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Inspection on 30/10/08 for Eastleigh (Residential) Care Home

Also see our care home review for Eastleigh (Residential) Care Home for more information

This inspection was carried out on 30th October 2008.

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

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

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

What the care home does well

Eastleigh care home is set on the hill above Minehead and has scenic views of the hills and the sea. These views from the home can be enjoyed from the communal rooms and some bedrooms. Eastleigh has been suitably adapted for older people and provides a homely, clean and well maintained care home. People are encouraged to retain as much control and independence as possible in their lives. The home has good facilities and a range of activities are provided. Routines are flexible and people can choose how they spend their time each day. People can join in with activity from the programme that is circulated each month, if they wish. All people spoken with were complimentary about the staff working at the home . Staff were described as kind and cheerful. All observed interactions supported this feedback, staff were observed to be friendly, respectful and helpful towards the people in their care. The food served at the home is of a good standard and people were very satisfied with quality of the food provided.

What has improved since the last inspection?

The manager, Miss Jennifer Hodges, has been successfully registered with the Commission for Social Care Inspection, through the fit person process. The recruitment checks of new staff are completed before they commence working at the home. The service user guide and statement of purpose have been updated since the last inspection. The manager has reported in the AQAA that monthly review of care plans is made. Monthly e mails are sent to families to update them on the well being of their relative.

What the care home could do better:

