Inspection on 18/11/08 for Green Park Care Home

This inspection was carried out on 18th November 2008.

CSCI found this care home to be providing an Good 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

Similar services:

Chirnside House

Keer Sands Residential Home

Sunny Bank (P.R.S.) Ltd

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Green Park Care Home Southwold Crescent Great Sankey Warrington Cheshire WA5 3JS     The quality rating for this care home is:   two star good 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: Elaine Stoddart     Date: 1 9 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 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 31 Information about the care home Name of care home: Address: Green Park Care Home Southwold Crescent Great Sankey Warrington Cheshire WA5 3JS 01925791121 01925791140 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Mary Ann McNeece Type of registration: Number of places registered: Leyton Healthcare (No 6) Limited care home 105 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 Additional conditions: The maximum number of users who can be accommodated is: 105 The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP, maximum number of places 105 Dementia - Code DE, maximum number of places - 105 Mental Disorder, excluding learning disability or dementia - Code MD, maximum number of places 105 Date of last inspection 105 105 0 Over 65 0 0 105 Care Homes for Older People Page 4 of 31 Brief description of the care home Green Park is a purpose built care home situated in Great Sankey, which is approximately two miles from Warrington town centre. It is easily accessible by road from Warrington, Runcorn, Widnes and St Helens. There is a bus service to all areas, stopping close to the home. The home is well located and is central to all community facilities, eg. local library, shops, post office and churchs of all denominations. The home is now owned by Leyton Health Care and was registered with the Commission in August 2008. The home is separted into five units. Cavendish unit provides residential dementia care. Devonshire provides residential care. Balmoral provides general nursing care. Windsor upper and lower ground floor provides dementia and nursing care. The charges range from 345.00 pounds to 584.00 pounds per week. Care Homes for Older People Page 5 of 31 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: two star good 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: The key inspection (site visit) took place over two days and was an unannounced visit. This was conducted by two inspectors, Elaine Stoddart and Claire Lee. All the key standards and a selection of other standards were assessed as part of the inspection process. A full tour of the premises took place and a selection of records viewed. These included care files for people who use the service, a selection of staff files and policies and procedures. Five people were case tracked. Case tracking means that the inspector concentrates on the care given and their experiences of living at the home. Discussion took place with the manager, deputy manager, staff on duty, residents and visiting relatives to obtain their views on the service provided. This report has been put together using the information gathered from a number of sources. This includes information on the service and details provided in the AQAA (Annual Quality Assurance Care Homes for Older People Page 6 of 31 Assessment). The AQAA was completed by the manager and contained information on the service. The AQAA comprises of two self questionnaires that focus on the outcomes for people. The self- assessment provides information on how the manager and the staff are meeting the needs of the people they provide a service for and a data set that gives basic facts and figures about the service, including staff numbers and training. Have your say surveys were sent out to people who use the service and to the staff. The surveys enable everyone to give their views about the management and the way the service is delivered. The comments received have been incorporated in this report. What the care home does well: Greenpark care home is well managed to make sure that it is run for the benefit of the people who live there. There is a good management structure in place to provide support to the staff who work at the home. Assessments of need are completed for people before they move in to determine if their needs can be met. Advice is sought when required from health care professionals, such as specialist nurses and doctors, to ensure residents health care needs are met. The clinical needs assessments should provide more detailed information on residents clinical needs. Care plans are in place for residents and these provide detailed information on their care needs to enable the staff to provide the best care possible for them. Records are organized and easy to access to ensure the staff are able to carry out their roles and responsibilities. The home is well maintained, clean and comfortably furnished to provide a good standard of accommodation for the people who live there. There is a complaints procedure in place to enable people to express their concerns and have their rights protected. The management and staff are knowledgeable regarding protection of vulnerable adults and have dealt with incidents through the correct procedures. The staff are supported in their roles by an ongoing training programme, supervision and appraisals. This ensures that staff are competent to carry out their roles. The staff are polite and caring in their approach to the residents and provide a pleasant atmosphere in the home. No agency staff are employed and this enables continuity of care for the residents. Recruitment and selection procedures are robust to safeguard the residents. Equality and diversity is promoted through recruitment and selection, induction, training and policies and procedures in place. The activity programme in place is excellent and