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Inspection on 02/10/08 for Hawthorn Lodge Care Home

Also see our care home review for Hawthorn Lodge Care Home for more information

This inspection was carried out on 2nd October 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People are assured that their needs will be assessed and met before they make a decision to move into the care home. Plans of care are person centred and reflect people`s likes, dislikes and preferences to ensure that they receive care in their preferred way. Plans of care clearly outline what each area of need people using the service have and how staff would support them to meet these. People using the service told us, `I am happy and settled here, the staff look after me and help me,` and `the staff help me when I need it.` One relative spoken with spoke highly of the staff and the care that their relative received. The health care needs of people using the service are supported through liaison with the district nurse and GP as well other health care professionals. There are no restrictions on visiting to ensure that people using the service are able to maintain relationships with people that are important to them. People using the service told us, `my visitors are made welcome, I like it,` and `I can have visitors if I want to, my son comes to see me here.` Twenty seven members of staff have achieved the National Vocational Qualification level 2 or above (a nationally recognised work and theory based qualification) which enhances knowledge and skills in caring for people using the service.

What has improved since the last inspection?

People using the service now have the necessary aids and adaptations that they require to ensure that their needs are met. Arrangements have been made for the safe storage, administration and recording of medication to ensure that people using the service are protected and receive their medication as prescribed. The poor staff practices that undermine the privacy and dignity of people using the service have been addressed to ensure that people are treated with respect and their privacy and dignity is maintained. Further development in regard to the activities on offer has taken place and people have been consulted with about the arrangement for stimulating activities so that their needs are met. People using the service are now aware of how they may make a complaint to ensure that they are able to do so if the need arises. All complaints received are now fully investigated to ensure that these are resolved tothe complainant`s satisfaction. An investigation was conducted into the safeguarding allegations raised at the previous inspection to prevent reoccurrence. Staff have received proper training for the tasks they are to undertake and they understand and follow the philosophy of care at the home. They know how to use the whistle blowing policies to protect people using the service from potential harm or abuse. Sufficient numbers of staff are be available to meet the needs of people using the service. Staff files now contain all the required documentation required by law to ensure that the people using the service are protected from unsuitable people being employed. Work has taken place to ensure good personal and professional relations with staff and people using the service. This ensures open communication networks are available where people feel they can approach the management with concerns Supervision sessions with staff have commenced to encourage and assist them in maintaining good personal and professional relationships with people using the service to ensure that they are protected.

What the care home could do better:

Ensure that handwritten entries on medication charts are signed by two members of staff to show that these have been checked as correct. Ensure that people using the service are aware that staff are always available to meet their health and personal needs so that they feel reassured that staff care about them. Ensure that the new regime for cleaning the carpets is maintained to prevent mal odour and stained carpets, so that people using the service live in comfortable and well maintained environment. Ensure that people using the service are assured that staff are available at all times to support them, so that they feel staff are concerned about their welfare and that they are there to support them as needed.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hawthorn Lodge Care Home Beckhampton Road Bestwood Park Nottingham NG5 5LF     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: Karmon Hawley     Date: 0 2 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 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 30 Information about the care home Name of care home: Address: Hawthorn Lodge Care Home Beckhampton Road Bestwood Park Nottingham NG5 5LF 01159676735 01159671815 managerhawthorn@regalcarehomes.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Jayne Elizabeth Newbutt Type of registration: Number of places registered: Regal Care Homes Ltd care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Within the total number of beds, a maximum of 30 may be used for the category DE(E) Within the total number of beds, a maximum of 60 may be used for the category OP Date of last inspection Brief description of the care home A copy of the most up to date report is found in both the managers office or the senior carers office. Hawthorn Lodge is a large home registered to provide personal care for up to 60 older people. It has several lounges and one large dining room as well as eating areas in some of the lounges. Some of the bedrooms are ensuite. There is a passenger lift to the first floor, making it accessible to any wheelchair users. The home is set in its own grounds with a pleasant enclosed garden. It is in a residential area with easy access to shops and bus routes. There are hoists available for people who require hoisting and there are suitable bath and shower facilities available