Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: East Cosham House 91 Havant Road East Cosham Portsmouth Hampshire PO6 2JD 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: Richard Slimm
Date: 1 1 1 1 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 31 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 31 Information about the care home
Name of care home: Address: East Cosham House 91 Havant Road East Cosham Portsmouth Hampshire PO6 2JD 02392321805 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Cllr David Fuller Type of registration: Number of places registered: Mrs P Drabble,Mr G Drabble care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 24. The registered person may provide the following category/ies of service only: Care home only - (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) Dementia (DE) Mental disorder, excluding learning disability or dementia (MD). Date of last inspection Brief description of the care home East Cosham House is registered with the Commission for Social Care (CSCI) to accommodate up to 24 residents who are over 65 and have an age related mental Care Homes for Older People
Page 4 of 31 Over 65 0 0 24 24 24 0 Brief description of the care home health need. The home is a large detached property and is situated up a short drive; it is just off the main road through East Cosham and provides easy access to the town centre. The home has two gardens, one that is enclosed to the rear of the premises, with seating areas for residents. There are 18 single and 3 double bedrooms. The home has three communal lounges and a dining room, which are all pleasantly furnished and decorated providing a valuing environment for the people living there. There is parking for up to 6 vehicles. Please contact the home for up to date information regarding the fees. 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 service is 2 stars. This means the people who use this service experience good quality outcomes. This inspection was an unannounced Key Inspection of the home, a Key Inspection being part of the CSCI inspection Programme, which measures the service against the key National Minimum Standards, and outcomes for people using the service as part of a process known as Inspecting for Better Lives (IBL). This report incorporates information gained from people using the service and/or their advocates / relatives, staff, including managers and comments from external stakeholders who completed professional comment cards. We were also provided with Care Homes for Older People
Page 6 of 31 the services annual quality assurance assessment (AQAA) completed by the manager and other relevant information gained by the inspector via such processes as observations, interviews, inspection of documents and records and case tracking, during a site visit to the home. The visit to the home was undertaken by one inspector and lasted 4 hours. What the care home does well: We were able to identify an number of improvements at the home in the interests of service users. People living at the home that were interviewed or spoken to more informally were found to be happy and contented with the quality of care and support they received on a daily basis. People were observed to have good relations with the staff team and the newly registered manager, and spoke highly of the staff in general. Residents choose the food they eat and are offered alternative if the main menu options were not to their liking. A recent initiative to place menus on each table is appreciated by the residents spoken to by us. People said there are usually options at main meal times. There was evidence of an increase recently in activities arranged with residents, and people confirmed they enjoyed these events. As far as possible these were planned and provided on the basis of each individuals assessed needs and wishes, and people are consulted via the regular resident group meetings. It was evident that people were being supported to lead the lifestyles they chose, and that support also took account of the abilities and skills of the person concerned. We noticed that some residents are taken out by families. The home was, clean and pleasantly presented providing a valuing environment for residents. Due to the high dependency of some people there were some odours evident, but staff were observed to be working hard to manage these problems. The home offers a mixture of shared and single room accommodation. The home continues to develop systems of assessment and care planning to promote a good quality of care, support and continuity of services. Each person benefits from an individualised plan of support and care, and from these documents the home plans service development that is in line with the needs and wishes of the people living at the home. People told us there are regular resident meetings where residents are consulted about the running of their home. Staff members were found to engage well with residents, and there was a range of skills and experience in the team. Staff are supported in their training and development, and the home were meeting the national benchmark for the number of staff trained and qualified to national vocational levels. In addition to this the manager is trained and qualified to NVQ level 4 with the Registered Managers Award. The manager makes sure documentation provides information needed by staff members relevant to any specialist needs of service users and also provides staff with opportunities to attend more specialist