Inspection on 28/10/08 for Elizabeth House Benfleet

This inspection was carried out on 28th October 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Elizabeth House Benfleet 15/05/07

Elizabeth House Benfleet 08/06/06

Elizabeth House Benfleet 03/11/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Elizabeth House Benfleet 42-45 Benfleet Road Hadleigh Benfleet Essex SS7 1QB     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sarah Buckle     Date: 0 3 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 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: Elizabeth House Benfleet 42-45 Benfleet Road Hadleigh Benfleet Essex SS7 1QB 01702555786 01702555786 manager.elizabeth@runwoodhomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Peter Michael Brooker Type of registration: Number of places registered: Runwood Homes Plc care home 72 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Personal care to be provided to 36 service users with dementia and who are over 65 years of age. Personal care to be provided to 72 service users over 65 years of age. Date of last inspection Brief description of the care home Elizabeth House provides care and accommodation for 72 older people. They can also offer care to older people who have dementia. The Home consists of two physically separate buildings sited on the same plot, but run by the same manager. They are referred to by staff and residents as E1 (the original building) and E2. Each building has its own kitchen and laundry areas. E2 does not have the benefit of a garden, however residents can be escorted to use the garden facilities at the rear of E1. Accommodation is all (apart from one room on E1) in single rooms, and there is a Care Homes for Older People Page 4 of 32 0 0 Over 65 36 72 Brief description of the care home range of communal areas in both buildings. The furnishings and fittings are of a good standard. The home is situated close to local amenities and local transport links. Inspection reports are readily available for visitors to the care home and are displayed in the entrance areas of both E1 and E2. Also on display, and available for visitors and residents are copies of the homes Statement of Purpose and Service Users Guide. 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: three star excellent 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 was a routine unannounced key inspection which included a site visit to Elizabeth House. The site visit was carried out by one inspector over the period of a day. Elizabeth House consists of two separate buildings on one site, however, these are registered as one service and consequently inspected as one service. A partial tour of the premises was undertaken. A number of staff members were spoken with as was the manager of the service, a relative and some of the people who live at the home. Records and documents were examined and staff interaction with residents was observed. Surveys were sent to staff members and relatives. 10 staff surveys were competed and Care Homes for Older People Page 6 of 32 returned to the Commission and 13 relative surveys were also completed and returned. An annual quality assurance assessment was completed by the home. Information from all of these sources will be reflected within the body of the report. At the end of the site visit feedback was given to the manager, operations manager for the service, deputy manager and administrator. What the care home does well: What has improved since the last inspection? What they could do better: 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. Care Homes for Older People Page 8 of 32 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. Prospective residents and their representatives are given the necessary information to make an informed choice as to whether or not Elizabeth House is the right care home. The home has a good system for assessing the needs of prospective residents. Evidence: Sufficient information was available at Elizabeth House for prospective residents, residents and their relatives/ representatives. The statement of purpose, service user guide and most recent inspection record were available in the lobby of the home. The registration certificate was also displayed. The manager confirmed in discussion that a brochure and the service user guide was made available to potential residents. Three care plans were sampled and assessment information was examined. It was clear that a thorough assessment of the residents needs was completed prior to admittance at the home. The assessment included information about the residents Care Homes for Older People Page 11 of 32 Evidence: personal details, i.e. GP, date of birth, next of kin, preferred name etc. A Runwood Homes assessment was also completed. This is a document which identifies possible areas of need which includes memory, communication, mobility, transfers, washing and dressing, bathing, eating, eyesight etc. The appropriate information is ticked and further detail added as necessary. This information then transfers directly into a care plan. For example, one assessment seen stated in the memory section poor short term memory recall, and this information and how to support the resident was detailed in their care plan 4. Further assessments were also completed including a nutritional assessment, including monthly weight records, a falls assessment, continence assessment and a pressure ulcer assessment with a fully completed and up to date body map. All of these assessments had clear evidence of monthly review and updates to care planning where changes had occurred. A mental status questionnaire and a dependency tool were also completed. Elizabeth House provides care for both older people and people with dementia. It was positive to note that the manager of the home had undertaken significant training in dementia care, and that 56 members of the staff team had completed some form of dementia training during 2007 and 2008. Only 6 members of staff have not yet completed dementia training according to the training matrix compiled by the home. In discussion, the manager stated that some members of staff had completed an 8 week dementia course, Yesterday, Today, Tomorrow. 