Inspection on 22/06/07 for Golden Sands

This inspection was carried out on 22nd June 2007.

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

The inspector 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

Golden Sands 14/10/05

Golden Sands 20/12/04

Golden Sands 16/07/04

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

CARE HOMES FOR OLDER PEOPLE Golden Sands 10 Nelson Road Westward Ho! Bideford Devon EX39 1LF Lead Inspector Susan Taylor Key Unannounced Inspection 10:00 22 & 28th June 2007 nd X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Golden Sands Address 10 Nelson Road Westward Ho! Bideford Devon EX39 1LF 01237 477730 01237 421214 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Robert Thisby Mrs Thisby Vacant post Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th October 2005 Brief Description of the Service: Golden Sands provides 24-hour personal care for 17 older people who are mobile or weight bearing. The home is situated in the centre of Westward Ho! The home has undergone major refurbishment and renovation. This included the addition of a spacious conservatory and landscape gardens. There is level access to the home. A passenger lift provides access to the first floor. There is also a stair lift leading to rooms situated up a flight of four stairs on the first floor. Accommodation comprises of 15 single and 1 double rooms. Five have ensuite facilities. Communal areas comprise of 2 lounges, a dining room and large conservatory. Toilets and bathrooms are easily accessible and include equipment to assist service users. The staff team have a range of skills and experience appropriate for caring for older people. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first key inspection of Golden Sands under the ‘Inspecting for better lives’ arrangements. The deputy manager was managing the home until such time as an application for registration was made. The inspector was at the home with people for 8 hours. The purpose for the inspection was to look at key standards covering: choice of home; individual needs and choices; lifestyle; personal and healthcare support; concerns, complaints and protection; environment; staffing and conduct and management of the home. We looked at records, policies and procedures at the office. A tour of the home took place. Surveys were sent to four people that live at Golden Sands, seven staff and five health and social care professionals: 100 of the people living at the home; 71 of staff and 20 health and social care professionals responded to the survey. The comments of the people who responded are included in the report. As at June 2007, the fees ranged between £315 and £450 per week for personal care. People funded through the Local Authority have a financial assessment carried out in accordance with Fair Access to Care Services procedures. Local Authority or Primary Care Trust charges are determined by individual need and circumstances. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at www.oft.gov.uk What the service does well: People living at Golden Sands say that they are made to feel “very welcome” from their very first day living at the home. Important information is obtained about residents prior to agreeing to their moving to the home. This helps to reduce the risk of an inappropriate admission to the home and ensures that the team can meet people’s needs. Care plans are well structured around what each person wants from the team. The team of staff have good links with professionals, which helps to improve residents’ health. People who live at the home say that the staff are very attentive. Their relatives are very satisfied with the care and also say that their relations are happy living there. People living at the home told us they are treated as individuals. Professionals say that the people they support are well cared for. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 6 The home has an open feel. People living there say that they have the freedom to do what they want to, when they want to. At the same time, they are confident about the way staff protect their property for them. The also feel able to voice their concerns, if they have any, and know that these are taken seriously and looked into by the acting manager and provider. Families and friends say that they are encouraged to visit whenever they wish to. The people living at the home get support to keep in touch with their families and friends if they need to. At the same time, the home plays an active part in the community. A group of people had enjoyed knitting for charity and their work had been used in making a giant knitted ‘gingerbread’ house that was displayed at Atlantic Village, which the national press had shown an interest in. There is a good choice of appetising and well-balanced meals at Golden Sands. People say that the choice is good and meals are “tasty” and are “always of good quality and plentiful. Golden Sands is a spacious and comfortable place to live. At the same time, people who use wheelchairs or walking aids find it easy and safe to get around the home. People living there say that they are encouraged to see it as their own home and that it is always clean and well maintained. Staff feel well supported and are encouraged to do training so that they care for people properly. What has improved since the last inspection? What they could do better: The provider and acting manager had not ensured that appropriate checks had been done before staff were allowed to work with the people living at the home. We made an immediate legal requirement. When we checked the same files a week later, written references had been obtained as required. We have recommended that thorough checks be done every time a new employee is appointed before they are allowed to care for people in the home. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 7 Quality assurance is informal and there is no system for regularly capturing important views from people living in the home, relatives, other visitors, staff and health and social care professionals. It is important that the home knows when they are improving or when something needs to be done to improve. A legal requirement has been made. The provider and acting manager need to ensure that people receive best practice care by providing regular, recorded supervision for staff working at the home. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality in this outcome area is excellent Individuals are supported and encouraged to be involved in the assessment process. Information is gathered from a range of sources including other relevant professionals, and with the individuals agreement, carer’s interests are taken into account. The home does not offer intermediate care; therefore no judgement has been made about this. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home and relatives verified in a survey that the home provides sufficient information for them to make decisions about whether to live at the home or not. Similarly, everyone that responded in the survey had received a contract. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 10 We spoke to a number of people that live at the home who told us that Golden Sands meets their needs. The acting manager told us that people are assessed by herself or the provider who go to visit the person in their current setting to make an assessment. The pre admission form seen included information about their current abilities, medication, next of kin and equipment required. We examined three care files. A thorough assessment of needs had been completed with people and their relatives when they moved into the home. Assessments completed covered establishing any risks for an individual about their tissue viability, falls, and nutritional status. Additionally, information about the individual had also been obtained from social services if the care package had been commissioned by them. The acting manager and provider verified that intermediate care is currently not provided at Golden Sands. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is excellent People that live at Golden Sands receive effective personal and healthcare support that is person centred and is based upon the rights of dignity, equality, fairness, autonomy and respect. Care is delivered to people in a sensitive way that promotes their dignity and privacy. The team works in partnership with other professionals to ensure that the healthcare needs of people are met. Procedures ensure that medication is stored, administered and recorded in a manner that protects people living at the home and ensures that they are given the right medication at the right time. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We examined three care files and saw that the needs of people living in the home are translated into detailed care plans that staff and the individuals Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 12 themselves have access to. We tracked care for the individuals that had a range of health and social care needs including diabetes, dementia and immobility. Advice had been sought from healthcare professionals such as the diabetic nurse and tissue viability nurse specialists. Where needed, specialist equipment had been obtained such as a pressure relieving mattress and cushion. The person who was immobile told us that they were well cared for and needed a lot of attention because they were in bed. We saw that the person was lying on a pressure relieving mattress that was fully operational. A skin flap following a fall and a saccral sore had been documented in the individuals care plan, which had been regularly reviewed. Daily records demonstrated that the person was seen regularly by the district nursing team treating the wounds. Similarly, the person had also been visited regularly by their GP to monitor their healthcare needs. We tracked the care of a person with dementia, who was being treated for an infection as detailed in their care plan. Daily records demonstrated that the GP had visited this person regularly. Antibiotics and pain relief that had been prescribed by the GP was given as prescribed. Continence advise had also been sought from a specialist practitioner. Staff told us that they were working to the guidance given. We observed staff talking to the individual discreetly about going to the toilet after lunch. The individual was taken to the toilet and we saw that the door was closed behind them to maintain their privacy and diginity. Training records verified that six staff had been booked to attend a course on dementia awareness on 25th June 2007. The nutritional needs of a person with diabetes were tracked. A care plan had been written outlining how the person would be monitored, the type of diet they needed and medication they were prescribed. At lunchtime the individual concerned told us that they always had a meal that was suitable for them, reduced sugar and low fat. They told us that their weight was regular monitored and we saw a record that had been kept in the individuals file. Daily records documented when the person had attended the eye clinic at the local hospital for regular screening, and correspondence about this was also examined. All of the people we spoke to and received surveys from were completely satisfied with the health and personal care they receive. Particular examples are given such as prompt attention to dental care and contacting GP in the event of ill health of the service user. Similarly, at the inspection people told us that staff “always knocked” before entering their rooms and treated them as individuals. The home uses a monitored dosage system. Senior staff are responsible for stock taking. Records of ordered drugs and a register of controlled drugs were seen and tallied with those being stored. The system was easy to audit and the inspector tracked medication administered to three people. Records accurately reflected medication having been administered as prescribed by the Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 13 GP. All medication was kept in a secure place. We observed medication being given to people after the evening meal. This was done safely and records were completed appropriately after each person had taken their medication. Other care staff that were spoke to during the inspection told us that medicines are only adminstered by people that are trained to do this. We examined a random selection of staff files, some of which had certificates demonstrating that the people responsible for giving out medication had received training. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14 & 15 Quality in this outcome area is good. Routines and activities are flexible for people. Staff are aware of the need to support people to develop their skills, including social, emotional, communication, and independent living skills. People are consulted or listened to regarding the choice of daily activities. People are encouraged to maintain contact with friends and family in the community, which demonstrates a commitment to the principles of inclusion. The food in the home is of good quality, well presented and meets the dietary and cultural needs of people who use the service. Staff are trained to help those individuals who need help when eating and are sensitive in their approach. This judgement has been made using available evidence including a visit to this service. EVIDENCE: 23 of people living at Golden Sands told us in their surveys that they are of christian faith. The remainder do not follow a religion. People we spoke to told us that some people like to go to church on a Sunday and are enabled to Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 15 do this. Staff told us that either they take them to church or relatives or congregation members do so. A small group of people living in the home enjoy knitting and had contributed their work to a local fundraising initiative in aid of the Childrens Hospice. Their knitted work had been used to make a giant knitted house that was on display in Atlantic Village and had attracted a lot of media interest nationally. We were told that people had been taken to Atlantic Village to see the knitted house and they felt very proud to have taken part in it. Surveys from people living in the home and relatives indicate that the home has a good level of activities and outings. We observed an individual ask to be taken out for some fresh air in their wheelchair. This was organised immediately for the person, who was taken out in their wheelchair along the promenade and returned telling us that they had had an icecream whilst out. According to information sent to the Commission seven out of seventeen people have dementia. We wanted to establish how those peoples needs were met with regard to meaningful activity. We examined a care file for someone with dementia and saw that the home had information about the individuals interests in gardening and had tried to accommodate them where ever they could. The garden is a safe place for people to walk or sit and raised beds had been created so that if people wanted to do some gardening they could do. Additionally, plants in the garden included fragrant colourful flowers that people living there had chosen. People living in the home, relatives and staff indicated in surveys that the food and menus at the home is good. Lunch was served during the inspection, which was well balanced and appetising. We saw at least three different choices being served. The cook had creatively incorporated plenty of fruit and vegetables into all courses and sought informal feedback from people throughout the meal. People we spoke to made comments like “lunch is lovely” and “they know what you like . We also observed how staff supported people that needed help with eating their meals. Carers focussed all their attention on the individuals concerned chatting with them, gently explaining what was on the plate and at a pace that suited the person. The inspector saw that equipment such as plate guards were used enabling people to continue feeding themselves without assistance. We examined three care files, which demonstrated that people’s weight is checked on a monthly basis. These records showed that people had either steady gained or decreased weight towards more healthier levels dependent upon their needs. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good Golden Sands arrangements for the protection of vulnerable adults, including dealing with complaints ensures that people are protected and able to voice their concerns. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Complaint procedure is prominently displayed in the hallway and is contained in the service users guide. In a survey, people living in the home, staff and relatives are satisfied that the home listens to them and deals with any concerns in a timely way. The provider verified that no complaints had been received since the pre-inspection information had been sent to the Commission. Staff that returned surveys verified that the majority of staff are aware of adult protection procedures. We saw a copy of the ‘Alerters guide’. The home also had a whistleblowing policy, which all of the staff we spoke to understood. Kind and caring interactions were observed throughout the day between staff and people living in the home. Staff engaged positively with people who had dementia and demonstrated a high level of skill in engaging those individuals. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 17 Four out of five staff had attended recognised training about safeguarding people. Sixty two percent of care staff held the national vocational qualification in care, of which a component module is about abuse and adult protection. Senior carers from Golden Sands and the other home owned by the same provider - The Warren - were in the process of doing an NVQ level 4 in care management. Part of the award includes a training and assessment module, which the staff were being assessed on and were doing a presentation for the team about the importance of early intervention and non abusive techniques when dealing with potential aggressive behaviour. Pre-inspection information sent to the Commission verified that no safeguarding referrals had been made to POVA. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is excellent. The provider and manager have ensured that the physical environment of the home provides for the individual requirements of the people who use the service who live there. The living environment is appropriate for the particular lifestyle and needs of the residents and is homely, clean, safe and comfortable, well maintained and reflects the individuality of the people using the service. The management has an infection control policy and they work closely with their own staff and external specialists, such as NHS infection control staff, to ensure that infections are minimised for the people that live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We toured the premises and saw that radiator guards were in place throughout the building. Fire exits were clear and accessible. All the bedrooms were inspected and found to be clean, individualised and comfortably furnished. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 19 People living in the home told us that there is always a housekeeper on duty. All of the wcs and bathrooms had locks on the doors. Communal areas were comfortable and homely. Maintenance certificates were seen for the lift, assisted baths, electrical installation, and central heating and fire alarm systems. Surveys from people living in the home and relatives verified that the home is kept fresh and clean. The commission received notification from the home that one person had suffered diarrhoea and sickness, however this was an isolated case and did not constitute an outbreak. The acting manager verified an audit using the department of health guidance had been carried out. All of the staff we spoke to had received training about the prevention of infection and management of infection control. Hand towels and soap dispensers were seen in wcs, bathrooms and bedrooms. Good hand washing practices were observed as staff were seen to deliver care to people. The laundry was clean and well organised. We observed good infection control measures being followed when staff were dealing with soiled linen. Sluices were clean and fully operational. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. People have confidence in the staff that care for them. Rotas show well thought out and creative ways of making sure that the home is staffed efficiently, with particular attention given to busy times of the day and changing needs of the people who use the service. We found that Golden Sands had a poor recruitment procedure with shortfalls in recording and processes being evident, staff had been appointed and started working without references or other important documentation being received and therefore put people at risk. These shortfalls were addressed after an immediate requirement was issued. The service will need to continue demonstrate that the procedures are consistently followed to ensure that people living in the home are safeguarded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The acting manager told us that three staff had recently left that had an impact on staffing levels. We saw old duty rosters that demonstrated that shifts had been covered by the team. During the period of the inspection each member of staff was looking after five people. Half of the people living in the home needed minimal support, and a quarter needed substantial care support. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 21 We observed that staff did not appear stressed or rushed in their work. People living in the home told us that staff had left and occasionally felt that extra help was needed and theyre very good, they do what they can. We examined duty rosters for the weeks beginning 4th, 11th and 18th June 2007. On the day of the inspection there was two carers and the acting manager on duty during the day till 8pm and two waking staff at night. Staff we spoke to told us that they were busier in the mornings but did not feel rushed. The acting manager told us that four staff were on some shifts to enable staff to review care plans and risk assessments. In addition to this a cook was on duty every day. Domestic staff were employed for 20 hours per week. Maintenance staff are employed for sixty-four hours per week. We examined the files of four newly recruited staff. One written reference had been obtained for 50 (2) of the new employees. The remaining files (2) did not contain any written references. All of the staff concerned had commenced duties in the home (verified by duty rosters and written dates of employment) without two satisfactory written references or POVA checks having been obtained. With exception of one file, criminal records bureau certificates had been obtained at a later date by the home. These shortfalls were discussed with the registered provider who told the inspector that long term sickness within the administration team had affected their normally robust recruitement procedures. We issued an immediate requirement preventing the four staff from working in the home until satisfactory written references had been obtained. We showed the provider the Commissions publication Safe and Sound? Checking the suitability of new care staff in regulated care services and clarified what constitutes good practice. The provider tolder us that they would address the shortfalls and improve the recruitment process as a priority. A day after the inspection, the provider wrote to us outlining what action they had taken to address the issue. The following week on 28th June 2007, we examined the same files again and established that written references had been obtained as required. Additionally, administrative staff told us that the whole process had been reviewed and tightened up. Staff told us that they enjoyed their work and felt well supported. The preinspection questionnaire verified that a wide range of training had been provided over the last 12 months. Records demonstrated that 62 of the care staff had achieved the NVQ level 2 award in care. The inspector saw individual training files, which contained further evidence of specialist training having been provided e.g dementia awareness. Induction records seen demonstrated that training meets the appropriate standards set out by the ‘Skills for Care’. We spoke to staff about their experience and training opportunities in the home and people verified that this was regularly offered to them. The training and development plan for the home contained information for the period 20034 and had not been reviewed since then. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 Quality in this outcome area is Good. The acting manager and provider are qualified and have the necessary experience to run the home. They are aware of and work to the basic processes set out in the NMS. Quality assurance systems tend to be informal and it is evident that the views of people living and visiting the home are respected. However, this is an area that needs further development so that outcomes for people who use the service are collated and reported upon to meet the current legal requirements and good practice. Golden Sands does not manage money on behalf of the people living there, preferring instead to have relatives do this for people. therefore, we are unable to make a judgement about whether the financial procedures safeguard people’s interests. Interim management arrangements meant that individual supervision sessions had been infrequent, which are an important means of communicating change and good care practice that can improve care for people living in the home. Health and safety issues are managed well and people living in the home are aware of safety arrangements and have confidence in the safe working practices of staff. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 23 This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of the home left in January 2007 and at the time of the inspection there was an acting manager. The provider verified that an application for registration would be submitted for the acting manager and had been delayed due to ill health. We received feedback from people living in the home, relatives, staff and a health and social care professional about the overall management of the service. Their comments included the owners/manager are very open, supportive and understanding. Great family atmosphere. Great team morale and Golden Sands seems to run like clockwork helped by the owners and deputy manager. A professional verified that the team always seek advice and act upon it. We saw a certificate displayed, which demonstrated that the service had retained the Investors in people award for a further two years. We read minutes of meetings held with staff and discussed these with the people we met. Staff told us that meetings were held regularly and that there is an open atmosphere in which they feel confident to make suggestions about improving their practice and the quality of life for the people they care for. We received four surveys from people living at Golden Sands, five from staff and one from a health/social care professional. All of the comments were positive and in particular people felt that they were always listened to. Similarly, people living in the home told us that they were always asked how things are. None of the people we spoke to had been asked to participate in a quality assurance survey during 2006-7. We read the minutes of a meeting that had been held with people living in the home and their relatives, which covered a discussion about events, outings and activities people were interested in. Additionlly, people attending were asked for feedback about the home. The acting manager demonstrated an understanding about quality assurance and told us that this was an area for development. She verified that a quality assurance survey had not been undertaken and therefore a development plan had not also been compiled. According to the pre-inspection questionaire, Golden Sands does not manage any money for people that live in the home. People we spoke that live in the home verified this and told us that either they managed their own money or relatives did this for them. One out of four files contained a written record of supervision with the individual concerned. The acting manager told us that supervision had been Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 24 infrequent since the manager left at the beginning of the year. Staff we spoke to told us that they felt well supported by the acting manager and provider. However, we also asked them whether they had had one to one supervision during the year. None of the people we spoke to had had supervision since the beginning of the year. According to the pre-inspection questionaire, the last electrical system test was in May 2002. Comprehensive Health & Safety policies and procedures were seen. The organisation uses an external advisor, and we examined the annual audit report that had been completed. The staff we spoke to verified that they had had recent moving and handling training. People told the inspector that they felt safe at Golden Sands. Electrical appliances had been checked to ensure conformity and safety. The electrical wiring system was last checked for compliance in May 2002, arrangements had been made for this to be done again. Staff on duty had First Aid qualifications. First Aid boxes were accessible to staff. A fire risk assessment and strategy in the event of fire was seen. All of the staff that the inspector spoke to had received training in the last twelve months. We examined the fire log and established that the fire alarm system, emergency lighting and extinguishers had been regularly checked and properly maintained by an outside company. Induction records for new staff were seen. Accident records were examined, were well kept and demonstrated that prompt and appropriate action had been taken. Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X N/A 2 X 3 Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation Requirement Timescale for action 13/07/07 19(4) b (i) People living are safeguarded by thorough pre-employment checks having been carried out on all new employees prior to commencement of duties at the home. An immediate requirement was issued on 22/6/07 and had been met when we reexamined staff files on 28/6/07. Make arrangements to enable people living in the home to be fully involved in improving the quality of the service they receive by holding regular meetings with them and their representatives. Additionally, carry out surveys with them, their representatives and professionals visiting the home. Summarise findings and set these out into a report, so that people can see how and within what timescales steps will be taken to improve the service. 2 OP33 24(1,2) 31/03/08 Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP29 Good Practice Recommendations Safeguard the people that live at the home by developing written policies and procedures about the recruitment and retention of staff and ensure that these are consistently followed. Apply for registration of the new manager to demonstrate that they have the required qualifications, experience and competency to run the home. Ensure that people receive best practice care by providing regular, recorded supervision for staff working at the home. 2 3 OP31 OP36 Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Regional Office Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Golden Sands DS0000022192.V331333.R03.S.doc Version 5.2 Page 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. 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