives said, Staff always have time to talk to the residents whatever their worries. Staff talk to my relative and listen to any worries we both might have. Care Homes for Older People Page 15 of 31 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. Arrangements do not always ensure that all the people who live there can do the things they enjoy, which could impact on their quality of life. Evidence: People said there are regular activities provided that they enjoy including the exercise class. Records sampled showed that regular activities are provided in the home. Three people told the ex by ex that there were a great variety of activities and that they enjoyed them. One person said that they would like to go on day trips. Staff said that people do go out but sometimes staff have to take people in their own time as there is not time during their shift. Another person said that they would like to have exercise sessions more often. One person told the ex by ex that they would like to have more interesting activities as they are now bored with some of the activities on offer. Care plans sampled included a care plan on what activities and hobbies the person enjoyed. The ex by ex found from talking to people and looking at activity records that a wider selection of activities which engage people in a meaningful way was needed. This could include reminiscence activities. The ex by ex said that this would greatly improve the quality of life of the people living there. Care Homes for Older People Page 16 of 31 Evidence: People said and it was observed that the TV is not often on in the large lounge as it cant be seen by all the people in there because of the layout of the room. Some people said they would prefer to watch TV in the lounge rather than on their own in their bedroom. There was a TV in the small lounge but only a few people are able to sit in there. People told us that they have a garden party in the summer that they can invite their relatives to. A relative said, The manager and staff arranged a garden party in August. There were singers and everyone had a wonderful time. People told us that peoples birthdays are always celebrated and the cook always makes a cake. A relative said, The manager has arranged a singer for my mums birthday party. People told us and records sampled showed that they can have visitors when they choose. Some records showed regular visits from family and friends and people often went out with them. A visitor said, Residents who are able to, go out with their families. A relative said, I see my mother every other day. My sister phones her and my mother takes her calls in the office. This is good as it shows that people can take their calls in private. A visiting professional said, Staff have good relationships with residents and families. Families say that staff keep them informed. They provide support for residents and families to make informed choices. There are meetings held every other month with the people living there. Records showed that people talked about special events, how they would like money that had been raised for the home spent, how they would like to celebrate their birthdays, what food they liked to eat, new staff that are working there and new people coming to live at the home. Minutes showed that people had an opportunity to speak at these meetings if they wanted to. It is not clear whether people are able to bring their personal possessions with them and if they do whether the safekeeping of these will be monitored at the home. Records sampled included a clothing list. These were either not completed or had not been updated for several months. This means that it is not clear what belongs to which person, which could result in possessions getting lost. Staff at the home are not responsible for the financial affairs of any of the people living there. Small amounts of personal money are kept at the home where relatives have given this. Records sampled showed that this is held safely and receipts are kept when money is spent so it is clear that people are spending their money as they want to. Care Homes for Older People Page 17 of 31 Evidence: The ex by ex had lunch with the people living there. She found that all people had the same meal, which was roast lamb. The manager said that the menu was chicken or lamb and everyone had chosen lamb. Trifle was on the menu as the only pudding but all people had ice cream. The manager said this was because staff training was arranged that afternoon so it was easier to provide ice cream. This does not show that people always have a choice of what they eat. Food records sampled showed that people who have diabetes regularly have cakes and puddings. This may be detrimental to their health although their records did not show that their diabetes was poorly controlled. The cook said that people with diabetes have smaller portions of puddings and they are made with ingredients that are specifically for people with diabetes. The cook said that sometimes people have fruit instead of puddings. This was not stated in the food records sampled. One person told the ex by ex that getting fresh fruits was a rarity. There were not any fresh fruits offered that day. The manager said that fruits were not available for people around the home because some peoples needs would mean that this was detrimental to their health if they could take fruit from a bowl. Fresh fruit was available in the kitchen. The ex by ex observed that people were served cold drinks with their lunch but two people said that they could have tea of coffee if they asked for it. People said that they enjoyed their lunch and liked the food they have at the home. Tables were laid with table cloths, placemats, serviettes, cutlery and salt and pepper. People were supported by