One requirement and five recommendations for good practice are made as a result of the findings at this inspection visit. The requirement was made for monitoring and safe maintenance of the medications fridge. The fridge temperature had been recorded as very low, the temperature must be kept within safe range for safe storage of temperature sensitive medication. The manager may choose to record Waterlow scores where people have increasing health care needs. This will alert staff to early referral for appropriate intervention to prevent pressure area damage occurring. Foot operated flip top waste bins are recommended for best practice infection controlmanagement of staff hand wash waste. Staff recruitment was improved but the following recommendations were made for best practice. Staff files should contain a photograph. The application form has little space for a ten year work history to be recorded. Staff interview records should held on file and should include the explanation given for any gaps in a candidates work history that may have been explored at the interview. People reported both verbally and in writing to the inspector that they spend a lot of time waiting at the dining tables, at meal times. This should be monitored and a problem solving review should be undertaken if proven necessary.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Eastleigh (Residential) Care Home Periton Road Minehead Somerset TA24 8DT     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: Barbara Ludlow     Date: 3 0 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 32 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 32 Information about the care home Name of care home: Address: Eastleigh (Residential) Care Home Periton Road Minehead Somerset TA24 8DT 01643702907 01643707649 garry@eastleighcarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Jennifer Ann Hodges Type of registration: Number of places registered: Mr Garry John Wilson care home 23 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 23. The registered person may provide the following category of service only: Care home providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Eastleigh (Residential) Care Home is registered with Commission for Social Care Inspection to provide personal care to twenty-three people whose care needs fall within the conditions of registration listed above. The proprietor is Mr Garry Wilson and the home has very recently appointed a new manager. Mr Wilson took over the home (previously known as Boyd House) on 1 June 2003. The site has been developed and there is now a sister home providing nursing care adjacent to the residential home. Eastleigh is situated on the outskirts of Minehead and enjoys views over the sea. The Care Homes for Older People Page 4 of 32 Over 65 23 0 Brief description of the care home accommodation is provided over two floors, with a passenger lift to the first floor. There is one room accessible by stairs and this is kept for service user who is independently mobile. Stair lifts have been added to enable access to two bedrooms to the rear of the home. The home has well-maintained gardens to the side affording views over surrounding hills. The current scale of charges is 450 pounds to 575 pounds per week. Care Homes for Older People Page 5 of 32 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: This unannounced inspection took place over the course of one day on 30th October 2008. It was conducted by Barbara Ludlow, Regulation Inspector. Nineteen people were in residence at the home. The manager reported that currently two people attend for day care only. The registered manager was on duty throughout the day and assisted with the inspection process. A tour of the premises was made, all communal areas were seen and bedrooms were sampled with the consent of the person in residence. People and staff were seen throughout the day and daily life was observed. People Care Homes for Older People Page 6 of 32 were spoken with in the communal areas of the home and in private in their rooms. Staff were asked about their training and the management support they receive at the home. Questionnaires had been sent out prior to the inspection visit and a small number from staff and people living at the home were returned to CSCI. Positive comment and feedback was given and is included in the body of the report. Three people were selected for case tracking and they were spoken with and their care plans and records were sampled. Files were sampled for newly recruited staff and these supported improved recruitment practice. Staff training and supervision records were seen. Records were sampled for the servicing and maintenance of the premises and equipment at the home. No visitors were seen. The inspection was well received and was positive in all outcomes for service users. The inspector would like to thank the manager, staff team and all the people living at the home for their input into the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: One requirement and five recommendations for good practice are made as a result of the findings at this inspection visit. The requirement was made for monitoring and safe maintenance of the medications fridge. The fridge temperature had been recorded as very low, the temperature must be kept within safe range for safe storage of temperature sensitive medication. The manager may choose to record Waterlow scores where people have increasing health care needs. This will alert staff to early referral for appropriate intervention to prevent pressure area damage occurring. Foot operated flip top waste bins are recommended for best practice infection control Care Homes for Older People Page 8 of 32 management of staff hand wash waste. Staff recruitment was improved but the following recommendations were made for best practice. Staff files should contain a photograph. The application form has little space for a ten year work history to be recorded. Staff interview records should held on file and should include the explanation given for any gaps in a candidates work history that may have been explored at the interview. People reported both verbally and in writing to the inspector that they spend a lot of time waiting at the dining tables, at meal times. This should be monitored and a problem solving review should be undertaken if proven necessary. 