Inspection on 31/07/07 for Edendale Residential Care Home

This inspection was carried out on 31st July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Edendale Residential Care Home 19/06/06

Edendale Residential Care Home 19/12/05

Edendale Residential Care Home 15/06/05

Edendale Residential Care Home 21/01/05

Edendale Residential Care Home 28/07/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Deepdene Care Centre

Aldwick House

49 Glendale

Ferndale Residential Care Home

David Gresham House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Edendale Residential Care Home 5-6 The Green St Leonards-on-sea East Sussex TN38 0SY Lead Inspector Jason Denny Key Unannounced Inspection 31st July 2007 10:10 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Edendale Residential Care Home Address 5-6 The Green St Leonards-on-sea East Sussex TN38 0SY Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01424 429908 01424 778797 info@edendale.com Mrs Andrea Fettiplace Mrs Andrea Fettiplace Care Home 31 Category(ies) of Dementia (31), Mental disorder, excluding registration, with number learning disability or dementia (31) of places Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The minimum age of service users on admission will be fifty five years (55). The maximum number of residents to be accommodated is thirty one (31). 19th June 2006 Date of last inspection Brief Description of the Service: Edendale is registered to provide accommodation for up to 31 people of 55 years old and over who suffer from dementia or mental illness and admits people with low to high dependency needs. The premises consist of two large separate detached properties situated in St Leonards using the numbers of 5 and 6 as they correspond to the street number. Edendale has 13 single rooms and nine doubles situated on three floors all of which have a wash hand basin. Residents in one house have the use of a ground floor lounge and a dining room and first floor smaller lounge/diner. In the other house residents have use of a ground floor lounge and dining room and a second floor smaller lounge and dining area. Smoking is allowed for residents in each house in the designated area .The home has a secure rear garden accessed by steps with seating and lawn area for residents to enjoy. The home is currently exploring levelled access to assist wheelchair users and those with higher mobility needs. The home also accepts pets. The house does not have lifts but has a number of ground floor rooms. The home benefits from having a large car park. The buildings are located a five minute walk from the nearest shops and is on a bus route with a bus stop just outside the home. The current fee scale is £405.00 - £465.00 per week. The lower rate is based on what East Sussex pays. The higher rate is based on what London boroughs pay. Those who are self funding [private] pay between £420 and £425 and receive the same facilities as those funded by Social Services. The latest inspection report is sent out to any enquirer who expresses an interest in the home. A copy of the report is obtainable via the manager. The home is currently reviewing management arrangements following the death of one of the joint owners/managers who worked there full time. It is anticipated that the assistant/deputy manager will shortly move forward for registration possibly jointly with the current registered manager/owner. Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced key Inspection, which included a visit to the home which took place between 10.10am and 4.50pm on July 31, 2007. This inspection process covers the period since the last inspection on June 19 2006. The focus of the inspection was on the newest residents who have moved in since the last inspection along with looking at the care provided for some longstanding residents. The visit also focused on improvements in those outstanding matters since the last inspection such as care planning, medication and quality assurance measures. Some diversity and equality areas were explored in relation to lifestyles. Care records for 4 residents along with their health and medication needs were looked at. Discussions with management looked at progress since the last inspection. The inspector toured all communal areas of the home. Meal arrangements examined, a record of complaints was inspected and staffing was looked at in detail along with the home’s management systems. During and following this inspection four relatives were spoken with along with some social workers and nurses who visit and place people in the home. Seven of the current 28 residents were spoken with in detail during the inspection all of who confirmed that it was a good service The visit also included discussion with some staff and observation of care-practices. The home completed and returned its annual quality assurance assessment [AQAA] on schedule shortly after the visit, which meant it could not be used to plan the inspection due to the visit being scheduled before the return date. The AQAA contains good information about improvements and plans for the future of the service, and will inform part of this report where information was not gathered during the inspection visit. Survey cards were not used during this inspection due to tight timescales with the inspector instead phoning a number of relatives and professionals involved with the home. Six areas are judged as Good, and one area is Excellent. What the service does well: Comments received from residents who could offer an opinion all described the home in positive terms with typical statements such as “Wonderful home…. staff know how to speak with you “. Comments received from relatives of residents all used the word “Excellent” in describing the service offered at Edendale. Social workers and health professionals who work with the home indicated how an exceptional service is provided at Edendale. Residents benefit from a well establsihed staff team who are well trained, respectful, friendly, and give excellent care. Relatives indicated how welcoming Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 6 they are when they visit unannounced and find all staff helpful and knowledgeable and in good numbers. Relatives and professionals receive good and open communication, which is