Inspection on 19/05/08 for Hibbert Lodge

This inspection was carried out on 19th May 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hibbert Lodge 25/05/07

Hibbert Lodge 17/01/06

Hibbert Lodge 01/06/05

Hibbert Lodge 04/01/05

Hibbert Lodge 10/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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: Hibbert Lodge Gold Hill East Chalfont St Peter Bucks SL9 8DL     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: Chris Schwarz     Date: 1 9 0 5 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: Hibbert Lodge Gold Hill East Chalfont St Peter Bucks SL9 8DL 01753 885278 01753 891491 manager.hibbertlodge@fremantletrust.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: The Fremantle Trust Mrs Lynette Evans care home 37 Conditions of registration: Category(ies) : People with Dementia Number of places (if applicable): 15 Older People (over 65 years old) who are 37 not covered by any of the other categories Additional conditions: Date of last inspection Brief description of the care home 2 5 0 5 2 0 0 7 Hibbert Lodge provides care and accomodation to older people, including people with high care needs arising from dementia. The home is a detached property set back from the road through Chalfont Common and is divided into four lounge groups. Each group has its own lounge, dining and kitchenette facilities, with bedrooms, bathrooms and toilets close by. There is outdoor space for people to wander around safely with railings to hold onto and various seats and benches to sit on. The home has a cat, a budgie and some fish. Information about the service is provided in a statement of purpose and service users guide. Care Homes for Older People Page 4 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: 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: This unannounced key inspection was conducted over the course of a day by Chris Schwarz and covered all of the key National Minimum Standards for older people. The last key inspection of the service took place on 25th May 2007. Prior to the visit, a detailed self-assessment questionnaire was sent to the manager for completion and comment cards were sent to a selection of people living at the home, relatives and visiting professionals. Any replies that were received have helped to form judgements about the service. Information received by the Commission since the last inspection was also taken into account. The inspection consisted of discussion with the manager and other staff, opportunities to meet with people using the service, examination of some of the home’s required Care Homes for Older People Page 5 of 29 records, observation of practice and a tour of the premises. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. People with dementia are not always able to tell us about their experiences, therefore a formal way to observe people has been used in this inspection to help us understand. This is called the ‘Short Observational Framework for Inspection’ (SOFI) and involved observing up to 5 people who use services for 2 hours and recording their experiences at regular intervals. This included their state of well being, and how they interacted with staff members, other people who use services, and the environment. Feedback on the inspection findings and areas needing improvement was given to the manager at the end of the inspection. The manager, staff and people who use the service are thanked for their co-operation and hospitality during this unannounced visit. What the care home does well: What has improved since the last inspection? What they could do better: Service users’ health and well-being could be improved through changes to medication practice. At present it is not consistently being managed safely, which could put people at risk of harm. The home’s own recruitment procedures are well managed but some attention is needed where agencies are providing staff to fill gaps on the rota. The manager needs to make sure that the supplying agency verifies proper checks are undertaken so that people are not placed at risk of harm. Staff practice is good overall with carers responding appropriately to service users and meeting their care needs. Practice could be enhanced through those staff taking responsibility for the service being familiar with and making use of the inter-agency safeguarding guidelines to make sure that vulnerable adults are protected from risk of harm and that any issues are promptly responded to. Training on communicating with confused people could enhance how staff respond to service users and make sure that they are consistent in their approach. 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. 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 home Page 9 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. People using the service are thoroughly assessed prior to admission and are given opportunity to visit the home beforehand to ensure it meets their needs. Evidence: The home had a statement of purpose and service users guide, outlining the scope of the service, its aims and philosophy of care. Both of these documents are in the process of being reviewed. A copy of the service users guide is given to each person as a reference and useful information was displayed in the foyer including the home’s statement of purpose, leaflets about advocacy and organisations providing support and advice for relatives of people with dementia People being considered for placement at the home are assessed by care managers Care Homes for Older People Page 10 of 29 from the local authority as well as being visited and assessed by the home’s staff. A sample of files of recently admitted service users showed that detailed assessments had been undertaken, outlining their care needs and how these were to be met. People’s unique needs relating to areas such as their culture, religion, disabilities and preferred form of address had been taken into account and documents had been dated and signed. People using the service said that they had received a contract and had been given enough information about the service before making a decision to move in. A relative said ‘we visited seven care homes before choosing Hibbert Lodge. The others were of a much lower standard. Here the staff really care about the residents.’ A care manager said that the home’s information gathering was satisfactory and that the service was ‘good at accepting clients in emergency situations – flexible/adaptive.’ The service does not offer intermediate (rehabilitation) care. Fees at the time of this visit ranged from £392.28 to £600 per week. care home Page 11 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 adequate 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 living at the home are well met, promoting health, well-being, taking into account their preferences and religious or cultural requirements. Medication is not being consistently managed in a safe and consistent manner, which could put people at risk of harm. Evidence: A care plan was in place for each person using the service, following a corporate format. A sample of care plans was looked at. Each file contained a photograph of the person and documented their preferred name, religion and ethnic origin, next of kin and doctor details, general physical health, mental health needs, mobility, communication needs and personal care needs. People’s likes and dislikes had been noted, such as food preferences, and all documents in the files had been signed and dated. Assessments were in place to accompany the care plans, covering areas such as moving and handling, risk of developing pressure damage and nutritional screening. There was evidence of these being reviewed on a regular basis to make Care Homes for Older People Page 12 of 29 sure that any changes were noted. A falls register was being maintained to note and monitor each occurrence. Medication was being managed using a monitored dose system of administration whereby the pharmacy pre-packs each dose of tablet into a blister pack for staff to pop out at the required time of day. There was a medication policy for staff to refer to for guidance in the operations manual in the duty office. None of the service users was managing their own medication but there is a locked drawer in each bedroom to keep medication in if anyone wanted to manage their medicines. The arrangements for storing, administering and disposing of medication were looked at in the group for people with high dependency needs. A member of staff from another group was observed coming into the lounge before lunch and handing another carer a pot containing a tablet and saying that this was a particular service user’s medication. The service user was in the lounge when the carer had come in but she had not given the tablet direct to the service user. The carer receiving the medication put the pot in her pocket and carried on with helping another person to the table. When asked about this the carer said the service user was in the process of transferring from another part of the home to the higher dependency lounge and that her medication was still being handled by the other group. She was aware that the practice of administering a medicine that she had not dispensed from the blister pack and signing the record to say it was given was contrary to the organisation’s policy on safe medication practice and that her training also told her that this was unsafe. Following lunch, the medication trolley was found to be unlocked with the doors wide open and unattended by staff in the corridor. Service users had been walking past it to leave the lounge to go to their rooms or the toilet after lunch. When asked why the trolley was unlocked and accessible, the person administering medicines said the manager had the key and that the inspector should speak to her about it. A packet of one hundred soluble painkillers was observed on the desk in the office which had not been locked away. A requirement is made to improve medication practice to ensure that medicines are stored and administered safely, and in accordance with The Royal Pharmaceutical Society guidelines. People who completed surveys said that individuals’ privacy and dignity were respected and that health care needs were ‘always’ met. They said they ‘always’ receive the support they need. Observation of practice showed that staff used people’s care home Page 13 of 29 preferred names when speaking with them and spoke in a gentle manner, making eye contact and using appropriate touch. Interactions conveyed dignity and respect, such as discretely asking people if they needed to be helped to the toilet and talking to them about what they needed to do for moving and handling manoeuvres before carrying out the action, such as moving people’s chairs closer to the dining table. A doctor who returned a survey also considered that the service was meeting health care needs. Another health care professional said ‘I have visited for over four years and am treated well, bringing residents to me to treat has improved.’ A care manager said the service was ‘sensitive to individuals’ needs’ and that ‘relatives give good feedback re: the ‘feel’ and quality of care’. Another care manager said the home ‘provides a confident and accepting service.’ People who completed surveys considered that the staff team responds to the different needs of individuals such as race, ethnicity, age, disability and faith and this was backed up by recording in care plans. A service user’s friend wrote ‘She has settled very well and is happy as can be expected (as nobody wants to leave their home). I feel she is being well looked after and allowed her independence, while there is help if she needs it.’ Staff who completed surveys said they are given up-to-date information about people’s care needs. care home Page 14 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. Activities are available to people using the service to provide them with stimulation and contact with family, friends and the community is supported to maintain social links. Food is well prepared and presented attractively to make sure that nutritional needs are met and respecting people’s preferences and religious or cultural requirements. Evidence: People who completed surveys said that there were ‘usually’ activities arranged by the home that they could take part in. In the pre-inspection self-assessment the manager said there it had been difficult to recruit an activity organiser/leader but she had successfully done so by the time of this inspection. The post covers seven hours a week. The manager said there had been an increase in the number of staff who can drive the minibus which meant that people using the service have had trips out to places such as the London Eye and Brighton. Pub lunches, trips to the garden centre and the Care Homes for Older People Page 15 of 29 theatre have also been arranged and regular entertainers are booked to visit. Two churches support the home and a local priest is available to visit and give communion. Some volunteers maintain a mobile shop for people living at the home. Some of the service users had taken part in a quiz during the morning, others were seen reading newspapers, some spent time in their rooms, some were chatting in lounges. When a programme about the Chelsea Flower Show came on the television, staff in the high dependency lounge initiated conversation about gardening with service users, which they responded to. Service users also took an interest in a siting of the cat outside their lounge, when staff pointed this out. Visitors to the service are made welcome and can help themselves to a drink in the kitchenettes. People who completed surveys said that they ‘usually’ liked the meals. Copies of the weekly menu were displayed in lounges and reflected a range of meals on offer to people. Tables had been nicely set with table cloths, napkins and glasses with service users participating in setting them. Dining chairs had unobtrusive ‘gliders’ to help with getting to and from the table and made manoeuvres easier. The lunch time meal was enjoyed by people in the high dependency lounge and consisted of bacon badger, two fresh vegetables, potatoes and gravy. Vegetables had been placed in serving dishes and staff encouraged people to have more vegetables when they had finished what was on their plates. Staff showed service users what it was they were offering ‘seconds’ of, to help them decide. They also made sure that people were offered a drink to accompany the meal. They were observed offering to cut food up, to give people the choice, rather than doing this automatically. An alternative meal of meat and pickles had been prepared for one person, if he wanted it. Pudding was tapioca, or alternatives of fruit or yogurt. The yogurt was appropriately decanted into a pudding bowl to enable the person to manage the task easily. Staff made the lunch time a relaxing experience by switching off the television and putting on some gentle music at a sensible volume. They asked service users if they had enjoyed their lunch and received favourable comments back such as ‘that was a nice dinner’. They were also observed speaking to a service user about his cultural needs in terms of meals and dietary provision. care home Page 16 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. Complaints and adult protection are effectively managed to listen to views of people who live at the home and reducing the risk of harm to them. Evidence: The service had a complaints procedure and a complaints log to keep a record of any issues raised. The version of the complaints procedure in the log needed to be updated to reflect the revised contact details of the Commission. People who completed surveys said they knew who to speak to if they were unhappy and how to make a complaint. In the pre-inspection self-assessment the manager said that there had not been any complaints in the past twelve months. The Commission had not received any complaints about quality of care directly. There were adult protection/safeguarding procedures in place and a copy of the local authority inter-agency procedures. The duty senior was unable to help in locating a copy of this, which was found hanging from the daily board adjacent to her. If it does not already form part of the training, it is recommended that staff, particularly staff taking responsibility for the service, are familiar with and make use of the guidelines. The manager and group care leader are trainers