Inspection on 16/11/08 for Heathfield Care Home

This inspection was carried out on 16th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Heathfield Care Home 11/05/10

Heathfield Care Home 20/10/09

Heathfield Care Home 26/07/06

Heathfield Care Home 08/12/05

Heathfield Care Home 27/06/05

Heathfield Care Home 02/11/04

Heathfield Care Home 22/05/04

Heathfield Care Home 10/10/02

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

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 20/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Heathfield Care Home Main Road West Wittering Nr Chichester West Sussex PO20 8QA     The quality rating for this care home is:   one star adequate 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: Judy Gossedge     Date: 1 6 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Heathfield Care Home Main Road West Wittering Nr Chichester West Sussex PO20 8QA 01243511040 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : heathfield@tesco.net Intercare Orthopaedic Services Limited care home 21 Number of places (if applicable): Under 65 Over 65 21 old age, not falling within any other category Additional conditions: 0 The maximum number of service users to be accommodated is 21 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Heathfield Care Home is a privately owned establishment registered with the Commission for Social Care Inspection to accommodate up to twenty service users in the category of old age (OP). There is also a variation for one named person in the category of Physical Disablement (PD). The establishment is a detached property set in its own attractive grounds. Situated six miles from Chichester and two miles from West Wittering village. The registered provider is Intercare Orthopaedic Services Ltd. Mrs J Ovington is a director and registered manager responsible for the day-to-day management of the home. The responsible person on behalf of the company is Dr Nita Care Homes for Older People Page 4 of 28 Brief description of the care home Gupta. Fees at the time of the inspection are £400.00 - £550.00 a week. A Statement of Purpose and Service Users Guide is available to reference. Care Homes for Older People Page 5 of 28 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: one star adequate 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 reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001 uses the term service users to describe those living in care home settings. For the purpose of this report, those living at Heathfield Care Home will be referred to as residents. Since the last inspection on 26 July 2006, an Annual Service Review has been completed. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection. No concerns were raised. The Provider had been asked to complete an Annual Quality Assurance Assessment Care Homes for Older People Page 6 of 28 (AQAA), information from which is quoted in this report. This unannounced inspection took place over five and a half hours on 17 November 2008. A tour of the premises took place to look at communal areas and a selection of residents bedrooms and care records were inspected. Twenty-one people were resident and three were spoken with individually in their bedroom, two in a communal area and a number were spoken with as part of the inspection process. The care that four of the residents received was reviewed. The opportunity was also taken to observe the interaction between staff and residents in the communal areas. Residents and care workers surveys were not sent out on this occasion. Three care workers; the senior care worker, the cook and kitchen assistant on duty were all spoken with. Three relatives and a friend visiting the home were spoken also with. The Registered Manager was not on duty at the time of the inspection and so not all the records were available to view, but was spoken with on the day and subsequently to confirm procedures in place in the home. What the care home does well: 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 8 of 28 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 9 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is available for residents and their representatives to view, although it must be ensured that it details all the required information. Potential new residents are individually assessed prior to an admission to ensure that their care needs can be met in the home. Intermediate care is not provided. Evidence: There is a Statement of Purpose and Service Users Guide and both documents were read. Currently these documents do not detail all the information to be included and as detailed within Schedule 1 of the Care Standards Regulations and are in need of review. The home is also providing respite care, which needs to be detailed in the documents. A copy of the last inspection report is available to read in the entrance of the home. The AQAA details that prospective residents are assessed in their homes, hospital or Care Homes for Older People Page 10 of 28 Evidence: other places prior to admission and are provided with information about the service. That prospective residents and their family are encouraged to visit the home and to tour the home if possible to familiarise themselves with the lay out and the room or choice of room they will require. The documentation completed for new residents was not available to view during the inspection. Three residents care plans were viewed, which detailed that the residents were living with dementia. This was discussed with the Manager who stated that one resident