provides stimulating, varied and enjoyable activities for the residents to take part in. The menus are varied to provide wholesome, healthy food with alternatives for the residents to choose from. Positive comments were received from residents and relatives spoken with over the two days and from the surveys received. Comments include: I am happy here there is nothing I can find fault with (Resident) The staff are lovely, kind and caring. I have made lovely friends (Resident) The staff are brilliant Care Homes for Older People Page 8 of 31 (Relative) What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 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. The residents have information prior to making an informed choice as to whether to move in to the home. Assessments are undertaken prior to admission to ensure staff can meet their needs effectively. Evidence: The home is under new ownership and there is a service user guide and statement of purpose. These are documents that provide details of the service. The documents are available in the entrance hall for prospective residents and their families to view. Residents accommodated have a copy of these in their individual rooms. The manager was advised that they could extend the information in this document to demonstrate staff expertise and qualifications. Surveys received from residents confirmed that they had information on the service prior to making a choice to move in to the home. Comments included: I came to view the home and was quite taken up with it. I have been here over twelve months and all the carers are wonderful Care Homes for Older People Page 11 of 31 Evidence: The company have yet to provide new contracts of terms and conditions for residents identifying the change in ownership. The provision of new contracts is recommended within this report. Prior to admission residents needs are fully assessed with regard to their health and social care needs, medication, risk assessments, family involvement and choice and preferences as to how they wish to be cared for. This helps to promote individual choice to ensure care needs can be met. With regards to assessing clinical care more detail could be recorded in the assessment document. This was discussed with the manager and a recommendation made within this report. Equality and diversity is promoted within the assessment so that staff have an understanding of their cultural and religious beliefs. Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Resident have a plan of care which enables the staff to provide the care and support needed. Residents are treated in a respectful and dignified manner by the staff. Evidence: Case tracking took place for five residents to establish the care and support they receive. Staff, residents and relatives were spoken with to obtain their views on the care provided. Individual care files seen were kept in good order, easy to read and accessible for staff. These care files contained a plan of care which reflected the residents current needs. Care plans identified certain areas of need. For example, mobility, eating and drinking, mental health care, communication, personal care and sleeping. Staff had been given good instructions on how to deliver the care required. Care plans are reviewed monthly to show any change in need or treatment and care is adjusted accordingly. This ensures good outcomes for them Staff interviewed showed they had detailed knowledge of individual care needs and the action to be taken to keep them well. Letters are sent out to families to ask them whether they wish to be involved in the care planning and the reviews. This is being incorporated on all five Care Homes for Older People Page 13 of 31 Evidence: units within the service. Staff help to monitor the health of the residents by involving external health professionals for example, doctors, dieticians and a physiotherapist. Evidence was seen of care plans relating to care of the skin where a resident needed to spend long period of time in bed due to frail health. They also had special beds and aids to keep them comfortable. Other equipment is available to promote independence for the residents. To help monitor care needs staff complete risk assessments which identify the area of concern and how to manage it. These were seen for moving moving and handling, nutrition, care of the skin, continence, falls, mental health and risk of wandering. Risk assessments were very detailed to evidence the support needed and action to be taken by staff to minimise risk. Security systems are in place in certain areas to keep residents safe. Relatives spoken with expressed their satisfaction with the security systems and were pleased with the overall care and support given. Comments from residents spoken with included: All the staff are are lovely to live with I have been happy since coming to live here Comments from relatives included: GP sees my mother regularly Staff are very good at getting the GP Staff are all lovely Medication policies and procedures are in place for all units and all staff are trained in medication administration to ensure these are given safely to the residents. This was confirmed looking at records and observing staff administering medication Residents who to self administrate can do following the completion of a risk assessment. This ensures that this practice can be undertaken safely. Care planning showed that individual choice and preferences relating to residents health care and social needs had been assessed. Church services are conducted so that residents can continue with their chosen faith. Residents are supported to choose what they want to wear and how they wish to spend their day. Personal care was seen to be given in a polite and professional manner by the staff on duty. Staff were respectful in their approach when talking to residents and they were also seen to help them at meal times in an unhurried manner. Staff were observed to knock on private rooms prior to entering. Care Homes for Older