staff during the meal where needed. The ex by ex said, The people living there sat in the dining room for their lunch, there were two to four people sat at a table. The food served appeared to be warm, of a reasonable proportion and was well presented. Care Homes for Older People Page 18 of 31 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. Arrangements ensure that the views of the people living there are listened to and acted on so ensuring that they are safeguarded from abuse. Evidence: The complaints procedure displayed in the home did not detail how a complaint would be investigated, the timescale in which this would be done or what would happen if further investigation was needed. However, in the service users guide this was stated and each person has a copy of this in their bedroom. Complaints procedures stated that people could contact us if they wanted to but our current contact details were not provided. These should be updated. We received a concern from a social worker before our visit that there had been no heating or hot water in the home. This had also been raised with the home by the social worker. There was no evidence to suggest that this was true and the manager was unsure where this complaint had come from. She said that some taps had been changed recently so hot water may have been limited for a short period. The social worker was satisfied that this complaint was not upheld. No other complaints had been received by us or the home. There was a grumbles book in the home and minor grumbles were recorded. One had been recorded since our last visit and this had been resolved to the persons satisfaction. Care Homes for Older People Page 19 of 31 Evidence: People who live there told us that they knew how to make a complaint but did not have any. A regular visitor to the home said, I would make a complaint via the manager or CSCI. No one has ever raised any concerns to me. A relative said, The manager is very approachable and will sort out anything you ask. I have no complaints. A professional said, No need to make a complaint but I know how to. The ex by ex said, The seven people I spoke to, were not aware of any formal complaint procedures. However, concerns and difficulties they had raised with the care manager were resolved quite quickly. They all have a very strong belief in the care managers strong leadership and her ability to sort matters out quickly to their satisfaction. The people living there appear to verbally let their concerns known and this is acted on. Staff receive training, records sampled showed and staff spoken to demonstrated that they were aware of how to safeguard the people living there from abuse. Some staff had received training in the Mental Capacity Act, other staff had been booked to attend this training. The Mental Capacity Act came into force in April 2007. It requires an assessment to be completed where there is any doubt that a person does not have the capacity to make decisions about their health and welfare. If it is assessed that the person does not have capacity an Independent Mental Capacity Advocate (IMCA) can be appointed to help them with this. Therefore, it is important that all staff know about how this legislation may affect the people living there. As part of this legislation there are the Deprivation of Liberty Safeguards (DOLS). This requires that where a person lacks capacity staff should ensure that the care they receive does not take away their liberty and that any care they receive is in their best interests. For example, a person may be denied the freedom to enter the kitchen as it may be thought that this is an area where they may be at risk of harm. If this is so it must be considered whether this is in the persons best interests or are they are being deprived of their liberty, in which case their care could be given differently to manage this risk. The manager said that she was aware of this legislation and training in this is to be arranged for all staff. The trainer who was at the home during our visit said that all training that is needed is requested by the manager so that staff are well updated with the current legislation. Care Homes for Older People Page 20 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally comfortable and is safe providing a homely place for people to live in. Evidence: Since our last visit the kitchen had been refurbished. The decoration in the dining room was looking worn. The manager said that this was on the redecoration programme to be done in the next year. There were contrasting colours in the dining room to help people who have a visual impairment find their way round more easily. The bathrooms on the first and second floors had been refurbished since our last visit. The manager said that the ground floor bathrooms and toilets were to be refurbished soon. There is a large conservatory off the dining room. People said that they used this in the summer for the garden party. There were several items stored in there and nobody used this room during the day. There were two radiators in there and blinds on the windows so it was not cold. It was well decorated and furnished making it a pleasant place to spend time in. The ex by ex looked at some bedrooms. They said, The bedrooms are of a decent size Care Homes for Older People Page 21 of 31 Evidence: but are in need of decorating. Some people have personalised their rooms with pieces of furniture, soft toys and photographs. Some of the rooms had visible dust on the furniture, television and ornaments. There were small pieces of crisps on the floor in one room. I discussed this with the manager, who told me that it was the Cleaners day off. The people living there informed me that their room is usually cleaned once per week Rotas showed that a cleaner