in adult protection. There had not been any safeguarding issues in the past twelve months. Care Homes for Older People Page 17 of 29 There was also information in the pre-inspection self-assessment to say that staff induction now includes input on The Mental Capacity Act 2005 and that other staff are able to access training on the Act via the local authority. care home Page 18 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 is clean, well decorated and adequately maintained, promoting a positive environment for the people who live there. Evidence: Hibbert Lodge is a detached building set back from the road running through Chalfont Common. Accommodation is on two floors with a passenger lift to enable access between floors. There are four lounges, two on each floor, each with bedrooms, bathrooms and toilets and living areas close together. All of the bedrooms were single occupancy and had been decorated and arranged to different tastes and personalised to different degrees. The home has been able to provide accommodation to a couple and they have the choice of separate or a shared room. The home had a programme of redecoration and maintenance to keep the premises in good order and the only part of the home that was looking a little worn was already identified to be attended to this year. The kitchen had recently been improved to provide a pantry, new worktops and a new section of flooring. Odour control was well managed overall; most people who completed surveys said the home was ‘always’ or ‘usually’ fresh and clean. The garden provides a pleasant area for service users to walk around, with railings to Care Homes for Older People Page 19 of 29 hold onto and various seats and benches to stop at. The only point raised with the manager regarding standards of accommodation was that some of the windows needed cleaning to remove smears and a recommendation is made to address this. Re-provisioning of the service is planned to take place as part of an initiative between the provider and Buckinghamshire County Council. This will improve the quality of accommodation for people using the service as it will be designed to meet modern standards for people with disabilities, such as en-suite rooms. care home Page 20 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 staff cover to meet needs and undertakes thorough recruitment procedures, coupled with effective training to ensure staff have the right skills and competencies to support the people who live there. Some attention is needed where agency staff are used, to make sure that the supplying agency verifies proper checks are undertaken so that people are not at risk of harm. Evidence: Rotas were being maintained of staff cover and these seemed to be sufficient to meet current care needs. Where agency staff were being used, staff were noting just the person’s first name on the rotas. It is recommended that the first and surnames of agency staff are put on the rota and the name of the agency that supplied them, so that it is clear when looking back who was providing care at the home. Each shift had a duty senior who has responsibility for co-ordinating and running the shift and handovers were taking place to make sure that information was passed on and to provide continuity. Staff were maintaining daily logs to note significant events. People who completed surveys said that staff ‘always’ listen and act on what they say and are available when they need them. A service user’s friend wrote ‘the staff are all Care Homes for Older People Page 21 of 29 very caring and kind.’ A relative wrote ‘my mother and I find the staff very friendly and helpful. No complaints about them at all. They all seem dedicated and professional and offer any help required.’ A care manager, responding to a question about whether staff have the right skills and experience to meet needs, said ‘my main contact was with the manager who was excellent.’ Staff who completed surveys said that they are receiving training that is relevant to their roles and helps them understand people’s needs. One person added ‘we undertake regular training in all essential areas including moving and handling people, dementia training, person centred care, infection control etc. All staff undertake this as it is considered mandatory.’ They said that they have ‘regular’ opportunities to meet with their manager for support and felt that the system in place to share information ‘usually’ worked well. Staff considered that there were ‘usually’ enough people on duty to meet needs and use of agency staff was mentioned to supplement numbers. In the pre-inspection self-assessment, the manager stated that twenty one of twenty seven staff had achieved National Vocational Qualification level 2 or above and a further seven were working towards it. Training records showed that staff receive input on dementia care and mandatory courses (moving and handling, fire safety, safeguarding adults, first aid, food hygiene) were largely up-to-date. A selection of recruitment files was looked at and found to be in good order with evidence of required checks and clearances in place. Agency staff have been used to cover gaps on the rota. The home had a verification letter from the agency, to show that appropriate checks and clearances had been undertaken, of one person who had recently worked at the home but there was not one in place for another person who had been used. This was rectified immediately when pointed out to the manager but she needs to be mindful not to