for people accommodated who need assistance with bathing. Care Homes for Older People Page 4 of 30 0 0 Over 65 30 60 Brief description of the care home Care Homes for Older People Page 5 of 30 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 quality rating for this service is 2 star this means that people who use the service experience good quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people living at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. One regulatory inspector conducted the unannounced visit over 1 day, including the lunchtime period. We were joined by an Expert by Experience who is a person who, Care Homes for Older People Page 6 of 30 because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. Experts by experience do not need to have experienced an identical service. What matters is that they know what it is like to need a service. The expert by experience visited the home for two and a half hours and spoke with five people using the service and two visitors. A review of all the information we have received about the home was considered in planning this visit and this helped decide what areas were looked at. The main method of inspection we use is called case tracking which involves selecting the care plans of 4 people and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. The area manager, members of staff and people who use the service were spoken with as part of this visit. A partial tour was undertaken by the regulatory inspector, which included looking at the bedrooms of those people who we case tracked and communal areas of the home. The current weekly fees for the service range from 350 pounds - 360 pounds depending upon peoples assessed needs. These fees do not include the cost of hairdressing, chiropody, newspapers or personal toiletries. Information about the fees and facilities are made available on enquiry. What the care home does well: What has improved since the last inspection? People using the service now have the necessary aids and adaptations that they require to ensure that their needs are met. Arrangements have been made for the safe storage, administration and recording of medication to ensure that people using the service are protected and receive their medication as prescribed. The poor staff practices that undermine the privacy and dignity of people using the service have been addressed to ensure that people are treated with respect and their privacy and dignity is maintained. Further development in regard to the activities on offer has taken place and people have been consulted with about the arrangement for stimulating activities so that their needs are met. People using the service are now aware of how they may make a complaint to ensure that they are able to do so if the need arises. All complaints received are now fully investigated to ensure that these are resolved to Care Homes for Older People Page 8 of 30 the complainants satisfaction. An investigation was conducted into the safeguarding allegations raised at the previous inspection to prevent reoccurrence. Staff have received proper training for the tasks they are to undertake and they understand and follow the philosophy of care at the home. They know how to use the whistle blowing policies to protect people using the service from potential harm or abuse. Sufficient numbers of staff are be available to meet the needs of people using the service. Staff files now contain all the required documentation required by law to ensure that the people using the service are protected from unsuitable people being employed. Work has taken place to ensure good personal and professional relations with staff and people using the service. This ensures open communication networks are available where people feel they can approach the management with concerns Supervision sessions with staff have commenced to encourage and assist them in maintaining good personal and professional relationships with people using the service to ensure that they are protected. 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 30 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 30 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. People who may wish to use the service are assured that their needs will be assessed and met before they make a decision to move into the home. The service does not offer intermediate care. Evidence: The manager visits people within the community to carry out a preadmission assessment to see if staff are able to meet their needs before a decision to move into the care home is made. There is evidence of these assessments taking place within case files examined. People may also come to visit and spend time at the home to get a feel for what it would be like to live there before they make a decision to move in. One relative spoken with confirmed that they had visited the home and received all the necessary information before a decision had been made. Care Homes for Older People Page 11 of 30 Evidence: The service does not offer intermediate care. Care Homes for Older People Page 12 of 30 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. The health and personal care needs of people using the service are met. Although staff ensure that they treat people with respect and maintain their dignity some people using the service feel that staff do not care for them. Evidence: People using the service undergo assessments in regard to the daily activities of living; plans of care are then devised for all highlighted needs. Plans of care examined showed us that they are person centred and reflect peoples likes, dislikes and preference to ensure that they receive care in their preferred way. There is evidence within some plans of care that people using the service and or their relatives have been involved in this process so that they can negotiate their care to ensure that they receive this in their preferred way. Risk assessments are in place for all highlighted risks to ensure that staff are aware of the actions that they must