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 32 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 32 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. The home has a good level of information available about the service. The statement of purpose and service user guide have been updated in 2008. Pre admission assessment is undertaken to ensure that care needs can be met at the home. Evidence: The home had reviewed their Statement of Purpose and Service User Guide on 5th October 2008. The documents are clearly written and informative for prospective people and relatives making an enquiry at the service. The Service User Guide entitled What happens next, is produced to inform people placed on the waiting list of what they can expect to happen next. The document invites people to make contact with the home to discuss any questions arising. Care Homes for Older People Page 11 of 32 Evidence: People asked confirmed that they had received a contract and they said it was clear. The contract indicates that the first four weeks are a trial period. Four contracts were seen, both privately funded and social services assisted placement contracts were sampled. The costs of care were clear. Evidence was seen of the cost charged for a carer escort when attending an appointment, the charge was calculated per hour. Care Homes for Older People Page 12 of 32 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 are treated with respect, in a dignified manner and receive a good level of health and personal care. Care is regularly reviewed. Medications are carefully dispensed and recorded. The medications fridge required temperature adjustment to be within a safe temperature range. Evidence: During the tour made of the premises all people in residence were seen. Staff were seen with people they care for throughout the day and they were heard to interact with kindness and patience at all times. Privacy is respected and staff knock on bedroom doors before entering a persons bedroom. Each person had a care plan and a sample of three care plans were chosen for examination in detail as part of the case tracking process. Care Homes for Older People Page 13 of 32 Evidence: The pre-admission information was on file and is used to inform the care planning process. Care plans contained necessary personal information such as the next of kin, any social arrangements and contact details for relatives. One care plan did not have a completed inventory. Inventory recording is good practice from the point of admission and with subsequent review and updating. Medical information had been recorded such as any ill health conditions. Visits by the doctor and community health care specialists including the district nurse were clearly recorded. Attendance at health facilities such as the dentist and the diabetes clinic were recorded. There was a good range of help evidenced in the care plans as given by community health care professionals. Risk assessments were in place for dependency and manual handling, there was no pressure sore risk assessment tool being used. This was discussed with the manager, it would be useful to have this information to inform the care planning where people become unwell or more frail. The risk of developing a pressure sore may then be detected early for skin condition to be closely monitored. Skin integrity is checked when people are admitted to the home and thereafter is discreetly monitored at bath times. Any marks or bruising would be reported and a body map would be commenced for recording and monitoring any changes. A daily evaluation record sheet is used and is kept in each care plan. Staff use a daily handover sheet to record information such as, who may have gone out to an appointment. Medication management was seen. The storage facilities were satisfactory. The waste bin for hand wash waste was not foot operated, this is recommended for best practice and infection control. The controlled medication held was checked and the stock and recording was accurate. The AQAA indicated that staff receive training in medications management. Staff spoken with confirmed having received training from Boots the Chemist. The company also has a specialist nurse for training staff with medications management. The medications fridge was noted to be too cold and the fridge required some adjustment to prevent the risk of temperature sensitive medication becoming frozen. Capillary blood sugar monitoring is carried out for the monitoring of blood sugar levels in diabetes. Staff equipment was sharp safe and best practice. Care Homes for Older People Page 14 of 32 Evidence: Staff demonstrated good infection control practice and wore aprons at mealtimes when serving food. There is access for staff to personal protective equipment such as gloves and aprons as required. People asked said they are well cared for one person asked about their care plan said they were asked lots of questions but wouldnt need to wait for a review, they would just ask for a change. People were seen to be very relaxed and comfortable around the home. Care Homes for Older People Page 15 of 32 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. There are a range of activities and choice of social opportunities available to people living at Eastleigh. These are clearly advertised in house each month. Activities are supported by dedicated activities staff who are well regarded by the people living at the home. The catering is judged by the people living at the home to be of good quality. Evidence: People living at the home were seen to make use of the ample communal space. The lounge at the front of the home has panoramic views and was being used by four people who reading newspapers and books or sitting quietly. People were spoken with and those asked said they enjoyed the view from this room. There are a selection of books available for people to access. People sitting in this lounge all had their call bell within easy reach. The second lounge looks onto a lawn at the side of the house which is level and is used in warmer weather for outdoor events. We heard there had been an agility dog show held on the lawn in the summer that had been very entertaining. The lawn has a path Care Homes for Older People Page 16 of 32 Evidence: around and provides level access and there is seating. The home has an organised activities programme this is circulated to everyone as part of the newsletter each month. Two activities staff working four days each week support the programme which covers the nursing home as well as the residential home. The size of the print on the programme is small and could be increased to make reading easier. There is shared transport, a minibus and a pool car are available for the activities staff to use. The home has a cat, Chloe and we heard that the home will take small pets by arrangement. People who were seen in private said they could choose how they spend their time and opt into the activities if they wish. People spoke highly of the activities staff and praised them from their support and the activities they organise. People said the flexercise and the quizzes are very good and they enjoy the trips out once a week in the summer. People said they had newspapers each day. These are ordered individually, the cost is charged to their account. The home no longer has a trolley shop but shopping is arranged. The activities staff were described as excellent and wonderful. The activities staff receive training and development, we heard from the manager that specialist activity training has been arranged for them. People asked said their visitors are made welcome and confirmed that they are offered refreshments. Visitors can be received in private or in the communal areas of the home. The timing of meals and the availability of drinks and snacks throughout the day were described to the inspector by people spoken with during the visit. Breakfast is served across a broad timescale of seven am to nine thirty am. so people can choose what time they have their breakfast. We heard this works well and allows people to decide what time they want get up. People also have the choice