Inspection on 07/10/08 for Hazelwood Nursing Home

This inspection was carried out on 7th October 2008.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hazelwood Nursing Home 25/10/06

Hazelwood Nursing Home 23/11/05

Hazelwood Nursing Home 04/05/05

Hazelwood Nursing Home 16/11/04

Hazelwood Nursing Home 17/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hazelwood Nursing Home Main Road Longfield Kent DA3 7PW     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Susan Hall     Date: 0 7 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Hazelwood Nursing Home Main Road Longfield Kent DA3 7PW 01474573800 01474573801 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Valerie June Setrem Type of registration: Number of places registered: Smartmove Homes Limited care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Patients detained under Sections of the Mental Health Act are not to be admitted to the home Date of last inspection Brief description of the care home Hazelwood Nursing Home is owned by Smartmove Homes Limited, and is a purpose built, large detached property set in its own grounds. The Director is in day to day contact with the home, and provides active involvement during his visits, which are four to five times per week. The home is close to the centre of Longfield, and this has all the usual shops and facilities. It is near to the Bluewater Shopping Centre, and is also within easy distance of the towns of Maidstone and Tonbridge. Accommodation is provided on two floors Wood Unit on the ground floor, which is for older people with nursing needs; and Hazel Unit on the first floor, which is for older people with dementia and nursing needs. The house has plenty of car parking space at the front, Care Homes for Older People Page 4 of 29 Over 65 0 20 30 0 Brief description of the care home and gardens at the side and rear of the property. Current fee levels can be obtained from the manager. These are set according to individually assessed needs and the location of the room being used. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The home has been assessed as having a rating of excellent, 3 stars. This was a key inspection, which includes assessing all information obtained about the home since the previous inspection visit. This includes formal notifications which the home is legally required to make to CSCI; phone calls and letters; and any concerns or complaints made directly to CSCI. Survey forms were sent out to a percentage of residents and staff, and ten of these completed forms were returned to the inspector. These all had very positive comments on them with views such as: I am always made to feel welcome and I admire the staff. They show dedication to the residents; and the standard of care has always Care Homes for Older People Page 6 of 29 been of the highest level. My relative is shown respect, consideration, kindness; and is content and happy. Staff survey forms were also very positive with comments such as: There is good communication in the home, and good team work; and The management are very supportive. It is a very nice place to work. The inspection visit was carried out by one inspector and lasted over seven hours. All areas of the home were viewed, and the inspector met and chatted with eight residents, one relative and seven staff members during the day. Documentation was inspected, and this included care plans, medication records, staff files and servicing records. The home was clean in all areas, and had a relaxed and friendly atmosphere. Staff were seen to be carrying out their duties in a professional and caring manner. There have been no concerns or complaints made to CSCI since the last inspection. What the care home does well: What has improved since the last inspection? What they could do better: The home is running well in all areas. There are no requirements from this inspection. Documentation could be further improved in some areas, including records for wound care, and there is a recommendation for this. The complaints procedure could be simplified so that it is easier to follow the Care Homes for Older People Page 8 of 29 information provided. 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 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides comprehensive information for enquirers and prospective residents. Pre-admission assessments are thorough, and ensure that the home can meet the individual needs of each resident. Evidence: The home provides a colour brochure with photographs, as well as a statement of purpose and service users guide. The statement of purpose is clearly set out, and includes all the required information. The aims and objectives state that the home provides support which is tailored to the needs of the individual. The home provides care for older people with nursing needs, and for older people with dementia and nursing needs; and in order to meet these needs, the provider employs nurses with different nursing skills i.e. Registered General Nurses, and Registered Mental Nurses, so that they can work together to meet residents needs. Care Homes for Older People Page 11 of 29 Evidence: Enquirers are sent a copy of the homes brochure, the statement of purpose, the most recent inspection report, fee levels and a covering letter. They are invited to visit the home and look round, and chat with the manager and staff. A pre-admission assessment is carried out for each prospective resident, either at home or in hospital, and as much information as possible is obtained from relatives and nursing or care staff. The assessments are carried out by the manager or by senior nurses from the two units. Four pre-admission assessments were viewed, and