People Page 14 of 31 Evidence: Care Homes for Older People Page 15 of 31 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. Residents can choose how they wish to spend their day and have access to a very good stimulating activity programme to suit individual need. Residents are offered well balanced nutritious meals in comfortable surroundings. Evidence: Two activity organisers are employed to provide a varied and full activity programme for the residents to choose from. These include, exercise sessions, fish suppers, trips out, manicures, reminiscence, quizzes, bingo, music, dancing, baking and entertainers. The programme is planned weekly to ensure a good variety of events to suit individual need. A good budget is available to purchase materials for individual activities and pay for outside entertainment. Information on what the home offers is stated in the welcome brochure to the home. The units displayed photographs of outings and activities which the residents had taken part in. During the two days at the home residents were observed to take part in baking, what the papers say and individual sensory sessions. Very good interaction was observed between all staff and residents and there was a pleasant, friendly atmosphere. The activities organisers are enthusiastic and offered encouragement to residents to join in and enjoy themselves. Those who choose not to join in have their wishes respected. Records are maintained Care Homes for Older People Page 16 of 31 Evidence: of all activities residents take part in to monitor their involvement and enjoyment. Their responses on how the session went are sought. For example, How did the session go, did you enjoy it and can it be done differently. Visiting relatives were also seen joining in the activities. There is a newsletter which keeps residents up to date and individual activity programmes are provided on each unit. Residents who have dementia receive a lot of one to one input by the staff and there are sensory aids to promote stimulation. Photographs from the past are used for reminiscence therapy. A recent visit by a dance group was enjoyed and Christmas events are being arranged. This includes baking a Christmas cake and a visit to a local pantomime. All events are celebrated including, birthdays, bonfire night, Halloween and Easter. There is vegetable patch in the garden for residents to help grow vegetables. Pets are welcomed. Residents can attend services of worship so that they can practice their own faith. There is a hairdressing salon for the residents to use. Each unit has a dining area where the residents can eat their meals or they are able to choose to eat in their own private room. The dining room tables were laid nicely with matching crockery. Meals were observed to be served in an unhurried manner and those with dementia care needs were able to leave the table for short periods of time and return to finish off their lunch. Residents were seen to be eating breakfast between 9am-10am of the morning of the two visits thus promoting flexibility. The main meal is served at lunch time with a choice of two main courses, cod mornay and pork stew. This was nicely served and staff assisted where necessary. Residents are asked the day before what they would like to eat and menus are displayed. The chef is notified of any special dietary needs or requirements. Nutritional assessments were also contained within care files seen. This helps to ensure residents receive a health varied diet to keep them well. A tour of the kitchen showed that the kitchen is well organised and meals are served from heated trolleys to all units. The chef said that there was a good budget for food. There is one chef, one assistant chef and three kitchen assistants employed. Meal times are flexible to meet the needs of residents who are going out or for hospital appointments. A recent environmental health report gave the kitchen a five star rating for good practice and cleanliness. Comments from residents include: We have a nice garden at the side of the home, which we are able to use when the weather is suitable I like to join in the activities I get a choice of two meals every day at lunch, if I dont like something they will change it I prefer to stay in my room for all my meals. Meals are very good I love doing the baking sessions The home has a flexible approach to visiting and friends and family can call in at any Care Homes for Older People Page 17 of 31 Evidence: time. This was observed during the two days as relatives popped in at various times of the day. Relatives were seen to meet with their family member in the communal areas or in their private rooms. Relatives spoken with provided positive comments on the care and support provided and said that staff were always happy, friendly and responsive in their approach. Robust finance systems are in place if the resident lacks capacity to manage their own monies. This ensures that all finances are handled safely. Care Homes for Older People Page 18 of 31 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. Residents are able to express their concerns and complaints and are confident they will be listened to. Safeguarding procedures in place ensure that the residents are kept safe. Evidence: There is a complaints policy and procedure, which is contained within the service user guide and statement of purpose. These are located in the entrance for visitors and within each resident room and unit. The policy and procedure on the units should be updated in line with the information in the service user guide regarding who complaints should be made to. The AQAA reported that no complaints had been made since the new ownership. A record of complaints was viewed and this showed that no complaints had been received. Discussion took place with staff to obtain their understanding of what to do should a complaint be raised. They were knowledgeable regarding this. Residents were also asked if they knew how to complain should they be unhappy. They confirmed they were