Inspection on 21/11/08 for Fell House

This inspection was carried out on 21st November 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

Fell House 04/01/10

Fell House 24/11/06

Fell House 20/03/06

Fell House 06/12/05

Fell House 06/10/04

Fell House 27/04/04

Similar services:

The Highlands

Turret Villa Retirement Home

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Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Fell House Albion Terrace Springwell Village Gateshead Tyne & Wear NE9 7RJ     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: Steve Tuck     Date: 2 1 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things 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 38 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 38 Information about the care home Name of care home: Address: Fell House Albion Terrace Springwell Village Gateshead Tyne & Wear NE9 7RJ 01914174520 01914177977 fellhouse@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southern Cross Care Homes No 2 Ltd Name of registered manager (if applicable) Mrs Gillian Batey Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The service may from time-to-time admit persons under the age of 65 within the OP category of registration Date of last inspection Brief description of the care home This purpose built home is in a residential community away from the main road. It is in a quiet location with no through traffic. There are shops and other community facilities. Fell House provides care, including nursing care, to older people over the age of 65 years; some of whom may have physical disability. There is level entry to the ground floor and the upper floor has passenger lift access. There are lounge/dining areas on each floor and a South-facing conservatory. The corridors are wide and the communal areas and bathrooms are of generous proportions. The grounds are well kept, and Care Homes for Older People Page 4 of 38 care home 52 Over 65 52 41 0 41 Brief description of the care home although the majority of this space is devoted to car parking, service users enjoy the use of a small south-facing terrace in fine weather. The Statement of Purpose and Service User Guide is available in the home. The Guide also includes information about how residents’ rights will be respected regardless of age, gender, sexual orientation, race and religion. The information is available in large print and also in pictures. The previous inspection at this home was carried out on 24/11/06 At the time of this inspection fees charged ranged from £394 to £526 per week. The costs of newspapers, hairdressing, and toiletries are not included in the fees. Fees vary depending on people’s circumstances, further details can be found in the homes Service User Guide. Payments for nursing care is set nationally and is added to the fee rate. Fees for private chiropody and hairdressing are in addition the these charges. Care Homes for Older People Page 5 of 38 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: Before the visit We looked at Information we have received since the last Key Inspection. How the service dealt with any complaints and concerns since then. Any changes to how the home is run. The providers view of how well they care for people. We asked them to examine their Care Homes for Older People Page 6 of 38 own service and write to us with the results. We sent surveys to people who use the home, people who arrange for people to live there, those who visit the home to support people like doctors and therapists and the staff who work in the home to ask what they think about services there. The Visit An unannounced visit was made on 21 November 2008. During the visit we Talked with the people who use the service the staff, the manager and visitors to the home. Observed life in the home. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around parts of the building to make sure it was clean safe and comfortable. Checked on what improvements had been made since the last visit. We told the manager what we had found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated it is likely that enforcement action will be taken. Care Homes for Older People Page 8 of 38 What the care home does well: The home has a friendly atmosphere and the staff who work there are open and welcoming. The people who live their and their relatives or visitors feel comfortable supported and are put at ease. One person who lives at the home said, After visiting several homes we liked the set up at Fell House to be the best. It has lived up to its reputation. People who move to the home have their needs assessed by social or healthcare workers and the manager so that everyone is sure that this is the right place for them to live. This is very important as people often have complicated needs that require well managed and agreed ways of supporting them. The home provides excellent nursing and personal care for the people who live there. People are treat as individuals and their needs, preferences, dignity and privacy are respected by staff who are aware, in detail, of all areas where their support and intervention is needed. Nursing and personal Care is provided to people with a wide range of needs with varied expectations and backgrounds. This diversity is reflected in the staff team, giving the manager the opportunity to recruit staff from the same background as the people living in the home. This match helps staff to understand peoples needs and people who use the service are more reassured that they get support from staff who understand them. Both care practice and staff recruitment practices are governed by equal opportunity principles. There are always fully trained nurses available to meet peoples nursing care needs. As well as this there are enough well trained care staff employed at the home to make sure that peoples needs can be properly met and the way that staff are recruited makes Care Homes