Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Eshcol House 12 Clifton Terrace Portscatho Truro Cornwall TR2 5HR 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: Lynda Kirtland
Date: 2 9 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 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 29 Information about the care home
Name of care home: Address: Eshcol House 12 Clifton Terrace Portscatho Truro Cornwall TR2 5HR 01872580291 01872580646 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Margaret Ann Stobbart-Rowlands Type of registration: Number of places registered: Mark Fairhurst,Mrs Gillian Fairhurst care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability terminally ill Additional conditions: Up to 1 service user with dementia aged 50-60 years may be admitted. Date of last inspection Brief description of the care home Eschcol House provides accommodation, personal and nursing care for up to 31 older people. Four of these may have a physical disability; Four may be terminally ill, Four may have a mental illness, up to fourteen may have dementia and one adult aged 50Care Homes for Older People
Page 4 of 29 Over 65 14 4 31 0 0 1 0 0 4 4 Brief description of the care home 60 years may have dementia. The registered providers are Mark and Gillian Fairhurst. They are actively involved in the business on a day-to-day basis and employ a manager and a team of staff to assist them. There is always a qualified nurse on duty at the home. The home is located in the village of Portscatho on the Roseland Peninsula. It overlooks the sea and several rooms have spectacular sea views. The home is accessible by road and the village is within walking distance. The home has three storeys. The upper floors are accessible by a serviced lift, stairs and stair lift. There are two lounges on the ground floor and a separate dining room. Most of the bedrooms provide en suite facilities. The home is set in its own attractive grounds with parking space at the front of the building. There is level access to all communal parts of the building and the grounds and suitable facilities for people with physical disabilities to enter and move around the building independently. Care Homes for Older People Page 5 of 29 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: An inspector visited Eschol house for an unannounced key inspection on the 29th October 2008. It lasted for approximately eight hours. Information about the home received by the Commission since the previous inspection was taken into account when planning the inspection. The purpose of the inspection was to ensure that people who use the service needs are appropriately met in the home, with particular regard for ensuring good outcomes for them. This involved meeting with people who use the service to discuss with them their experiences in living at the home. Observation of the daily life and care provided occurred as well as an inspection of the homes premises and of written documents concerning the care and protection of people who use the service and the ongoing management of the home. Staff were Care Homes for Older People
Page 6 of 29 interviewed and observed in relation to their care practices and there was a discussion with the homes registered manager. Another method used was case tracking, of which four people were selected. This involves examining the care notes and documents for a select number of people who the service and following this through with interviews with them or their relatives and staff working with them. This provides a useful, in-depth insight as to how their needs are being met in the home. People who use the service said that the care they received was excellent, first rate and all were more than happy with the facilities on offer. Fees range from six hundred and thirty to seven hundred and sixty three pound per week. Additional, variable charges are made for (optional) hairdressing, according to information provided by the manager at the time of the inspection. What the care home does well: People who use the service are provided with an up to date Statement Of Purpose and Service Users Guide. These documents give the person information regarding the facilities available in the home. These are available in each persons room. Pre admission assessments occur prior to a person being admitted to the home so it can be assessed whether Eschol house has the correct facilities to meet an individuals needs. This in turn allows the prospective service user to form a view as to if they believe the home can cater for their needs and make an informed choice about living at the home. People who use the service said that their recent admission to the home was a positive experience, as staff made them feel welcome and relieved some of their anxieties. People who use the service said that they are satisfied that their healthcare needs are being met. There are qualified nurses on duty at all times and people who use the service have good access to external healthcare providers, such as general practitioners when they need them. There are safe and sound systems in place to ensure that peoples medicines are properly managed so that they are kept safe and as comfortable as possible. There is an appropriate complaints policy so that staff are provided with guidance if they receive a complaint as to the process in how to manage this. People who use the service said that they felt able to approach the registered manager if they had any concerns. None were voiced at this inspection. There is also a suitable adult protection process. The home has a range of communal facilities and a garden, which people can make use of. Most people who use the service said that they are satisfied with the lifestyle the home provides. Some go out independently or with relatives and make use of the facilities in the local community. People who use the service are able to make choices over issues that are important to them. Most maintain control of their own finances or do so with the assistance of their relatives and they are able to personalise their bedrooms if they wish, for example. Staff were observed to promote privacy and respect for people who use the service i.e. by knocking on bedroom doors before entering, mail received unopened and access to phones in private. People who use the service commented that they felt staff treated them with kindness and respectful. The home appears comfortable, well maintained and safe so that people who use the service can enjoy attractive and homely surroundings. It was clean and tidy throughout at the time of the inspection, which was unannounced and relatives, staff and rpeople who use the service said that it is always