courses. In addition staff are being provided with regular individual sessions for their support and supervision by the manager. We were advised that any visitors are always made to feel welcome, and could visit at any reasonable time. There is a clear statement in respect of visitors. There was a reasonable response to surveys included comments such as Our relative suffers from dementia, so he is unable to keep in touch personally, but the care home keep us informed at all times. I feel the home look after and care for my father well. Care Homes for Older People Page 8 of 31 The home seems to be run effectively, and he is being very well cared for. My relative has Alzheimers and her behaviour can be erratic. Staff are generally very supportive. The home are very welcoming to friends and relatives. The home needs to provide more activities for residents, there are not enough distractions / stimulation. Resident comments in response to surveys included - Staff are always helpful and listen to me. They are always good and quick when I need a doctor. There is always an alternative if I dont like a particular meal. I am happy with the environment I live in. I am happy that the staff try to do their best. We spoke to two people visiting a relative at the home. They confirmed that they are always made welcome when visiting, and said they felt confident that the registered manager or other staff would deal with any issues as they arose. What has improved since the last inspection? What they could do better: From our inspection of personal care records known as case tracking, we found the home continues to develop and improve systems of assessments and care/support planning. However, there is potential to develop these systems further in line with current best practice in respect of more person centred approaches. In addition to this we found that the methods of recording, monitoring and review could be developed further as identified in the main body of this report. People said they would like to have trips out more regularly. We noted that people with no family networks do not go out very often at all. While the staff work hard to maintain a fresh and clean environment, there were some areas of the home where odours of urine were evident. Care Homes for Older People Page 9 of 31 Feedback from a relative included the comment - The home needs to provide more activities for residents, there are not enough distractions / stimulation. 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 10 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 11 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. No person is admitted unless they have had their needs and wishes assessed and been assured their needs will be met at the home. The home does not provide intermediate care. Evidence: The service AQAA said - People visiting the home with a view to admission, either for themselves or on behalf of a family member, are made very welcome and shown round by a senior member of staff who explains what service we offer and what the facilities are. All such visitors are give a copy of the brochure (service users guide) which gives detailed information on the service, core values, facilities, activities and events, residents rights, fees and the complaints procedure.A comprehensive preadmission assessment is undertaken by suitably qualified and experienced staff and information gathered from social workers and health professionals. A senior member of
Care Homes for Older People Page 12 of 31 Evidence: staff undertakes the assessment and carefully considers whether we can meet the needs. Where appropriate, the assessment will be discussed with other staff members to fully ensure we are able to meet the identified needs. A place is only offered if we can meet the assessed need. The offer of a place is always to a specified room which, unless an emergency, the resident or family will already have visited.Prospective residents are encouraged to visit the home pre-admission to get a better feel of life at East Cosham House All residents have a contract, signed by them or their representative, setting out the terms and conditions of residency, including the specific room number and the fee. They are issued with a copy for their own records. Surveys told us people had been enabled to make informed choices about moving into East Cosham House. We case tracked three peoples personal records, in order to evidence outcomes and to assess their quality of life at the home. There is an admissions book. All potential residents are pre- assessed by the manager prior to admission. People funded by the local authority also have a local authority assessment carried out by a care manager from that agency. People are offered a visit to try out the home. When admitted people have a full assessment carried out. There is then a six week review to see if the placement is working for all concerned. Assessments include key information and there were personal profiles in place given the needs of the resident group. Assessments took account of all relevant areas of daily living, and areas of risk. Assessments aimed to ensure people were only admitted if the home could meet their needs and wishes. Care Homes for Older People Page 13 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. People have an individual plan of care and support that is drawn up with their involvement as far as possible. People make decisions about their lives with support and assistance where needed. People are supported to take their medicines safely at the times that their doctors prescribe. People feel their right to privacy is upheld at East Cosham House, and that they are treated with respect. Evidence: The homes AQAA told us - Each resident in the home has a person centered care plan which has been compiled with the residents and their relatives involvement where possible. All care plans are reviewed on a regular basis. We have a review meeting with the resident and their relatives/representatives to discuss all areas of their care,