for Older People Page 9 of 38 sure that they are suitable for working with vulnerable people. The home is sucessfully run by a qualified and experienced manager and senior managers who show that they are have the commitment to invest time skill and finances in the home to make sure that there are good outcomes for the people who live there. They have the confidence of the staff who work well with them. The manager talks to visitors relatives and people living at the home to make sure that they are happy with the service they receive and people are asked for their views so that changes and improvements can be made if these are required. The home is visited by senior managers who check that the manager and staff are working well and following the organisations way of working. What has improved since the last inspection? What they could do better: There remain minor repairs and maintenence to be made which was pointed out to the manager at the time of this inspection and having a working reliable dishwasher would make the kitchen more efficient and hygienic. The manager has recognised where improvements have been required and with the support of the organisation has taken steps to make sure that there are no areas which Care Homes for Older People Page 10 of 38 fall below the national minimum standard. The homes managers demonstrate that they have a commitment to continue to improve the quality of the service and enhance the lives of people that they support. 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 11 of 38 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 12 of 38 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. Trained staff from the home find out and understand the needs of people who wish to live there before they move in. This information helps to make sure that peoples needs can be met at the home and agree the ways in which staff are to support them. Evidence: By looking at the record kept at the home we could see that each persons needs are assessed before they move to the home, either by health services staff local authority social workers and the manager. This is so that the manager has a good understanding of peoples health and social care needs and can be sure that the home is going to be Care Homes for Older People Page 13 of 38 Evidence: suitable for people who are going to live there. Where possible the person themselves or their representative is involved in the assessment process. The manager also finds out what cultural and lifestyle needs people have to make sure that these can be met. The manager and senior nursing staff have also had training which has given them the skills to find out what peoples needs are. As a result of these measures, all of the people living at the home at present have been properly placed and the home is able to meet their needs. One relative said, When my relative came to the home I was impressed with the way that they found out what (my relative) needed to support him. It made me feel confident that they knew what they were doing. There is good information about the home in the Statement of Purpose and a Service User Guide is available for people and their relatives who live or are interested in moving there. The Service User Guide has information in it about what it is like to live at the home, how people can be supported, what the accommodation is like, how to make a complaint and a copy of the recent inspection report. This is available in the home and relatives said that they were given information which told them all about the home before their relative moved in. The Guide also includes information about how residents rights will be respected regardless of age, gender, sexual orientation, race and religion. The information is in large print and easy read style to make it easier for people to understand. There is clear information about the terms and conditions of living at the Care Homes for Older People Page 14 of 38 Evidence: home and the cost for services. Care Homes for Older People Page 15 of 38 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. Peoples care and health needs are well supported at this home and the way that staff give out medication makes sure that they get the treatment that has been prescribed. And every person has a plan of their care which shows in detail how their nursing and care needs will be met and gives the practice guidance that staff need; people get excellent support at the end of their lives. Evidence: All people living at the home have a detailed plan of care, which gives a thorough description of how their physical, emotional and lifestyle needs are to be met. Staff know Care Homes for Older People Page 16 of 38 Evidence: how each person is to be supported and how they prefer their care to be given. Staff have a good understanding of peoples histories, needs and preferences which they need to support people. They also work closely with other community-based health and social support staff to make sure that peoples wider needs are supported by fully coordinated care. For example there are regular visits from GPs and other health professionals including, dentists, opticians and chiropody services. The way that care plans are written down shows that how they are to be supported and there are examples of where a great deal of thought consideration and care has gone into this planning. For example how the home supports end of life care and how relationships are supported. Care plans are regularly reviewed and updated according to changes in social, personal and health care needs. For example those people who have reduced appetite or low weights are regularly weighed and treatment advice sought from dieticians. Their recommendations are acted upon and care plans are updated. There are records which show the measures in place which help prevent pressure damage, wound care, moving and assisting, catheter care, continence promotion, nutrition