these contained detailed information, enabling the manager or senior staff to make an informed decision about the homes ability to meet the needs of the person concerned. Each new resident is provided with a copy of the service users guide. This document is produced in a separate folder for each person, with their name on the front of it. An index enables easy access of information. The guide contains relevant information about the day to day running of the home, such as staffing, meal times, visiting, activities, meeting religious needs and communal facilities. It stresses that there are no set times for getting up or going to bed, this is dependent on individual preferences. Visitors are welcome at any time, and can stay for meals or join in with activities. Useful contact telephone numbers are provided for discussing legal or financial assistance available. Each resident whether privately funded, or funded from other sources, is provided with a contract and the terms and conditions of residency. Details such as insurance cover, and the items included or not included in the fees are clearly explained. Fee levels are determined according to the individual needs of each person, and the locality of the room in use. All admissions are for an initial trial period of four weeks, and there is a review at the end of this time to check that the placement is suitable. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and personal care is managed by a team of dedicated staff, who ensure that residents needs are met in a caring and sensitive way. Evidence: Care plans are prepared in individual folders, and are set out in colour coded sections, which makes it easy to find the information concerned. They are stored in locked areas to ensure that confidentiality of information is maintained. Detailed assessments are carried out on admission, and these form the basis for the care plans. All care plans are then reviewed monthly by the nursing staff, and are audited by the manager. The care plans and associated assessments follow the Ropers activities of daily living, which include items such as maintaining safety, communication, eating and drinking, continence, mobility and social activities. We (i.e. CSCI) inspected four care plans, two from each floor, and found these to be well maintained, up to date and with detailed information. For example, a care plan for mobility, reminds care staff to check that the footwear of the resident is suitable, and that their walking frame is easily Care Homes for Older People Page 13 of 29 Evidence: available. A care plan in regards to communication reminds staff that they should listen carefully to what the resident says, speak clearly, and talk with the resident (not at them). Care plans in regards to pressure relief, state the type of mattress and pressure relief cushion in use, and stipulate positional changes every two hours in the day, and every four hours at night. Turn charts are maintained to confirm that these are carried out properly. Other charts are used for residents who are really unwell such as fluid balance charts to record intake and output, and food record charts to record the amount eaten at each meal. Wound care is well documented with a separate record for each dressing change. These records could be improved still further, with a written record, as well as a chart, to note the changes in the healing process. Each care plan includes detailed risk assessments. These show how much assistance is needed with different activities such as washing, dressing, bathing, toileting, mobility, memory, and understanding information. These assessments - which include moving and handling, continence, nutrition, mouth care, mental check and dependency, - are completely re-assessed each month and not just ticked as reviewed, which is good practice. Assessments for the use of bed rails are discussed with the resident or next of kin as appropriate, and are signed accordingly. Permission for taking photographs, i.e. for medication charts or for wound care, is also obtained. Care plans contain good evidence for input from other health professionals such as GPs, specialist nurses, dietician, optician and physiotherapy. There has been some difficulty with accessing specialist support at times e.g. speech and language therapist and dentist, but the manager and provider work together with GPs to ensure that the required support is obtained. A transfer sheet is completed and kept at the front of the care plan, so that if there are any emergency transfers to hospital, the documentation is already available. All residents are accompanied by a member of the care staff if they attend hospital. There are two clinical rooms for the storage of administration, one on each floor, and both were inspected. These are both good sized rooms with sufficient storage space, drugs fridge and controlled drugs cupboard. Room and fridge temperatures are recorded daily and are satisfactory. Both medication trolleys were found to be in good order, and are kept clean and tidy. There is evidence of good stock rotation, and no out of date drugs were found. Medication Administration Records (MAR charts), were examined for both floors, and these are good records. All medication is receipted into the home, and audits are carried out to check that proper administration is being given. Handwritten entries are signed for by two nurses, for safety and accountability. There was some discussion with the manager about the use of sticky labels on MAR charts, provided by the pharmacy. There have been concerns raised by the Royal Care Homes for Older People Page 14 of 29 Evidence: Pharmaceutical Society that there is no guarantee that these