take to make sure that people using the service are kept Care Homes for Older People Page 13 of 30 Evidence: safe. Staff spoken with are able to discuss the needs of people using the service and the support that they offer them in meeting these. The expert by experience observed staff supporting people whilst they were exhibiting behaviour that was challenging. Staff interaction at this time did not appear to resolve issues to ensure that people received the care and support that they needed. However when we examined plans of care, they showed us that staff had acted accordingly, using methods that had been proved successful to ensure that peoples needs are met by following these strategies. Staff spoken with are able to discuss how they support people who may exhibited behaviour that is challenging and the methods that they use to ensure that people receive the care and support that they need. People using the service told us, I am happy and settled here, the staff look after me and help me, and the staff help me when I need it. One person using the service however told the expert by experience, they don’t care about how my leg hurts. One relative spoken with said, my father is settled here, and well looked after, it is not home but is a near as it can be. There is evidence within peoples case files to show that they receive specialist services as needed such as the doctor, district nurse and dentist. On the day of the visit two district nurses were observed to enter the care home and attend to peoples needs. During the tour of the care home specialist equipment was seen to be available such as cushions, chairs and mattresses to ensure that people have the aids that they require. One person spoken with said, I can see the doctor if I need to. All staff who administer medication have been trained to do so to make sure that they follow good practices. Medication practices observed on the day of the visit showed us that staff are following the training that they received. All medication charts examined are clear and medication that has been administered signed for. Handwritten entries are not always signed by two members of staff to show that these have been checked as correct. The service has changed suppliers to make working practices better thus the administration, recording and storage of medication safer for people using the service. Care Homes for Older People Page 14 of 30 Evidence: Staff spoken with are able to discuss how they respect peoples privacy and dignity. They can discuss how some people may decide to remain in their nightwear during the day and how they support them to make sure that their dignity is maintained. They told us how the people we saw in this state of dress are supported in this choice. Plans of care examined clearly reflected how staff are to support people in maintaining their privacy and dignity whilst offering support with personal care. One person using the service told us that the staff are always kind and respectful towards them, whereas several people told the Expert by Experience that staff dont care. This was discussed with the area manager who will look into these issues further. Care Homes for Older People Page 15 of 30 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 using the service are supported and enabled to join in a variety of activities and be part of the local community as they wish. People using the service are enabled and supported to maintain contacts with people that are important to them. Evidence: An activities coordinator is employed to carry out activities such as bingo, arts and crafts and baking with people who use the service. The activities coordinator has begun work to look at the things that each person would like to do and arrange individual plans of care so that activities can be arranged to suit their needs. In addition to in house activities a person visits the care home on a monthly basis to carry out movement to music, which one person spoken with said that they enjoyed. Trips out into the local community also take place, and one person spoken with said that they are really looking forward to a concert that has been arranged at a local school; a 1948 day. Although we observed a number of people sleeping following breakfast we saw a group Care Homes for Older People Page 16 of 30 Evidence: of other people joining in an arts and craft session on the day of the visit. A variety of equipment had been purchased and people were encouraged to participate in card making, the people joining in appeared to be enjoying this. People using the service told us, I join in the activities when we have them, I like reading, I chose to sit here as I can enjoy the sun and look out of the window. A reminiscence room is also available for people to use, this has old time furniture and articles placed around such as ration books for people to look at and remember. Comments expressed to us and the Expert by Experience are varying in regard to how flexible the routine of the care home is. Whilst some people using the service felt that they could make their own choice and spend their time as they wished, there are others that feel that there are restrictions place upon them such as bedtimes, one saying the they all had to go to their rooms when bed time was called. Staff spoken with stated that the routine is flexible and that people can chose when they get up and go to bed and what they do throughout the day. We saw people walking freely around the home during the visit. Within plans of care peoples personal preferences such as the time that they would like to go to bed and get up are documented. So that people can maintain contact with relevant others there are no restrictions on visiting. We saw several visitors come throughout the day and they were made welcome by staff. One visitor spoken with said that they are made welcome when they come and people using the service told us, my visitors are made welcome, I like it, and I can have visitors if I want to, my son comes to see me here. The