aware of the procedure to follow. Seven visiting relatives were spoken. The following comments were received. No complaints. Would not hesitate to say so. The staff and management are very approachable We have no complaints. We would discuss any issues with the manager Care Homes for Older People Page 19 of 31 Evidence: Under the new ownership all the policies and procedures are in the process of being brought up to date. This was evidenced for the adult protection policy. A flow chart for dealing with allegations of abuse was seen on noticeboards for staff to follow This shows staff the action to be taken should an allegation be made. The policy and procedure for the local agreement with Warrington Borough Council was seen. Since the new ownership, one safeguarding issue has been received. This was was dealt with appropriately and to the satisfaction of all parties. Records viewed and people spoken with confirmed their satisfaction with the outcome of the investigation. A relative said Green Park is a lovely home, really good communication, good care and no issues. Likewise, a resident said, I feel safe and the staff are kind. Care Homes for Older People Page 20 of 31 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 residents live in well maintained, safe, clean and comfortable accommodation. Evidence: The site visit was conducted over two days and this included a full tour of the premises. The home was found to be very clean , odour free and tidy with comfortable accommodation. A number of bedrooms were viewed and were found to contain items from home and pleasantly decorated. Residents have access to bathing facilities on each unit. Each unit has a communal lounge, dining area and small seating area thus providing ample space for the residents to sit, relax and meet their visitors. Windsor Unit is to undergo refurbishment to improve the accommodation. There is sensory equipment on the dementia unit to help provide stimulation for residents. There is system in place to monitor and record all ongoing repairs. Two maintenance men are employed to respond to day to day repairs and the provision of a safe and clean environment for people who live there. Security systems are in place in the form of a key pad on all entrances, exits and window restrictors. This helps to keep the residents safe. There are sufficient domestic and laundry staff to keep the home clean and provide an efficient laundry service. The kitchen was seen and found to be organised, clean and well equipped. Food stores were plentiful to provide a well balance menu for the residents. A recent environmental Care Homes for Older People Page 21 of 31 Evidence: health gave five stars for maintaining good standards.. Two lifts provide access to all areas and there is an internal fire escape. Emergency lighting is subject to safety checks and records seen were up to date to ensure the safety of people who live there. A check of the bed rails is undertaken to ensure the equipment is safe to use. External grounds were seen to be tidy and accessible. There is ample car parking space for staff and visitors. The entrance hall was welcoming and contained information regarding the service. This included the service use guide and statement of purpose. There is a small seating area and a receptionist is on duty to greet people. Residents spoken with made the following comments: The home is very clean and always kept very tidy. The staff and the cleaners are very careful to see everything is spotless I like my room I am very happy with my room Care Homes for Older People Page 22 of 31 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. Residents needs are met by trained and competent staff. Evidence: Staff were available in sufficient numbers to meet the needs of the residents. A Registered Nurse is on duty 24 hours for those residents who require nursing care. Domestic laundry and kitchen staff are supplementary to the staff on duty for all units. This enables the care staff to concentrate on providing care and support to the residents at all times. Training records viewed showed a training programme is in place, which includes courses in safe working practices relevant to the older person. This ensures that people are cared for safely. Food hygiene training is required for all staff so they are trained to handle food in accordance with best practice. A date for this course was provided by the manager at the time of the site visit. Staff can attend other courses relevant to the people they care for. These include dementia care, risk assessments, abuse, continence care and care of the dying. A number of staff from overseas are employed whose English is not their first language. These staff are provided with further training to assist them with communication if needed. Residents spoke positively regarding all staff and their kind, Care Homes for Older People Page 23 of 31 Evidence: caring manner. Good communication and interaction was also observed whilst the staff attended to residents needs. No agency staff are employed as existing staff cover shifts. This provides continuity of care. Three staff files viewed showed that recruitment and selection procedures are robust to ensure residents are safe. All are staff are employed on receipt of two written references and a satisfactory criminal record bureau check (CRB). All staff have a two week induction programme in line with Skills for Care. This is provided by the local authority social services department and is a formal introduction in to care practices and their current employment. Within the induction equality and diversity is outlined so that new staff have a clear understanding of this area. Staff have contracts which need to be renewed in view of the new ownership. National Vocational Qualifications (NVQ) for staff stated in the AQAA is below the 50 ratio required by the National Minimum Standards. Discussion with the manager confirmed that further training is planned within the next twelve months for a number of staff. Staff