will be applied to the correct charts. However, the management have good procedures in place, and have not found this practice to cause any problems. The manager said she would continue to monitor this. Regular medication reviews are carried out with the GPs, and medication is reduced wherever possible. Surveys completed by residents and their relatives confirmed that residents feel that staff treat them with respect, and are caring and supportive. One said that there is always someone ready to help. Residents are addressed by their preferred name and staff do not enter their rooms without first knocking on the door. Mail is given out unopened, and residents are assisted with reading it as needed. Official letters received, (for residents who have dementia), are retained until their next of kin or representative visits, or are sent on, to ensure that the contents are dealt with properly. Residents who are dying are cared for with sensitivity and compassion. Nursing or care staff will sit with them if a relative or friend is not available. The home tries to ensure that they are kept as comfortable and pain free as possible. Discussions about end of life care are usually carried out soon after the admission process, so that if someone is unexpectedly taken ill, there are some guidelines for their preferences. The home has a document in place to discuss with relatives and the GP if the resident has the mental capacity to make clear decisions about day to day life; and the manager is just completing a new form to discuss and sign agreements for making more serious decisions for residents who lack mental capacity, such as end of life care. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a varied programme of activities for both Units. Food is well managed, with a nutritious and varied menu. Evidence: The home employs a full time activities co-ordinator, and another staff member is gaining experience in providing activities on her days off. This enables the home to provide an activities programme for six days out of seven at present. Activities are carried out on Hazel Unit (for residents with dementia) in the mornings, and on Wood Unit in the afternoons. There are also times when one to one activity is carried out, which may include walks in the grounds as well as quiet chats and reading etc. in residents own rooms. Group activities include items such as singing, quizzes, ball games, art and craft, reminiscence and gardening. One resident at the inspection visit said that he had been very pleased with his participation in a quiz. Hazel Unit has many items of art and craft work on display, and the activities coordinator has developed an understanding of the things which different residents appreciate and enjoy. Hazel Unit also has a sensory room, which is a quiet area with soothing music and lighting, for anyone who feels upset or distressed. Next to this is a Care Homes for Older People Page 16 of 29 Evidence: small room called the decade room, which has displays of items from previous decades, and collages etc., which residents have helped to create. The garden has been redesigned during the last year, and includes a pond and fountains, as well as seating areas, and secure space for residents to walk in. There is a raised flower bed, and next year, the home will be able to provide increased opportunity for residents to take part in potting plants and enjoying the gardens. There is a variety of wildlife in the area, and residents enjoy watching rabbits, squirrels and bird life etc. Themed days are carried out for special events, and also to enable residents and staff to enjoy learning more about specific countries where staff come from. This may include items such as showing residents their national dress. Visitors are always welcome to take part in activities, and there are special tea afternoons with the manager, when there is specific time just to chat together, and discuss how the home can develop further. There are local visitors to the home - such as schoolchildren at Christmas, who come in and entertain the residents with carol singing. Spiritual needs are met as required, and include a vicar coming in to carry out a C/E communion service once per month, visits from the R/C priest, and ministers from other faiths as requested. The home makes a conscious effort to ensure that there is recognition of other special days for residents and staff, and there is a multi-faith calendar on display to remind people of different events throughout the year. Outings are sometimes arranged on an individual basis, ensuring that frail residents have all the support they need for going out somewhere special. Some residents also have the opportunity to go out with relatives. The home has a very relaxed, warm and welcoming atmosphere, and visitors commented that they are always made to feel welcome. As well as having the use of a kitchenette for drinks, snacks etc., visitors can stay and have meals with residents; they are asked to arrange this the day before if possible. Residents are enabled to bring in their own possessions and to retain their independence as much as possible. Mental capacity assessments help to determine if residents are able to make even small decisions for themselves, and they are encouraged to make choices where possible. All bedroom, bathroom and toilet doors are lockable, to promote privacy. The home has details available to assist residents and relatives in obtaining additional legal or financial support. Meal times are flexible for residents who are going out, or who wish to get up or go to bed later. Cooked breakfasts are available on request, and a resident said that they are able to choose from the menu for