is employed who works four days one week, five the next and six the next. The manager said that when it is the cleaners day off care staff do the cleaning. The cleaning had not been done that day as staff also had training. Care staff also cover the cook when it is their day off. This puts an extra demand on care staff, which could result in them not being able to meet individuals needs. Generally the home was clean and free from offensive odours with the exception of one part near to bedrooms on the ground floor where there was an odour of urine. In order to ensure that the home is always clean for people to live in consideration should be given to providing extra hours to cover the cleaners days off. The manager said that the kitchen was awarded 4 Hygiene Standards by the Environmental Health Officer and this was displayed at the front door. This was before the kitchen was refurbished so it is hoped at the next visit they will be awarded the highest standard. Care Homes for Older People Page 22 of 31 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. The arrangements for staffing, their recruitment and development ensure that the needs of the people living there are met and they are safeguarded from harm. Evidence: The manager said there is one vacancy for a senior care staff, which had just been advertised in the job centre. The manager said and rotas showed that there are usually three staff on each shift. The manager works in addition to the staff on the rota. There are also separate maintenance staff. Most days there are also a separate cleaner and a cook but when they are off care staff cover these tasks. Six people told the ex by ex that there are enough staff on duty during the day. One person said that sometimes you have to wait for assistance depending who is on whether it is day or night. Four people expressed concerns to the ex by ex that there were only two staff on duty at nights but two people said the staffing levels at night were fine. Throughout the day it was observed that when a person called for assistance using the call bell staff immediately went and gave them the support they needed. People told the ex by ex that they always have access to a call bell and can call for staff when they need to. They said that sometimes they have to wait a while to get assistance when staff are busy. People living there who responded in the survey did not express any concern that staff did not support them when they needed it. Care Homes for Older People Page 23 of 31 Evidence: Relatives said, Very caring staff, always helpful and attentive. Staff always give 100 per cent support. The staff are very professional in carrying out their duties. Professionals said, Staff have good relationships with residents and families. From my observation staff always put the individual first. Staff were observed to get on well together and work as a team, which helps the people who live there to live in a pleasant environment. The ex by ex said, The staff were very welcoming, friendly and pleasant. The minutes of staff meetings showed that since our last visit there had been four meetings. These showed that staff discussed the changing needs of the people living there and had opportunities to update their skills and knowledge. There should be at least six staff meetings a year to ensure that staff are kept updated with changes and best practice. The AQAA stated that ten staff have achieved National Vocational Qualification (NVQ) level 2 in Care and two staff have achieved level 3. It stated that another two staff were doing NVQ 3 and two were doing NVQ 2. This exceeds the standard that at least 50 per cent of staff have this qualification so that staff should have the qualifications they need to meet the needs of the people living there. The records of three of the staff that work there were looked at. These included the required recruitment records including a satisfactory Criminal Records Bureau (CRB) check to show that suitable people are employed to work with the people living there. Staff records sampled showed and staff said that they have the training they need so they have the skills and knowledge to meet the needs of the people living there. The home employs a trainer who was there during our visit to give first aid training to staff. The trainer said that the staff have completed the training they need and the manager always make sure that this is updated every year so that all staff have the updated knowledge they need. The trainer said that the staff are good learners and put the things they learn in their training into practice. One member of staff had received an award from the training company for Learner of the Year showing the committment of staff to training so they know how to support the people living there. Care Homes for Older People Page 24 of 31 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 management arrangements ensure that the home is well run and that it is a safe place to live. Evidence: The registered manager has over sixteen years experience of working with older people, nine of which are in a management role. She has the Care and Management qualifications required to be a registered manager. The manager has managed the home for six years. Relatives said, The manager is very approachable and will sort out anything you ask. Staff said, The manager is an asset to the home and ensures its smooth running. Reports of visits by the owner showed that they visited every month as required, to audit the home, until October 2008. There were no reports since this date. The manager said that they had visited more regularly than every month but the reports were not available. The owner should do this every month so it is clear that they are Care Homes for Older People Page 25 of 31 Evidence: auditing the home to ensure it is meeting the required standards and regulations to provide a good service to the people living there. The manager does not manage the money of any of the people who live there. If relatives or the people who live there want to give the manager some money to keep safe they can do this. Records are kept of what money is being held in the home, how it is spent and receipts of any purchases. Monies sampled showed that these cross referenced with the record, showing that peoples money was safe and is spent in the way they want. Staff records sampled showed that two staff had four formal supervision sessions with their manager in the last year. The other staff member had recently started working there and had received no formal supervision. All staff should have at least six formal supervision sessions a year to ensure they are kept updated and are supported in their role to meet the needs of the people living there. Some people need assistance from staff to move around. Records sampled included a moving and handling assessment that guided staff how to support the person ensuring their safety and that of the individual. During the day staff were observed supporting people to move safely to reduce the risk of any injury. Staff records sampled showed that staff have regular updated training in moving and handling so they know the best way to support people in this. Fire records showed that usually staff test the fire equipment regularly to make sure it is working. However, staff had not tested the emergency lighting since January this year and this should be done every month. Regular fire drills are held so that staff and the people living there can practice what they would do if there was a fire. The fire risk assessment had been updated recently. This was detailed and showed that all rooms in the home had been assessed so that action could be taken to reduce the risk of there being a fire. Records showed that all the equipment in the home had been regularly serviced to ensure that it was well maintained and safe to use. Care Homes for Older People Page 26 of 31 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 31 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 1 The service users guide should be updated with our current contact details so that people know how to contact us if they need to. Care plans should be reviewed monthly and updated where their needs have changed so that staff continue to support the person to meet their needs. Care plans should include all the identified needs of the individual. This will ensure that all staff know how to support the individual to meet their needs so ensuring their well being. Staff should record the outcome of a health appointment or test so that it is clear what action is being taken or what advice is given. This will ensure that peoples health needs are met. Staff should ensure that when they are completing pressure area assessments that they look at all the information needed. This will ensure that people are supported and not put at risk, which could impact on their well being. A wider range of activities should be provided including trips out of the home to improve the quality of life of the people living there. Page 28 of 31 2 7 3 7 4 8 5 8 6 12 Care Homes for Older People 7 12 Consideration should be given to re positioning the TV in the large lounge so that more people can watch this there if they want to. Clothing lists should be completed when a person moves into the home and these should be regularly updated. This will ensure that peoples personal possessions are kept safe and it is clear what belongs to each individual. Records should show that people are being provided with a healthy diet that meets their dietary needs to ensure their well being. More fresh fruit should be provided as part of the menu to ensure that people have a healthy diet to esnure their well being. The complaints procedure should be updated with our contact details so that people have the information they need to contact us if they want to. All staff should receive training in the Deprivation of Liberty Safeguards (DOLS) so they are aware of this legislation and how it may affect the people living there. More use should be made of the conservatory to ensure that people have a range of comfortable, shared rooms they can spend time in. The dining room and ground floor bathrooms should be redecorated to ensure the home is comfortable for people to live in. Consideration should be given to providing extra hours to cover the cleaners days off so that the home is clean for people to live in. There should be at least six staff meetings a year to ensure that staff are kept updated with the changing needs of the people living there and are updated with best practice. People should be asked regularly in meetings or through satisfaction surveys whether there are always enough staff on duty to meet their needs. If they say that more staff are needed there should be a review of the staffing levels. The owner should visit the home every month to audit how it is meeting the standards and regulations. They should make a report of this visit, which should be available in the home. All staff should have at least six formal supervision sessions a year to ensure they are kept updated and are supported in their role to meet the needs of the people living there. Staff should test the emergency lighting every month to 8 14 9 15 10 15 11 16 12 18 13 19 14 19 15 26 16 27 17 27 18 33 19 36 20 38 Care Homes for Older People Page 29 of 31 make sure it is working and keep a record of this. Care Homes for Older People Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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. 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