supported by a well-trained assistant manager. The management of the home ensure that health needs are closely monitored and that changing needs are promptly responded to .The home was found to be good in helping new Residents to settle in a process helped by the variety of activities on offer along with a spacious environment. All relatives felt well informed about the service before deciding on the home. A calm warm and respectful atmosphere is maintained in the home despite some residents’ complex conditions. The home is kept clean and fresh smelling at all times which creates a good impression. What has improved since the last inspection? What they could do better: Outcomes are clearly good for residents although closer attention to the following areas could lead to excellence and more securely promote and protect residents’ rights and needs. Residents receive good care, although the way in which this take place needs to be better recorded and should include more information on residents’ individual choices, preferred routines, rights, [such as to keys] and capacity. The assistant manager was found to be working on how to improve care plans and is hopeful of making the required improvements by the end of the year. The home has a number of informal ways of ensuring that residents remain satisfied and that the wishes of relatives and other professionals are included in the running of the home. However, these practices needs to be recorded such as in the form of regular surveys of views with an action-plan published to show how residents and their representatives are being responded to and affect the development of the service. Relatives of those who are self funding [private] are happy with contract arrangements and fees although the home is asked to ensure that those funded by social services also have Edendale’s terms and conditions [the contract] to protect their rights. Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 7 The home has a spacious and well-maintained garden, which is popular with Residents. The creation of level access to the garden suitable for wheelchair users will improve access and outcomes. The popular joint owner manager of the home who was full time has passed away after a long illness. This has not affected the running of the home but has to be recognised as a major event, which has affected improvement, plans. The home is asked to clarify management arrangements moving forward in order that the home has registered manager who is full time and qualified. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, & 5. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home provides both prospective and existing residents, with a good level of information, with the exception of contracts for some. The way in which the home assesses prospective or existing residents ensures, that it currently meets their needs. EVIDENCE: The management of the home confirmed during the Inspection that the residents [Service User] guide in the form of a brochure was being updated to reflect staffing qualifications and other changes. A discussion took place around what is needed in Statement of Purpose, which the home confirmed, would be in the new guide and which will be sent to the Commission when complete. Relatives of new residents spoken with indicated satisfaction with the information they received prior to deciding upon the home including the Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 10 contract and fee and found all maters to be transparent and represent good value. The management of the home confirmed on an inspection of records that an amendment is necessary for contracts [terms and conditions] to show how fees vary when a resident is self-funded. The manager confirmed that the range of fees is now £405 to £465. The lower fee being what East Sussex pays for and the higher rate what London boroughs pay. It is positively noted that selffunding residents pay between £420 and £425, which is less than the higher Social Services rate. The manager confirmed, as seen in the records, that residents who are Social Services funded have a financial contract with Social Services but no record of a signed contract of Edendales terms and conditions. The manager confirmed that organising this along with ensuring that the contract for all residents has all the necessary information indicated in the new regulations will be done shortly. No relatives or residents indicated concerns with contracts. Assessments are carried out by external agencies, which consist of full community care assessments for new residents. Intermediate care is not provided. The inspector found on examining four examples of residents’ assessment information, two of which are new residents, that all had been assessed by the home prior to moving in. However the assessment sheet used by the home is one side of A4 and contained only the most basic of health information and lacked information on people’s holistic and diverse needs such a preferred routines, capacity [what they can do for themselves], and interests. The assistant manager indicated how she is looking to develop a more comprehensive pro-forma in order to ask more questions and record more information at the assessment stage which will aid the development of more comprehensive care-plans. This was not found to be affecting the needs of those residents who were observed and spoken with during the inspection. The relatives of one of these new residents indicated how the service had asked them a wide range of questions before their mother moved into the service straight from home. Although this was not recorded on the resident’s care-plan the relative indicated that the resident took an opportunity provided by the home for a trial visit, including a meal, before deciding on the home. The relatives also supplied an exceptional amount of information in a useful format, on admission into the service. The assistant manager indicated how this format could be one to be followed. This assessment information was found to be stored separately from the care-plan and had not been transferred over although the resident had only moved in 2 weeks before the Inspection. The assistant manager agreed to copy assessment information stored in the manager’s office, in to the front of the care-plan to assist staff in having access to the required information. Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents clearly benefit from good, skilled and prompt care although better recording of how this is done and of each individual’s full range of needs will more clearly evidence that residents are receiving care as they require it. Medication arrangements have improved reducing the risk to residents who benefit from a skilled and careful review of such health needs Residents can feel very confident that they will be treated with dignity and respect at all times. EVIDENCE: The inspector sampled four care –plans, two of which related to newer residents. Risk assessments were found to be in place for behaviour and falls. These risk assessments were found to be reviewed on a regular, mainly monthly basis. Some of these risk assessments were detailed such as one Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 12 reviewed over a 3-month period the most recent review being July 22, 2007. One plan’s risk assessment showed how a resident who used to go out independently is receiving more support due to changes. Care-plans were still found to need improvement in order to be comprehensive and show the full range of needs and how these will be met for that individual. The assistant manager was found to have introduced a typed 3 section guidance sheet which is to assist staff with giving residents personal care, cope with dementia related behavioural challenges, and to help someone sleep. However these guidelines were found to be the same for each individual with the exception of one who has specific diabetes guidelines and a diet. It was positively noted that where there have been serious issues such as when a resident had to move rooms the assistant manger had typed out a full explanation. The care plans lack information around people’s preferred routines such as waking up times and interests. Similarly, residents varied range of skills with some having a greater capacity to attend to their own personal care is not reflected in the care-plans. The assistant manager indicated that she wants to show more evidence that diversity needs are being met. Some of the assessment has basic information, which could be put into the care- plan or attached to the front. Decisions around people’s rights such as sharing rooms and having keys needs to be recorded into each plan. Daily recording notes make reference to people’s health needs in terms of eating, sleeping, and whether the plan was followed. It was recommended that these notes be expanded slightly to show what individuals do during the day and their wellbeing. The assistant manager confirmed that she is currently working with staff to get them more involved in care planning and recording of “holistic” needs. Despite these shortfalls in the care-plans, which are limited by not having enough sections to prompt questions, staff were observed to know what each resident needed as confirmed by relatives and professionals and staff’s conversations with the inspector. The home’s Annual Quality Assurance Assessment forwarded to the Commission after the Inspection and by the deadline date, highlighted that further development of the care-plans was a goal for the coming year. Through conversation the assistant manager indicated how she is researching a range of different care-planning packages to find the right one. The Assistant Manager who is also a registered nurse has run training courses for staff in the administration and handling of medicines. Staff are also, or have carried out this training in their NVQ courses. All residents now receive their medication through a monitored dosage system to avoid re-dispensing medicines. Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 13 The home’s medication policy and dispensing and administration procedure is comprehensive and based on best guidance. Senior Staff were observed to dispense medication at lunchtime and did so in a wholly appropriate manner. The home has now obtained a bound book to record the administration of a controlled drugs. The charts which record the administration of medicines now show a full audit trial of all medication that comes into and leaves the home and reflects up to date medication for each resident. The home has installed two medicine cupboards, one in each house, though these are not of the metal type. The assistant manager explained that the type in place are more secure as they fitted to the wall, and work for the home. A double security system has also been introduced. The issue at the last inspection has been resolved in relation to an oxygen cylinder Accidents forms are now stored individually to protect residents’ confidentiality. Residents were observed to be alert and the assistant manger explained how medication is kept to a minimum to avoid the risk of over sedation. Health care needs are well met and currently GP’s, the District Nurse, Community Psychiatric Nurses and the continence advisor support the home. A chiropodist visits the home six weekly. Residents’ weight is now recorded in the care plan to enable the monitoring of any weight loss or gain. A diabetic was found to have weekly checks as seen in her plan. Relatives and professionals indicated the exceptional way in which health needs are met. The knowledge of the assistant manager in this respect was evidenced throughout the inspection in discussions and conversations observed, including those with visiting GPs and discussions with residents and staff. Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home provides a good range of activities based on residents’ preferences and which are advertised and regularly reviewed with residents. Residents benefit from experiencing routines that are flexible and can be confident they will be treated as individuals. Residents enjoy food, which is under constant review, is good and tasty, varied, healthy, and in good portions. EVIDENCE: Although records could improve, some written evidence shows those activities residents are offered and participate in. In-house activities include listening to music, radio or tapes, daily newspapers and magazines and watching television. Some residents are able to go out independent shopping and visit friends. Staff also accompany other residents for walks. Outside entertainment comes into the home including a music man singing and playing a keyboard; a popular female keyboard player, a Nostalgia singing group, which bring in Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 15 instruments for residents to play, and a weekly music and movement session. A more recent activity brought in the home is a fortnightly session called Motivate, which is very popular and well attended, as seen during the inspection. In response to the popularity of this activity the home is currently exploring whether the quiz master/entertainer can be booked for every week. The hairdresser visits every two weeks. Seasonal activities include visiting carol singers and a Christmas meal out to a restaurant. Some residents were observed to enjoy using the various lounges on some floors of each house [no 5 and no 6] whilst others met in each other’s bedrooms for morning tea. The spacious grounds and the relationships, which residents have formed within each house, promote residents’ opportunities to move around the site. The front doors have key a pad system, which some residents have the code for and just need to attract the nearby staff to unlock the outer door, which is locked for their protection due to the nearby road and the urban location. Some residents who spoke with the inspector indicated that they recently went out in minibus for tea at a country estate. Other residents were observed to be regularly supported to access the popular rear garden. Those residents who remain in their rooms or the various lounges were found to be regularly attended to by staff with opportunities offered for mental stimulation. Social Services and other records indicated that some residents have been in the home for over 10 -15years with it noted how well the service ensures that people keep occupied and stimulated. Contact with families and friends is encouraged. A volunteer visits the home twice a week to spend time talking to residents. This part of the home’s provision was found to be exceptional with relatives indicating how they encouraged to visit unannounced and always find staff to be knowledgeable, friendly, and open. Although decisions are not fully recorded in care plans some residents were found to have keys to their bedroom based on their capacities and preferences. Menus rotate six weekly. Although there is no advertised choice residents confirmed that alternatives are available. The cook is aware of likes and dislikes and an alternative that the resident would like is cooked. All residents who could give an opinion indicated that they liked the food served and the portion sizes. Fresh fruit was found to be available for residents along with regular snacks between meals. The management of the home also conduct a weekly shopping list of any additional items each residents likes, either snacks, sweets or other personal items. Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, & 18. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a home that operates in an open manner and which has not had a formal or upheld complaint for a long time Residents and their representatives can be very confident that any concerns will be welcomed and well dealt with in their best interests. Residents benefit from staff’s understanding of how to prevent abuse. EVIDENCE: Complaints or concerns within the service are taken seriously and dealt with appropriately. There have been no upheld complaints about the service for several years. There has been no recorded complaint as seen in records since March 2006 of last year. The home’s investigation found that this complaint was not upheld. All staff complete Protection of Vulnerable Adult training and the manager, Train the Trainer Adult Protection Training shortly after the last inspection. All staff revisit this training once a year, which is now, called Safeguarding Adults training. The deputy became a certified trainer in June of last year and attended a further Adult Protection course in December 2006. Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 17 Staff were observed to treat Residents with respect and knock whenever they entered a room. Relatives and social workers described the care as excellent. Staff spoken with indicated clear knowledge of what might constitute alleged abuse and how to report it. Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, & 26. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a fresh, clean, warm, and homely environment, which is spacious and well maintained. Access to the popular rear garden can be improved to ensure it is fully accessible to all Residents. EVIDENCE: The inspector toured all communal areas and some bedrooms. The home was again found to be clean, warm, spacious, comfortable and homely. There is on going maintenance to support the environment. The home is in keeping with local properties, and the grounds are safe and well maintained. The inspector and the manager discussed access to the popular garden, which requires residents negotiating at least two steps. The manager confirmed that she has Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 19 explored levelling an area to create wheelchair and level access. The most likely solution in the meantime is the use of a portable ramp. This was not found to be seriously affecting outcomes but will ensure that residents who develop mobility needs can still access the large popular garden. The home’s management confirmed that fire checks and training continues to be regularly organised. The home has taken advice from the local fire department in respect of locking by key, the front doors to the home. The home has worked hard over the last two years to make all the necessary improvements to infection control measures such as soap dispensers in each bathroom. The inspector was shown new bathroom facilities in some parts of the home along with an ongoing redecoration and renewal plan with further carpets identified for replacement. Staff are now banned from smoking in the home. The designated area of the dining room is used by a small number of residents and they do not smoke close to meal times. The assistant manager has since the last inspection set up an environmental audit of the home and has developed a full