had been admitted in to the home who had been diagnosed to be living with dementia. It is not detailed in the homes Statement of Purpose that residents living with dementia can be accommodated in the home, how their care needs will be met in the home, staffing levels in place and training/guidance that staff have received to provide care to these residents. One relative spoken with whose relative had become a resident since the last inspection confirmed the Manager had visited their relative to undertake an assessment, they had had the opportunity to look around the home on behalf of their relative and had received enough information about the home prior to the admission. Intermediate care is not provided in the home. Care Homes for Older People Page 11 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have individual plans of care in place and personal care and support is provided in a way that maintains and respects the privacy, dignity and lifestyle of the resident. There are policies and procedures in place to manage medicine. But safe storage of medication, and the recording of medication administration should always be maintained to ensure residents are protected. Evidence: Five of the residents individual care plans were viewed and gave guidance to staff of the care to be provided, residents health care requirements, dietary needs, and social and leisure interests. The detail varied in the care plans viewed and would benefit from further development. Three of the care plans detailed they had been reviewed in August 2008 and for two it was not applicable. This was discussed subsequently with the Manager who stated a new care plan format is being introduced in to the home and regular reviews of the care plans are undertaken. Two of the residents who had been recently admitted to the home did not have a photograph in place, and the admissions process should be reviewed to ensure that a photograph is taken. The Care Homes for Older People Page 12 of 28 Evidence: Manager has written and confirmed that photographs are now in place. Supporting risk assessments were also viewed and where there are any identified risks the recording detailed how these will be managed. The AQAA details that the home maintains and promotes residents health and help them access health care services to meet their needs. Records viewed evidenced residents are registered with a local General Practitioner (GP) and have access to other health care professionals, including district nurses, via the surgeries. It was noted, in care plans that were examined, that appointments with or visits by health care professionals are recorded. Residents spoken with confirmed good access to their GP . The AQAA details the home has a policy for the handling of medication which includes receiving, recording, storage, handling, administration and disposal of medicine. Residents are free to self medicate within a risk assessment framework. None of the residents self medicated at the time of the inspection. Medication was being stored temporarily in a shower room due to the medication room being part of the homes kitchen refurbishment. Not all the medication was found to be stored safely to protect residents. An Immediate Requirement was left to address this issue and the Manager subsequently confirmed in writing that this had been addressed. The administration of medication was observed at lunch time and a sample of medication records were which viewed, which evidenced a number of omissions in the recording of administration of medication. This was subsequently discussed with the Manager who stated this would be addressed, so a Requirement has not been made on this occasion. Two care workers spoken with confirmed they had received medication training and for one it was not applicable. The AQAA detailed that four new staff have been on a twelve week medication training. The three residents spoken with felt that their medical care needs were met in the home. The staff was observed to deliver care with dignity and respect. Three residents spoken with felt the care provided respected their privacy and dignity. Feedback received from residents and relatives/visitor was that they were happy with the overall care provided. Comments received were, the staff are splendid, even tempered and they are all kind, first rate, there is always something going on, the atmosphere in the home is very good, no complaints, food is good, the home is always warm and clean, very happy, excellent, staff are excellent, and the best home in the district. Care Homes for Older People Page 13 of 28 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. Where possible residents are enabled to exercise choice in their lives whist resident in the home, there are opportunities to participate in social and recreational activities, residents are encouraged to maintain contact with family and friends as they wish and a varied diet is provided. Evidence: Residents social interests are recorded on their individual care plans and the AQAA detailed that there are activities offered for residents to participate in every day. These range from board games, trips out in a mini bus, exercises, line dancing, belly dancing and trips on a boat up the harbour. Health & beauty treatments are offered and an aromatherapist visits the home. Visitors are encouraged to visit and join in any of the activities organised. As well as the daily activities there are special shows or excursions provided throughout the year. A newsletter is produced with information of events and a copy