spoken with and surveys received provided the following comments: We are given an induction when we start on all aspects of the home Well skilled and flexible staff are the best words to describe Green park care home staff We are given a variety of training courses to improve our knowledge and skills and on how to meet the standard of care for the people we care for I wouldnt have been allowed to start without my Criminal Record Bureau check (CRB) Comments from relatives include: Staff are very good The staff are wonderful Staff are brilliant Comments from residents include: Staff are lovely, very caring. I have made lovely friends They work very hard. Always pleasant, they pull my leg. They make me smile Care Homes for Older People Page 24 of 31 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in a home that is run in their best interests by a qualified experienced manager. Evidence: The manager is a registered nurse and she is experienced and competent in running the home. The deputy manager who supports her is also a registered nurse and has a lot of managerial experience. The manager has the necessary qualifications in management and the deputy manager is working towards this. Staff, residents and relatives spoken with commented on their open approach and good management skills. They provide daily contact on each unit are are not included on the staff rota. This means they do not routinely work on the floor but they have time to oversee the care being delivered. Each unit has a designated manager responsible for the running of each unit. Good lines of accountability were evident and all staff communicate well. Staff meetings, Care Homes for Older People Page 25 of 31 Evidence: staff supervision and appraisals take place to ensure good lines of support are in place. It was discussed with the manager that a meeting should be held to introduce the new owners to staff, residents and relatives to attend. The unit managers are given time to meet with staff and conduct formal supervision to support them on the units. Comments received from staff, relatives and residents were positive. These include: Staff and management are very approachable (relative) Excellent nursing staff (relative) Manager very approachable (staff) I love it here (staff) I feel very safe here (resident) As part of reviewing the service, medication and care file audits are routinely completed to ensure standards are maintained. Satisfaction questionnaires were sent out to residents, health care professionals and relatives in January 2008. It was discussed with the manager that a new quality assurance survey should be conducted to obtain feedback regarding the change in ownership. The manager agreed to conduct this in the near future. A record of supervision was seen for a selection of staff and it is undertaken by the manager of each unit. Unit managers are supervised by the deputy manager and manager. Financial procedures are robust and therefore help protect the residents. Two administrators oversee this and are accountable for maintaining records of all transactions made. A system is in place for managing peoples monies safely. A separate non interest account is available for people living in the home who wish staff to manage their monies. A monthly statement is sent to their individual or the family as requested. Satisfactory records were seen. There are a good number of policies and procedures to support the staff in their job roles. These are in the process of being updated to reflect the change in ownership. A recommendation was made for this to take place. As previously stated it is recommended there is a need for a clear training plan to identify staff training needs. The AQAA evidenced that contracts for safe working and equipment and services were in date. A selection were seen and this included the certificate for moving and handling equipment, lift and legionella compliance for the hot water systems. Fire prevention equipment is serviced and checked regularly by the maintenance staff to ensure that people are not at risk. Fire training is given to staff so that they are aware of what to do in the event of a fire. Care Homes for Older People Page 26 of 31 Evidence: All accidents and injuries are recorded within the individual units. Any concerns in relation to residents having trips and falls is risk assessed and close observations are carried out to monitor their continuing safety. Care Homes for Older People Page 27 of 31 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 28 of 31 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 1 The service user guide should be developed to reflect the experience and qualifications of the staff and management of the service. The new company should provide residents with contracts of terms and condtions relfecting the change in ownership.With regards to assessing clinical care more detail could be recorded in the assesment document. The clinical needs assessment could be more detailed to reflect the care needed. The complaints policy and procedure should be updated and a copy be placed on each unit for staff to access. New staff contracts should be issued to all staff in view of the change of ownership. NVQ for care staff should continue to provide a ratio of 50 staff qualified. Staff training should continue to ensure training is kept up to date to enable staff to meet the needs of the residents. A training plan would be beneficial to evidence training obtained and those in need of updating. Satisfaction surveys should be distributed to residents and other interested parties to obtain feedback regarding the 2 2 3 4 5 6 7 3 16 27 28 30 8 33 Care Homes for Older People Page 29 of 31 care and support provided by the new ownership. 9 38 Policies and procedures should be updated with regard to the new ownership. Care Homes for Older People Page 30 of 31 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 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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