13 surveys were completed by relatives/representatives of the people that use this service. 10 of these stated that they felt the home always meets the needs of their relative and 3 of these stated that the home usually met the needs of their relative. Examples of comments received regarding this include, Always caring, consistent, friendly; Always take the time to talk to her and try to keep her occupied and My mother would not be cared for better in the Hilton. It is a nice home. 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. All care plans are in the process of becoming appropriately person centred. They are agreed with the individual, easy to understand and clearly look at all areas of the individuals life. The care plan is a detailed working document and is reviewed regularly. Evidence: In discussion, the manager of Elizabeth House stated that the care planning process was undergoing a review, and that care plans were being rewritten. Four care plans were sampled at random during the course of the inspection. Two of these were examined in depth and demonstrated the difference between an original plan and a newly written one. The care plan that had been revised was a clear and thorough working document, whereas the care plan awaiting revision was not. This was discussed with the manager during feedback, when she explained that all of the care plans were in the process of being up dated to this standard. The updated care plan had detailed support plans in place around each of the persons Care Homes for Older People Page 13 of 32 Evidence: needs as identified in the initial assessment. The support plans paid attention to the specific details of the person concerned and were centred on meeting their personal needs. For example, a support plan regarding poor eyesight stated (the resident) is able to distinguish shapes and outlines of objects; (the resident is) unable to see details and small objects; ensure all hazards are removed where possible (wire/rubbish)........refrain from moving objects and furniture around in (the residents) room as this will unsettle (the resident) etc. A support plan regarding Parkinsons Disease also shows the person centred and detailed nature of the information, (the resident) is able to stand from bed/chair but requires support of a carer as (the resident) may become unsteady.......staff to be vigilant to (the residents) Parkinsons and look out for its progression such as tremors or rigidity and Staff to remain sensitive to (the residents) condition and they are to ensure that they are observing and assisting as needed. This resident had 10 thorough support care plans in place and a night care plan outlining their preferred night time habits. All of this information was reviewed on a monthly basis and any changes in need reflected in the care plan. The care plan also contained evidence of multi disciplinary reviews and 3 monthly reviews. Appropriate risk assessments were completed for the resident and these tied in with the information in the support plans i.e. a risk assessment for falls stated that staff members were to monitor the resident, and that medication for Parkinsons Disease should be regularly administered and that the residents room must remain unchanged to prevent problems occurring. 10 staff surveys were completed and returned to the Commission. 4 staff members stated that they are always given up to date information about the needs of the people they support, 5 people stated that they usually are, and 1 person said that they sometimes receive this information. 9 of the relative surveys said that the care home always gives the support they expect to their relative/friend, 2 said that the care home usually does and 1 said that it sometimes does. One person stated (My relative) is very well looked after, another person said My father is well cared for in all respects and a further comment stated excellent. There was clear evidence in the care plan to show that the health care needs of the Care Homes for Older People Page 14 of 32 Evidence: resident were being met. A protocol for the administration of as required (PRN) medication was completed and stored on the file and a risk assessment was completed to accompany this which detailed the PRN procedure at the home. Records of health care professionals were maintained i.e. 30/07/08 the Parkinsons Disease nurse visited the resident and checked their medication; 01/08/08 Chiropodist etc. During the key inspection a District Nurse was at the home visiting residents who required her input. She stated that she was new to the home, but that two other district nurses who visit the home had no problems. She said that the home is always clean and that the staff do as they are asked and that they are spot on. The nutrition records were examined and both the head cook and the manager explained the process regarding these which amounts to a thorough audit of nutrition. The records are completed daily after each mealtime and at the end of the day are taken to managers office for the care team managers to complete the process and the manager to monitor it. The manager stated that there is also input from the CHANT nurse re nutrition and health at the home. The medication process, storage and records were examined during the inspection. The manager stated that all staff who administer medication have training. A care team manager was spoken with in depth and they reiterated that this was the case. Only CTMs administer medication at the home and they have completed in house training and Boots training. The manager also gave evidence of a medication competency work book that has been introduced for staff who administer medication to work through. The medication trolleys are stored in a locked cupboard, and were attached to the wall. The fridge and room temperature were recorded daily. However, it was noted that the medication fridge was running at a 9 degrees Celsius when it should be between 2 and 8 degrees. A new fridge was ordered during the course of the inspection, and all the medication stored were placed in another available medication fridge. The controlled drug