kept clean. The homes recruitment processes ensures that people employed at the home have had all relevant checks and are safe to work with this vulnerable client group. Care Homes for Older People Page 8 of 29 Views been sought from people who use the service about the facilities that Eschol house provide via surveys and resident meetings, as are relatives views. The response they have received has been positive and people who use the service commented in the surveys that they are satisfied, happy with the care and could not identify areas for improvement. Overall, the home is well managed, in the best interests of the People who use the service. The person in charge is well qualified and registered with the Commission for Social Care Inspection as a fit person to manage a care home. The home manager ensures that relevant health and safety checks, such as fire equipment are maintained and regularly checked and staff are well trained and guided on how to keep the home safe for them. What has improved since the last inspection? The registered manager has successfully completed and received an excellent rating from external verifiers for introducing the Gold Standards Framework at Eschol House. This framework aims to help deliver a gold standard of care for all people as they near the end of their lives. It involves them working with other professionals to help to provide the highest standard of care possible for people who use the service and their families as they face the last stages of their lives. People who use the service and their families are actively involved in this process and it compliments the current care planning process. The registered manager and staff commented that networking with various professionals has also improved especially in light with the introduction of the Gold Standards framework i.e. with the hospice, hospital, community teams, Department of Adult Social care and other care homes. In addition they have introduced a remembrance book, which is available for all people who use the service to see if they wish. Staff training has increased. Over 90 percent of staff have achieved a minimum of NVQ at level 2 and attended updated various mandatory courses such as first aid, infection control, manual handling. Specific nurses have delegated lead nursing roles such as tissue viability to ensure that staff training remains up to date with current practice. There are two dedicated activities coordinators who provide activities seven days a week and people who use the service interests and hobbies are actively pursued both on a individual and group bases and within and outside of the home. PAT dog now visits the home and they have access to a community bus, which has given opportunities for people who use the service to go on outings. Visits from various churches occur, and coffee mornings have been introduced. There is now a newsletter to people who use the service, which informs them of what is occurring in the home. There have been various refurbishments throughout the home such as new carpets, a dedicated hair salon, new soft furnishings and redecoration. In addition new specialist equipment for example at least six profiling beds have been purchased along with more pressure reliefing mattresses. Bathrooms have also been upgraded. Policies and procedures and information leaflets are continuously being updated so that information for people who use the service, their relatives and staff receive remains Care Homes for Older People Page 9 of 29 accurate and reflect current practices. 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. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 29 Details of our findings
Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 29 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. A contract of care is provided to people who use the service so that they are aware of their rights whilst resident at Eschol House. The needs of prospective service users are assessed prior to admission so that they can be assured that the home can provide adequate care and meet their individual care needs. People who use the service are invited to meet with staff and visit the home that will assist them in making the decision about living at Eschol house Evidence: The homes Statement Of Purpose and Service Users guide have been updated so that they accurately reflect what services and facilities the home provides to people who use the service. From case tracking new admissions to the home it is evident that prospective service users and their representatives are fully involved in the assessment process so that
Care Homes for Older People Page 12 of 29 Evidence: they can identify what help they need and how staff will then meet this care need. Records from relevant professionals are also gained as part of the assessment process. The manager visits prospective residents and complete a needs assessment, which takes into account the persons physical, emotional, social and diverse, needs. All the records case tracked contained needs assessment, which recorded their care needs in detail and included their views and preferences. Residents felt that the home involved them in their care arrangements. In discussion with residents they confirmed that staff lessened their anxieties when moving into Eschol house and that this was a positive experience for them. A contract of care is provided to each person who uses the service which stipulates their terms and conditions of the placement. Care Homes for Older People Page 13 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person who uses the service has a care plan format, which in the main inform, guide and direct staff in the caring interventions that they need to undertake with individual people. In addition an Advanced care plan, which outlines a persons wishes in the event of their death, is in place. There are satisfactory arrangements to ensure people who use the service have access to healthcare service. Evidence: All of the people who use the service said that they felt competent staff met their care needs, some were also aware of their care plan. Of the four care plans case tracked, they in the main informed, directed and guided staff in how to meet the persons individual needs. The registered manager agreed that all care plans should direct, inform and guide staff in how to meet a persons needs consistently and this is constantly being reviewed. Staff commented that they found the care plans to be informative There was documentary evidence that care plans are regularly reviewed and updated as an individuals needs change. The daily records for people who use the service summarised what care had been provided that day.