environmental risk assessment which is conducted each month as evidenced in the record seen of July 24 2007. A kitchen-cleaning audit was carried out in May 2007 with the home confirming that the last Environmental Health Inspection found no concerns and made no requirements. The kitchen was found to be clean and well maintained with new worktops fitted All ten bedrooms looked in at no 5 and no 6 were found to clean and fresh smelling. A noteworthy achievement given some of the continence needs of some residents. Each house benefits from having a daily dedicated cleaner. It is noted that a number of residents share bedrooms which is based on positive reasons such as in the case of one highly able resident who experiences depression who acknowledged that she needs someone in her room to avoid isolation. The management were advised to record in each careplans where residents share rooms to show the decision making process. Most care plans showed why residents move rooms due to health needs such as moving to the ground floor due to there being no lift or to be under closer supervision. A detailed report in one plan showed why it was necessary for one resident to move between the houses. At the time of the inspection Edendale was providing services to 28 residents. The home does not go above 30 residents as one double room is used as a single. Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, & 30. Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from good numbers of excellent and experienced staff on duty who are well supervised and who benefit from improved training. Residents are protected by the home’s tight recruitment procedures with an exceptional staff induction in place The care of residents is enhanced because a high number of staff have met all training targets and are well supported by management. EVIDENCE: On the day of the inspection there were twelve and sixteen residents in each respective house [No 5 and no 6]. Staffing levels were found to be excellent as seen in observation with residents needs promptly met. Relatives also commented positively on the staffing levels along with excellent attitude and skills of all staff. As well as the full time assistant manager, each house benefits from having their own dedicated supervisor who oversees all staff in each house, which includes a team of four carers, one of whom is the senior. Having a dedicated cook with each house having their own cleaner further complements staffing levels. The rota examined was found to match those staff on duty. Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 21 The assistant manager confirmed during the Inspection visit that over 80 of all care staff now have a National Vocational Qualification at Care Level 2 or above. All other staff has completed foundational training or are on National Vocational Qualification in Care Level 2 course. Even staff that have worked 20 years have received new inductions where things have changed. This was confirmed in discussions with staff. Staff spoken with identified training as the major improvement over the last year. One of the supervisors spoken with indicated that she is now a National Vocational Qualification 2 Assessor and supports staff through this process. She also demonstrated how as nighttime supervisor she carries out unannounced spot checks on staff and supervise them including structured written supervisions. Staff identified clear examples about how additional training has improved care such as safety awareness, an example being the use of wet floor signs. An instructor carries out moving and handling and all staff are booked for annual refresher training to commence shortly. No new staff have been employed since the last inspection. An inspection of three existing staff files showed all had suitable Police CRB Checks. The assistant manager indicated that the home continues not to use agency staff. The assistant manager showed the format for interviewing any prospective new staff, which covers area such as discussing inductions, and looking at attitudes. The Assistant Manager runs the Level 2 and Level 3 NVQ training programme for all staff, which has significantly supported staff progress. The ongoing training programme is comprehensive and includes dementia and metal disorder awareness along with protection of vulnerable adults. The assistant manager is trained to deliver most of this training and supervises the senior staff that in turn supervises the rest of the staff team The home has introduced an induction workbook which mirrors the basic 12 week Skills for Care recommended induction programme but which exceeds it in terms of detail and expands upon this to an National Vocational Qualification in Care Level 3. The assistant manager confirmed how the home’s induction has been positively approved by a training organisation she liaises with. Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, & 38. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a home that is well managed although further evidence of how quality is being measured and how this involves residents and their representatives is needed. Residents benefit from living in a safe home, which is committed to their needs. EVIDENCE: The service benefits from the Assistant/Deputy Manager appointed shortly before the last inspection. The Assistant Manager is a Registered Mental Health Nurse, (RMN), a NVQ assessor and NVQ internal verifier along with having a Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 23 NVQ level 4 in Management and in Training and Development. The assistant manager confirmed that her PIN remains active in respect of being a registered nurse and has all the necessary qualifications to go forward for registration. The home had until recently two registered managers until the full time manager died after a long illness. This person was highly popular with residents as indicated in discussions during the inspection. This has understandably affected some of the home’s progress with moving forward with aspects of administration, such as care-plans and quality assurance measures along with planning. During the inspection the remaining registered manager / owner confirmed that she was exploring options in respect of having a full time registered manager with the necessary