cupboard and register were examined. The controlled drug cupboard was attached to a stud rather than a solid wall which breaches regulation, however, the manager confirmed that this would be moved. The register was completed appropriately with a witness for each administration and the medication available tallied with the number recorded in the register. The medications administration records (MAR) were examined. It was positive to note that there were sample signatures of all staff who administer medication in the file and that there was a photo of each resident. The MAR sheets were completed appropriately Care Homes for Older People Page 15 of 32 Evidence: and no omissions noted. During the course of the site visit to Elizabeth House all of the residents who were observed were seen to be treated with respect by the staff team. There was a friendly atmosphere in the home and a lot of chatter and banter. One relative made a comment in a survey which stated, Staff have a caring attitude in their dealings with residents and help them to retain their dignity as much as possible. Care Homes for Older People Page 16 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. The people that live at Elizabeth House are satisfactorily involved in meaningful activities of their own choice and capability. Evidence: The residents at Elizabeth House were observed making choices about how they wanted to spend their time. A number of people were in their rooms, reading, watching TV or DVDs. One gentleman resident was observed watching The Flintstones. Some residents were walking around the home, talking to staff or wandering. One gentleman was sitting in the lobby looking at a newspaper. For those residents that wanted to participate there is a schedule of activities. This information was posted on a number of notice boards throughout the home and included such things as, arts and crafts and painting, arm chair movements, bingo, dancing to old time songs, knitting and film afternoons. One activities co ordinator was observed doing armchair movement with a small group of residents and a relative. There is a church service on a Sunday morning. Elizabeth House has a sensory room which can be used by residents. A hairdresser was at the home and residents were observed having their hair done in the salon. Care Homes for Older People Page 17 of 32 Evidence: The activities folder was examined. This document contained an activities assessment for each resident detailing what they liked to do with their time. Examples of the activities recorded include bingo, musical movement, (the resident) did not want to do knitting but sat in with us, painted bird box, in sensory room, joined in sing a long etc. The staff engagement with residents in the home was positive and familiar. This was evidenced by the way in which they communicated and responded to the residents needs. Forthcoming activity events were displayed on a notice board and these included a pub visit, sea life centre, firework night and BBQ. It was positive to note that a number of relatives were visiting during the key inspection site visit. One relative spoken with was full of praise for the service provided by the home, and her relative agreed with her. She stated that she thinks the home is great. It was also positive that the manager had established a weekly relative surgery, whereby for a three hour period relatives could raise any areas of concern with her. All of the bedrooms seen during the tour of the premises were personalised. Some of the residents had telephones in their rooms. The kitchen was visited and the head cook spoken with. Infection control procedures were followed appropriately, with all visitors to the kitchen being given a plastic apron to wear. The head cook stated that she had completed infection control training. The kitchen was well organised. The head cook stated that she completed Safer food Better Business, and this was examined during the inspection. There was a daily cleaning schedule with each task ticked as completed and daily recordings of fridge and freezer temperatures. The menu on the day of the inspection offered a choice, however all of the residents had chosen roast chicken with all the trimmings. Dessert was apple and sultana pie and custard. The head cook stated that all of the food at the home is homemade, including cakes. She said that at least one vegetable is offered at each meal. For afternoon tea there was a choice between scones and jam tarts, and ham salad or sandwiches for tea. Those residents who required soft food had each portion of their food pureed separately. Care Homes for Older People Page 18 of 32 Evidence: Nutrition records were examined. These were completed appropriately, and detailed whether a full portion or half a portion or less had been eaten. There was also information regarding fluid intake recorded. Care Homes for Older People Page 19 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. Elizabeth has an open culture which encourages people who live and work there to express their views. Evidence: The complaints log was examined during the inspection. It was positive to note that all of the complaints were recorded with the detail and outcome. There were 6 complaints recorded for the months between April and September 2008, and these were mainly from residents regarding such issues as a sponge and soap missing from the bathroom, or because of another resident shouting out. There were also complaints from relatives regarding issues relating to care practice and these were detailed as was the managers response. The compliment file was also examined and there had been 20 of these since September 2008 i.e. Many thanks for what youve done for my mum. I know I picked the right home for her to be in and she was in very good hands. I think very highly of you all. All of the relative surveys completed and returned to the Commission were clear about how to make a complaint about the home if they needed to. Comments received include, So far I have never had any need to complain, Always deal with concerns and want to help us and If needed I do know, but so far I have no complaints. Care Homes for Older People Page 20 of 32 Evidence: 10 of the relative surveys stated that the care home always responds appropriately if concerns are raised about their care, 3 stated that the care home usually does. Comments received include, Nothing is too much, I have no concerns at the present, or in the past and .....a query or concern may need to be raised several times with different members of staff. At the last resort written queries/complaints have always been taken seriously and actioned. According to the homes training matrix 58 members of staff have completed training in the safeguarding of vulnerable adults in 2007 or 2008. 