Care Homes for Older People Page 14 of 29 Evidence: Since the previous inspection Eschol house have been granted a commendation in Advanced Care planning under the gold standard framework, which has led to improvements in the care planning process. These care plans focus on the individuals wishes in the event of their health deteriorating and their death which are recorded in detail so that all who are involved in the individuals care is aware of the persons preferences at a emotional time. These records were completed with sensitivity and fully inform those in contact with the individual i.e. family members as well as professionals all their wishes including for example pain relief, resuscitation wishes and funeral plans. Risk assessments are appropriate and identify the potential risk and what action should be taken to minimise the risk further i.e. moving and handling to prevent falls. It also records what equipment, if any is needed to ensure that the person is for example transferred safely from one place to another to again minimise the risk of harm. People who use the service said that their healthcare needs are met well. The manager said, and rotas confirmed, that there are qualified nurses on duty at all times and the home has good links with local external health providers. Records on people who use the service personal files verified this. Nursing staff have delegated roles to ensure that training is kept up to date and cascaded to staff i.e. tissue viability nurse, first aid trainer, mental heath link, continence link nurse and received recent training in venapuncture. All the people who use the service who were interviewed confirmed that the staff care for them well. In a recent survey people who use the service responded by saying that staff respect their privacy and dignity 100 percent. Staff were observed to treat people who use the service with kindness and respect at all times. Bathroom doors are lockable and bedrooms can be supplied with door locks upon request. Staff were observed to knock before entering peoples bedrooms. The home has suitable storage facilities for medicines. There are clear written guidelines for staff on the safe handling of people who use the service medicines. People who use the service have the option of managing all or some of their own medicines themselves. All staff that handle medicines are trained. Medication is ordered weekly and is in loose form i.e. bottles. Nursing staff said they preferred the medication to be received in this manner as they could keep up to date more easily with changes in medication i.e. dosages. However on attempting to audit medicines in the cupboard with those recorded on the homes medication sheet was difficult to do.
Care Homes for Older People Page 15 of 29 Evidence: In addition an internal monthly audit of medication as per the homes policy, had not been completed since July 2008. The registered manager agreed to address this immediately. Other medication records i.e. controlled drugs register appeared to be up-to-date and accurate. Care Homes for Older People Page 16 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported in a lifestyle, which accords as far as possible with their own expectations and preferences. People who use the service stated they are satisfied with the range of activities that takes place that meets their social, religious and recreational interests. The diet provided is varied and nutritious with attention to individual preferences. Evidence: People who use the service assessment and care planning information demonstrate that their social, cultural, religious and recreational interests are taken into consideration. The registered manager and staff were able to provide examples of the activities available to them and this was verified in the daily care records that were inspected. At the time of the inspection there was a harvest festival in progress in the lounge, which some people who use the service chose to participate in, others were aware of the service but chose not to join in and this was respected. From the discussions with people who use the service they felt they had control over their daily lives and were supported to make choices about their routines and activities. They felt that there was plenty to do and were pleased with the Wii bowling
Care Homes for Older People Page 17 of 29 Evidence: game that they played the previous day. In a recent survey ninety eight percent of the people who use the service told the home that there is a good balance of thing to do in the home. In discussion with one of the activity coordinators she explained that two staff members provide seven-day activities. They aim to provide individual activities in the morning i.e. passive exercises, hand massages, talking to people individually, going on walks and even a paddle in the sea. In the afternoons it tends to be a group activity such as the harvest festival, art and crafts and a recent trip to Heligan Gardens. These sessions are recorded in a activities folder. It is recommended that how this is recorded be reviewed, as it does not meet the current requirements of the Data Protection Act, as confidentiality is not adhered too. The registered manager agreed to address this. People who use the service reported that they found the visiting arrangements open and flexible. They felt that visitors were made welcome and choose where they meet their guests. People who use the service confirmed they brought in possessions and furniture at admission by agreement with the provider. Many