Care Homes for Older People Page 14 of 31 Evidence: including the care plan, 6 weeks after admission and on an annual basis. We regularly monitor the weight of residents and have a procedure for seeking medical advice for significant weight loss. Our staff are trained to provide support and assistance to residents in a manner which respects their dignity and promotes their choices, preferences and independence. Personal care and health care is carried out in the privacy of the residents room. We develop a record of the personal history of the resident and use this to inform the care plan and to enhance how staff interact with the resident. We view the safe administration of medication as a very high priority. We have a comprehensive policy on the receipt, safe storage, handling, administration and disposal of medication. Medication is only administered by trained and authorised staff. Medication is stored securely. Whenever possible, with the support of health care professionals and the wishes of the family, we care for service users who are dying. This enables the resident to be cared for by staff who know them well and it also provides support for their family. We case tracked three peoples personal records, in order to evidence outcomes and to assess their quality of life at the home. Assessments are considered above. We found that each person had a plan of care and support drawn up from the information gained via assessment. Plans are developing to become more person centred, and there is a commitment at the home to continue to look at promoting more person centred approaches at the home. Plans included good quality information about peoples histories and these were presented in the form of personal profiles. These documents would enable new staff to get to know people with dementia and associated communication difficulties quickly and are to be commended. Other aspects of care planning were individualised and provided good information to staff as to how to best meet the needs of each person. Plans also addressed such areas as privacy, dignity and respect. Staff interviewed were also able to demonstrate an awareness of these and other core values. There was evidence of some variability in recording quality in the daily notes, monitoring records and review notes. Some daily notes were of good detail and provided quality information in order to monitor outcomes for people. Other daily notes were less detailed and did not fully capture outcomes in any detail. This was discussed with the manager and we have made a recommendation in this report. Care Homes for Older People Page 15 of 31 Evidence: As a result there was little detailed or good quality information to inform the monthly or annual review of care and support, or any way to measure the effectiveness of the current assessment and plan of care and support in at least one case. From our evidence we feel that staff may benefit from further input in the area of recording, monitoring and review of care. The manager listened to our observations and advised us he planned to do some in-house communication training with the staff team soon and would be putting these matters on the agenda for this training. Care plans did cover health issues in detail. Staff were found to know what peoples health care needs were. People told us they could access their doctors or nurses on request. Survey feedback told us people had access to health services and that their needs were being met in this essential area. We inspected the arrangements for the storage, recording and handling/administration of drugs and medications at the home. The home adopts a monitored dosage system that provides for the safe storage, recording and handling and administration of medicines. There is a secure cabinet for controlled drugs that is double locked. Other medications are held in a purpose built drug trolley that is secured to a wall when not in use. We observed staff giving out medications and recording administrations. People told us they were happy with the support arrangements with their medication provided at the home. Most people need support in this area of daily living due to failing memory. Staff involved with medications confirmed they are trained in the homes policies and procedures. People told us they felt staff treated them well. People spoke highly of the staff saying such things as - they are always so helpful. staff are there when we need them. staff are very nice, and so helpful. I feel safe here, even though Im a bit confused sometimes, people are so good to me. We observed staff knocking on private doors before entering, checking that peoples dignity was protected in such areas as continence, dress and choices. Staff were seen to treat people in an age appropriate, good humoured and valuing way. People told us their privacy is respected at the home. Care Homes for Older People Page 16 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People lead the lifestyle they wish, that