4 of the staff team have not yet completed this. One member of staff spoken with was able to demonstrate clear understanding of the safeguarding procedure within the home. Care Homes for Older People Page 21 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. Elizabeth House provides an environment that is appropriate to the needs of the people that live there. It is comfortable, homely and clean. Evidence: Elizabeth House has two separate buildings E1 and E2, however these are registered as one service and inspected as one service. A partial tour of the premises was undertaken. The home was clean and comfortable. There were fresh flowers and pot plants all around the home which added to its homely atmosphere. All of the bedrooms looked at were personalised with photographs or pictures and ornaments. The lounges were decorated with the arts and crafts that people had made. Dining areas were well laid with tablecloths, flowers and matching cutlery. Juice and beakers were available in each lounge. Bathrooms and toilets were clean. All of the pedal bins had lids, and there was liquid soap available and plenty of paper towels. The bathrooms contained aprons, alcohol gel rub and paper towels. The baths were clean and the bathrooms homely and welcoming. One pedal bin was not working, however, this was replaced during the Care Homes for Older People Page 22 of 32 Evidence: course of the inspection once pointed out to the manager. The garden area had plentiful wooden tables and chairs for residents to access if they wished. It was positive to note that there was clear signage on the bedroom doors, which included an image and the residents name. No cleanliness or odour issues were noted in the home. One relative stated: The home is very comfortable with good facilities and excellent staff who care and communicate with residents as personal friends. Overall, I doubt if this home could be improved for the service given at this time. All except 9 members of staff had completed training in infection control. 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. The staff team at Elizabeth House are skilled in their roles and consistently able to meet the needs of the residents. Recruitment is robust and safeguards the people that live at the home. A high level of importance is placed upon the training and support of staff to ensure they can meet the needs of the residents. Evidence: The staffing levels at Elizabeth House are currently 1 care team manager and 4 care staff during the day in one building and 1 care team manager (CTM) and 5 care staff in the other. At night, both buildings have a CTM and 2 care staff on duty. The manager is supernumerary and has her office in one building, but clearly manages both. A deputy manager is also in post. An anonymous concern was raised at the Commission in August 2008 regarding the level of staff on duty. The complainant stated that the home was always short staffed especially at night. This was discussed with the manager who stated that the amount of staff on duty is adequate, but that there had been some problems with night staff which have now been resolved. From information received in staff surveys, 2 people stated that there were always enough staff to meet the individual needs of all the people who use the service, 7 people stated that there are usually enough staff and 1 person said that there sometimes are. Only one comment was received in this area by staff which stated, Some staff let you down at times, but CTM and manager always help on the floor. One relative commented that Care Homes for Older People Page 24 of 32 Evidence: There always seem to be periods when the home is understaffed and and I believe that a greater emphasis should be put on minimum staffing levels - obviously when the home is understaffed the remaining staff, who are usually brilliant, are put under pressure and unable to spend as much time with the residents as they perhaps would. One staff member spoken with stated that there are always enough staff to meet the needs of the residents, but that you could always use more staff to spend more time with the residents. A second member of staff stated in their survey that the service could be improved by allowing more time for staff to socialise with the residents. During the inspection staff and residents were seen interacting positively. The home was calm and routines were observed to be flexible. This was reiterated by comments received from relatives i.e. The staff are brilliant. They are caring, friendly and deal with all the (residents) exceptionally well and this is the most important thing and The manager and staff... are very considerate and kind to residents and have made very good communication with (them) over a long period of knowing the individual needs of different persons. The manager has established a staff surgery on a weekly basis for two hours, where staff can meet with her and discuss any problems, concerns or issues. Information regarding this was displayed in the staff room. Five staff recruitment files were requested and three of these were looked at in depth. All of the files seen contained the information specified in regulation to ensure residents are safeguarded. One staff member had a Criminal Records Bureau check that was completed on 15/08/05 and this was in need of renewal. There was evidence of induction being undertaken on the files and this was signed off once the member of staff was competent. One staff file examined had evidence of completion of the assessment of competency