had personalised their bedrooms. In discussion with people who use the service they said that they enjoy the meals provided and that they are offered a choice. In a recent survey by Eschol House forty seven percent of the people who use the service told the home that the meals were very good with a further fifty two percent stating they were good. In speaking with the people who use the service they were complimentary about the quality and quantity of food provided. From menus inspected it demonstrated that there is a daily choice of breakfast, main meal and tea. Three catering staff provides all meals and caters for individual dietary needs and special occasions. The catering staff meet with new admissions so that they can be aware of a persons dietary needs, and their likes, dislikes so that they can cater for them. A staff member said that their nutritional needs are assessed and external support from specialist nutritionists is provided, if necessary. All the catering staff has gained the Intermediate food and safety certificate. A recent environmental health inspection (October 2008) was satisfactory and all appropriate records are kept. Care Homes for Older People Page 18 of 29 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a satisfactory complaints procedure that would ensure that complaints are listened to and acted upon. There are arrangements to protect People who use the service from abuse and are attending relevant training. The Safeguarding policy would benefit from review so that staff are fully informed of what actions they are expected to take if they suspect a person is being abused. Evidence: The complaints procedure is appropriate. The majority of people who use the service said that if they had any issues of concerns they felt able to approach the management team and believed they would be listened too. The registered manager said that there have not been any formal complaints since the previous inspection. New residents are provided with copies of the home formal complaints procedure in their information packs upon arrival in the home. All of the people who use the service who were interviewed said that they are satisfied with the care and services provided to them in the home and most knew how to go about making a complaint if necessary. Staff who were interviewed demonstrated a good knowledge of the homes complaints procedure. A number of recent compliments to the home were seen. People who use the service said that they felt safe in the home. The registered manager has attended the Safeguarding Multi Disciplinary course and needs to ensure that the homes Safeguarding policy reflects the actions as per these guidelines to
Care Homes for Older People Page 19 of 29 Evidence: make it clearer in what actions staff must take when they are alerted to or have a suspicion of abuse. The policy needs to state that the registered person is required to notify the CSCI of all incidents of abuse, this does not constitute a referral. The registered manager agreed to action this immediately and has arranged for some staff to attend this course. Staff have attended either external or internal course on adult protection and in discussions with staff they verbalised a good understanding in this subject. The registered manager has ensured that the homes recruitment procedures are robust so that new staff are recruited on the basis that they are fit and safe to work with vulnerable people in a care setting. Please refer to staffing section. Care Homes for Older People Page 20 of 29 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is accessible, well maintained and safe. The premises are clean and hygienic providing a pleasant environment and reducing risks to people who use the service. Evidence: The home looked well decorated and well furnished throughout at the time of the inspection. In discussions with people who use the service they said they were happy with their own accommodation and the communal areas and could not think of any improvements needed. From inspection of maintenance records plus discussion with the registered manager they confirmed that maintenance tasks are undertaken promptly, as and when they become necessary. It was evident that new furnishings had been brought recently as you walked around the home. People who use the service said that the home is kept clean and it appeared clean and tidy throughout at the time of the inspection, which was unannounced. The domestic staff described the systems in place to maintain good hygiene, including written procedures to guide staff, access to training in infection control and provision of suitable equipment to maintain good hygiene. Care Homes for Older People Page 21 of 29 Care Homes for Older People Page 22 of 29 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. Staffing levels ensure that there are sufficient staffs on duty at all times. Recruitment policies and practices are robust so people who use the service can be sure that staff are suitable to work with vulnerable adults in a care setting. Staff training is provided to assure people who use the service that they are skilled and competent to work with them. Evidence: All of the people who use the service commented that there was sufficient staff on duty at all times to meet their needs. Staff were observed working in different capacities such as catering and domestic work, care work and nursing so that they are able to work effectively with the resident group. There is a qualified nurse on duty at all times in the home with six carers on in the morning (one of which may be a nurse). This is reduced to four carers and a qualified nurse from six pm. There is one qualified nurse plus one carer on waking night duty. Over ninety percent of the care staff are qualified to NVQ 2 or above which is in excess of the national minimum standards. Staff records that were inspected verified this. People who use the service said that staff responded to call bells promptly and spoke positively regarding staff commenting they are so kind, helpful, nothing is too much