all meals on the day before. Mid morning and Care Homes for Older People Page 17 of 29 Evidence: mid afternoon drinks are served with biscuits and homemade cakes respectively, and evening drinks are served with snacks as wanted. Residents said that the food is very good, there is plenty of choice and good portions are served. The cooks use fresh vegetables, and fresh fruit is always available. Menus include choices for residents from non-British cultural groups, and curries are currently popular in the home. Food is served in attractive dining areas, or in residents own rooms according to choice. The kitchen area is well equipped, extremely clean and well organised. The cooks are assisted by a kitchen assistant throughout the day. Care Homes for Older People Page 18 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are confident that they are listened to, and that any concerns or complaints are taken seriously, and are addressed properly. Residents are protected from abuse. Evidence: The complaints procedure is on display in the reception area and is also included in the residents guide. It contains all the required information, but could be simplified and made clearer to follow. Complaints and compliments are logged into a hardback notebook, with details showing the action taken and when. There have been two minor concerns raised during the last year, and both of these were addressed promptly and resolved to the satisfaction of the complainants. Any serious complaints are recorded and stored separately, keeping copies of any letters sent or received. There is also a suggestions or compliments box in the reception area, by the signing in book, and visitors take advantage of this. A compliment slip found in the box on the day of the inspection, was from a relative, and stated how pleased they are with the standard of care at Hazelwood, they feel that their relative is very well cared for, and they are very pleased with everything. Staff are all trained in the prevention of adult abuse, and training records confirmed that this training is kept up to date. This training was taking place during the afternoon Care Homes for Older People Page 19 of 29 Evidence: of the inspection. The home has copies of the Kent and Medway policies and procedures in the event of any suspicion of abuse, and staff are familiar with these. Care Homes for Older People Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a clean, comfortable, safe, and relaxed environment for residents. Evidence: The home was purpose built eight years ago, and is well designed for its purpose. It is situated near to the main road running through Longfield, and has plenty of car parking space at the front, and secure gardens at the rear. The gardens are well maintained, and have been developed during the past year to include fountains and a pond. There are plans for further development during the next year, to include further planting and more areas of seating. The home is well decorated and maintained, and is kept extremely clean. A relative said that the staff always work hard to keep the home clean, and this includes daily cleaning of carpets as needed. There are usually three or four cleaning staff on duty each day. There is a call bell system throughout the home, but most residents on the first floor are unable to use the call bells, and there are systems in place to ensure that they are checked frequently. There is always a member of staff assigned to the lounges and dining area. The home provides an excellent choice of communal areas, with three lounges and a dining room on the ground floor, and two lounges, a sensory room and a decade room Care Homes for Older People Page 21 of 29 Evidence: on the first floor. Furniture and fittings, and soft furnishings throughout the home, are of good quality. The manager stated that they are currently in the process of ordering some new dining chairs, and there is ongoing replacement of any furniture as needed. All bedrooms have en suite toilet and washbasin facilities, and these are large enough to take over-toilet chairs. There are additional toilets sited near to the lounges, and a variety of different bath and shower rooms on each floor. These provide the choice for residents to have either a bath or a shower. The home has other suitable equipment such as nursing beds, bed rails and side cushions, grab rails, hoists and a passenger lift. There are two sluices on each floor, and each floor has a sluicing disinfector. Bedrooms can be personalised according to choice, and are equipped with suitable furniture. Residents on the first floor each have a picture on their bedroom door which includes something special to them, so that it helps them to identify their own rooms. The home is kept suitably warm and well aired. Radiators have a low surface temperature, and windows on the first floor are fitted with window restrictors for safety. Hot water temperatures are checked to ensure that the thermostats are working correctly, and staff record each bath or shower temperature prior to residents use. The laundry room is situated on the ground floor, and has separate entrances for clean and dirty linen. There is also a linen chute from the first floor. There is a laundry assistant on duty each day, and some of the laundry staff will carry out minor repairs to clothing as well as keeping up to date with washing and ironing. The laundry has two washing machines, which are fitted with sluice facilities, and two tumble dryers. A red alginate bag system is used for dealing with soiled items of clothing. The laundry was seen to be very well organised, and clean and tidy. Care Homes for Older People Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides sufficient numbers of dedicated and well trained staff to provide effective care for residents. Evidence: The provider and manager are committed to maintaining good staffing levels, and ensuring that there is a good skill mix of staff. As the home is registered for nursing care, and for people with dementia, it is appropriate that they employ Registered General Nurses (RGN) and Registered Mental Nurses (RMN). The ground floor Wood Unit has one RGN and four carers in the mornings, and one nurse and three carers in the afternoons and evenings; and one nurse and one carer at night. The first floor Hazel Unit has one RGN and one RMN on duty in the mornings, and four care staff; one nurse and four care staff in the afternoons and evenings; and one nurse and two carers at night. The staff are not employed for one particular floor but for the whole home (except for the RMNs), and so the staff are allocated to work on different floors, and become familiar with all the residents. This means that if there is an emergency on either floor, Care Homes for Older People Page 23 of 29 Evidence: it is possible to borrow a staff member from the other floor to help cover in time of need. Residents and relatives said that there are always enough staff, and a staff member stated in a survey form that shifts are always well covered. Other staff in the home each day include a cook and a kitchen assistant, who are both on duty all day from breakfast until after tea; three or four cleaning staff; a laundry assistant; an activities assistant; a part time administrator, and a maintenance man. The home employs many overseas care staff, many of whom are trained as nurses in their own countries, and who are working as students to study for NVQ level four. Other care staff train to NVQ level two. There are currently 73 of care staff who are trained to NVQ level two or higher, which is excellent. Recruitment procedures are well managed. Three staff files were examined, and contain all required information. Each applicant has a POVA first check, a CRB check in this country, and two written references, obtained prior to confirmation of employment. Each new employee is assigned two mentors to assist them through the induction process, and staff said that they shadowed more experienced staff for up to a week. Mandatory training is carried out at the commencement of employment, and the staff training matrix showed that this training is kept up to date, e.g. health and safety, moving and handling, fire safety, infection control, basic food hygiene and POVA. To date, the home has provided over twenty-five training courses for staff during this year. The provider and manager are both trained to deliver training in applying the Mental Capacity Act. Nursing staff are encouraged to focus on specific aspects of care, such as tissue viability or continence, so that they can learn more about specific subjects and pass on their knowledge to colleagues. They are also enabled to continue with developing their nursing skills and competencies. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager works with the provider to ensure effective overall management of the home. Evidence: The manager is a level one trained nurse, and has been managing this home for eight years. She has many years of nursing experience, and has completed the Registered Managers Award. Staff spoke highly of her caring attitude towards residents, relatives and staff, and said that they find her to be very supportive as a manager. Another staff member said that she is very helpful, easy to talk to, and has an open door policy. She ensures that good levels of communication operate in the home, and it was very evident that there is good team work amongst the staff, and respect for each other. There are regular staff meetings, and the manager ensures that staff are kept updated on any changes. Several staff said that the home is a happy place to work, and that they enjoy coming Care Homes for Older People Page 25 of 29 Evidence: to work. The manager visits every resident every day when she is on duty, and makes herself available to night staff throughout the week, as well as to day staff. Relatives and visitors are invited to join in with regular tea afternoons when the manager is present, as well as with activities and special events. Annual questionnaires are distributed, and these can be completed anonymously if preferred. The results are amalgamated and action is taken to meet any ideas which are put forwards. Residents can arrange to have small amounts of pocket money kept in the homes safe if they wish to do so. All transactions are recorded, and all receipts are retained. These individual accounts are checked regularly, and are audited by the provider. Staff all receive one to one supervision, usually six times per year. This is delegated to different senior staff. They are also given post training evaluations to complete, which helps to determine the quality of the training and its effectiveness. Records are generally well maintained, and are stored so as to protect confidentiality. Some maintenance and servicing records were viewed, and showed that there are up to date checks on facilities such as gas and electricity, and for equipment such as hoists, and lift servicing. Policies and procedures are clearly written and are reviewed yearly, or more frequently if indicated. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 8 To improve documentation for wound care still further, by including a written report for each dressing change, as well as recording these on a chart. Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). 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