matched their skills and their expectations. Social, cultural, religious and recreational needs and interests are met. People are encouraged and supported to maintain contact with family and friends in the wider community as they wish. People are encouraged and supported to exercise choice and control over their lives. People receive a wholesome, appealing, balanced diet in pleasing surroundings at times convenient to them. Evidence: The homes AQAA tells us - The routines in the home are arranged around individuals. Residents are encouraged to personalise their room with furniture and possessions. Visitors are encouraged and welcomed at any time. Residents are encouraged to take part in activities, but their wishes are respected if they choose not to. Birthdays are celebrated and the resident made to feel special. Menus are regularly reviewed to provide variety and ensure they are balanced and nutritious. Alternative options are
Care Homes for Older People Page 17 of 31 Evidence: always available. At times like Christmas, special menus are developed to celebrate the occasion. Residents are regularly consulted about the menu. We observed care practices at the home and staff interventions with people. Routines appeared to be minimal and resident led. People were observed moving around their home as they wished with complete freedom. The home has recently increased the amount of activities on a daily basis. This is in addition to other activities and entertainments that were already being provided. The main meal is served in a comfortable dining area, and was relaxed and unrushed. Staff took account of the needs of each individual and support and encouragement was offered in a symathetic and discreet manner. Once more people were not forced to do things, staff were seen to step back and let people make choices and take as much control as possible. We were told by a relative that there is a weekly Mass that her reletive can attend if she wishes. People told us they had made friends at the home with other residents, and this was evident at the meal time and during our site visit. We interviewed two visitors who had come to visit a family member. They told us they were happy that their loved one receives a good service, even though this is not always appreciated. They felt confident in the abilities of the staff and management of the home, and confirmed they were able to visit at any reasonable time and were always made to feel welcome. Other people we spoke to said they were often taken out by their relatives and received visitors at any time. We did note a more dependent service user, with no immediate family did not appear to have gone out from the home for some time. It was agreed this would be more closely monitored and action taken to address this sort of issue. As identified above people were seen to enjoy the lifestyles they liked at the home. There was freedom of movement, and choice of when to come to lunch, what to eat, and where to sit. People said they felt they were asked about things, such as food choices and menus. People were not clear if they had been asked about other areas such as colour schemes in the house. There has been a recent initiative where menus are now routinely placed on each table, showing the food on offer and the options available. We found that people were being supported appropriately and safely with their personal finances when needed. People told us they had been able to bring their personal possessions into the home, and there was also evidence that people had been involved in the development and completion of their perosnal records. We were able to join residents at lunch time. People said they appreciated the new
Care Homes for Older People Page 18 of 31 Evidence: menus displayed on the tables. There were three choices to the main meal, and people said they enjoyed their food and looked forward to meal times. We also received positive feedback from other stakeholders about the quality of food provided at the home. Menus offered a full varied and nutritious diet, served in a valuing environment, that was supported and unrushed. Care Homes for Older People Page 19 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. People who live at the home, and their relatives / advocates are confident that any concerns of complaints will be listened to, taken seriously and acted upon. People are protected from abuse. Evidence: The homes AQAA tells us there is - A clear and comprehensive complaints policy is in place which gives details of who will deal with any complaint, the time scale for a response (max 28 days) and contact details of CSCI, Portsmouth City Council and the Local Government Ombudsman. We ensure complaints are responded to within the correct timescales. We learn from the outcome of any investigation into a complaint and use it to improve the standard of service we provide. We investigate fully any allegations regarding abuse or neglect. Any member of staff reporting concerns or bad practice is supported. Recruitment procedures are robust and thorough. There had been two complaints since the last inspection. We checked the complaints records folder at the home, and found evidence that these complaints had been investigated and responded to appropriately. We followed up a number of areas relevant to our role as a regulator and found that the provider and management had taken the action needed to remedy the concerns of the complainant and to deal with other issues such as the need to repair a sash window.