regarding the supply, storage and administration of medication. The training matrix completed by the home demonstrated that core training has been undertaken regularly and frequently by the staff team at the home. All bar one member of staff had completed manual handling training in 2007 or 2008, all except four members of staff had completed training in safeguarding of vulnerable adults. Training had also been completed in health and safety, first aid, fire awareness, basic food hygiene, infection control, dementia and where appropriate medication administration. One staff file examined had evidence of training which included an NVQ4 equivalent course, manual handling 23/05/08, safeguarding 25/02/08, health and safety 28/01/08, First Aid 09/05/08, Dementia 22/10/07, Fire awareness 09/05/08, food hygiene 12/04/07, infection control 21/04/08, challenging behaviour Care Homes for Older People Page 25 of 32 Evidence: 23/11/07. A second staff file examined had evidence of manual handling training 02/10/08, safeguarding 04/10/07, health and safety 18/03/08, first aid 05/02/08, dementia 22/01/08, fire awareness 20/03/07, food hygiene 03/07/08, infection control 24/04/08 and challenging behaviour 29/02/08. All of the staff surveys returned to the Commission stated that they were being given training relevant to their role. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has achieved more than the required qualifications, is experienced and is highly competent to run the home. All aspects of the home inspected were consistently managed to a high standard. Evidence: The manager at Elizabeth House has been in post since May 2008. From May to August 2008 the manager had responsibility for running two Runwood homes, and in August became the full time manager solely at Elizabeth House. The manager has previously been registered with the Commission and is currently in the process of registering for the position of manager at Elizabeth House. Whilst in post as manager of a separate Runwood home it is positive to note that significant improvements were made to the service provided. The manager has completed her Registered Managers Award, a five day dementia care workshop Dementia Care Matters and is currently completing a certificated Care Homes for Older People Page 27 of 32 Evidence: dementia programme through the University of London. There is positive feedback regarding the managers support and commitment throughout the surveys received by the Commission and these comments are from staff and relatives. For example, one staff member stated I have been at Elizabeth House for two years and it has had its ups and downs. Since the new manager came the home feels nice. She is always about the home and has a surgery for staff and deals with lots of problems. There is always a cheerful atmosphere and fresh flowers. It is a nice place to work. The manager works lots of hours and works to help us at all times. The same person also said that (The manager) is always friendly and caring and helpful to us when we are busy. (She) assists with mealtimes. We are lucky to have someone who cares, knows what to do and is a nice person. A second member of staff stated The manager always has her door open to talk about any problems and a third staff member stated I would like to say thank you for our manager who is always there to support the staff. One relative stated, The home has an on going improvement programme in place at present and are regularly looking at ways to improve the quality of life of the (residents). With this in mind at present I cannot think of any more that they could do. Three other relatives also stated that they did not think the service could be improved. Runwood Homes undertake an Annual Audit Report of the service provided at the home. This was completed in May 2008 and a copy of the findings were sent to the Commission. The audit identifies recommendations for improvement which the manager has been systematically addressing. Almost all of these have now been met. Residents monies were examined. These were securely stored and records and receipts were maintained. The tallied amount of money matched the money available for the resident whose account was looked at. According to the completed annual quality assurance assessment (AQAA) all of the systems and services within the home are monitored and maintained. A number of zimmer frames were examined during the site visit to the home and all of these were in good condition. The accident records were examined and these were completed appropriately. It was positive to note that this information was copied and contained within the persons care plan. Care plans and risk assessments were updated according to the accidents recorded. Staff training in care areas regarding health and safety was seen to be completed by Care Homes for Older People Page 28 of 32 Evidence: all of the staff team in an on-going manner. The ethos of the home was summed up in the comments section of their annual quality assurance assessment (AQAA), which stated (Elizabeth House) provides a quality service which gives real value for money. A service that has the resident at its core and develops resident focused, activites based care that fulfils their care needs. The involvement of the residents and their relatives fosters a close link that the home is their home or a home from home where they have a strong voice to change, compliment and complain about what is happening. We have a home where complaints and concerns are not seen as a nuisance or a problem but as a productive learning tool where lessons could be learnt and this can be voiced without fear of intimidation or harm. We employ a dynamic workforce that looks give their best and encourage the residents they look after to be themselves and have the best quality of life. Care Homes for Older People Page 29 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 30 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 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 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. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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