qualifications as despite her experience she lacks the qualification and works part time. The owner/registered manager manages the business side of the home and gives good support to the assistant manger that effectively manages the care side of the home. The assistant manager has range of expert skills as already indicated in this report and has driven the improvements in staff training. Staff spoken with indicated satisfaction with the support they received from management. Relatives and professionals described the management of the home as excellent with skills and knowledge of the assistant manager an added reassurance. The management of the home indicated during the inspection that despite some new audit forms and environmental checks, they have not yet carried out a survey of residents and their representative’s views to develop an action plan based on the results. The management of the home have ideas for the business planning of the home such as better garden access and further redecoration and renewal but have yet to formalise this into an annual development plan, which involves those, connected with the home. The home were therefore advised that over the next four months they should develop and circulate appropriate questionnaires and carry out a survey, develop an action plan and publish the findings in the home and the Service User [Resident] guide. Linked to this should be the overall plan for the home over the coming year to show how they have responded to their views. It is evident that a lot of informal quality monitoring takes place due to staff and managements close attention to residents’ and relatives’ needs as confirmed in the high levels of satisfaction indicated in this and the last inspection which included the Commission’s surveying of relatives. The inspector sampled a selection of the monies retained by the service on behalf of a small number of residents who do not have appointees outside the home. Whilst these monies did not tally up with the balance recorded on the card these did reflect an accurate balance of what is owed to each resident. The manager/owner explained that due to residents’ benefits being paid as cheques which also included fees, it would be difficult and very labour intensive Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 24 to be ensure that monies held for residents corresponded with actual balances all of the time. For instance, items such as hairdressing for some residents will be paid out of petty cash in one lump sum, then later deducted for residents’ individual monies with the other appointees [relatives] invoiced. The manager confirmed that residents’ monies held in the home are adjusted at the end of each month to ensure that they correspond to the actual balance recorded. The manager/owner confirmed that on advice of the last inspector that residents’ monies are no longer pooled into one company account with all having separate statements and account numbers of that small number which the home manages. Records and discussions with staff indicated that all staff received regular and written supervision. The assistant manager confirmed in discussions along with an inspection of some records and the Annual Quality Assurance Assessment received after the inspection that all necessary health and safety checks are carried out. During the inspection staff were reminded by the assistant/deputy manager to wear aprons when preparing sandwiches for residents. Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP2 Regulation 5 as amended 2006 Requirement That the registered person must ensure that all residents or their representatives sign and have a copy of Edendale’s terms and conditions [the Contract]. That the contract contains all items indicated in the new amended regulation effective from September 2006 That the registered person must ensure that care plans are comprehensive with all the aims identified, reviewed and assessed. That care plans will follow on from a comprehensive assessment, which covers a range of information important to residents such as routines, interests and how specific person centred needs will be supported. Requirement of the last 2 inspections. Requirement first made June 19 2006 That the registered person must ensure the implementation of an effective quality assurance and monitoring system that meets the requirements set out in the stated standard and regulations. DS0000021092.V345597.R01.S.doc Timescale for action 30/10/07 2. OP7 15(1) 30/11/07 3. OP33 24(1)(a)( b)(2) 30/11/07 Edendale Residential Care Home Version 5.2 Page 27 That the quality assurance system is based on the regular obtaining of residents and their representatives views with a report published of this survey including any action plan and how this affects the homes own business annual development plan. That the Commission receives a report of this survey along with the home’s annual development plan by the timescale shown. Requirement of the last 3 inspections. Requirement first made 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP1 Good Practice Recommendations That a copy of the currently reviewed Service User [Residents] guide containing the Statement of Purpose is comprehensive and is sent to the Commission when complete. That the home’s own pro-forma for conducting preassessments of prospective new residents is comprehensive and then used in practice to form the basis of the care-plan. That daily reports contain more detail to show how needs are being met and the residents’ participation such as in activities. That all parts of the home to be used by residents are accessible with the provision of a ramp or level access to the rear garden to assist those with mobility needs. That the registered person reviews the arrangements for managing the home to ensure that the registered manager [S] is full time and has the necessary qualification. It is DS0000021092.V345597.R01.S.doc Version 5.2 Page 28 2 OP3 3 4 5 OP7 OP19 OP31 Edendale Residential Care Home advised that the home informs the Commission of this review within the next 3 months and submits any necessary application as appropriate. Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Edendale Residential Care Home DS0000021092.V345597.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!