accept an agency worker to work at the home unless proof of checks has been received first. It was noticed that the letters used by the agency do not confirm that an enhanced level of Criminal Records Bureau clearance has been undertaken plus a check against the Protection of Vulnerable Adults list. Additionally the letter has no signature of someone in authority at the agency to vouch that the information supplied is accurate. A recommendation is made to address this. During observation of practice, staff were seen to be responsive to people using the service and involved them as much as possible with daily routines. For example a carer asked a service user if she wanted a cardigan when she said she was cold and another invited service users to help set tables. Staff took an interest in service users, care home Page 22 of 29 asking how they were, had they enjoyed lunch and were seen to be respectful in relating to people, using their preferred name and making use of appropriate touch at times. They were also mindful of allowing people to do as much for themselves as possible and offering assistance if it was necessary, such as only cutting up food on one person’s plate after she had tried to manage it whole and after agreeing to some help. Staff also moved at the pace of service users and by doing so helped create a positive atmosphere and gave people the opportunity to make decisions for themselves. In feedback to the manager, there was some discussion about the different approaches that staff use to address questions from service users such as ‘where’s my mum’ and comments such as ‘I want to go home’. Two different approaches were heard in use at the home and some input on communication around these difficult areas would be advisable. care home Page 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home promote continuity and quality of care for the people who live there and ensure that risk is safely managed to reduce the likelihood of injury or harm. Evidence: The home has an experienced and competent manager who is registered with the Commission and holds the Registered Managers Award. A care manager described her as ‘friendly and positive’. She was working towards National Vocational Qualification level 4. The provider undertakes regular monitoring visits to the service with reports available Care Homes for Older People Page 24 of 29 in the duty office. The operations manager for the service additionally produces a monthly report. A quality audit is carried out each year – one had recently been undertaken and the report was awaited. Service users’ money is managed using the provider’s residents’ savings scheme, if people are unable to manage their money themselves or their relatives are not involved. This system is overseen by staff at the provider’s head quarters and audited by external consultants. Receipts and records of transactions are maintained and access to the records and money is restricted within the home. Staff had access to a number of policies and procedures to refer to in an operations manual. The shelves storing files and policy manuals in the office were not ideally located as staff need to reach over the desk, and whoever may be sitting at it, to pull files down. It is recommended that another place is found for these. There was good regard for health and safety around the premises. The home had been awarded the silver award by the environmental health officer and good standards were observed when serving food such as staff putting on tabards and washing their hands before touching food. Staff training in health and safety related areas was well maintained and certificates of servicing were in place for hoists and the passenger lift. The home had a current gas safety certificate and a certificate of satisfactory electrical installation. care home Page 25 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 26 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 1 9 13 Medication is to be administered and stored in accordance with the provider’s policy and The Royal Pharmaceutical Society guidelines at all times. This is to ensure that people using the service receive their medicines in a safe and consistent manner. 21/06/2008 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 10 18 If it does not already form part of the safeguarding training, it is recommended that staff, particularly staff taking responsibility for the service, are familiar with and make use of the inter-agency safeguarding guidelines. Windows should be kept clean throughout the service to maintain the accommodation to a good standard. The manager should ensure that there is verification from agencies that they undertake an enhanced level of Criminal Records Bureau clearance, plus a check against the Protection of Vulnerable Adults list, and that the Page 27 of 29 11 12 19 27 Care Homes for Older People information being supplied is signed by someone who is in position to vouch for the accuracy of the details. 13 27 The first and surnames of agency staff should be put on the rota and the name of the agency that supplied them, so that it is clear when looking back who was providing care at the home. Training on communicating with confused people is recommended, to make sure that staff are consistent in their approach. The duty office should be made safer by relocating the shelves containing policy and procedural manuals. 14 30 15 38 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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