was available to view in the home. On the day of the inspection a group of residents were observed participating in an exercise to music activity arranged in the home during the morning. One resident went out to lunch with their relative. Four residents confirmed activities occurred, but not all stated they participated preferring to stay in their bedroom. Care Homes for Older People Page 14 of 28 Evidence: The AQAA details that residents are free to have visitors at any reasonable time. The three residents spoken with and the relatives confirmed there was flexible visiting, that staff are very welcoming and they could see their relatives or friends in private if they wished. A number of visitors were observed visiting residents during the day. The care and support provided was observed to enable residents where possible to exercise choice whilst at Heathfield Care Home. The four residents files viewed, staff and the three residents and relatives spoken with confirmed this. The AQAA details that all of the catering staff and fifty percent of the care staff have undertaken basic food hygiene training. The cook and kitchen assistant on duty were both spoken with. The cook stated and evidenced he holds a basic food hygiene certificate and the kitchen assistant stated she was due to attend this training. A further cook works three days a week and there is a supper cook on duty seven days a week. A four week rotating menu is place, which details choices at all meals and the cook stated this takes into account residents likes and dislikes with residents who are able to contribute to menu planning at residents meetings. A reduced menu was being followed at the time of the inspection due to the work in progress to refurbish the kitchen. This did not identify a choice, but staff and residents confirmed they had been made aware that this was only for the period of refurbishment and the residents spoken with did not raise any concerns about these arrangements. Lunch on the day was chicken pie, boiled potatoes with carrots and broccoli, cherry crumble and custard followed by tea and coffee. Special diets are catered for. Residents were observed eating their lunch in the dining room and others in their bedroom. The meal served was well presented, appetising and ample in quantity. It was a relaxed environment taking into account the different length of time that individual residents would need to finish their meal. All the residents spoken with stated they had enjoyed their meal. Records are kept of food consumed individually by each resident to ensure they are receiving an adequate diet. Care Homes for Older People Page 15 of 28 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. Procedures are in place to enable residents or their representatives to raise any concerns about the care being provided, also to ensure that residents are protected from abuse. Evidence: The AQAA details there is a complaints policy and procedure in place and a copy was viewed in the Service Users Guide for residents to reference. The AQAA detailed that one complaint had been received at the home during the last year, the records of which were not available to view during the inspection. The CSCI have not received any concerns in relation to the care provided at Heathfield Care Home. Feedback from the residents spoken with was that they had not raised any concerns and knew who to speak to if they did have any concerns. The AQAA detailed that there are policies and procedures in place in relation to the safeguarding of vulnerable adults. The Manager subsequently stated that a copy of the new East and West Sussex County Council, Brighton and Hove safeguarding adults procedures is available to reference in the home. Two of the three care workers had received training/guidance and one had not. This was subsequently discussed with The Manager who stated training is provided in the home and that this would be addressed. Care Homes for Older People Page 16 of 28 Care Homes for Older People Page 17 of 28 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. Residents live in a clean and homely environment and are provided with comfortable indoor and outdoor communal facilities. Evidence: The AQAA detailed that decor, carpets and furnishings are maintained or replaced as necessary. At the time of the inspection the kitchen was about to be refurbished and extended. The Manager subsequently confirmed that further work is planned to improve the corridor linking the house to the area known as the villas with the addition of a sun room, giving more residents access to the rear garden. Also a designated space for the hairdresser is planned. A tour of the building was made. The home is decorated and furnished in a homely style. There are twenty-one bedrooms on both floors in the home. A number of bedrooms were viewed and displayed residents individual styles and interests. All bedrooms have an emergency call bell system. All but one of the bedrooms has ensuite facilities of a toilet and wash-hand-basin. Bathroom facilities are provided throughout the home. All the residents spoken with confirmed there was adequate hot water provided in the home. Staff and residents stated that there had been a problem with the heating in the villas area of the home the previous week. Several residents had supplementary heating provided in their room and risk assessments were not Care Homes for Older People Page 18 of 28 Evidence: viewed during the inspection. This was subsequently discussed with the Manager who stated that work had been undertaken