of where they would like to take their breakfast, the dining room or their bedroom. Two mealtimes were observed. we heard that there is a set menu at lunchtime but that you can have something else if you dont like what is planned. We heard lunch would be served from twelve midday. Sixteen of the nineteen people in residence were seated in the dining room and they had finished eating lunch by quarter past one. One person commented on the waiting once seated at the table. They said there is a lot of Care Homes for Older People Page 17 of 32 Evidence: waiting, always waiting. We also had a comment card that indicated that a lot of time is spent sitting at the table before the meal is served. The care staff served drinks from a selection of fruit juices and sherry on request. The meal is served from a hot trolley in the servery opposite the dining room and is brought in on plates and is served table by table. Some people were observed to be seated for a while before their meal arrived. People were assisted politely and discretely by the care staff at all times. The food looked appetising. One person had made a written comment saying that there always seems to be a rush to clear the tables away at mealtimes. People who eat their meals in their rooms said the food is served hot and covered. Drinks were served throughout the day and we heard that biscuits are offered mid morning with tea or coffee. Cake is served in the afternoon with tea at three pm except on Sunday when biscuits are offered. The AQAA indicated that personal dietary preferences are recorded in the main kitchen and accommodated where possible. Special dietary requirements are catered for. We heard that the chef visits people to ask about the menus. The AQAA stated that the chef visits at lunchtime and records any comments, compliments or criticisms. These records were not requested at this inspection. The AQAA indicates continuing development of the social activity programme is planned for the next twelve months. The home wants to grow a herb garden and improve links with the local community. The home is currently forming a residents choir. Care Homes for Older People Page 18 of 32 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. The complaints procedure is made available to all people living at the home. People are treated with respect and their civil rights are upheld. Staff are safely recruited to reduce the risk of harm coming from people who are unsuitable being employed at the home. Staff receive abuse awareness training. Evidence: The home has a clear complaints policy and procedure. The AQAA indicated that during the past twelve months a laminated reference copy of the home life at Eastleigh, which includes the complaints procedure and relevant addresses and telephone numbers, has been placed in each bedroom. The home has also liaised Age Concern regarding advocacy services for people living at the home. There have been no complaints recorded during the past twelve months at the home and none received by CSCI. One safeguarding referral was made during the past twelve months. There have been no referrals to POVA ( Protection of Vulnerable Adults list.) People asked said they would be able to raise any concerns at the home. Care Homes for Older People Page 19 of 32 Care Homes for Older People Page 20 of 32 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. The care home is clean, homely and well maintained. It provides a suitably adapted and equipped, safe environment for people to live. The home has sufficient communal space which is all well used. Bedrooms are treated and respected by staff, as a persons private space. Infection control is well managed. Evidence: The home is well presented. There has been a separate entrance created for level access or wheelchair use, however this requires entry to the home via the homes small kitchen, this is not ideal. A tour of the premises was made as part of the inspection visit. There are two pleasant lounge areas, both with views across the garden and countryside. Both are well decorated and have sufficient comfortable seating. There are there are three double bedrooms and seventeen single bedrooms, sixteen have en suite facilities. Bedrooms were seen with the permission of the individuals in residence. Bedrooms had been personalised. Photographs, pictures and personal Care Homes for Older People Page 21 of 32 Evidence: belongings helped to make the rooms feel lived in and homely. All were clean. People said that the home is always clean and fresh smelling. The premises were updated as part of a refurbishment programme when the present owners took over in 2003. This programme was reported at the last inspection in November 2007, to be complete but for the storage room. The home has a small kitchen that is used at breakfast time and for serving at other mealtimes. All main meals and cooked hot food comes in from the nursing home kitchen in an electrically heated trolley. The main kitchen in the nursing home was not inspected, at the last key inspection it was found to be well managed. The small kitchen / servery was seen at this visit and was found to be clean and tidy. A good laundry service is provided, one person reported that it is better than good it is excellent. Clothes are reported to be nicely attended and promptly returned within 24 hours. People reported that any missing items are usually located. The nursing home has facilities other than the kitchen that are shared with the residential home. The hairdressing room provides the experience of going out and the salon provides other beauty treatments such as manicures at cost. There is also a gymnasium, sauna, and a quiet library where there is internet access. The home has a call bell system that has individual call bell handsets. People had these on their tables in the lounge. The home has a fire alarm system and emergency equipment. The AQAA indicated that these are tested annually and the records sampled supported regular servicing and safety checks. The fire alarm testing is every Thursday and was up to date. The home was nice and warm in all areas. People said they can adjust the temperature in their bedroom if they wish and said they had turned it up in the winter months last year. There is passenger lift from ground to first floor, stair lifts provide access to two rooms, all had been serviced. There is an assisted bathroom, five toilets and a shower facility. There are toilets close to the lounge areas. Infection control is well managed and the home has appropriate waste control contracts. The staff sleep in accommodation is on the secod floor, this was not seen. Care Homes for Older People Page 22 of 32 Evidence: Care Homes for Older People Page 23 of 32 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. Staff working at the home are carefully selected and safely recruited. Staff receive induction, mandatory and ongoing training and development. The staff complement was adequate and the staff are all well regarded by the people they care for. Evidence: On the morning of the inspection the registered manager was in charge with one senior and two care assistants, providing care for the nineteen people in residence. During the afternoon there were two care staff and at night