and mental health condition which are completed, reviewed and updated monthly. Up to date information regarding changes in wound care is documented on a regular basis Care Homes for Older People Page 17 of 38 Evidence: and regular reviews take place with people living at the home, their relatives and care managers to make sure the home is still meeting their needs. There are appropriate pressure relieving devices available to support the staff and residents in daily activities. Twenty four special beds have recently been purchased which has improved peoples comfort and safety; and anyone at risk of pressure damage has special mattresses and cushions to help prevent the condition. Due to their levels of need, most people living at the home need support to administer their own medicines, and designated staff therefore help in this area. The home has detailed instructions which gives staff direction about how they are to administer medication. Medicine is securely stored in a locked purpose made cupboard and records are in place for all medicines received, administered and disposed of. A check of medicines kept at the home showed no discrepancies although it difficult for staff to check where spare medicines have been added to with new prescriptions. There is a register of staff who are authorised to administer medication. People living at the home are treated with respect by staff who know them well. Examples include locking their bedroom doors, receiving their mail, being addressed by their preferred name and being able to go wherever they wish inside and where possible, outside of the home. Relationships between people and with staff are relaxed, friendly Care Homes for Older People Page 18 of 38 Evidence: and informal which helps them to feel comfortable. People appeared to be relaxed and happy with the support they get from staff. Staff meet at the start of each shift where they talk to each other about peoples needs so that they remain up to date, work well as a team and remain consistent. One person who lives at the home said, The staff are most helpful and at hand to attend to my everyday needs. People who live at this home have excellent support when they are at the end of their lives. Peoples care plans record their wishes about dying (if they want to say) and the arrangements they want after death. The families, palliative care specialist nurses and consultants are also involved in their support. The majority of care and nursing staff have been trained to follow the Liverpool Care Pathways for end of life care to make sure that peoples dignity, comfort and choice is promoted. Staff have also received training in use of specialist pain control and information about pain control is available. The Medication Administration Records and Controlled Drug records show that staff make sure that pain relief is given when people need it. All of the staff are caring, supportive and sensitive to the needs of both the people living at the home and their families at a very difficult time. Care Homes for Older People Page 19 of 38 Care Homes for Older People Page 20 of 38 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are encouraged and supported by the staff to lead fulfilling lives with their rights as individuals being respected and to eat healthily which supports their physical and emotional wellbeing. Contact with family members and friends are supported where possible so that people keep up links with those outside the home. Evidence: The home has an activity person who organises events both inside and outside of the home. The staff also help people who live at the home with social and recreational activities. Activities are displayed in a written and picture style in the hallways of the home. Care Homes for Older People Page 21 of 38 Evidence: There is also a newsletter, which describes the monthly activities, events, and poems and has puzzles to keep everyone busy. The activity person keeps records of all events that residents have taken part in. Care plans contain information about people so that staff can make sure their likes and dislikes are known. On the day of the inspection people enjoyed a quiz morning, visits from relatives and watching films on television. People living at the home and their relatives said that there was always something going on to keep them entertained. There are lots of photographs on display, which show events that have taken place throughout the year. One person said they liked to be on their own and did not join in any events and they staff respected these wishes. People living at the home are encouraged to be in control of their lives as far as possible. They are able to maintain links with their friends, relatives and the local community and groups from the nearby school visit the home which helps people to remain included. Several people had visitors throughout the inspection. Staff spent time with them and shared information about their relative if necessary or acceptable. Information about advocacy is available for anyone who needs impartial support and people at the home and their relatives again said that they were confident that the Care Homes for Older People Page 22 of 38 Evidence: manager would sort problems out if they had any. All of the people living at the home are encouraged to bring items and keepsakes with them to making their own bedrooms homely and personalised. There are dining rooms on both floors, both are pleasantly decorated and furnished. The dining tables were attractively set with cutlery, crockery, napkins and condiments. People living at the home are encouraged to make choices about their diet. Everyone said that they like the meals at the home and that they are asked what they would like to eat. Staff were seen asking people about their choice of meal, size of portion to make sure that they always had their choice of meal. Comments from some of the people living at the home