Care Homes for Older People Page 23 of 29 Evidence: bother for them, staff are first class and couldnt ask for better. From inspecting recently recruited staff it was evident that the registered manager has ensured that all checks are completed as per the Care Standards Act requirements. Therefore practises are sufficiently robust so that staff are recruited fairly and on the basis that they are suitable to work with vulnerable people in a care setting. In discussions with staff they echoed that the recruitment process was fair. Staff confirmed that there has been training in the last year for example medication, moving and handling and infection control. The registered manager has introduced an overall training programme for all staff at the home so that she is able to monitor what training is needed and when refresher courses need to be organised. Staff who were interviewed during the inspection said that they have good access to ongoing training so that they maintain and develop their knowledge and skills. Staff records also confirmed this by documenting attendance at a variety of mandatory and specialist courses. Staff records also documented induction and ongoing training. Care Homes for Older People Page 24 of 29 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 homes manager is registered with the Commission so that people who use the service can be confident that the home is in safe hands. People who use the service and staff are able to contribute their views to the ongoing improvement and development of the service. There are satisfactory systems in place to ensure that the home is a safe place to live and work in. The homes policies and procedures are reviewed so that staff are aware of what is expected of them, and that relevant legislation is being adhered too. More formal recorded supervision of staff needs to be evidenced so that there is accountability for staff working at the home. Evidence: The homes manager is qualified and has been registered as a fit person to be in charge, by the Commission. She was able to describe recent training she has undertaken to update her own knowledge and skills. Staff and people who use the service expressed confidence in her abilities. Care Homes for Older People Page 25 of 29 Evidence: The manager described formal systems in place to measure the quality of the services the home provides. This includes questionnaires to people who use the service and people who have an interest in the home and regular formal meetings with residents, and relatives when they can express their views and concerns. Recent surveys completed by people who use the service, relatives and stakeholders were highly satisfied with the facilities and care provided by the home. Evidence was available in the form of the homes published annual development plan. Staff confirmed their attendance at staff meetings, which records their contributions and ideas as to how to improve the care and facilities that the home currently provides further. All felt that the management team were supportive, included them when discussing improvements to the service and were complimentary about the leadership of the registered manager and how she encourages their views to be shared and acted upon. All felt they worked well as a team and that this then had a positive influence for the people who use the service as they had job satisfaction which came across to the people who use the service who received positive care. The registered manager has looked at ways of improving the practices in the home further for example by introducing the Gold Standards framework, having two staff dedicated to provide activities seven days a week. Staff who were interviewed said that they have good access to ongoing training to ensure that they know how to keep the home safe for residents. Training records inspected verified this. The registered manager acknowledged that their needs to be some improvement in the recording of formal supervision sessions with staff, as whilst staff confirmed they do occur this was not recorded. A selection of health and safety records were inspected including the homes fire safety risk assessment and records of equipment tests and checks, which were up-to-date and complete. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations
These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 A monthly audit of medicines in the cupboard with those recorded on the homes medication sheet needs to occur as currently it is difficulty to identify if all medication is accounted for and needs to reflect the accountability as written in the homes policy and procedure. the adult protection policy should be reviewed to ensure that staff are aware of the processes when a allegation of abuse is made. Formal recorded supervision sessions of staff should occur a minimum of six times a year as per the national minimum standards guidelines. 2 18 3 36 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - 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!