the arrangement is one waking and one sleep in staff. The home has a care staff of twelve and there are ancillary staff. Six of the twelve care staff hold a National Vocational Qualification to level 2 or above, this meets the National Minimum Standard of fifty percent of the care workforce being NVQ qualified. There are domestic staff for the residential home; the catering is undertaken in the nursing home complex. Care Homes for Older People Page 24 of 32 Evidence: There had been some changes to the staff team since the last inspection, five staff having left and six having started. Two staff have moved to the residential home from the nursing home and there were four new starters. The recruitment files for these staff were sampled. Enhanced Criminal Record Bureau (CRB) checks had been made and two references had been obtained before the staff had commenced working at the home. The registered manager stated that interviews are undertaken by a panel of five senior personnel. Whilst this is commendable practice, records of all interviews were not seen on all the files. The application form does not have much space for a ten year work history to be documented, it was therefore unclear from the evidence that if any gaps in employment history had occurred, that they had been explored at the interview. Two of the four files did not have a photograph. Recruitment is undertaken at the company head office and it was suggested that missing photographs for new staff may have been in transit to the home. Recommendations are made for best recruitment practice. Staff spoken with confirmed the recruitment process and the induction and training they have received at the home. Staff said they are encouraged to undertake training to achieve an NVQ. Staff were observed to be helpful, friendly and confident. One staff member said it is great to work here, we have great team work. Staff undertake the common induction standards and receive regular supervision and training opportunities. The staff file records demonstrated mandatory training in fire safety, manual handling, infection control and abuse awareness. There was also evidence seen of medications management and first aid training. Comment cards from staff commended the training and updating available to them. One person said if we feel there is something more we would like to be trained on we just ask and it gets sorted. Staff development received praise for the management support and the opportunities given to staff. Staff felt that information was passed on between staff and staff commented that the care plans are full of all the information they need to know and are up to date. People living at the home that were asked all spoke of staff being helpful and kind. One person wrote that staff are attentive, helpful and cooperative and always ready to listen. One person praised the domestic staff saying they are always cheerful, willing and helpful and their work is always well done. There was a perception amongst people living at the service that staff are always Care Homes for Older People Page 25 of 32 Evidence: busy, one person said this is why people have to wait. One person wrote that there are too few staff to cope with everything. Another said one more carer was needed to prevent the client having to wait sometimes up to 30 minutes on the toilet. This was not reflected by staff working at the home or in the written comments to CSCI. A recommendation is made to monitor the periods of waiting at meal times. Care Homes for Older People Page 26 of 32 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 home has a competent registered manager in post. There are health and safety policies and procedures in place and the home is well maintained. Records sampled showed us that equipment is regularly serviced and checked to ensure the home is a safe environment. Evidence: The registered manager, Miss Jennifer Hodges, was on duty and remained at the home to receive feedback at the end of the inspection visit. Miss Hodges has settled into her role and had implemented some changes resulting in improvement to the care plans and record keeping. Miss Hodges has an open management style. People spoken with expressed their confidence in her as the manager saying they could take any concerns to her to be Care Homes for Older People Page 27 of 32 Evidence: dealt with. Staff similarly expressed their confidence in the manager saying they are well supported, advised and have access to regular training and development. Miss Hodges is attending to her own professional development and is enrolled to study for the Registered Managers Award with a completion target date of December 2008. Monthly management meetings are held at the home with the proprietor. All aspects of the care service are reported to be covered at these meetings. The AQAA indicated that services and equipment are maintained under contract. A sample of maintenance and equipment records were inspected. These demonstrated that the fire alarm is tested each week and had been serviced on 30/07/08. The emergency lighting had been checked on 2/09/08. The fire extinguishers were serviced on 2/06/08. The passenger lift had been serviced on 29/09/08 and the stair lifts in 03 and 09/2008 The hoists are checked under contract and were serviced on 14/08/08. The Malibu assisted bath was serviced on 23/07/08. The home has appropriate waste control contracts. The oil boiler had been serviced on 23/06/08. The minibus is maintained and serviced regularly. The AQAA indicated that the home fosters an open and friendly working relationship with people living at the home and their families and care teams. opinions are canvassed and comments on the service outcomes are valued. Care Homes for Older People Page 28 of 32 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 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 (2) The medications fridge 12/01/2009 must be kept within the safe temperature range of 2 to 8 degrees Celsius. To ensure that temperature sensitive medication is safely stored and is put not at risk of being damaged by freezing. 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 8 A pressure sore risk assessment should be undertaken and recorded where there is evidence of person being unwell and requiring preventative skin care. The level of risk should also be determined where a health condition such as diabetes or ill health prevail, in order to prompt early health care intervention. Foot operated flip top waste bins are recommended for areas where staff hand wash waste is produced, to reduce the risk of cross infection. The waiting experienced by some people at meal times should be monitored to ensure that there are sufficient staff on duty. 2 26 3 27 Care Homes for Older People Page 30 of 32 4 5 29 29 Staff files should contain a recent photograph for identification purposes. The application form does not have much space for a ten year work history to be documented. A ten year work history should be evidenced and any gaps in employment should be explored at the interview and a record be made of this at the interview. Care Homes for Older People Page 31 of 32 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. 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