were, I am pleased to say that we have three first class ladies who cook out meal. Menus are always varied and the fish and chips are first class. Staff are available during meals to offer support and assistance where needed and this makes meal times a relaxed, social and unhurried experience for everyone. The cook has extensive knowledge of the meals which people living at the home prefer and make sure that the only good quality ingredients are used to prepare meals. Menus were available which confirmed that a range of meals are provided which give people a balanced diet and refreshments are available throughout the day and night. People living at the home Care Homes for Older People Page 23 of 38 Evidence: and their families are involved in choosing the meals that are included in the menu. Where people need it food supplements are available to help people to maintain their health for example if they have diabetes or have difficulty maintaining their weight. Care Homes for Older People Page 24 of 38 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at this home and their families can make a complaint if they are unhappy, have a grievance or dispute which helps them to have control over their lives and there are measures in place which protect people from being harmed which helps to promote their safety and security. Evidence: There is a clear complaints procedure in place at the home, which tells people how to complain, and the length of time a response will take. Observations of the staffs day-to-day practices show that they ask for the views of service users all the time and help people to make real choices and decisions. People who live at this home assert their views and preferences and are clearly empowered to say what they think. There is a record kept at the home of all complaints, which includes details of any Care Homes for Older People Page 25 of 38 Evidence: investigation and the outcome. No one has approached the Commission for Social Care Inspection (CSCI) because they have been unhappy with the way that the home has managed their complaint. One person living at the home said,The manager is always there to sort out any complaints. Another person said, The manager is always on the case - you can talk to her easily. The homes has an adult protection procedure which is robust and complies with the Public Disclosure Act and the Department of Health Guidance. There is a staff guide, which gives clear instructions about the actions which they must take if abuse is disclosed or witnessed and all staff spoken to are knowledgeable and vigilant. In the last 12 months, staff and the manager have taken direct steps to protect a person who had been abused. They alerted the Police and their managers and worked with them and other agencies to make sure that people at the home were safe. There is a staff guide, which gives clear instructions about the actions which they must take if abuse is disclosed or witnessed and all staff spoken to are knowledgeable and vigilant. Care Homes for Older People Page 26 of 38 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, hygienic, well equipped and comfortable environment, which promotes their health, privacy, independence and comfort during their stay at the home. Evidence: All communal areas and some of the bedrooms were viewed during the inspection. The home has had recent repairs and there is ongoing maintenance taking place. There were several maintenence issues seen but the manager confirmed that repairs had been planned for. The home has been designed so that all the people who live there can have safe access to the areas where they live. Everyone is able to lock their bedroom doors so that they Care Homes for Older People Page 27 of 38 Evidence: can have privacy and there are areas where people can meet and talk in private. There are garden areas which are accessible to everyone and popular when the weather is good. The bedrooms are pleasant areas, which have a useful range of comfortable furniture and fittings. Special beds which improve peoples comfort and safety had been replaced in 24 of the bedrooms. Most people have decorated their rooms with their items photographs and keepsakes. There are enough toilet and bathrooms available, all of which have been designed to help people who have mobility needs to use them. The home is kept clean by staff who take effective steps make sure that there are no unpleasant smells. There are laundry facilities are in place to make sure that that peoples clothing and linen is hygienically cleaned and the risks of passing on any infections is reduced. Arrangements are in place to make sure that clean clothing is always returned to their owner and mistakes are avoided. There is a large well equipped kitchen, however the dishwasher has been broken, awaiting spare parts for several months which causes inconvenience for service users and kitchen staff. The home is inspected by the Fire Prevention Authority and the Health and Safety Executive (HSE) to make sure that the building and safety systems are suitable for the Care Homes for Older People Page 28 of 38 Evidence: protection of those who live and work there. Care Homes for Older People Page 29 of 38 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. There are sufficient staff working at the home to meet the needs of the number of people who presently live there and most staff have been trained to make sure that their care practice is good. Evidence: The manager has organised the home so that overall there are sufficient staff available to meet the needs of the people who currently live there. Nursing and care staff support each other and their manager both in their practice and also in their willingness to remain flexible about their working hours so that people who live at the home will benefit. Staff show that they know a great deal about the needs of the people who live at the Care Homes for Older People