Care Homes for Older People Page 20 of 31 Evidence: People we spoke to said they felt the staff and manager would deal with any concerns. This was also in feedback from surveys. The visitors we spoke to also said they felt the staff and the manager were approachable and would listen to any concerns and deal with such matters quickly. As identified above there have been a number of difficulties at the home due to a lack of adequate management. This has also lead to concerns in respect of safeguarding. However, these matters have been fully investigated and are now resolved. The home has clear guidance in respect of safeguarding adults. Staff were able to demonstrate an awareness of what may constitute abuse of vulnerable people, and what to do in the event of suspecting or discovering abuse. People said they felt safe living at the home, and confirmed that staff always treat them with respect and kindness. Staff had received training in safeguarding adults. Staff are subject to checks at the point of their appointment/recruitment. Care Homes for Older People Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe well maintained environment. The home is clean, pleasant and hygienic. There were minor odour problems evident. Evidence: The homes AQAA tells us - East Cosham House is clean, safe, hygienic and free from unpleasant odours which reduces the risk of infections. All staff are aware of their responsibility to identify and report any deficits in the environment which require maintenance.We have an ongoing program of maintenance and redecoration. When a resident leaves us the room is redecorated and carpets replaced as necessary.The temperature of water in taps and at boiler is taken regularly and any faults rectified by plumber in a timely manner. Fire equipment is maintained to a high standard. We undertook a tour of the premises. We visited a sample of rooms, some had an odour of urine. We were advised that there had been some urinary illnesses at the home recently. We observed staff trying to manage the problems of odours. Communal areas of the home were found to be fresh and well presented. Many rooms do not offer en suite so people are having to use commodes at night. Commode pots are emptied in the mornings and sluiced in the sink within the laundry area. The manager has put a plastic barrier up between the clean and operational ends of the
Care Homes for Older People Page 22 of 31 Evidence: laundry room to prevent cross infection. Staff were observed using barriers such as gloves and aprons, and were seen to observe good cross infection practices. We visited a room that had been subject to a recent complaint and found the issues identified in the concerns had been addressed by the home. We saw an empty room and confirmed the information provided in the AQAA above. The room was in the process of being redecorated and upgraded. With the exception of some odour problems the home was well presented, safe and clean. People told us they liked their home, and were happy with the decor. One person said she had noticed the cleanliness had improved recently. We noticed that the home provides specific house keeping staff to ensure domestic tasks are maintained to a good standard. The home follows good practices in the area of hazardous substances, and there was an awareness of extra vigilance evident due to the special needs of the resident group. Mr Fuller the manager confirmed that if he identifies the need for additional resources the owners are very good at ensuring these are made available. Care Homes for Older People Page 23 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. People know their needs will be met by the number and skill mix of the staff team. People feel they are in safe hands at all times. The safety of people using the service is promoted by the homes recruitment policies and practices. The staff team are trained and are competent to do their jobs. Evidence: The homes AQAA tells us - Staff are recruited following a robust recruitment and selection procedure supported by clear and detailed procedures. New staff undergo a thorough induction process. Over 50 have NVQ2, 4 members of staff have achieved NVQ3. We actively encourage and support staff to undertake NVQ2. We provide a comprehensive training Programme which includes statutory training and more specific training based on the needs of our residents. Staff are committed and work as a team for the best interests of the residents. The home employs 19 permanent staff. 10 of these staff have NVQ level 2 training or above. There were three care staff, a cook and a house keeper on duty when we
Care Homes for Older People Page 24 of 31 Evidence: arrived. The manager was working supernumerary to these staff. People told us there were always staff available to assist if and when you need them. We interviewed 2 staff members who were able to demonstrate an awareness of their role. They had both received appropriate training in a variety of areas relevant to their roles within the home. Staff confirmed they were well supported. Survey feedback from staff included comments such as - We get very good training. We provide good meals. Staff here have good communication with external health care professionals and interact well with residents and their families. We look after the residents well. It would be good to provide more activities. We work as a team. From records, observations and interviews we found evidence that there was a mix of skills across the staff team, and this was also reflected in the staff team structure. Residents said they liked the staff and confirmed that the staff always treat them with dignity and respect. We