menu, which is traditional in nature, offers people choices at each meal. The menu is on display in the main entrance and communal areas; this is in an easy read format so that people are able to identify with what is on offer to them. The meal on the day of the visit consisted of a roast beef dinner or omelette, bread and butter pudding or ice cream. People using the service said that they had enjoyed the meal when spoken with. Following lunch a basket that contained different varieties of crisps and snacks was brought into the lounge for people using the service. People were seen to help themselves and when asked by us if this was a regular thing, they said that it was. One person using the service said, the food is good, I didnt know we had a choice, I Care Homes for Older People Page 17 of 30 Evidence: tend to eat what I am given, it is the way I was brought up. Two other people also said that the food is good. Care Homes for Older People Page 18 of 30 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 using the service are protected from abuse and are assured that their complaints and concerns will be listened to and resolved. Evidence: So that people using the service are aware of how they can make a complaint, each person using the service has been issued with an updated complaints procedure. This is also on display in the main entrance in an easy read format for people to access. To address any issues of concern early the manager has put into place a new system where people are able to leave comments, suggestions and concerns on a daily basis. Following this she looks into any concerns that have arisen. Two concerns had come to light via this route; evidence is available to show us that the manager responded to these concerns promptly. The service has also received one additional complaint in regard to the standard of care. Again there is evidence to show that this had been investigated and resolved. One person using the service told us, I am settled and happy, I like living here, I have no complaints. One relative told us that they also had no complaints about the service. Staff spoken with are able to discuss how they would deal with a complaint if one was received, and they said that they would refer it to the manager. Care Homes for Older People Page 19 of 30 Evidence: Staff training records showed us that most of the staff employed have now undertaken training in safeguarding vulnerable people. Staff spoken with are aware of their roles and responsibilities and are able to tell us what they would do if they thought that bad practice was occurring. Staff spoke of ensuring that people using the service feel safe and secure and that their wellbeing is maintained. Care Homes for Older People Page 20 of 30 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 generally well and comfortably maintained environment, however the offensive smell on entering the care home does detract from this. Evidence: There are various seating areas throughout the care home that people using the service may access. People were seen to move freely around the home on the day of the visit and sit where they felt comfortable. The home is generally well maintained and there is evidence of regular maintenance taking place. However on entering the care home there is a distinct mal odour and carpets in the main dining room are soiled and dirty. This was discussed with the area manager, who stated that a new rota had been drawn up so that staff can keep on top of keeping carpets cleaned. Within the care home there is a number of flats, which are available for people to use. These flats offer people more independence, as they are more like bed sits. During the brief tour of the care home we saw that peoples rooms are personalised and kept clean and tidy. Care Homes for Older People Page 21 of 30 Care Homes for Older People Page 22 of 30 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. People using the service are supported by sufficient numbers of staff who are trained to meet their needs. Evidence: The manager has completed an audit on the dependency of people using the service so that she can make sure that sufficient staff are available to meet peoples needs. The duty rota shows us that there are 8 members of staff on shift in the morning, 7 in the afternoon and 4 during the night. Staff spoken with said that there are enough staff available to meet peoples needs and also confirmed that shifts are covered with agency if needed. However one member of staff said, it would be nice to have more staff so that we can spend more quality time with people. People using the service told us and the Expert by Experience, there are enough staff here to help me, they come when I need them, they wont help, and it is no good asking them, they dont bother. On observing staff during the afternoon period we saw that staff are available to help people and help and support was offered appropriately to people using the service. We did not see anyone left waiting when they had requested assistance from a member of staff. Care Homes for Older People Page 23 of 30 Evidence: People using the service told us the staff are nice here, they understand you, like I understand them, they are polite and help you when you need help. Whereas another told us that staff tend to shout at them, they assume that you are deaf, they are not unkind but it does bother me. This was discussed with the area manager who confirmed that this person did have communication difficulties, which are highlighted within the plan of care. One relative told us, I have never heard the staff shouting at people, they are kind, helpful and respectful to people. To make sure that all new staff are aware of their roles and responsibilities when they first start work they undertake an induction. One new member of staff spoken with confirmed that they had undertaken an induction and that this had been helpful. There is evidence within staff files to show that this takes place with all staff that start work at the