Page 30 of 38 Evidence: home and can describe these in detail; they get on well together and with people who live at the home and promote an inclusive and supportive structure at the home. Staff work in teams and they have structured ways of working so that people get consistent support. One person living at the home said, You couldnt get any better. Another said, They are always happy to see you. Staff spend time with people who live at the home, listening to their opinions and experiences and taking part in discussions and laughing together which creates a happy atmosphere at the home. Staff turnover at the home is low which gives people who live there and staff the opportunity to get to know each other. For example some of the staff have worked at the home for over 10 years. There are qualified nurses at the home who have taken further training over the years to improve and review their skills. As well as this almost three quarters of the care staff team have now achieved National Vocational Qualification awards in care at level 2 or above. The remaining staff are either working towards either Level 2 or higher levels. There is a plan in place which describes the training which staff are to undertake based on the needs of the home and their personal training requirements. Records showed that all staff have received fire, food hygiene, infection control, moving and assisting and COSSH training. Care Homes for Older People Page 31 of 38 Evidence: The manager makes deliberate attempts to recruit staff from similar cultural backgrounds as the people living at the home. In some cases they share the same community and social links, which helps to ensure that people are confident with the way in which they are supported. Examination of records for staff newly appointed in the home confirm that rigorous checks are carried out before they are employed to work in there. This includes receiving appropriate references and completing the necessary criminal record check to make sure that staff are suitable to work with people who are vulnerable. Staff files contain employment history, records of training and any training certificates. Care Homes for Older People Page 32 of 38 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 home is well managed, organised and efficient; and people are asked for their views about their care. All of which gives people who use this agency the confidence that they will continue to have their needs met by staff who support their best interests. Evidence: The registered manager is a first level registered nurse who has worked at the home for the part 18 years. She has completed a Registered Managers Award, is a trained National Vocational Qualification assessor and carries out regular training as a Care Homes for Older People Page 33 of 38 Evidence: professional nurse so that she can show that her Nursing and Midwifery Council practice skills are up to date. The home is well organised by the manager who makes sure that staff get the support and guidance from senior staff and herself to make sure people get good quality nursing and personal care. The owners Southern Cross Healthcare oversee the managers work and the running of the home. Senior managers visit the home at least once a month to check that the staff and the manager are working well and that the quality of care remains high. The manager collects the views of people living at the home, their families and friends so that she can check to see if the service is meeting everyones needs and expectations. There are a number of meetings held at the home and other informal occasions where the manager is able to check that people are satisfied with the service. This helps the manager to monitor progress and develop the service. There were no significant hazards at the home throughout the inspection and arrangements are in place to minimise risks for people living at the home and staff. For example, Staff have had training in safe working practices. Fire training is completed every three months for night staff and six months for day Care Homes for Older People Page 34 of 38 Evidence: staff. Accidents are clearly recorded and the manager completes monthly accident analysis to examine and track any trends. A fire risk assessment is available and up to date. Risk assessments for the safe use of bedrails are available and up to date. In house health and safety checks are carried out weekly. Water temperatures are recorded to ensure temperatures of 44 C is not exceeded. External contract certificates are up to date. The home is also subject to inspections by the Fire Authority and local authority environmental health officers to make sure that it is safe to live and work there. People living at the home said, The manager is always there to see to whatever my needs are. The quality is good here staff are friendly and they make sure were all right. This home has a good feeling about it - the manager makes sure of that. The manager makes sure she is available if people living at the home or their families need to talk to her. Through out the inspection numerous people came for advice, direction and support. Care Homes for Older People Page 35 of 38 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 36 of 38 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 The way that new medication is aded to existing stock levels should be reviewed to make it easier for accurate checking to take place. Repairs and modifications to damaged doors and doorframes caused by wheelchair users should continue to take place to improve the appearance of these areas. The dishwasher should be repaired or replaced so that it is reliable which will improve the efficiency of the kitchen. 2 19 3 26 Care Homes for Older People Page 37 of 38 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 © (2009) 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. 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