to rectify the problem with the heating and that risk assessments had been undertaken and recorded where supplementary heating had been provided. A passenger lift is available from the ground floor to the first floor. There is a lounge and a dining area on the ground floor. Residents also spoke of a further seating area, but this was not accessible during the inspection as was being prepared to be used for meal preparation whilst the homes kitchen was being refurbished. Residents have access to a private and well-stocked garden at the front and rear of the home. The AQAA details that the home has a number of visitors to the back garden consisting of deer, foxes, pheasant, partridge, rabbit, squirrels, numerous birds and a resident woodpecker. That in the front garden the ducks often visits from the pond, and they bring their young to to be fed. Two residents spoke of their enjoyment at sitting out in the garden in the better weather and several residents spoke of their enjoyment at watching the wildlife in the garden. The AQAA details that there is a policy and action plan in place for managing infection control. That Department of Health Guidance has not been used to assess current infection control management, but that there is an action plan in place to manage infection control. The majority of the home was clean and free from offensive odours at the time of the Inspection. Some areas were still awaiting cleaning, a bedroom carpet was soiled and an en-suite was in need of cleaning, which at the weekend is undertaken by the care workers. The domestic member of staff had also be away the previous week and this should be kept under review to ensure the cleanliness of the building is maintained. A cleaning trolley with cleaning fluids was observed to be stored in a corridor. This was discussed with the senior care worker and the Manager, who arranged for this to be moved during the inspection. So a Requirement was not made on this occasion. Staff confirmed that there was good access to protective clothing, liquid soap and paper towels. Recording was viewed of routine fire checks that had been carried out in the home. The recording did not evidence regular checks of the emergency lighting in the home. The Manager subsequently also confirmed that checks are completed and recording in place to evidence the checks completed. So a Requirement was not made on this occasion. Care Homes for Older People Page 19 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A robust recruitment procedure needs to be in place to ensure residents are in safe hands at all times. Staffing levels in the home need to be kept under review to ensure that all the residents care needs continue to be met. Care workers are being provided with training to ensure they can meet the care needs of the residents. Evidence: On the day of the inspection the senior care worker and three care workers were on duty during the morning, with the senior care worker and a one care worker working after 14:00, and two care workers due to work that night. Staff rotas were viewed and detailed that at the weekend, particularly on a number of Sunday afternoons only a senior care worker and a care worker are due to be on duty. Feedback received during the inspection was that it is very busy at the weekends and that this issue had been raised with the Manager. Residents in the lounge were observed to be unsupervised for periods of time during the afternoon whilst the care workers were attending to residents in other areas of the home. This was subsequently discussed with the Manager who stated that staffing levels in the home would be reviewed again, and who has now written and confirmed that staffing levels have been increased accordingly. A Requirement has been made to ensure that staffing levels are kept under review to ensure that all the residents care needs continues to be met. Care Homes for Older People Page 20 of 28 Evidence: The AQAA detailed that five of the twelve care workers holds an NVQ Level 2 in care and four further care workers and a member of the bank staff are working towards this qualification. The AQAA detailed that new staff working in the home had satisfactory preemployment checks. The documentation was not available to view for new staff, who had been recruited since the last inspection. This was subsequently discussed with the Manager who stated that new staff are provided with training/familiarisation in the home, and this can be prior to a POVA First/Criminal Records Bureau (CRB) check being received. But to meet current requirements a satisfactory POVA First/CRB check should be received prior to the new member of staff training or working in the home. The Manager has written and confirmed that upon this further clarification the required checks will now be undertaken and received prior to a new member of staff training or working in the home. The AQAA details that induction training for new members of staff in place, which meets the requirements of the General Skills for Care induction standards. Induction records were not available to view during the inspection. One new care worker was spoken with during the inspection who confirmed they were in the process of undertaking their induction. Care Homes for Older People Page 21 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home benefits from a Manager who ensures an open, supportive, homely and caring environment, but the outcome of the quality assurance process needs to be published annually. Evidence: The Registered Manager is a State Registered