inspected a sample of three staff files. These all contained documentary evidence that the selection and recruitment of staff took full account of safeguarding issues, and that all relevant checks had been carried out as part of the recruitment process. This was also confirmed verbally by staff, who also told us they had received good inductions into the home. There was also further evidence of a clear commitment to the ongoing training and development of staff at the home. The manager also engages staff in training related matters during staff team meetings, and the home has purchased a number of resource packs / DVDs / etc to support such informal training sessions. Care Homes for Older People Page 25 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. People live in a home that is run and managed by a person who is fit to be in charge, of good character and able to discharge his/her responsibilities fully. The home is run in the best interests of the people who live there. Peoples financial interests are safeguarded. The health, safety and welfare of people and staff are promoted and protected. Evidence: The homes AQAA tells us - We have recruited a new manager who has 12 years experience of managing care homes. He has NVQ4 in care and RMA. He has been interviewed and accepted by CSCI for registration as Registered Manager. He has undertaken a general Train the Trainer course to enable him to more effectively train staff. In addition he is booked to undertake the Manual Handling trainer course. He
Care Homes for Older People Page 26 of 31 Evidence: actively seeks training opportunities to further his knowledge and meet his continuous professional development requirements. The manager leads his team well and promotes and demonstrates good practice at every opportunity. Staff demonstrate respect for residents. All staff receive appropriate supervision. East Cosham House is run in the best interests of residents. Policies and procedures are clearly written and accessible. The business is financially secure with budgets for continual reinvestment and refurbishment. We received feedback from surveys that indicated the home is running smoothly and in the best interests of residents. There was also evidence of positive relations from outside of the home with external stakeholders. The new manager Mr David Fuller was registered this year, and has shown us he has the right skills, experience and training to manage a registered care home. Mr Fuller showed us a number of initiatives he had introduced to improved and further develop resident consultation and their involvement in decisions about how the home is run. There was also evidence that things had been changed at the home following listening to resident feedback. Staff interviewed told us they felt supported by the manager, and were receiving good quality support and supervision. Residents told us they liked and trusted the new manager. Visitors said they felt the manager was approachable. We saw evidence of developing systems of quality assurance that had residents at the centre. People received surveys about their home, they have regular resident meetings, and individual plans of care and support continue to develop more person centred approaches at the home. Policies and procedures are in place to provide operational guidance for staff, and informs the induction for new staff, and all have been checked and updated this year since the new manager took up post. The AQAA states - We have developed a quality assurance plan and improvement plan, both of which are used to improve outcomes for residents. The quality assurance plan addresses the national minimum standards under the key headings, these are then reviewed and audited systematically throughout the year. We use the AQAA to inform this process. We checked arrangements where the home is supporting people with their personal finances, and these arrangements were found to be transparent and good quality records were in place as well as receipts where money is spent on behalf of people. We found evidence that the manager takes his responsibilities in respect of health and safety very seriously, and has a keen understanding of his duties. This also applies to other areas of safety such as fire, COSHH, food hygiene, manual handling and cross infection. Mr Fuller told us he is to become an accredited manual handling and moving
Care Homes for Older People Page 27 of 31 Evidence: instructor. During our tour of the premises there were no hazards observed. Systems are in place to ensure that such items in the following areas are checked, monitored and safety maintained - Premises electrical circuits; Portable electrical equipment last tested on 3/9/08; Lifts/stair lifts; Hoists [including portable]; Fire detection and alarm; Fire fighting equipment; Emergency lighting; Emergency call equipment; Heating system; Soiled waste disposal; Gas appliances. People told us they felt safe living at East Cosham House. Care Homes for Older People Page 28 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 29 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 7 Methods for monitoring care and support plans, and recording outcomes on a daily basis need to focus on recording quality outcomes for/with people. This information then needs to inform monthly and annual reviews that will in turn feed quality and detailed information about monitoring outcomes, changes in independence etc. Records should quality assure good outcomes for people. 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 © (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 31 of 31 - 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!