care home. To ensure that staff have the necessary knowledge and skills to care for people living at the care home 27 have achieved the National Vocational Qualification (a nationally recognised work and theory based qualification) level 2 and 4 have achieved level 3. One member of staff spoken with told us, I am currently working towards gaining my NVQ level 2. An audit has taken place since the previous inspection to make sure that all the staff files contain the necessary documentation required by law to ensure that people using the service are protected from unsuitable people being employed. Staff files show us that the necessary documentation such as identification and references are in place. One staff member spoken with outlined the recruitment process that they had undertaken and stated that they had undergone a Criminal Record Bureau check, (a police check to see if an individual has a police caution or criminal record) before they had commenced employment at the care home. The staff training matrix shows us that staff continue to undertake compulsory training as required to ensure that they have the necessary knowledge and skills to meet peoples needs. On speaking with staff they are able to discuss how they handle difficult situations and care for people who have dementia care needs. A number of staff have attended further training since the previous inspection in safeguarding adults, first aid, medication and fire. Staff spoken with said that they felt supported in their training and development and confirmed the training that they had attended. Care Homes for Older People Page 24 of 30 Care Homes for Older People Page 25 of 30 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. People using the service live in a care home that is well run and managed where they are enabled to express their views and opinions about the service that they receive. Evidence: The manager is registered with us to manage the care home. She ensures that she remains up to date with compulsory training so that her knowledge and skills are up to date. She was not available to assist with the inspection due to sick leave, however the area manager did assist us during this visit. Staff spoken with said, I like the manager, she is helpful, if you have a problem you can go to her, and the manager is ok, she keeps you on your feet, she does checks as she should. Four people using the service told the Expert by Experience that there is an atmosphere of anxiety when the manager is present; this was discussed with the area manager for her to pursue and establish more information. Care Homes for Older People Page 26 of 30 Evidence: So that people using the service can have a say in how the home is run and managed they are given the opportunity to complete questionnaires on an annual basis, these have been circulated to people and the manager is in the process of analysing the results. We saw some questionnaires that had been returned from visiting professionals such as the doctor and the visiting optician and some that had been returned from relatives. All of these are of a positive nature and the following comments were expressed: I am grateful and cannot fault the care my relative is receiving. I have nothing but praise for the staff and their kindness and patience in what at times must be difficult situations, we are very happy with the care provided to our mother and always notice how clean and fresh the home is, our visits are always enjoyable and we are provided with the assistance and information that we require in order to provide the best eye care to residents. We saw that a residents and relatives meeting has been held. The minutes of this meeting showed us that they had discussed the activities on offer and the proposed developments for the future. The manager and area manager carry out monthly audit such as medication, care planning, accidents, equipment and personal allowances to ensure that these are maintained as required. Peoples personal accounts show us that accurate records of all transactions are maintained. Receipts are available for transactions and two members of staff sign for these. People using the service may access their money at any time should they wish. There is evidence that the manager has begun to update supervision sessions with staff so that issues of the poor practices highlighted in the previous report are addressed. Maintenance certificate such as the gas, electrics and hoist show us that these are serviced as required to ensure they remain in good working order. A number of staff have undertaken training in health and safety and on speaking with them they are able to discuss the relevant issues in regard to keeping people using the service safe. Health and safety audits are carried out to highlight any concerns so that they may be addressed. Care Homes for Older People Page 27 of 30 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 30 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 Ensure that handwritten entries on medication charts are signed by two members of staff to show that these have been checked as correct. Ensure that people using the service are aware that staff are always available to meet their health and personal needs so that they feel reassured that staff care about them. Ensure that all people using the service are aware that they are able to make their own choices about when they retire to bed, so that they can execise this right. Ensure that the new regime for cleaning the carpets is maintained to prevent mal odour and stained carpets, so that people using the service live in comfortable and well maintained environment. Ensure that people using the service are assured that staff are availble at all times to support them, so that they feel staff are concerned about their welfare and that they are there to support them as needed. 2 10 3 12 4 26 5 27 Care Homes for Older People Page 29 of 30 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. 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