Nurse and has completed the Registered Managers Award (RMA) and is an NVQ Assessor. The Manager is now supported by a new deputy manager, who is also a trained nurse and commenced working towards the RMA in July 2008. Feedback received was that the running of the home was open and transparent and there were opportunities for staff, residents and their representatives to affect the way in which the service is delivered. But there was evidence of shortfalls in respect of the storage and recording of administration of medication, recruitment and health and safety practice in the home. The homes quality assurance system was not available to view during the inspection. Care Homes for Older People Page 22 of 28 Evidence: Manager subsequently confirmed the quality assurance system in place. Minutes from staff and residents meetings were viewed and it was evident that both groups are given the opportunity to influence how the home is run. Feedback from the outcome of the quality assurance process undertaken in the home should be be collated and available for interested parties to read. The AQAA detailed that policies and procedures are in place and that these had been reviewed. Not all the required policies and procedures were detailed to be in place and should be subject to further development. The Manager stated residents are encouraged to retain control of their own finances for as long as they are able to do so and if unable then this responsibility is taken on by a relative or another responsible person external to the home. When items are purchased on behalf of residents the cost is invoiced monthly. The AQAA details that supervision for care staff is in place to meet the requirements of Standard 36. The three care workers spoken with stated that they did not receive regular supervision. This was discussed with the Manager who stated that the majority of care workers receive supervision and that this would be addressed. The Manager has written and confirmed that all staff on the day had been supervised and supporting records were in place. The AQAA details that with the new deputy manager now in position and staff training has been developed, increased and improved. That over the next twelve months it is planned to further improve the training programme for staff. Training records were not available to be viewed during the inspection. Staff spoken with confirmed they have received training in moving and handling, one had attended basic food hygiene training, none had undertaken first aid training and two had completed infection control training. The Manager subsequently stated that there is an ongoing rolling programme for training and updates of training provided in house and by external providers, and that first aid and basic food hygiene training is due to be facilitated shortly. Some moving and handling training is provided by an external agency and in house. A Requirement has been made for further guidance to be sought from the Health and Safety Executive about the requirements for the provision of moving and handling training and that this is acted upon. A detailed check of the environment had been completed, but detailed that this had not been reviewed since March 2007. This was discussed with the Manager who agreed to ensure this is reviewed and updated as required, so a Requirement was not made on this occasion. The AQAA detailed that the maintenance of equipment and services has been carried out. The records of testing of the hot water temperatures at outlets accessed by residents to ensure these are being maintained at close to 43 C were not available to view, and the Manager subsequently stated these checks are maintained Care Homes for Older People Page 23 of 28 Evidence: and recorded. A fire risk assessment is in place, which detailed had been reviewed in October 2007, and the Manager agreed to ensure that this is reviewed and updated as required. Records were viewed of regular checks of the fire procedures in the home. Records viewed evidenced staff had been provided with fire training. care workers spoken with all confirmed they had attended fire training and a fire drill during the last year. Recording was viewed of incidents and accidents. Care Homes for Older People Page 24 of 28 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 25 of 28 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 1 1 4 That the Statement of 28/02/2009 Purpose is updated to reflect all the required information and the service provided. To ensure that up-to-date information about the care provided is available to reference. 2 1 5 That the Service Users Guide contains all the required information. To ensure that residents and their representatives have all the required information to reference. 28/02/2009 3 7 17 That the assessment process 28/02/2009 ensures that all residents have an up-to-date photograph undertaken To protect residents. 4 29 17 That staff do not commence 28/02/2009 work in the home before a satisfactory Criminal records Bureau/POVA First check has been received Page 26 of 28 Care Homes for Older People To protect residents. 5 33 24 that the outcome of the quality assurance undertaken in the home is collated and available to view. To ensure the required information is available to be viewed by interested parties. 6 38 13 That further advice is sought 28/02/2009 about moving and handling training provided and is acted upon. To protect residents and staff. 31/03/2009 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 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!